w 600 C434o 1876 CHAILLE MEDICAL JURISPRUDENCE W 600 C434o 1876 28330140R NLM D511Sflm M NATIONAL LIBRARY OF MEDICINE DUE SK-: 1 9 WD ST DATE NLM051158414 koviai i i YOFMEDICINE NATIONAL LIBRARY OF ME Dl CI NE N A T I O N A L L I B R A R Y O F M E D I C I N E N A T I O N A I L I B R A R Y O F W IY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF ARY OF MEDICI IY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE N A T I O N AI I I B R A R Y OF I vl j /*W"! ! r ^ i *■ IBM 1VNOUVN JNI3I01W JO ABVBBI1 1VNOUVN J N I 3 I 0 3 W J O A » V » fl II 1 V N O 11 V N JN I 3 10 SWJO UYHI1 1 S ORIGIN AND PROGRESS OF medical Jurisprudence. 1776-1876.. A CENTENNIAL ADDRESS BY STANFORD E. CHAILLE, A.M., M.D., PROFESSOR OF PnYSIOLOGY AND PATHOLOGICAL ANATOMY IN THE MEDICAL DEPARTMENT OF THE UNIVERSITY OF LOUISIANA. A REPRINT FROM THE "TRANSACTIONS OF THE INTERNATIONAL MEDICAL CONGRESS," Philadelphia, September, 1876. FOR THE BENEFIT OF THE LEGAL AND MEDICAL PROFESSIONS X. OF THE \ UNITED STATES. PHILADELPHIA: 1876. k/ GOO C,/ NATIONAL LIBRARY OF MEDICINE WASHINGTON. D. C. PHILADELPHIA: COLLINS, PRINTER, 705 Jayne Street. ADDEE8S. Medical Jurisprudence owes its power to knowledge derived from every branch of medicine, but the law determines how far this power shall be utilized in the administration of justice. Hence, the develop- ment of Medical Jurisprudence has varied in different nations with the progress of medical science, and with the extent of its application to the protection of property, reputation, and life. Efficiency in this legal application varies with the appreciation of medical knowledge by the rulers of a nation ; and (since an adequate appreciation is limited to the educated few, and is not yet disseminated among the mass of any people), it results, that laws more favorable to the culture of legal medicine are to be found in nations ruled by the educated few, than in those governed by the people. The unequal development of Medical Jurisprudence in different nations finds in these facts an explanation, in large part at least, and recalls the political axiom that " arbitrary powers well executed, are the most convenient," while " delays and inconveniences in the forms of justice are the price that all free nations must pay for their liberty in more substantial matters."1 The papal canon-laws,2 originating many medico-legal questions, sowed in 1(320 by the hand of Zacchias,3 a pope's physician, the first sound seed of Medical Jurisprudence in the land of Columbus, then the home of Science and the Arts.4 1 Blackstone, iv. p. 350. Blackstone's "Commentaries on the Laws of England" (four books) were published a century ago, viz. 1765 to 1769, and, hence, are frequently referred to. 2 The " Corpus Juris Canonici," a compend of the canon-laws, is dated 1580. 3 B. 2. This and all succeeding references to " B," refer to the Bibliography, with the numbers therein. 4 From many facts which might be cited to prove this statement, as also that the development of medical jurisprudence in different nations has varied with their culture of medical science, the following quotation is selected from p. 142 of Russell's " History and Heroes of Medicine," London, 1861: " If we survey the social and political state of Europe from the twelfth to the sixteenth century, in its relation to the development of medical art, our attention is at once arrested by Italy, which at this period was far ahead of the rest of the world. Taking the number of Universities as an index of civilization, we find that before the year 1500, there were sixteen in Italy, while in France there were but six ; in Germany . . . there were eight; and in Great Britain two; making sixteen in all— the exact number which existed in Italy alone. The Italian Universities were likewise no less superior in fame than in number to those of the North." Italy maintained this supe- riority during, and even after, the sixteenth century. 4 CHAILLE, The new-born shoot, languishing in Italy, was transplanted in German soil, where it received such culture as nourished its growth, developedjts fruit, and reproduced seed to germinate in other lands. To favoring legislation from 15321 to the present day, the fatherland owes its pre- eminence in Medical Jurisprudence. Germany, for two centuries, has had an organization of medico-legal officials, to whom alone it intrusts the duty, both to procure the medical facts needed by the courts, and to estimate the weight due such facts from whatever source obtained; it alone requires that these experts shall be especially educated, and provides medico-legal clinics2 for their practical instruction. In 1650, Michiaelis3 delivered the very first lectures on Legal Medicine, and as early as 1720 professorships of the same were founded by the state. By 1725, the celebrated works of Valentini, Teichmeyer, and Albertus,4 had supplanted that of Zacchias; and since then a medico-legal literature more abundant than in all other languages has nourished the science of Medical Juris- prudence both at home and abroad. In fine, Germany, specially excelling in the Art, has consequently excelled in the culture of the Science. France, from 1570 to 1692, enacted laws which, like those of Germany, favored the culture of Legal Medicine; but in 1692, medico-legal offices became hereditary and venal, and Legal Medicine languished until after the French Revolution. Since 1790, no nation has surpassed France in the culture of medical science; in addition, the judges appoint medical experts, who, since 1803, must be graduates in medicine, and must have attended one course of lectures, and have passed an examination on Legal Medicine, professional chairs of which were established by the state in 1794.5 However, French authorities denounce their didactic instruction as insufficient for the education of experts, and declare the appointment of these by the judges, and the lack of skilled medico-legal officials to procure medical evidence, to be most unsatisfactory, and their whole system to be much inferior to the German. Still, France has at least a system, and meanly as this does apply the art, it has served to greatly stimulate the culture of the science, as has been notably illustrated since 17966 by French medico-legal literature. A critical appreciation of how much of this literature has been derived from Germany, and how much of medico-legal science without the art has been transported from Ger- many and France to Great Britain, and the United States, would, I fear, prove offensive to Gallic, and still more to Anglo-American, vanity. Great Britain transmitted to this nation laws, barbarously conspicuous for the absence of provisions to apply medical knowledge to the admi- nistration of justice, and Anglo-American law continues to be. in laro-e measure, hostile to Medical Jurisprudence. However, British laws have done something for the science, and a little for the art. For Great Britain has fostered medical education ; did in 1803 found a chair of 1 The Constitutio Criminalis of Charles V, 1532, (published in 1553) rendered it obligatory on the Courts to take the evidence of medical men in medico-leal cases. 2 The first one established was at Vienna, about 1830 ; a second at Berlin 1833 • a third at Munich, 1865; and probably a fourth since 1870 at Strasbourg, where France had its only medico-legal clinic, 1840 to 1870. In France, Great Britain, and the United States, Medical Jurisprudence cannot be said to be practically taught except as to Toxicology. ' ^ 3 University of Leipzig; Michiaelis was succeeded by Bohn. 4 B. 29, 30, 31. 5 Chaussier, in 1790, was the first lecturer, and Mahon, in 1795, (B. 115) the first professor. Fodere says the state enacted the first laws favorable to Legal Medicine in !',()•> 6 The date of the first French general treatise (B. 114). ADDRESS OX MEDICAL JURISPRUDENCE. o Forensic Medicine in one University,1 and now has such chairs in all its medical colleges (some of these conferring a special degree in State Medicine);2 has by the Registration Act and other laws3 greatly strengthened the medical profession ; and has compelled its courts to accept expert evidence only from registered, and therefore educated, medical men. Still, " the crowned republic" remains destitute, as does its democratic American offspring, of popular, and hence of governmental, appreciation of the legal importance of medical knowledge, as is proved by the same lack of any system to secure the medical evidence of com- petent experts that characterized its laws when surgeons were barbers,4 and when physicians were astrologers, sorcerers, and interpreters of dreams. "What wonder that Germany and France began the study earlier, and have prosecuted it more successfully? The States of this Union have, for the most part, left the culture of medical science to individual enterprise which supplies solely that which the private citizen demands—practitioners of medicine to heal the sick. The States have as yet made no demand for competent medical experts to aid the administration of justice, and have done nothing designedly for the culture of Medical Jurisprudence. What growth can this branch of State Medicine have as long as a State does not recognize even its existence? Before attempting to answer this question, it will be well— having now briefly examined the causes—to present as briefly some illus- trations of the extent of the general progress of Legal Medicine. To appreciate progress during any period, it is necessary to keep in mind the empire of the dead over the living ; to recall some of the victo- ries gained over superstition and ignorance during the preceding century, as well as during that now closing. From 1620 to 1722, the authority of the father5 of medico-legal science was supreme. He-devoted chapters to Torture, Sorcery, Prophecy, Mir- acle, and Immaculate Conception. Admitting one hundred and fifty births at a labor, he skeptically doubted the three hundred and sixty- five brought forth by the prolific Countess of Henneberg! During this period doctors gravely discussed whether a woman could be got with child by the devil, or by a dream; and French judges legitimized an infant in a case where the husband had been separated four years from the mother, on the ground that the child owed its paternity to a dream. Doctors taught that grossly deformed infants had a bestial parentage; judges, even in 1769, declared that they had " no inheritable blood" for 1 University of Edinburgh : Dr. Duncan, Sr., in 1801, was the first English speaking lecturer on Forensic Medicine, and his son the first professor, in 1803. In this same University (chartered in 1582) was established, in 1726, the first English-speaking Medical Faculty, which conferred degrees on less than 300 graduates from 1726 to 1776. From 1705 to 1726 twenty-one medical degrees, which would now be deemed irregular, perhaps honorary, were conferred. Institutions for medical education were established in Italy, Germany, and France, long prior to 1705 or 1726. 2 Each of the twenty-three medical colleges reported in England and Scotland in 1875, had a regular teacher devoted to Forensic Medicine; and some of these, at least those at Cambridge, Oxford, Edinburgh, and Dublin, confer a special degree in State Medicine on those applicants only who ^have already graduated in medicine, and have thereafter satisfactorily pursued this special study. 3 The Registration Act was passed "in 1858. " Glenn's Manual of the Laws affecting Medical Men," London, 1871, gives a list of 36 such laws from 1800 to 1870, and of these 25 from 1850 to 1870. 4 Surgeous were barbers in England until 1745. s B. 2. 2 6 CHAILLE, a "reason too obvious and too shocking to bear a minute discussion, and the priest, encouraging doctor and judge, cried " Si tu es homo, te baptizo." Until 1726 (Albertus), it was taught that, in presence of the murderer, his victim's wounds did " open their congeal'd mouths and bleed afresh, and courts accepted the testimony of medical experts to this miraculous bleeding of the corpse.2 The effect upon a suspected homicide of touching the dead body of his supposed victim, continued to be a legal expedient within the nineteenth century.3 Unearthed bones served to convict men of murder, and yet these accusing bones, since not even human, were not those of missing men. A cranial foramen devised by nature, yet perverted by ignorance into an assassinating awl-hole, would have hung Thomas Bowman, but for accident. Superstition, denouncing medico-legal autopsies even more fiercely than it now does cremation, did not permit these to become frequent until about 1750; and the work of the father of morbid anatomy,4 a foundation stone of Legal Medicine, was not published until 1761. By superstition, and by ignorance of normal and morbid anatomy, of the causes of sudden death, of diagnostics, and of chemistry, Legal Medicine wras powerless, when compared with its present state. So great was its helplessness, that a horrible atmosphere of suspicion encompassed the fear of death by poison. On those even suspected, the grossest legal abuses were everywhere inflicted ; while those convicted were long boiled alive by English law, and burned (as late as 1780) by the French " Chambre Ardente,"5 which was not abolished until 1791. The highest medico-legal authorities6 taught belief in ghosts, witches, and possession by the devil; and united with the clergy until 1752 in denouncing all disbelievers thereof as heretics and atheists. They found demoniacs for the jailor and the stake, where we find patients for the doctor and the asylum. The distinguished medico-legist, Hoffman, com- mended to the barbarity of the law those who " vomited nails, hair, wax, glass, or leather," as indisputable witches.7 The "great and good" Lord Chief Justice Hale, prompted by the medico-legal testimony of the learned physician Sir Thos. Browne,8 illuminated thestake with witches—exem- plifying in 1664 the practice of Anglo-American witch-laws till 1727, laws not repealed until 1736.9 Thus did the legal medicine of our ancestors, only five generations removed, persecute, drown, and burn thousands of the insane, as "fire-brands of hell," who were "moved and seduced by instigation of the devil." 1 Blackstone, II. pp. 246-7. 2 See plea of the great scholar and lawyer, Sir George McKenzie, in the " State Trial " 1688, of Sir Philip Stansfield, executed for the murder of his father. 3 The latest American case was in New York in 1824. (See B 349 I d 807 1 4 Morgagni, B. 18. ' " F' '; 5 Instituted at the close of 17th century as a special remedy for poisoning which had become a very frequent crime in Paris. 6 Pare, Zacchias, Hoffman, Storck, Boerner, &c, (B. 100, 2, 34, 39). 7 " De diaboli potentia in corpora." Hoffman died in 1742.' 6 Author of " Religio Medici," and also of ;i Pseudoxia Epidemica," or Vulgar Errors 9 The " witch-mania " originated with a papal edict in 1484. The last iudicial exeoui j..*!. ^..niuugu me wnui-iaws were repeaieu in ureat Britain in 1736 vet as late a< 1760 supposed witches were murdered by mobs, and there were "witch-doctors" in 1838 In France there was a legal trial for witchcraft as late as 1818. ADDRESS ON MEDICAL JURISPRUDENCE. 7 These few examples must suffice to recall the parentage of the Medical Jurisprudence of our century, and the facts that, with the impotence of science to aid the law, it adopted miracles as explanations, suspicion as proof, confession as evidence of guilt, and " torture as the chief witness,"1 summoning the medical expert to sustain the accused until the rack forced confession.2 During the hundred years now closing, the progress of medicine has been greater than in all preceding time. To detail the means acquired to aid the law, would require the record of every medical discovery; for what one of these may not contribute to the administration of justice? This occasion precludes more than bare suggestions illustrative of the general progress of medico-legal science. (1) Innumerable precious facts have been contributed by every branch of Anatomy, and especially by Pathological Anatomy. The study of putrefaction, fractures, burns, scars, marks, stains—in fine of every change and injury to be found on the living or dead body—has given the skilled expert a power (miraculous to the ignorant) to identify the bod}7, to distinguish real from apparent death, to approximate the date of death, to decide whether it be due to morbid, accidental, or criminal causes, and often to point unerringly to the criminal.3 So great is this power that medico-legal autopsies have become indispensable to justice; and, since 1837,4 the Microscope, strengthening notably Anatomy as also Toxicology, has repeatedly released the innocent from the jailor's clutch, and delivered the culprit to the hangman. (2) Diagnostics, aided by stethoscope, thermometer, and many other instruments5 invented or newly applied since 1776, have stripped the malingerer of power to feign disease, become the corner-stone of Life Insurance, and aided the law in many other particulars. 1 Montesquieu, 1748. 2 It is true that in our motherland, England, torture was abolished in 1640 (a century and a half earlier than in continental Europe); but, to such extent did suspicion replace proof, and the single penalty of death overtake every species and grade of crime, that the law had much less need than now of medical experts. Prisoners accused of a capital crime were not permitted any witnesses until 1702 (Blackstone, IV, p. 360); an accusation of infanticide sufficed for conviction, unless there was one eye-witness to the birth, until 1802 (B. 153, p. 309); and "prisoners were first allowed the assistance of counsel" about 1830 ( " Science of Law " by S. Amos, p. 312). Even in 1769 there was " a dreadful list of 160 capital offences," and, not content with this liberal supply of the halter, English laws provided for criminals horrible mutilations, as branding, castration, slitting the nostrils, cropping the ears, and cutting off the hand, with a medical expert to sear the stump; death by exposure and starvation ("Peine fort et dure"), till 1772, by beheading, by drawing and quartering, and by burning alive; and brutal persecution of widow and orphan by corruption of blood and confiscation. Yet Blackstone asserts (1769), with evident pride, that this " disgusting catalogue " when compared with the criminal codes of other European nations did " honor to the English law." It is calculated to soften impatient indignation to remember that "it cannot be justly regarded as a fault in [legislators] courts or juries not to be in advance of the age in which they live "; and it is encouraging to recall that many of these barbarous laws were repealed because courts and juries did get so much in advance of them, that they could not be executed. 3 Among errors credited by the profession and corrected within the 19th century may be mentioned here : the beliefs that the human hair could grow after death; that the wind of a canon-ball could destroy life; and that violent and fatal injuries, which at times do fail to leave any visible signs externally, might also fail to present any lesions internally. 4 Schwann and Schleiden. 5 Spirometer, Pneumatometer, Galvanic and Electric Batteries, Ophthalmoscope, Laryngoscope, Endoscope, Spectroscope, Sphygmograph, Cardiograph, Dynamometer, ^Esthesiometer, etc. 8 CHAILLE, (3) Obstetrics, until 1750 in the hands of ignorant midwives,1 conse- quently remained a special nursery of mystery and credulity. During the present century, Obstetrical Jurisprudence has rescued from igno- rant superstition monsters, retarded births, superfoetation, and hermaph- rodism ; has discovered new signs of pregnane}', and the significance of uterine moles2 and hydatids; has appreciated the evidences of impotence, sterility, and "live-birth," and has discarded the hydrostatic test3 as con- clusive proof of the latter. In vindication of chastity, the signs of virginity4 have been duly estimated, false have been distinguished from true corpora lutea,5 and it has been proved that sexual connection "with- out consent" may be fruitful. Finally, the "jury of matrons" has been slowly despoiled of its authority to decide a question of pregnancy. It is mortifying to record that, in criminal cases, the laws of some of our States continue to regard "quickening" as proof of the very dawn of life; and yet add to this barbarism the inconsistency of admitting, in civil cases, the vitality of the embryo from the date of conception. More than a century ago, medico-legists,6 abandonipg a belief long universal, taught that life began months prior to, and was as sacred before as after, maternal sensation ; but, to the encouragement of foeticide, this ancestral superstition7 still prevails among a free people, and lingers in their laws. (4) Chemistry, since 1789, when Lavoisier gave it a firm foundation, has enriched every science, bestowing such services on State Medicine as to necessitate the distinct department of Legal Chemistry. Two of many services may be mentioned : the murderer has been deprived of one refuge, which even professional credulity supplied—Spontaneous Combustion8—a mode of death yet to be witnessed by a skilled expert; but this interesting service is insignificant when compared with that rendered toxicology. Though poisons have become much more procur- able and numerous, yet the skill of the medical chemist has so increased, that criminal poisoning has become, largely through this power, one of the most certainly detected, relativefy infrequent, and least dreaded modes of death. (5) By the knowledge acquired of the nervous system, medical science has influenced society and law to an extent difficult to over-estimate. 1 A man-midwife was first employed with the greatest secrecy, in 1663. In England, men-midwives did not secure respectable professional position until 1783. Prof. T. G. Thomas writes that in the United States the subject of obstetrics has " been recognized as one of paramount importance and dignity " since 1767. 2 The French Parliament decided in 1781 that virgins and nuns discharged moles («'. e. " blighted ova " ) without having had sexual connection. (B. 114, 2d Ed. I. p. 477.) 3 The hydrostatic test was first practically used in legal medicine by Jan Schreyer in 1682, and was long accepted as conclusive proof of live-birth. 4 Buffon, as also Fodere (B. 114, in the 1st Ed. of 1796, not in the 2d Ed. of 1813), Mahon (B. 115) and many others taught that there was no such thing as the Hymen. 5 In the trial of Chas. Angus (Lancaster, England), for the murder of Miss Burns in 1808, all the medical witnesses testified (to her dishonor) that all corpora lutea without distinction proved previous conception. 6 Faselius, 1767 ; Haller, 1782 ; Farr, 1788, etc. 7 "Absurd ecclesiastical canons handed this error down from one criminal code to nn other." B. 349, II. pp. 9 and 1076 ; Fodere, etc. 8 This debt is due chiefly to Liebig and Bischoff (Case of the Countess of Goerlitz 1850) Casper wrote: "It is afflicting to be obliged in a serious scientific work in 1861 to still spe ck of the fable, spontaneous combustion." A human body reduced in a few moments to a cup of ashes! To the credulous in this matter, one is prompted to recall Velpeau's attitude in reference to the " vagitus uterinus," or capacitv of the foetus (inclosed in its membranes) to cry in utero—a belief long firmly attested and universally credited Said \ elpeau : " ^ince learned and credible men have heard it. I will believe it- but I* should cot believe it if 1 had heard it myself!" ' S110Uld ADDRESS ON MEDICAL JURISPRUDENCE. 9 In 1774, England enacted the first law evincing one touch of pity for the insane; in 1792, Pinel1 adopted the first humane treatment of their dis- ease. Since then, civilization has been slowly taught that those upon whom our grandfathers inflicted "the pains of Hell" in order to thus drive the devil out of bodies " accursed by Cod," are the most pitiably diseased of all our fellow creatures, and we are enabled to point with pride to the palatial asylums with which our laws have replaced the garrets, cellars, stables, and dungeons, where starved and tortured insanity once writhed in filth and chains.2 The history of the Medical Jurispru- dence of Insanity is eloquent with the increasing number and efficiency of the laws designed to protect both society and the sufferer; and with assurances of the extension of these laws from insanity to habitual intemperance. Is it too much to claim that the progress of Psychological Medicine has strengthened the conviction that not only mental disease, but also hereditary organization, defective education, and circumstances for which society is more accountable than any of its units, do modify criminal responsibility in fact, and therefore should do so in law f Has not this special knowledge broadened man's charity, encouraged society's efforts to redeem its outcasts, and influenced the law's amelioration of its criminal code? Is it not forcing to the front that most important social question, the problem of heredity; thus disclosing an immeasurable field for the medical research and legislative labor of our descendants? In fine, is it not true that science, stripping nature of providential caprice and disheartening chance, divinely adorning her with eternal order and omnipotent law, has gradually established that the diseases and de- formities of the mind are as much as those of the body subject to nature's laws; and that the lunatic, the drunkard, the criminal, the sage, and the fool are not the products of chance, but of laws as comprehensible, though not yet as well comprehended, as those governing that thunderbolt which, once in the hand of Jove, now traverses even the depths of the sea at man's command ? The part this nation has taken in the general progress of Medical Jurisprudence must now be considered, and to test our progress five inquiries will be instituted. I. What have our Laws done to apply medical knowledge to the Administra- tion of Justice?—In the United States there are probably forty-five thousand medico-legal autopsies made annually. The service of a skilled expert at these " coroner's inquests," which have exceptional opportunity and power to detect crime, is of inestimable importance; the opportuni- ties there presented, if once lost, can never be regained. Further, our courts have annually from twenty-five hundred to treble this number of criminal trials necessitating medical testimony; and of these a large part originate from the coroner's inquests. If to these criminal be added all the medico-legal civil trials, it would be found, I doubt not, that our courts require medical evidence in not less than twenty thousand cases annually.3 Whatever the number may be, it would indicate inade- i b 129. 2 In New England, say " Wharton and Stille," the insane were sold out to the lowest bidder who starved them, and when violent chained them in stables. 3 I have sought in vain for full and reliable statistics to illustrate numerically the im- portance of legal medicine. The numbers given are only approximative estimates based partly on some meagre British statistics cited by Guy and by Taylor, and partly on the 10 CHAILLE, quately the number of citizens whose welfare is involved, and the extent to which society is interested in the efficient application of medical knowledge to the administration of justice. Now, "what are the methods which Anglo-American law adopts to secure in practice that " best attainable evidence" which in theory it demands? It entrusts medico-legal autopsies, which require special medical and some legal knowledge, to those having neither the one nor the other, except by accident; for, these coroners (whose inexperience our law insures by constant " rotation in office") owe their position wholly to political popularity, a qualification which a competent expert is most unlikely to possess. Are these unqualified officials supplied with efficient aid ? If so, again by accident, since the law leaves it to chance, or the coroner, or to his still less qualified jury, to provide a medical expert; and, as is usual, accident and ignorance provide inexperience and incompetence. Could ingenuity devise for medico-legal autopsies any methods more inefficient than these, which Anglo-American laws, framed before the birth of Medical Jurisprudence, have barbarously per- petuated ?' On this Pelion of inefficiency our legislative giants have piled an Ossa of absurdity; for, besides these fatal defects in the primary legal pro- ceedings, Anglo-American law, in order to secure "the best attainable evidence" for its courts, where poverty and dishonor as well as the halter are administered to the free citizen, clings to a method as sadly ludicrous as it is antiquated. To plaintiff and defendant the law gives full license to summon such medical witnesses as each has already found reason to following facts as to New Orleans, La., for the year 1875. The total number of coroner's views and inquests was 1026; of these there were 268 inquests, and out of these grew 47 trials. Giving New Orleans 210,000 and the United States 40,000,000 population, the New Orleans statistics would indicate for the United States annually 8952 medico-legal criminal trials, growing out of 51,047 medico-legal autopsies, or coroner's inquests. 1 Convincing reasons could be given in proof that the duties of coroners are discharged even worse in the United States than in England. The following facts indicate how the Anglo-American method works in the latter country. An Englishman writes (1876): " The coroner is elected for life by the rate-payers of his district [a superiority over the American method!, and he is paid a good salary out of the county rates. In most cases he is a medical man who has studied the arts of popularity with more success than those of medicine, or he is a small country attorney who has failed in the higher paths of his profes- sion." Dr. Wm. Farr officially reported as to England in 1868 : When all the verdicts of coroners " for the first time came under review [another great superiority over the American lack of any such system], they were not at all creditable to the intelligence of the country They conveyed the least possible information in the vaguest possible words." Prof A S Taylor wrote in 1873: " The coroner's inquest affords no certainty for the detection of crime. It, in some instances, tends to screen a criminal." " In the course of thirty years' practice, at least fifteen cases of the exhumation of dead bodies were referred to me On some of these inquests had been held, but no inspections were made. Verdicts of death from cholera or natural causes had been returned, and at intervals of from one to twentv two months the bodies have been disinterred, and it was then proved that the deceased Der sons had died from poison." (See B. 358, I. p. 12.) The British Medical Journal (Jan' 18 < 6) reports a glaring case of poisoning, undetected by the incompetent coroner National attention was recently attracted to the same monstrous evil in the inquest of a Mr Bravo An English writer asserts that " almost every day, from all parts of England tales come up of the inadequacy and absurdity of the institution. Notice has been given to dav TMnv 23d 1876] in the House of Commons, by an independent member on thl ministerial side that he will call attention to the office ot coroner at an early day " Other facts indi^tp that England recognizes this evil better than does the United States, and therefore wiU probably correct it sooner. July^18 <6, it was reported that » the practice of electing coro ners has been condemned in the House of Commons by a unanimous vote A hillIf th reform of the office of coroner is soon to be brought in." See also B. 259,' 274 and 330 ADDRESS ON MEDICAL JURISPRUDENCE. 11 believe entertain opinions the most contradictory.1 Who are these partisan witnesses thus summoned by the law to apply the power of medical knowledge to the administration of justice ? Surely these legal represen- tatives of science must be competent experts ? No.—Well, experienced and educated physicians of repute? No.—Then, of course graduates, at least some fledgling hatched in nine months, and fully feathered with the plumes of every branch of medicine, Medical Jurisprudence included ? No, not indispensable, since " as a general rule" it has been adjudged that any practitioner of medicine (that is, any man who dubs himself Doctor) has sufficient knowledge of medical science to furnish justice with its " best attainable evidence."2 "0, [this] offence is rank, it smells to Heaven '." Common sense would presume that laws, so prodigal to ignorance and pretension, would provide means to test the value of scientific opinions by eliciting the facts upon which, if valid, they must be founded. Not so ; since these opinions are replies to questions, which often by their very structure comically prove entire ignorance of the facts involved ; for they are propounded by lawyers to whom these facts are unknown. Finally, it would be presumed that the decision as to the weight due such opinions would be left to a judge or jury specially chosen. No, even this last poor boon is denied by the law I AVith the power of medical science thus crippled at the coroner's inquest, then prostituted by the partisan opinions of incompetent experts, then perverted by advocates, and at last when emasculated of all vigor submitted for decision to those unable to estimate its weight; what wonder that such gross misapplication of medical knowledge brings upon it that public contempt which belongs justly to methods so mon- strous, and to which true medical knowledge is a helpless, pitiable, and disgusted victim I But these legal defects, so paralyzing to the past, so discouraging to 1 Reference is often made to the well-known facts that the sound expert-evidence of the illustrious John Hunter was in 1781 overborne by the evidence of three ignoramuses, and that the testimony of the- famous Denman was in 1806 set aside by the Court in favor of one male and two female quacks. The same system is continued, and therefore the same evils persist. Prof. A. S. Taylor reports now, as to England, that a good search and good pay can always find, in abundance, the witnesses needed on either side of any medico-legal issue. This is certainly true as to the United States. Some facts may be cited in illus- tration. I have personal experience in a suit (unsoundness of a slave) in which the medical experts were selected by one side because of their well-known ignorance of the special knowledge (auscultation) which the issue involved ; and the judge decided that the whole medical testimony must be set aside, because the negative evidence of the incompetent suf- ficed to counterbalance the very positive affirmative testimony of the competent experts. Death, with a post-mortem examination, soon after the decision, conclusively proved that the ignoramuses deserved no consideration in justice, though they did receive equiponderant consideration in law. Whenever a notorious trial attracts public attention, the results of our defective laws become disgracefully apparent, as has been illustrated in recent years by the Steinecke-Schoeppe (1868), the Wharton-Ketchum (1872), and the Stokes-Fisk (1874) trials (B. 363, 344, 370). If the medico-legal proceedings are so discreditable in cases like these, exciting great public interest and engaging the best legal and medical talent, what probably are they in ordinary trials lacking these advantages ? 2 The text will be found fully sustained by reference to B. 317, pp. 131-2, B. 349, I. pp. 283-5, and B. 363, p. 406. However, Elwell (B. 330, p. 589) refers to eight decisions to the effect that " special knowledge must be fully established before a witness can be ex- amined as an expert;" but had he stated by what slight proofs, and by what incompetent judges, this "special knowledge must be fully established," the apparent discrepancy would have practically disappeared. An eminent lawyer assures me that in the courts of my native State (Mississippi) the competency of a medical expert rests solely on his own oath; and that, when his own interests and reputation prompt such an oath! 12 CHAILLE, the future of Anglo-American Medical Jurisprudence, are not the only disadvantages against which this nation has had to contend. It in- herited from Creat Britain not even a page of the literature, in fact nothing of Medical Jurisprudence except laws hostile to it. So desti- tute was it of those indispensable promoters of science, well endowed institutions, with libraries, laboratories, and museums ; so exhausted by the war for independence ; so closely occupied by the pressing demands of daily life; and so profitably absorbed by glorious efforts to present to civilization a savage continent, that every science seems to have required half our century to secure the conditions necessary to fairly begin its culture.1 Another potent, yet ill-appreciated friend to science, pressure of population, now wanting in many, was long wanting in every State. Finally, while a European nation requires but one legislative body to reform its laws, our political system now necessitates the action of thirty- eight State-legislatures to embrace the entire nation. Just consideration of all these impediments should incline other nations not to condemn, if we have done little for Medical Jurisprudence, but rather to wonder that we have done anything at all; and to con- gratulate us that, so great has been the diffusion of knowledge, so ardent the love of justice, we have in the main kept pace with, and in some particulars have even outstripped, our mother-land. Fairly we can claim no more; reasonably no more should be expected. II. What have our Medical Colleges done to cultivate and to disseminate a knowledge of Medical Jurisprudence?—The first chair of Medical Juris- prudence was established by the "College of Physicians and Surgeons" of New York City, and filled by Prof. Stringham,2 in 1813. In 1815 two other Colleges3 had chairs devoted to the usual branches with Medical Jurisprudence attached to some one of these. In 1825 there were about twenty-two medical colleges; of these only one had a full chair, and only five others had even" the fraction of a chair devoted to the subject.4 At present (1875-6) there are sixty-four regular medical colleges (four of these for women). A report5 as to forty-six of 1 To illustrate this as to medicine, and also the practical difficulty encountered bv the courts in securing, under our laws, the evidence of competent experts, the followin"- 'facts are stated: Prof. S. D. Gross reports that in 1776 the United States had about 3000 prac- tising physicians, of whom the great majority had never received a medical education and those who had, were educated abroad. Prof. Austin Flint, Sr., reports that in 1776 our two medical colleges (one founded in Philadelphia in 1768, the other in New York City in 1770) had not graduated even fifty doctors of medicine, and that up to 1800 the five colleges then existing had graduated only about two hundred. Thacher's " History of Medical Science in the United States" reports that it was computed that in 1826 the United States had 10,000 " very easily graduated" doctors of medicine, and more than 15,000 practitioners without diplomas Prof. John B Beck wrote that, » at no period in the history of this country, it may safely be asserted, has empiricism flourished to the same fearful extent as t ^-Hu^V™^1845}' notwithstanding our boasted improvements in other respects" |lnl8i"'nSf..L,,lted ^ ^^i8^ Petitioners of medicine; of these theS weKr- sZal ranks Vei7 ^ Sraduated doctors, and at least 15,000 quacks outside of profes- 2 Dr. Stringham was also the first lecturer on Medical Jurisprudence in tW TTnitod States, viz., in New York City in 1804. ^unspruaence in the United 3 In 1815 "The College of Physicians and Surgeons of the Western District of N™ York" appointed Dr. T. R. Beck '"Professor of the Institutes of Medidne L Medical Jurisprudence;" aiid the Medical Department oiuJ^^Z^y^^^ prudeic^ ^ alter Channing" Professor of Midwifery and of iidiS j& s n6 "+Thacher's *J istory of Medical Science in the United States, 1828 " Due to the courtesy of (my colleague on this occasion) Prof. N. S Davis M D of Chicago, 111. 'Jhe forty-six graduate more than nine-tenths of „u „„, „ 7 ' , "' 0l The twenty-five graduate fully one-half of the whole number "al ^duates. ADDRESS ON MEDICAL JURISPRUDENCE. 13 the most noted, shows that twenty-one do not profess to teach the subject; of the remaining twenty-five, only fourteen (and these not the best known and attended) have professorships devoted exclusively to Medical Juris- prudence, and, by five of these fourteen, students are taught to become medical experts by lawyers ;* while the other eleven have Medical Juris- prudence "tacked on as a caudal appendage" to some one of the usual branches. In fine, only about one-half of even our best colleges profess to pay any special attention to the subject; and many facts could be cited to prove that the true significance of the whole matter, from 1813 to the present day, is correctly represented by the following quotations from one of the most prominent of our living medico-legists:—2 " There are very few of the medical colleges in which it is taught, and still fewer in which it takes rank as a distinct and independent branch along with the other departments. Usually when it professedly receives any attention at all, it is tacked on, as a sort of appendix, to some other branch with which it has no natural affinity whatever, as, e.g., Obstetrics or Materia Medica. This is of course done to make a show on the pro- gramme, while the subject itself is not taught systematically to the student, if taught at all." "I very much doubt whether Medical Juris- prudence is ever made a qualification for graduation, even in those colleges where it is professedly taught as one of the regular branches."3 From these facts it is manifest that, since 1813, our colleges (the off- spring of the enterprise of individuals, and not of the State) have made ineffectual efforts to cultivate that special knowledge which, while highly beneficial to the State, would not benefit the individual members of our profession any more directly than any other citizens. In fact, the States through these citizens have failed to provide honorable and profit- able employment for medico-legal experts, and, therefore, the profession has not furnished them ; and, however enlightened the colleges, however praiseworthy their efforts, they will continue to contend in vain against the obstinate " demand and supply law" of political economy. The profession recognizes the absurdity of the popular and legal pre- sumption that every practitioner is a medical expert; but the profession does not yet recognize sufficiently that even the most skilful healers of disease are neither necessarily nor generally medico-legists ; and that the experience of other nations has fully proved that merely didactic lectures can never render medical graduates competent experts. Were this feasi- ble, any such ideal education is now impracticable; for who will deny (1) that our two short courses of lectures are insufficient for proper instruction even in the fundamental facts indispensable to the education of practitioners of medicine; (2) that the fundamental facts for the prac- titioner are the same as for the medical expert; and (3) that society remunerates the one, while the State finds no use for the other ? Finally, there is reason to fear that, until the State demands medical experts, the colleges, dependent on the student and not on the State for their exist- encef will be forced by these practical students to realize continually the 1 Casper insists, with good reason, that the medico-legist should remain a physician; and become neither a lawyer, jurisconsult, nor judge, but simply an expert witness, who does need from the law thorough instruction in the " rules of evidence." 2 John J. Eeese, M.D., Professor of Medical Jurisprudence in the University of Penn- sylvania. (See B. 247 and 362.) . 3 Some only of our Law Schools have professorships of Medical Jurisprudence ; and there is good reason to believe that the general facts as to the Medical are fully applicable to the Law Schools, as far as instruction in Legal Medicine is concerned. 3 14 CHAILLE, force of the homely adage, "you may take a horse to the water, but you cannot force him to drink." III. What new Facts have Americans added, by original research, to the com- mon stock of Medico-legal Science?—Restricting the list to researches design- edly and specially medico-legal, it must be borne in mind that the sum total of these in all nations has not been very large, and that few should be expected in this country for reasons already stated. Prof. John C. Dalton (though to some extent anticipated by Coste (1849) whose researches were unknown to Dalton) was the first (1851) to make a rigid comparison between the corpus.luteum of menstruation and that of pregnancy ; and to distinctly indicate the differences which, during a certain period, enable the expert to determine from an inspection of the ovaries whether pregnancy has or has not existed.1 Dr. Joseph (1. Richardson announced in 1869 the important medico-legal discovery that, by the proper appli- cation of high powers of the microscope, human blood-corpuscles could with certainty be discriminated from those of certain animals;2 thereby enabling the expert to refute such statements as criminals have often offered to explain the presence of condemnatory stains of blood. Though the justice of this claim has been questioned, yet some of the highest authorities emphatically sustain it; and this discovery has been usefully applied in several criminal trials.3 Dr. Richardson deserves the additional credit of having called attention in 18754 to a simple method of so treat- ing a blood-stain, of even microscopic size, that it can be successfully examined by the spectroscope and guaiacum test,5 as well as by the microscope. Researches by which error is exposed, or truth more firmly established, are often as important to science as those which discover new facts. Among such researches may be mentioned those of John B. Beck, on Ploucquet's6 and on the hydrostatic test,7 in 1817 and subsequently ; of Horner, on the mucous membranes of the stomach and intestines, in 1827; of Gross, on strangling, in 1833; of Wetherill, on adipocere,8 in 1855 ; and of Fleming, on blood-stains, in 1859.9 Contributions by my countrymen to the progress of Medical Jurispru- 1 See B. 257; also, Coste's second livraison, "Histoire du Developpement" 1849- and the adoption of Coste's views in Longet's " Traite de Physiologie," II. p. 88, 1850 « " An objective & to T'0- inch distinguishes human blood-corpuscles in stains (but not in ^^oTo^^Ul0'" those of the ox' Pte. sheeP- cat, horse, deer, and goat." (See H. 6Z0, did, d<4, 3(6, Sit.) v 3 Since the delivery of this address, eminent microscopists have made on the pre- SlH TS'T, First, that the word "discovery" is misused-since it has hi llf0™ tbat tl!e b °od;cuorPuscles of the "certain animals" are much smaller than those of man as also that high powers render this difference in size more appa- rent. Second, that the words "with certainty" demand a modifying explanXn snTce able observers declare that cases do occur wherein human corpuscles m dried s a ns shrank, so as to be as small as those of the »certain animals": hence, that the expert when confronted with such smal corpuscles cannot swear " with ceiinty" whetl these be human; but if the specimen of corpuscles approximate those o man 7size hen the expert can swear " with certainty" that they are not those of anyone of the certain animals," inasmuch as corpuscles in dried stains do shrink, but do no enlarge I he issue thus raised is as to the amount of shrinkage of human red blood-cSrpusc es hi dried stains ; Dr. Richardson asserts that this does not exceed ten top cpnt 3f tl assert that this may be thirty per cent., the corpuscle shllmr in ze to i "o™ even to ^j,1^ inch. ° slz,e L0 4 3iJ5> or « ns?5' r TanaD?en< 1862> and A. S. Taylor, 1868. llbZ- 7 Jan Schreyer, 1682 si? -,»„? „ 9 See B. 205, 215, 225, 267, 287. To this list mMit be added B' ™T™7, l,785"7, • ments in 1851 on Cadaveric Rigidity. (Am. Journ Wl Sci! Oct 1851 :feqUard S exPeri" ADDRESS ON MEDICAL JURISPRUDENCE. 15 dence during a century, present a field for investigation so extensive, that some of these contributions may have escaped my search, or may have been inadequately appreciated. To rectify, at least in some mea- sure, any such defects, I present, with this address, a Bibliography of American Medical Jurisprudence, to which attention is invited" The next inquiry is:— IV. What culture of Medico-legal Science is evinced by our Literature ? 1. General Treatises.—The embryonic stage of medico-legal litera- ture in our mother-tongue is attested by the'following " footprints on the sands of time." Farr's " Elements of Medical Jurisprudence,"1 an abridged translation of Faselius, was the first general treatise in the English language, and the only one from 1788 to 1815, when another worse little duodecimo was added by Bartley.2 In 1816 Male contributed an insignificant " Epitome of Forensic Medicine,"3 borrowed from Plenck,4 and in 1821 John Gordon Smith, M.D., published a small book,. which was the first original and meritorious treatise in our language.5 In 1823 appeared, in two large octavo volumes, the American, Theo- dric Romej-n Beck's " Elements of Medical Jurisprudence,"6 which, in spite of the merit of Smith's book, and of the greater merit of Paris's and Fonblanque's English treatise,7 also published in 1823, quickly sup- planted these wherever the English language was spoken. From the date of its publication, which may be deemed the origin, in fact, of Anglo-American medico-legal science, its twelve successive editions have ably kept pace with the progress of legal medicine. Filling man}' offices of trust and honor, a member of twenty American and seven foreign scientific societies, Prof. Beck8 lived to witness the issue of ten editions of his treatise ; of these, several were published in England, and even the prolific mother of medico-legal literature issued in 1828 a translated German edition. But to Beck's merit no testimony can be more con- vincing or pleasing than that gracefully given by the three eminent authors whose works eventually succeeded in largely supplanting his treatise in Great Britain. Traill, the distinguished Scotch professor and author, eulogizes it as "the best work on the general subject which has appeared in the English language;"9 Guy "acknowledges his obliga- tions in a special manner to Beck's learned and elaborate Elements of Medical Jurisprudence ;"10 and Taylor, than whom there is no higher living authority, testifies that he, when a student, was stimulated by Beck's work to study medical jurisprudence in 1825, when no lectures were delivered in England on the subject, and this book was the leading authority for both lawyers and physicians; and that it " will carry down" the author's " name to future years as one of the most erudite and distinguished writers on medical jurisprudence."11 To these testimonials from abroad may be added the eloquent eulogy of that son of America whom its medical profession delights to honor as one of its noblest representatives, and as its President on this occasion. His voice, generous to all, even loving to worth, declares that "this o-rand book" " was in its day the most comprehensive, able, and erudite production on the subject of which it treats in any language," and that it "constitutes a lasting monument to the genius, industry, judgment, » B. 150, also 207. 2 B. 151. 3 B. 152, also 207. 4 b. 47. s b. 153. 6 B. 209. 7 B. 154. 8 Born in 1791; died in 1855. For the biographies of Drs. T. R. Beck, John B. Beck, and Moreton Stille, see Gross's "American Medical Biography," 1861. » B. 158, 2d Ed. 10 B. 161, 2d Ed. » B. 359. 16 CHAILLE, and learning of its lamented author."1 It is pleasing to learn from the same source"that, in honoring this famous author, we are honoring the memory of a good and noble man; and this pleasure is enhanced by re- calling the humble estimate which he himself accorded to his " world- renowned book." For his own statements were that his "highest ambi- tion would be gratified" if his " collection of detached essays" should " in some tolerable degree" "prove useful." Knowing that these modest words will find a generous echo in the hearts of all noble men, to them is commended the fame of America's first and greatest medico-legal author. In 1850, Prof. Amos Dean, a lawyer, published his brief but excellent text-book, the " Principles of Medical Jurisprudence,"2 which has passed through three editions. A lawyer and a physician united to produce in 1855 the voluminous and admirable general treatise, " Wharton and Stille's Medical Jurispru- dence."3 After completion, but prior to its publication, profession and country had cause to mourn the death of the young and gifted Moreton StilleV His legal associate, deriving from other able pens indispensable medical aid, has lived to issue three editions of a work which both pro- fessions accept as one of the highest standard authorities. Evidence of our increasing appreciation of legal medicine, as also of our obligations to foreign sources, is found in the republication, since 1819, of nine books by British authors on the general subject, viz., Cooper's collection of the earliest English tracts (1819), and the nume- rous valuable articles in the "Cyclopaedia of Practical Medicine" (1845), which deserve mention with the general treatises of Ryan (1832), Chittv (1836), Traill (1811), Guy (1845), and Woodman and Tidy (1876); and of still greater value Taylor's "Manual," as also his "Principles and Practice of Medical Jurisprudence" (1845 to 1873).5 2. Treatises, Essays, etc., on Special Subjects.—Besides the excellent books of Ray, Elwell, Ordronaux, Wormley, Reese, and the New York " Medico-Legal Society," the essays and articles on special topics have been too numerous to permit full examination, or more than a partial sketch of this important branch of my subject. Infanticide and foeticide received from Prof. John B. Beck attention in 1817 ;6 and this thesis, enlarged and improved for the various editions of his brother's "great work," displays a combination of erudition, original research, sound sense, and rhetorical excellence, which render it one of the most classical essays in the medical literature of the English lano-ua^e. Abortion has been further illustrated by the essays ofP Hod!A^ if l»riO*»l I I 3 I* A t Y OF MEDICINE NATIONAL LIBRARY OF MIDintll Cf a if lord == SPEEDY BINDER - Syracuse, N. Y. ----- Stockton, Calif. 3NIDI03W JO AHVUSn 1VN0UVN h ThBSTTSD WIN a0t7t0££82 9i8T <>fr£M 009 /y\ NLM051158414