6001 H849s 1849, ■*vi. .v.-■■"•;■ ,y-N ■ ■ ■ '• . .'■?■ ai'§' ^ ■■' • ■■■/', ^%, ■, ■ 3#W'--1i> •■. v If?. M.:7 ifr • . • '■ ■> ;' ' ." -- 'Ml.fc*:Miv; •; * ■■:.-s.':>: ■'. .'•:^:v":v"' 4a£:".'^. \ Jj;' ►'.■'.; •.•■ ' ;' ■ ' j . '.'-•'• I^lj •■;.■". :' y J #-.'. .- \ ;':":.c'* ,■ .** i&-r^ i m m :.-n "ni'ifl !\.±:r. DUE TWO WEEKS FROM LAST DATE APR 8 1958 % A SYNOPSIS MEDICAL JURISPRUDENCE, FROM THE LATEST AND BEST AUTHORITIES FORMING THE BASIS OF LECTURES ON THE SCIENCE, HENRY HOWARD, M. D., Professor of the Pathology aud Practice of Medicine, Obstetrics, and Medical Jurisprudence, IN THE UNIVERSITY OF VIRGINIA, CHARLOTTESVILLE: PRINTED BY O. S. ALLEN & CO. 1849. . --fcs w Goo ■\\S43s 1649 >> CONTENTS. Wounds, .... Personal Identity, Persons found dead, Mental alienation, . , Idiocy, .... Imbecility, - Mania, - Intellectual .... Moral, .... Dementia, .... Delirium, Febrile, ... Tremens, - Suicide, .... Somnambulism, ... Drunkenness, ... Interdiction, . . . . Infanticide, .... Legitimacy of Offspring, Impotence and Sterility, Hermaphrodism, ... Signs of Pregnancy, Rape, .... Death by Latent Diseases, Survivorship, Life Insurance, ... Feigned Diseases. ... Toxicology, ... Metallic Poisons, ... Earthy and Alkaline Poisons, Acid Poisons, - Simple substances with poisonous qualities, Gaseous Poisons, ... Vegetable Poisons, - Animal or Septic Poisons, Glossary or explanation of terms, FORENSIC MEDICINE. WOUNDS. Wounds, in medico legal phraseology, comprise injuries of every kind occasioned by mechanical violence, as bruises, contusions, incisions, fractures, luxations, &c. The chief questions to be decided upon finding a dead and wounded body, are, 1, Was the wound inflicted during life? 2, Was it the cause of death ? 3, Was it the re- suit of homicide, suicide, or accident? Classification of wounds—4 classes. 1, Those absolute- ly mortal. 2, Dangerous wounds. 3, Not mortal. And 4, Accidentally mortal. Wounds absolutely mortal, and which generally occa- sion immediate death, are those of the brain, heart and large vessels connected with it, of the spinal marrow of the neck, and blows on the stomach. Wounds of the brain are less fatal than those of the heart, and these aie not necessarily immediately fatal. Next in order of mortality are those that interfere with respiration, as extensive wounds of the dia- phragm, and wounds of the lungs that lay open both sides of the thorax, thus impeding the dilatation of the lungs. Dangerous wounds are those of the pharynx and sceo- phagus, the stomach andchylopoietic viscera, urinary blad- der, of the large blood vessels of the liver, chest and abdo- men not already mentioned. Severe contusions over any of the great cavities : division of the vessels of the extre- mities: compound fractures, and wounds of the tendons causing tetanus. Wounds not mortal, or slight wounds, are injuries by which the skin and muscles arc coutuscd or divided, and 6 FORENSIC MEDICINE. the tendons and aponeurosis, nerves and large blood vessels escape, such as incisions, simple fractures and luxations. Wounds inflicted after death. Blows inflicted after death somewhat resemble slight blows inflicted before death, but the following results from blows before death never occur from blows after death. 1. Swelling from extravasations. 2. A yellow margin around the black spot. 3. Coagulated extravasated blood in the subjacent cellular tissue. But it may be doubted, whether clots may not form if the injury be inflicted very soon after death, and has the effect of lacerating a consi- derable vessel near loose cellular tissue. 4. In the in- stances in which the blood does not coagulate at all after death, contusions caused during life may be recogized by the extent of the effusion into the cellular tissue. Ex- tensive effusions of blood in situations not depending and not near a large vein : a deep effusion distending the cel- lular tissue can hardly be produced on the dead body: in- corporation of blood with the whole thickness of the true skin rendering it black instead of white, and increasing its firmness and resistance is characteristic as to time, and is perhaps one of the best signs of a contusion inflicted du- ring life. No precise limits can be fixed as to the time when wounds inflicted after death will not resemble those produced during life : it appears to vary with the state of the blood, and the time which elapses before the body cools, and the joints stiffen. Three hours, however, may be sta- ted as the extreme limit, and except on the trunk of the body the limit may be two hours. The chief circumstances that influence the medico legal character of wounds are age, sex, constitutional peculiari- ties, previous injury or disease, and malum regimen. Age. Adult age is most favorable to recovery from in- juries, (particularly burns,) except fractures, from those, children soonest recover. SSex. This is a circumstance of aggravation in the case of blows on the breast of the female, in consequence of its great sensibility in early life, and its proneness to cancer in later years. Blows on the abdomen of a pregnant female are always dangerous. Constitutional peculiarities. They are of two kinds, 1. Constitutional Infirmities. And 2. Malformations. Of the 1. Great irritability of the nervous system predisposes to violent effects from slight causes. The scrofulous diathesis and venereal disease influence the result of wounds, and FORENSIC MEDICINE. 7 predispose to violent effects from injuries of the joints. The hemorrhagic predisposition sometimes gives rise to large hemorrhages from the slightest scratch. Of the 2d or Malformations. Transposition of the viscera, either congenital or accidental, may bring them within the range of injuries, or operations, that would not otherwise prove dangerous. Previous injury or disease is sometimes urged in extenuation for the dangerous consequences of injuries. In such cases the three following inquiries should be made. 1. Was the new injury adequate to produce serious mischief in ordinary cases'? 2. Whether did the injury or the previous disease, or acci- dent cause death 1 3. Did the alleged previous harm really exist, or was it the consequence of the injury ? Subsequent injury or disease may alter the medico legal cha- racter of wounds. It may happen that a disease unconnected with the effects of an injury, may invade a person who has been wounded and carry him off; as typhus fever in wounds of the head : and pleurisy in wounds of the chest. Malum Regimen. Accidental or inevitable want of skil- ful treatment is not a valid plea ; but if the omission was in- tentional or avoidable it takes off the responsibility to the in- flicter in a great degree. In persons found dead from wounds, it is necessary to in- quire whether the wounds were the result of suicide, accident, or homicide. We must then ascertain, 1, The seat of the wounds. 2. Their direction. 3. The probable vyeapon used. Wounds of the spinal marrow with a sharp pointed instru- ment: wounds inflicted behind with fire arms: and incised wounds, except those of the throat, cannot be supposed to be voluntarily inflicted. Yet instances have occurred where wounds and even amputations of the extremities and penis, and other incised wounds have been thus inflicted. Wounds by fire arms in the mouth, are rarely done by an- other. In relation to the direction of a wound, a slab from above downwards must generally be inflicted by a tall, upon a small person, if both be standing : and if upwards, by a short upon a taller person, if both be standing. It should be ascertained whether the right or left hand had been used : and as the for- mer is that most commonly employed, the direction should cor- respond with it: but if the direction corresponds with the left 8 FORENSIC MEDICINE. hand, it should be inquired whether the deceased were left handed. In wounds by balls, it has been generally held that the en- trance wound is smaller than the exit. But Professor Malle says from many experiments on the dead body, and frequent examinations1 of the wounded, living body, exactly the reverse obtains.* The entrance wound has its edges inverted and de- pressed : while the exit wound has ragged, everted and uneven edges, and the same obtains in flat bones. Considerable discrepancy exists among writers on Medical Jurisprudence in relation to the size of the wound made by a ball, when compared with the ball. Some of them stating that the perforation, even in bones, is of the same size as the ball, others saying it is much greater: and a case has been published by Dr. Post of New York,f in which he says per- foration made by a " rifle ball" through the parietal bone, was smaller than the ordinary rifle ball." Perhaps all this discrepancy may be reconciled by ascertaining that balls pro- jected from the common musket, and all smooth bore guns, the rifle longitudinally grooved, and the rifle spirally groov- ed, make perforations different from each other. Professor Stoughton says : " The motion of a musket ball (independently of its pro- jectile course) on its own axis is at right angles with its di- rection. Hence, when a musket ball strikes the flesh, the hole made is smaller, to all appearance than the ball itself. The barrel of the American rifle, on the other hand, is grooved, not in a longitudinal direction, as the French and German rifles, but in a spiral manner. The ball is forced down so tightly that as it passes out, it is under the necessity of fol- lowing the spiral groove. This imparts to it a motion on its axis, corresponding with the direction of its course. Hence the ragged hole, which our hunters know so well, is always much larger than the ball. Hence the rifle ball, at full momentum, does not, like the musket ball, remove a cylinder of muscle and bone, but its rotary motion, tears the flesh and shatters the bone. Hence too, unless the ball is nearly spent, it never glances." Dupuytren attempts to reconcile the discrepancy as fol- lows : " When the gun has been discharged close to the wounded part, the opening by which the ball enters is * Annalis d' Hygiene, April, 1840, and Hay's Journal, October 1841, p. 505. t Hay's Journal. April, 1841, p. 5t4. FORENSIC MEDICINE. 9 smaller than that by which it makes its exit, but if at a distance, so that the ball is nearly spent, then the reverse will be observ- ed. The canal in the former case will be conical." The hole made by a ball in clothes is always smaller than that in the skin. Professor Lachese, in the Annalis d'Hygiene, vol. 15, p. 389, says : " In order that a discharge of powder shall pene- trate into the cavities, and make an external wound, like that produced by shot making but one hole, the gun must be of great calibre, be heavily charged, and there must be less than six inches distance between its muzzle and the body wounded. And to produce with a gun loaded with shot, a single round aperture, the gun must be fired at ten or twelve inches distance at most. And in either the case of powder or shot, if the body is covered with clothing the distance must be less." It is stated by John Hunter, and confirmed by other Sur- geons, that a ball striking a bone at an angle sufficient to ena- ble it to perforate it, will not have its form altered. This is contradicted by the case of Dr. Post, already cited : the ball was found, after passing through the parietal bone, "lying in the dura mater considerably flattened, and its diameter so much increased that it would have been impossible to have removed it by the same opening through which it had en- tered." In wounds by fire arms collateral circumstances will throw some light. The wadding has sometimes led to detection, be- ing torn from something in the possession of the infiiclor. Also, if the fire arms and ball can be found, the size of the latter should be compared with the calibre of the former. Detection of spots of blood. In cases of murder, it is sometimes important to distinguish stains of blood on the clothes, or on a deadly weapon, from those produced by some vegetable dye, or by rust. If the garment has diiectly re- ceived the blood, we shall find on the cloth remains of fibrin, as well as the serum and coloring matter of the blood. The best method of examining such is— a. Take an oblong slip of the stained article, and suspend it vertically for some hours in a narrow jar of distilled water. The water will separate the albuminous part and coloring mat- ter of the blood, which will subside to the bottom of the fluid. The fibrin will remain on the cloth, as a gelatinous body, and may be scraped off for examination. Dry the fibrin, and heat a portion of it in a tube, when it will give out the odour of burning animal matter, and ammonia will be disengaged, which becomes sensible to the sense of smell, or will affect test-paper introduced into the upper part of the tube. 10 FORENSIC MEDICINE. b. Draw off the colorless fluid, by the pipette, from the co- lored portion in the bottom of the glass, and divide this latter into five portions. If the stain has arisen from blood, it will give the following indications: A weak solution of chlorine added to one part will first make it faintly greenish, next co- lorless, afterwards opalescent, and then whitish flakes will be deposited ; to a second portion add a drop or two of ammonia, which will not change the color of blood; but if the color be produced by Brazil-wood, logwood, or the like, ammonia gives them a violet tint. Infusion of galls thiows down a precipi- tate, without changing the color of the blood. A few drops of nitric acid throws down a grayish-white precipitate from blood. If the blood has oozed through the first garment, and stain- ed an exterior one, the stains may be treated as above, but the fibrin will probably be only found on the interior garment. If blood has incrusted a knife or other cutting instrument, by gently heating one part of the blade, the stain will scale off, leaving the metal uncorroded below; but a stain from the rust will not thus form a crust, nor will the surface be clean. These scales may be tested for ammonia in a heated tube. It would appear, however, that sometimes rust of iron gives slight traces of ammonia, probably from the action of moist air on the iron ; but there is small danger of confounding this with the more decided indications of blood so treated; and, besides, the knife may be treated in the same manner as the slips of cloth, and the tests applied to the liquid. Stains of blood on wood are apt to sink into it, especially when it is soft, but it may be detected by a similar process, in many cases. PERSONAL IDENTITY. It is sometimes doubtful whether a child for whom an inhe- ritance is claimed, be the same that he is pretended. Long absence of the proprietor of an estate has given rise to the same doubt. It thus may happen that the true heir would not be able to prove his right merely by failing to establish his identity: while on the other hand an impostor may suc- ceed where he has no claim, merely by force of resemblance. In criminal prosecutions it is important to know if an ar- rested person be the guilty one or not whom he may resem- ble; or where a prisoner, after conviction, makes his escape and is retaken, whether he is the same person who was con- victed. The degree of light necessary at night, to enable a person FORENSIC MEDICINE. 11 to distinguish the features so that the individual may be after- wards identified. The flash of a pistol, or of lightning, or a coal of fire in firing a roof, are deemed suficient when the parties are near each other, say within 30 feet. Resemblance is sometimes so strong, that persons innocent of crimes, have been accused for those who really committed them. Therefore extreme caution should be exercised in admitting testimony of identity. In the case of a person claiming an estate after a long ab- sence from it, the best plan is to question him in respect to circumstances which none but the real proprietor can k«now. It sometimes becomes necessary to prove the identity of the dead, in doing which we should be very cautions how we assume any but indelible marks as means of recognition, be- cause so complete an alteration takes place in the features and general appearance soon after death, as to deceive even the nearest relations. PERSONS FOUND DEAD. This whole subject may be arranged under two heads. 1. Sudden death from natural causes, and 2. Sudden death from violent causes: (comprehending under the latter every variety, whether the result of accident, or of criminal inten- tion.) 1. In relation to respiration. The respiration may be so feeble as to be scarcely perceptible, and so continue for a long lime, but it cannot be entirely suspended longer than a very few minutes without life becoming extinct forever. The popular mode of ascertaining its existence, such as placing down, or other light substances, near the nose or mouth, a vessel of water on the chest, or a mirror before the mouth or nose, is fallacious; for any agitation of the surrounding air will move the down or water; and exhalations from the body will cloud the mirror. Physiological mode. Examine the chest, and see if the intercostal muscles move, or the ribs are elevated and the sternum pushed forward. When the diaphragm acts, the abdomen swells. 2. The Circulation. All evidences of the existence of the circulation may be absent and life still exist. Mode of ascer- taining the existence of the circulation. Sometimes the pul- sation of the artery at the wrist will cease upon extending I he arm and throwing the palm of the hand upward, but may be felt on flexing the arm and turning the palm inward and 12 FORENSIC MEDICINE. downward. Again the artery may not be felt unless we search for it between the thumb and first metacavple bone. The trial should be made at all parts where the arteries are superficial. We must be cautious not to mistake the pulsa- tion of the arteries of our own fingers for those we are ex- amining. Turn the body on the left side, and then place the hand in the region of the heart. If this fail, use the stethoscope or the ear. Temperature. For this see Survivorship. Flexibility of the limbs before rigidity, is evidence of ex- isting life; but flexibility succeeding rigidity, is a conclusive sign of death. Rigidity of the muscles, commences first in the trunk and neck, then the upper extremities, and finally in the lower ex- tremities and feet, and it subsides in the same way. The du- ration of rigidity is the greater, the later it occurs. lis ener- gy and duration are the greater, the greater the muscular strength. In all animals, the moment when stiffness com- mences, is that in which the vital heat appears to be nearly extinct. The most unequivocal signs of death are three, viz: 1. Flexibility succeding to rigidity. 2. The muscles failing to obey the galvanic influence. And 3. Incipient pu- trefaction. The following is the order in which the muscles after death cease to obey the galvanic influence : 1. The left ventricle. 2. The intestines and stomach. 3. Urinary bladder. 4. Right ventricle—this retains its contrastility under galvanism for one hour. 5. (Esophagus for half an hour longer. 6. Iris. 7. Muscles of animal life. 8. Auricles. The changes that take place in bodies after death, may be divided into those that occur before, and those that follow the invasion of putrefaction. To the first belong diminution of temperature, rigidity, and lividity of depending parts. The conditions of speedy putrefaction, are exposure to air, moisture and moderate heat. The presence of air is not in- dispensable, as it will take place in vacuo, but it promotes it. Adipocire resembles fat or wax, and is a soft ductile matter similar to cheese: it is the result of putrefaction under pecu- liar circumstances ; that is when bodies are heaped together in the earth: it is a soap with double acid and ammonial base, that is, it consists of magaric acid and oleic acid—of ammo- nia and very small quantities of lime and potash, and some salts, in scarcely appreciable quantities. It is only found when some fat and azortized substance are found together J he fatty substance furnishes the acids, and the azotized sub- FORENSIC MEDICINE. 13 stance the ammonia. Three years inhumation, is necessary for the body to undergo the complete change in the earth ; but it occurs sooner in water, yet is never perfect unless many bodies are buried together, those at the bottom undergoing it first. The gases must be confined by a covering of earth. Death from natural causes. Natural death may take place in two ways. 1. Either as the slow and gradual termi- nation of a lingering disease, or 2. Suddenly, as by apoplexy or concussion. Natural causes of sudden death. 1. Apoplexy. 2. Rup- tures of abscesses or blood vessels in the air passages. 3. Ossifications of the cardiac valves or arteries. 4. Ruptures of the heart. 5. Asphyxia. Death from violent causes, of which we may enumerate seven: 1. Asphyxia. 2. Poisoning. 3. Wounds. 4. Burn- ing. 5. Cold. 6. Hunger. And, 7. Lightning. Asphyxia. This may be defined the suspension of the function of respiration, and consequently of the circulatory and cerebral functions. It may be produced primarily, ei- ther by an interruption of the mechanical or chemical phe- nomena of respiration. The mechanical phenomena are the motion of the parieties of the chest and diaphragm. The chemical phenomena are the absorption of oxygen, the disengagement of carbonic acid, and the conversion of venous into arterial blood. Whichsoever be first interrupted, the other soon follows. Causes of Asphyxia. Those that interrupt the mechani- cal phenomena, are compression of the chest externally, or wounds of both sides admitting air, producing internal com- pression, and effusion of large quantities of fluid into the pleural sac. All these act mechanically. There are others that cause a cessation of the mechanical motion by their physiological action, as wounds dividing or compressing the nerves of the respiratory muscles, and causes extinguishing the nervous energy, as lightning. The chemical phenomena however, are most frequently concerned in the production of asphyxia; and the causes are, 1. Drowning. 2. Hanging. 3. Strangulation. 4. Smothering. 5. The inhalation of noxious gases, and 6. Air deprived of oxygen. The medico legal questions that are likely to arise in drowning are, 1. Whether the body was immersed before or after death. 2. Whether the individual has been im- mersed by accident; has drowned himself; or has been thrown in by others ? 14 FORENSIC MEDICINE. The most unequivocal signs of drowning are the existence, in the stomach of water of the same kind in which the body is found, and the elevation of the epiglottis, whh froth or rather lather in the upper part of the trachea: for if watei is found in the stomach, deglution must be the cause —and if lather, of this peculiar kind, is in the trachea, it must be the result of respiration upon the water and air. The peculiarity in this froth is that it does not adhere to the trachea by mucus, but is in immediate contact with the tube and all the bubbles that appear in it have a watery envelope^ and not a covering of mucus or other fluid; and on opening the trachea they generally disappear like soap bubbles: it exists longest at the bifurcation of the trachea, and in win- ter may be found 8 or 10 days after death ; the nearer the mouth it is found the more conclusive it is. The proofs that death occurred before immersion are, no tumescence of the vessels of the brain ; no froth in the trachea ; no water of the same kind in the stomach ; marks of violence on the body ; and a collapsed state of the lungs. It being ascertained that immersion took place durino- life, we should next enquire whether it was the result of^acci- dent, of suicide, or of homicide. The locality may either prove that the individual fell in accidentally, or preclude the supposition. Indications of struggling, and many footsteps on the bank, excoriation of the ends of the fingers and sand under the nails may lead to the supposition of homicide If it be suicide, ligatures about the person will probably be In death by drowning it is of importance to the survivors to know when it occurred. The following are the best signs of the period when death took place: No change takes place in the exterior of the body before the fourth or fifth day, and frequently not so soon. At that time the skin in the palms of the hands begins to whiten, particularly the ball of the thumb, the fleshy parts of the palms and the late- ral parts of the fingers. On the sixth or eighth day the skin on the back of the hand begins to whiten, at the same time mat or the sole of the foot has acquired a similar tinge The skm of the face is softened and of a more faded white than the rest of the body. On the fifteenth day the face is slight ly swollen and red; a greenish spot begins to form on the sternum : the skm in the hands and the sole of the feet pv cept the top of the feet is white, and the skin of the hand is wrinkled. The subcutaneous cellular tissue of the thorax FORENSIC MEDICINE. 15 is reddish, and the exterior of the cerebral mass, in the upper part of the organ, becomes green. A most remarkable fact, and one that establishes a striking difference between the progress of putrefaction under water and when the body is exposed to the air, is that in the im- mersed body the skin in the middle of the abdomen, as well as that of the arms, forearms, thighs and legs is the last to putrify, but ihefirst in the air. In hanging, death is not generally by apoplexy, but most- ly by asphyxia, for if the trachea be opened below the rope, death does not often take place. In the case of hanging, two questions present themselves to the medico legal inquirer: 1. Was the suspension before or after death? And 2. Was it an act of homicide, suicide or accident 1 The evidences of suspension before death, are lividity and distortion of face; protrusion of the eyes; the mark of the cord around the neck forming a livid depressed circle, the centre of which to the width of the ligature, resembles dark colored parchment, and the livid color is confined to the bor- der on each side; the fingers are bent; nails blue; hands nearly closed ; swelling of the chest, shoulders and arms, and sometimes ecchymosis of these parts; penis semi-erect, and emission of semen. An exception is sometimes found in the color of the face : it is pale when death has been very early and from compression of the spinal marrow. The second inquiry, or whether it is suicide or homicide, may be resolved by ascertaining—if the death has been by strangulation—that the track of the cord is low down and passes horizontally around the neck, while another and faint- er impression (made by the subsequent suspension) exists at the upper part, taking an oblique course; and if the dress is torn it corroborates the suspicion of its being homicide. Strangulation differs from hanging in no suspension having taken place. In strangulation the rope mark is lower down and horizontal, whereas in hanging it is oblique. When the strangulation has been manual, instead of the circular mark around the neck, there are irregular livid patches correspond- ing to the fingers. Smothering, leaves no sign by which it can be well diag- nosed from asphyxia produced by other causes. For death from the inhalation of noxious gases, poisons and wounds, see Toxicology, and wounds, death from. Burning. Upon finding a dead body sufficiently burned to have occasioned death, the first inquiry is, whether the 16 FORENSIC MEDICINE. body was burned before or after dea th. 2. Whether the com- bustion was ordinary or spontaneous. Around a burn, inflicted before death, there is a blush of redness of considerable exient removable by pressure, disap- pearing in no long time, and not permanent after death. There is also a narrow line of deep redness separated from the burned part by a stripe of dead whiteness, bounded to- ward the white stripe by an abrupt line of demarcation, los- ing itself gradually in the redness, but unlike it, not remova- ble by pressure. Blisters are generally, but not always, found, but when they do exist they are filled with serum. The only effects then of burns which appear immediately after the in- jury and remain in the dead body are, 1. A narrow line of redness near the burn not removable by pressure; and 2. Blisters filled with serum: the former is an invariable effect: but the latter is not always observable when death follows the burn in a few minutes. Blisters are also formed by burn- ing after death, but they are always filled with air, and none of the other diagnostic signs of burning before death are pre- sent. Was the burning spontaneous or ordinary combustion ? The greatest number of the victims of spontaneous combus- tion are females, and in every case they have used ardent spirits intemperately. A remarkable characteristic of this species of combustion is, that water will not extinguish the flame; and another peculiarity is, that inflammable bodies in contact with the burning body are not ignited. The trunk of the body always suffers most, the head and extremities being seldom consumed. The combustion is more rapid than is the consumption of the body at the stake or on the pile. There is no authentic account of spontaneous combustion of the living human body ever having occurred. The cases considered as such are merely preternatural combustibility of the body. In all the cases on record some ignited sub- stance has been in contact with the body. In almost all the cases the subjects have been for a long time intemperate. Nevertheless the alkoholic impregnation does not appear to be a mere imbibition of spirituous fluid by the tissues, (for this does not in any great degree increase the combustibility of flesh) but some general change produced in them, to in- flame from the mere contact with an ignited body. If the subject of combustion has been a female advanced in years, and of intemperate habits: when the destruction has been rapidly effected, and nothing remains unconsumed FORENSIC MEDICINE. 17 but portions of the head and extremities ; when the room is filled with an offensive empvreumalic odour, and a moist and foetid sooty matter is deposited upon the ashes which remain, and upon the walls and furniture : These circum- stances, or the greater number of them occurring, remove all doubts respecting the preternatural combustibility of the body. On the other hand, when the combustibility is of the or- dinary kind, the combustion will generally be but partial, and not directed in preference to any particular part of the body. In such cases, also, it will be almost invariably found to have extended to adjacent combustible substances. Lastly, when designedly produced, there will be evi- dence of the consumption of a large quantity of fuel. Cold. Any thing that impairs the nervous energy, and consequently diminishes the power of generating heat, as narcotics, intoxication, predisposes to death by cold. In the case of persons found dead by cold, if the accident be re- cent, attempts may be made to restore life ; the gradual application of heat, and artificial respiration should be tried until the signs of returning life are quite apparent, then the mildest internal stimulants should be very cau- tiously administered. Starvation. Young persons sink under starvation sooner than the old. Men perish sooner than women : a person who is surrounded by damp air, or has access to water will survive longer than one deprived of them. Post mortem appearances of death by hunger. General emaciation of the body together with an acrid foetid odour; eyes open and red ; tongue and throat dry ; intestinal canal empty and inflamed ; the blood thick and coagulated if no water has been used ; otherwise there is neither inflamma- tion nor coagulation of blood : gall bladder filled with bile, which by exudation tinges the neighboring organs; lungs shrivelled ; organs healthy. Lightning. When a person is stricken by lightning, Brodies' experiments prove that instantaneous extinction of vitality does not take place j but on the contrary the functions of the brain are those on which the electric shock exercises its principal influence—neither the irritability of the muscular system at large, nor that of the heart is pri- marily destroyed, but death takes place from a seveie in- jury of the brain, and destruction of the functions. The surface of the body is sometimes vesicated, especially along the spine ; the clothes are mostly torn ; buttons and coins 18 FORENSIC MEDICINE about the person are melted ; the limbs do not stiffen J and the blood is black and does not coagulate. MENTAL ALIENATION. The mind is that part of our being which thinks and wills, remembers and reasons. By means of the corporeal senses it holds intercourse with the things of the external world, and receives impressions from them. The brain is the organ of the mind. The mental faculties may be di- vided into intellectual and moral. The intellectual are memory, abstraction, imagination and reason or judgment. The moral are 1. The desires, the affections, and self love. 2. The will. 3. The moral principle or conscience, and 4. The moral relation of man to the Deity. We adopt Esquirol's arrangement, somewhat modified by Ray. The various forms of mental derangement de- pend upon very different conditions of the brain, and may be divided into two classes according to their dependence upon two distinct conditions of this organ. In the first class, there is deficient developement of the brain. In the 2d class, there is disease of its structure after full developement. In the 1st class we may arrange idiocy and imbecility, and mania and dementia may be arranged in the 2d class. Mania and Dementia are distinguished from each other, by the contrast they present in the energy and tone of their manifestations. Mania is characterized by an exal- tation of the faculties, and may be confined to the intel- lectual or moral powers, or it may involve them both, and these powers may be generally or partially deranged. De- mentia depends on a more or less complete enfeeblement of the faculties, and may be consecutive to injuries of the brain, to mania or to some other disease : or it may be con- nected with the decay of old age. FORENSIC MEDICINE. 19 Insanity. Defective de- velopement of the faculties. Idiocy. Imbecility 1. Resulting from conge- nial defect. 2. Resulting from an ob- stacle to the develope- ment of the faculties su- pervening in infancy. 1. Resultig from congeni- tal defect. 2. Resulting from an ob- stacle to the develope- ment of the faculties su- pervening in infancy. Lesion of the faculties subsequent to their devel- opement. Mania. Dementia. Intellectual. Affective or moral. 1, General. 2. Partial. 1. General. 2. Partial. 1. Consecutive to mania or injuries of the brain. 2. Senile, peculiar to old age.________________ Idiocy consists in a destitution more or less complete, of the reflective and moral faculties ; the grades are various, ascending from the character of the brute to that of the manifestation of some of the higher moral powers. The physical characters of congenital and incurable idiocy are very striking. Gall says the circumference of the head of the adult idiot, over the orbitar arch and most pro- minent part of the occiput, is from 13j to 14£ inches. Containing a brain not larger than an infant at birth, or only i, -}, or £ of the cerebral mass of the adult who is pos- sessed of a full share of mental powers. The anterior su- perior part of the head is very diminutive, except in hy- drocephalic cases, when it is very large in consequence of the water within. The forehead is low, angular and re- treating. The features irregular: eyes unsteady and squinting, lips thick, mouth open and slavering, defective 20 FORENSIC MEDICINE. teeth and spongy gums. Limbs crooked, feeble and limit- ed in their motion. External senses imperfect or absent, particularly audition : speech, vision, taste and smell are very deficient. Locomotion is deficient ot lost, and the power of grasping or holding is very weak or wanting. DISEASES THAT GENERALLY ACCOMPANY IDIOCY. Rickets, epilepsy, scrofula, paralysis, and a depraved or defective constitution. In the degree of idiocy now de- scribed, life is rarely prolonged beyond the 25th year. In Idiocy of less degree, however, some one or more of the intellectual faculties—never the reflective—are more or less perfectly manifested. Among the powers possess- ed by such, are self-esteem, love of approbation, religious veneration, and benevolence. Instances of which are given by Rush, Combe, and Gall. The several propensities, cunning, and destructiveness, are sometimes inordinately active in the cases of the less degree of idiocy. The cretenism of Alpine regions affords the best oppor- tunities to study idiocy in all its grades, as it is there en- demic. Its various degrees are divided into three classes. 1. Simple cretenism. In this life is merely automatic, the senses are wanting or extremely dull, and the attention is only aroused by the most urgent calls of nature. 2. Semicretenism. These notice what passes around them, remember simple events, and express their wants by lan- guage. They have no idea of numbers; they may, like parrots, be taught to repeat, but not to understand, certain passages. 3. Cretenism in the third degree. These have a strong memory of events, learn reading and writing, yet cannot be made to understand their use.—Music, drawing, painting, and some of the mechanic arts are learned in some degree by a few of them, but they are exceptions, and should teach us not to decide that the whole mind is sound, because one or two of its faculties are manifested in some degree of perfection. Imbecility. In this, unlike idiocy, there is some mani- festation of the reflective faculties, as well as of the percep- tive and moral powers: but the reflective faculties are manifested in a much less degree than is common among persons of similar rank and opportunities. Great activity of the animal propensities is generally evinced. They possess memory, have the power of forming a few simple ideas and of expressing them by words, and have some FORENSIC MEDICINE. 21 idea of the conveniences and properties of life. They ac- quire the ability to read, write, count, understand music, and their moral and intellectual powers exhibit a great va- riety of shades. They have the same tendency to the same physical imperfections, and diseases to which idiots are subject, though they have them in less degree. Georget says that the imbecile, sometimes steal adroitly, and hence are erroneously considered very intelligent—they repeat the offence as soon as released from confinement, and are then thought to be obstinately perverse—they are violent and passionate, and the slightest motive is sufficient to plunge them into deeds of incendiarism or murder; and those of strong sexual propensities soon become guilty of outrages on female chastity. The propriety of this cau- tion is manifested in the cases of Miss Baxter, 1st Beck 589. Portsmouth vs. Portsmouth, 1st Beck, 590. And In- graham vs. Wyatt, 1st Beck, 563. To form a proper estimate of the degree of mental im- pairment in the imbecile, it is necessary to scrutinize not only one act or trait of character alone, but every intellec- tual manifestation as it appears in the whole conduct, con- versation and manners. LEGAL CONSEQUENCES OF MENTAL DEFICIENCY. Every sane human being is endowed with a mental con- stitution that adapts it to the world on which it acts, and by which it is acted upon ; and the principle upon which all legal responsibility is founded, is on the completeness of this adaptation, or the existence of the elements of which this state of adaptation is composed. Thus, if any of the elements be wanting, the legal responsibility is lessened to the extent of this deficiency. The intellect must not only be sufficiently developed to acquaint the individual with the existence of external objects, (which is the province of the perceptive faculties,) but with some of their relations to himself—which requires the existence and exercise of the reflective faculties ; but the several powers of the men- tal constitution must be sound enough, and sufficiently strong to furnish, each its specific incentives to pursue that course of conduct, which the intellect has already ap- proved. In the sane mind the idea of crime is associated with injury and wrong: but in the insane there is no con- sciousness of wrong or intention of injury, but mere per- 22 FORENSIC MEDICINE. sonal gratification, in taking the life of a human being, precisely as if it were an ox that was slain. The insane has only a selfish object in view, and pos- sesses not the restraining influence, of a moral nature, of the sound mind, such as the natural right of every one to the undisturbed possession of his own life, and the injus- tice of depriving him of it. And as the existence of the Deity is unknown to him, his duties and accountability to Him cannot restrain him. The law looks to the intention and not to the amount of injury commitlted. These views are well illustrated in the cases of Schmidts, Ray 101. Piere Joseph Delepine 104. Abraham Prescott 1st Beck 623. John Barclay, Ray 117. and Louis Lecouffee 118. The following example will show that imbecility does not consist only in defect of intellectual power, or the fa- culties of reflection and perception, but also a deficiency of the moral powers to a great extent may constitute it when the intellectual are scarcely sensibly affected. E. S.Ray 123. Dr. Rush says that he was consulted in three cases of this kind, and observes there is, in these cases, probably an original defective organization in those parts of the brain which are occupied by the moral faculties. In relation to testamentary dispositions, they depend on a single arrangement, and one which the testator may have taken time to think on and mature; they do not re- quire the same degree of intelligence as the administration of property, the contracting of marriage, &c. Therefore, if the imbecile has the capability of comprehending the nature and effect of a will, a will made by him will be de- clared valid if there be nothing on its face showing impro* per influence, &c. In relation to marriage a less degree of imbecility will invalidate the contract, as here the pe- cuniary interests and whole future comfort and happiness are involved ; but even here if the imbecility is apparent, the other party cannot avail himself of it, yet upon proof of fraud or circumvention the courts will pronounce it null and void. Portsmouth vs. Portsmouth, 1 Beck 590, and Miss Bagster. Mania is a pathological state of the brain, and in its va- rious grades and forms it observes the same laws as dis- eases of other organs. The manifestation of the men- tal powers being one of the functions of the brain, every departure from the healthy state of the organ—from ir- ritation up to inflammation—deranges its functions as it does those of all other organs; and this will be the FORENSIC MEDICINE. 23 case whether the brain is primarily or sympathetically affected. When the diseased state amounts only to ir- ritation, post mortem inspection will not reveal it, but when it reaches inflammation, or even congestion, it will be apparent on dissection. Therefore, it is not a legiti- mate inference, that, because dissection does not reveal structural lesion, disease of the parts has not existed. Ir- ritation of the brain is then the first link in the chain, con- gestion the second, and inflammation or disorganization the third and last. Cerebral irritation sufficient to produce insanity may exist for years before disorganization takes place, and the patient may die of other disease while irritation of this or- gan lasts : but when death is occasioned by the insanity we will always find lesions of structure. Mania is mani- fested by a well marked change of character, or a depar- ture from the ordinary habits of thinking, feeling and act- ing without any adequate external cause. To ascertain when an individual is insane, we must compare what he is with what he was ; compare him with himself when sane, and not with other sane persons. But striking peculiari- ties of character, amounting to eccentricities, though strong proof of predisposition to mania, are far from constituting trlP (llS6HSC In investigating the nature of insanity, the first caution to be observed is not to confound disorders of mental func- tions with natural qualities which sometimes strongly re- semble them. Many men, in the full enjoyment of health, are remarkable for peculiarities and idiosyncrasies of thought and feeling, which contrast strongly with the general tone and usages of society : but they are not on that account to be held insane : because the singularity for which they are distinguished is with them a natural quality, and not the product of disease : and, from the very unhkeness of their mainfestations to the modes of feeling and acting of other men, such'persons are in common language, said to be eccentric. It is true that, on the principle already explained of excess in size of some organs over the rest, being favorable to the production of insanity, eccentricity involves, all other things being equal, a greater than usual susceptibility to mental derangement: but still it is not mere strangeness of conduct, or singularity of mind which constitutes its presence. It is the prolonged departure, without an adequate external cause, from the state of feel- ing and modes of thinking usual to the individual, when 21 FORENSIC MEDICINE. in health, that is the true feature of disorder in mind; and the degree at which this disorder ought to be held as constituting insanity, is a question of another kind, in which we can scarcely hope for unanimity of sentiment and opinion. Let the disorder, however, be ascertained to be morbid in its nature, and the chief point is secured, viz: a firm basis for an accurate diagnosis : because it is impos- sible that such derangement can occur unless in conse- quence of, or in connexion with, a morbid condition of the organ of mind : and that the abstract mental states, which are justly held to indicate lunacy in one, may, in another, speaking relatively to health, be the strongest proofs of perfect soundness of mind. A brusque, rough manner, which is natural to one person, indicates nothing but men- tal health in him: but in another individual, who has al- ways been remarkable for a defferential deportment, and habitual politeness, lays these qualities aside, and without provocation or other adequate cause, assumes the unpolish- ed forwardness of the former, we may justly infer, that his inmd is already deranged, or on the point of becoming so. yr, it a person who has been noted all his life, for pru- dence, steadiness, regularity and sobriety, suddenly be- comes, without any adequate change in his external situa- tion, rash, unsettled, and dissipated in his habits, or vice versa, every one recognizes at once these changes, accom- panied as they then are by bodily symptoms, as evidences pf the presence of disease affecting the mind, through the instrumentality of its organs. It is therefore, I repeat not the abstract act or feeling which constitutes a symptom- it %s the departure from the natural and healthy character temper and habits, that gives it this meaning: and in judging of a man's sanity, it is consequently as essential to know what his habitual manifestations were, as what his present symptoms are. For our purpose the mental faculties may be divided into intellectual and moral. The former are those mental Dowers that acquaint us with the existence and qualities of external objects, and the relation of cause and effect, and conduct to the knowledge of general truths. The latter are the sentiments, propensities and passions necessary to man as a social and accountable being. farSf maiy aff6Ct ^ rho,e of the intellectual or moral faculties singly or conjointly : hence we have two classes of MimfW 2: General Inte,,ectual Mania, and 2. General Moral Mama. It may affect some one o more of ciSer the FORENSIC MEDICINE. 25 intellectual or moral faculties, which will furnish us with two sub-divisions: I. Intellectual monomania, and 2. Moral monomania. Intellectual Mania is characterized by certain hallucina- tions, in which the patient believes in the reality of facts or events that do not exist, and acts accordingly : or having adopted some notion not altogether unfounded, carries it to an absurd and extravagant length. Maniacal hallucinations are made up of simple hallucina- tions and illusive sensations—the difference between the two is, that in illusion of the senses, the morbid activity of the perceptive faculties—which is a common element in the pro- duction of both—requires to be excited by outward impres- sions ; while in simple hallucinations the excitement is pro- duced by the recollection of past impressions ; but to consti- tute them maniacal hallucinations, the reflective faculties, or reason, must be so diseased as to believe in their reality, and not to think them errors of perception. General Intellectual Mania, is the impairment of one or more of the faculties of the mind, accompanied with, or in- ducing a defect in the comparing faculty or reason—and in- volving all or most of the faculties of the understanding. The affective or moral faculties are always more or less in- volved. Intellectual Monomania. In this the patient imbibes some single notion, or train of ideas, contradictory to com- mon sense and to his own experience, and which seems, and no doubt really is, dependent on errors of sensation. Al- though the perceptive faculties may be affected, the disease does not exist, unless the reflective powers are also deranged more or less in relation to one or more of the operations of the understanding, being in general, confined to one or two sub- jects and their connections. In the simplest forms the un- derstanding is perfectly sound on all subjects but those con- nected with the hallucination, and indeed the individual may reason acutely on all other subjects. Sometimes the opera- tions of the understanding, even on subjects connected with the insane belief, are not impaired in any appreciable degree. But Georget says when the disorder involves a longer train of morbid ideas though the patient may reason on many sub- jects unconnected with the particular illusion on which the insanity turns, the reflective faculties are more extensively deranged than is generally suspected. It is best detected by observing the individual in the domestic circle. Moral Mania consists in a perversion of the natural fecl- 4 26 FORENSIC MEDICINE ings, affections, inclinations, tempers, habits and moral dis- positions, without any notable lesion of the intellect or know- ing and reasoning faculty, and particularly without any ma- niacal hallucination. It may be divided into general or par- tial. General Moral Mania exists when the whole of the mo- ral powers present a scene of chaotic disturbance. Pritchard says there are many individuals living at large, and not en- tirely separated from society, who are affected in a certain de- gree by this modification of insanity. They are reputed per- sons of singular, wayward and eccentric character. An at- tentive observer may recognize something remarkable in their manner of existence, which induces him to entertain doubts of their entire sanity, and circumstances are some- times discovered on inquiry which assist in determining his opinion. In many instances it is found that there is a here- ditary tendency to madness in the family, or that several rela- tives of the person affected have labored under diseases of the brain. The individual himself is discovered in a former peri- od of life to have sustained an attack of madness, of a decid- ed character. His temper and dispositions are found on in- quiry to have undergone a change : to be what they were not previously to a certain time: he has become an altered man ; and this difference has perlraps been noted from the period when he sustained some reverse of fortune, which deeply af- fected him, or since the loss of some beloved relative. In other instances the alteration in his character has ensued im- mediately on some severe shock which his bodily constitu- tion has undergone. This has either been a disorder affect- ing ihe head, a slight attack of paralysis, a fit of epilepsy, or some fever or inflammatory disorder, which has produced a perceptible change in the habitual state of the constitution. In some cases the alteration in temper and habits has been gradual and imperceptible, and it seems only to have consist- ed in an exaltation or increase of peculiarities which weie always more or less natural or habitual. Individals, labor- ing under this disorder, are capable of reasoning, or support- ing an argument, on any subject within their sphere of know- ledge, that may be presented to them, and they often display great ingenuity in giving reasons for their eccentric conduct, and in accounting for and justifying the state of moral feel- ing, under which they appear to exist. In one sense indeed. their intellectual faculties may be termed unsound, but it is the same sense in which persons under the influence of strong passions may be generally said to have their judgment FORENSIC MEDICINE. 27 warped, and the sane or healthy exercise of their understand- ings impeded. They think and act under the influence of strongly excited feelings, and a person sane is under such cir- cumstances proverbially liable to error both in judgment and conduct. Moral mania has a great tendency to pass into in- tellectual mania, which we have seen is no less strongly cha- racterised by moral perversities than by hallucinations : and Esquirol and Georget actually describe it as belonging to the initiatory stage or incubation of intellectual mania. Hein- roth, Hoffbauer, and Pinel, recognise this form of mania.— See the case of Earl Perrers, 1 Beck 600, and Metzer, Ray 177. One of the most common features of moral mania is a great perversion of the social affections, and particularly those of the domestic relation, which is well illustrated in the case of Frederick William of Prussia. Ray 183. Partial moral mania, or moral monomania consists in a perversion of only one or two of the moral powers, the rest of the moral and intellectual constitution preserving its ordinary integrity. The moral monomaniac often manifests a propen- sity to steal. This propensity sometimes appears to have its origin in certain physiological changes in the body. Gall speaks of four examples of women when pregnant, being violently impelled to steal, though perfectly upright at other times. An inordinate propensity to lying is also no uncom- mon occurrence where the morals in other respects are irre- proachable, and in cases where it cannot be traced to faults of education, evil example or innate depravity. Morbid ac- tivity of the sexual propensity is frequently an accompani- ment of this form of mania, and is called erotic mania ; seve- ral cases of which are related by Gall and Pinel. The hor- rible propensity of destructiveness is often met with, and is usually called homicidal insanity. A morbid propensity to incendiarism frequently manifests itself in this variety of in- sanity. In most cases where the propensity to destructive- ness exists, some physical or moral disorder may be detected, many cases of which are related by Gall. A remarkable modification of the propensity to destructiveness sometimes occurs in females and appears to be produced by parturition, mensturalion and lactation, and they often select their own offspring as their victims. Again, we meet with cases when the propensity to destroy is excited by moral influences act- ing as a peculiar physical predisposition, and followed by some physical disturbance. It is preceded, for some time by despondency and depression of spirits. Sometimes the moral homicide will urge a motive for the act, which is entirely ra- 28 FORENSIC MEDICINE. tional and well founded, but totally inadequate to lead,a sane mind to the perpetration of it. Sometimes the destructive propensity is excited by that perversion of the religious senti- ments, called religious fanaticism ; of which Pinel gives a very interesting case. It is sometimes, indeed frequently, excited by the apprehension of coming to want. In all these cases of homicidal insanity, an irresistible, motiveless impulse to destroy is manifested. CONTRAST BETWEEN THE CRIMINAL AND MONO- MANIACAL SUICIDE. The criminal homicide is actuated by a motive of interest or of resentment adequate to the purpose., and the act isofleo accompanied by some other crime—he either denies or con- fesses liis guilt—if the latter, he begs for mercy, or glories in his crime; if the former, curses his judges and protests against the justice of his sentence. He never sheds more blood than is necessary, in his opinion, for the accomplishment of his pur- pose. He deliberates, devises plans for the execution of his criminal intention—selects the appropriate time, place, and weapons to facilitate the act, and uses every means to elude discovery. He frequently has accomplices, and always vi- cious associates, and his history, if closely scrutinized, will be j,n perfect correspondence with the nature of his crime. In the monomaniacal homicide, the act of destruction is often preceded by manifest physical disorder and mental de- pression ; the murder appears the only thing in view, and is rarely accompanied by any other improper act. He testifies neither remorse, nor repentance, nor satisfaction, and frequent- ly acknowledges the justice of his sentence. He sheds more blood than is necessary for the attainment of the object of the criminal homicide. He neither provides suitable weapons, selects secret places, nor appropriate times, but strikes his vic- tim in the presence of spectators, and generally voluntarily surrenders himself to the constituted authorities. The few that fly, and persist in denying the act, always give some strong indication of insanity. In the rare cases, where they prepare the means deliberately, and select appropriate opportunities, still they make no attempt to conceal ihe mur- der. They never have accomplices, nor are their associates vicious ; and their previous character affords a striking con- trast to the destructive act. and offers some remakable pecu- liarities of conduct or character. Their v.ictims.arc generally ihek own family or their best friends. FORENSIC MEDICINE. 29 The destructive propensity seems often to be called into ac- tion by the presence of murderous weapons, suitable opportu- nities, disgust or some imaginary evil. LEGAL CONSEQUENCES OF MANIA. The elements of moral responsibility are, the original ca- pacity, the healthy action, and the cultivation of the moral and intellectual faculties. The measure of moral responsi- bility being in proportion to the degree in which the moral and intellectual faculties are possessed. Of all the elements of the mental constitution which renders man legally accountable as a moral being, and the absence of which annuls his responsibility, the law only allows decid- ed non-developement of brain, or disease after developement. kEGAL CONSEQUENCES OF INTELLECTUAL MANIA^ General intellectual mania annuls all responsibility : while intellectual monomania only renders the subject of it irrespon- sible for acts coming within the sphere of the faculties diseas- ed. To render a marriage contract valid, it is not sufficient that the party is able to go through the marriage ceremony with propriety, as decided in the case 4, Pickering's Reports 32, and amply proved by John Nichol in the case of Brown- ing vs. Reed, 2 Phillimore's Eccles. Reports 69, and in the case of Turner vs. Meyers, 1 Haggard Con. Rep. 414. The intellectual monomaniac should be left in the posses- sion of all civil rights that he is clearly capable of exercising, and no duties should be exacted of him involving the inter- ests of others, and which may equally well be discharged by others. These views are sanctioned by many distinguished physicians and jurists, says Ray. Hoffbauer supports them to the fullest extent. Esquirol sanctions them. Georget ad- mits them in application to civil cases. And Paris and Fon- blanque have explicitly recognised their correctness. Evans in his translation of Pothier on obligations, expresses an opin- ion on the subject no less positive and precise, though they are not yet as distinctly received in courts as could be wished. In relation to testamentary dispositions, Sir John Nichol says, in the case of Dew vs. Clarke, 3 Adams' Report, 79 : " if the will is the direct unqualified offspring of the morbid delusion concerning the person who is disinherited, it should be pronounced null and void in law." Ray 242. And the same principle is iaid down in the case of Johnson vs. ;\Ior- 30 FORENSIC MEDICINE. lis' heirs, 1 Littel's Repoits 371, and Esquirol relates a simi- lar case. Criminal, like civil acts, should be annulled only when the act comes within the range of the diseased operations of the mind : for the connection of the morbid delusion with the criminal act is generally very direct and not easily mis- taken. If the connection be indirect, or remote, it ought to excite suspicion. Under Hale's decisions monomania has seldom been considered, by itself, sufficient to annul respon- sibility for crime, unless the principal delusion was of a re- ligious character. But the practice of the American courts has been guided by more liberal doctrines, as is seen in the case of Lawrence at Washington in 1836, in which the court said, that a person is not responsible for whatever criminal act is committed under the influence of delusion. See also the case of Theodore Wilson, tried in Maine, Ray 257. The same principle had been previously recognised in England by Lord Kenyan in the case of Hadfield. Collison on Lu- nacy, 1, 488. LEGAL CONSEQUENCES OF MORAL MANIA. Nature has established a certain adaptation of the moral and intellectual faculties to each other, and one cannot be deranged without disturbing, in some degree, the other. Therefore, general moral mania furnishes good ground for invalidating civil acts. Culpability supposes, not only a clear perception of the consequences of criminal acts, but the liberty, unembarrassed by disease of the active powers which nature has given us, of pursuing that course which is the result of the free choice of the intellectual faculties. In the healthy state of the faculties the power of perceiving the good and the evil, is associated with the ability of ob- taining the one and avoiding the other. An opposite con- dition should always annul responsibility or confer immu- nity. In all cases of the shadow of a doubt the trial should be postponed, for insanity is sometimes so completely veiled from observation, as never to be suspected by the most inti- mate associates of the patient. In the case of Brelet, related by Georget, the existence of insanity, though of several years duration, was not recognized until after the death of the subject.—Ray 271. The presence of mental alienation should be admitted in him who commits a homicide without positive interest. FORENSIC MEDICINE. 31 without criminal motives, and without a reasonable passion. Moral Monomania completely annuls all moral respon- sibility for acts committed under its influence. Yet these unfortunate beings should be placed where they cannot re- peat the act, and can have judicious medical treatment* DEMENTIA, Dementia is characterised by an enfeeblement of the moral and intellectual faculties, which were originally sound and well developed, and is produced by old age and disease. Symptoms. The most characteristic symptoms are for- getfulness of the past, indifference to the future, and child- ishness of disposition. Idiocy and imbecility differ from dementia in being con- genital, or nearly so, and they consist of a destitution of powers never possessed, and are incurable. The whole con- dition of dementia displays the existence, not of physical imperfection, but of physical weakness (many of the bodily powers being enfeebled also) and consequently it may be fre- quently relieved if not cured. - Dementia is distinguished from mania by the latter arising from an exaltation of vital action, and a corresponding in- crease of force and rapidity in the cerebral functions. In dementia the moral habits and natural feelings, so far as they are manifested at all—unlike mania—lose none of their ordinary character. The temper may be more irritable, but the moral disposition evinces none of that perversity which characterises mania. Dementia is not only a decay of mental power, but a pathological state of the brain ; the mind is not only feeble but deranged. The earliest symp- toms of its approach is aforgetfulnessof recent events, while a distinct recollection of former occurrences exists. Next, the patient forgets the intermediate ideas,—the connection between these he does remember, and that order and relation of them necessary to sound reasoning is destroyed. Coincident with this state, an inability occurs to. discern the qualities of form, size, weight and color, which is rather a defect of the internal perceptive organs than the external senses, which may be unimpaired, so that sound, light, touch, &c 1 LEGITIMACY OF OFFSPRING. Impossibility of access by the husband during the period in which the child may have been begotten will bastardize the child. But if there be a possibility of access, although the husband and wife both swear to its not having taken place, the law considers the child legitimate according to the decision of Lord Hale, in Lomax vs. Holmden, confirmed by Lord Ellenborough in 1807, and previously by Sir William Wynne in the case of Newport. But in 1813 Lord Ellenbo- rough seems to have reversed his case, "there is no proof of physical impossibility of Lord Banbury being the father. But in the absence of such evidence the question may be de- cided on the ground of a moral impossibility, which the con- duct of the parties in this case establishes." And in this opinion he was sustained by the House of Lords. It appears then that the law formerly stood thus : Presumption of legitimacy may be rebutted by physical evidence proving the contrary. And that since the Banbury peerage case it stands thus. Presumption of legitimacy may be rebutted by physical evidence proving, or by moral evidence rendering probable the contrary. Thus under the Banbury peerage case, Phillips says the jury may not only take into consideration proofs tending to shew the physical impossibility of (he child in wedlock be- ing legitimate: but they may decide the question of paterni- ty by attending to the relative situation of the parties, their habits of life, the evidence of conduct, and of declarations connected with conduct, and to every inducement which rea- son suggests for determining upon the probabilities of the case. The facts to be investigated in reference to questions of legitimacy, are 3. 1. The natural period of gestation in wo- men. 2. Premature births. And 3. The possibility of pro- tracted gestation. Period of Gestation. The natural period of gestation is nine calendar, or ten lunar months, two hundred and eighty days, or forty weeks. And this is the natural period recog- nized in law, as acknowledged by Lord Coke upon Little- ton 123. Premature Births. There are two distinct points of view under which we must consider this subject. We must inquire, first, what is the earliest period of gestation at which the condition of viability may be expected to exist: 62 FORENSIC MEDICINE. and secondly, what are the evidences of the maturity of a child. In relation to the first inquiry, it is admitted that the via- bility of the child exists at the completion of the seventh month of utero gestation, it sometimes occurs at six months, and Dr. Francis has furnished a case of a child born at five months and three weeks, which was alive and well at seven years: but seven months is the commonly received period with medical Jurists. In relation to the second inquiry it is ascertained that the following are the evidences of maturity mostly to be relied on. Hair covering the head ; solidity of the cranial bones and their close approximation along the sutures; nails firm and reaching to the extremities of the fingers; full develope- ment of the lower extremities ; the centre of the line, from the summit of the head to the heel, falling at the umbilicus or a little above ; sucking readily and eagerly ; and the length being from nineteen to twenty-one inches. For greater mi- nuteness see Infanticide. It must not be forgotten that some women always antici- pate, by a month or two, the natural period of gestation, going only seven or eight months ; and although these children may be viable, they never furnish as complete signs of matu- rity as a nine months' child. Protracted Gestation. Gestation protracted beyond the natural period has analogy as well as direct and absolute evi- dence in its favor. A mare, whose term of gestation is eleven months, if covered by a Jack will go eleven months—but an ass, whose term is only ten months, if covered by a horse will go eleven months with foal. There is a difference of one- tenth in the hatching of a clutch of eggs laid and hatched by the same hen. The result of Earl Spenser's observations for many years, communicated to the English Agricultural Socie- ty, is the following : it consists of observations made on seven hundred and sixty-four cases in cows, whose term of gestation is considered about the same as that of women, that is two hundred and eighty days ; but the Earl's cases would appear to establish two hundred and eighty-four or two hundred and eighty-five days as the period of gestation in the cow. The shortest period of gestation in a cow when a live calf was pro- duced was two hundred and thirty days, and the longest three hundred and thirteen days ; but no calf proved viable that was produced at an earlier period than two hundred and for- ty-two days. Any calf produced at an earlier period than two hundred and sixty days he considers premature, and any pe- FORENSIC MEDICINE. 63 riod of gestation beyond three hundred days must be consid- ered irregular, of which he gives seven cases. Of the cases that did not exceeed two hundred and eighty-six days there were of males two hundred and thirty-four, and of females two hundred and thirty three ; but of those that exceeded two hundred and eighty-six days there were of males one hun- dred and fifty two, and of females only ninety. In the whole number of calves, viz. seven hundred and eighty-seven, there were of free martins 11. It would therefore appear, that in the case of protracted gestation in the cow, the probability of the calf being a male is as one hundied and fifty-two to ninety, or as seven and a half to forty-two and a half. Tessier's experiments, conducted with great care through a period of 40 years, on cows, sows, and sheep, confirm those of Earl Spenser as regards protracted gestation. The highest authorities in the medical profession concur in the belief that gestation in women may be protracted from three to four weeks beyond two hundred and eighty days. And the laws of different countries recognize the possibility of protracted gestation. Thus the Code Napoleon extends ges- tation to three hundred days, within which time legitimacy shall not even be legally questioned, and a child born after three hundred days, is not declared illegitimate, though its legitimacy may be questioned at law. The Prussian law ex- tends it to three hundred and two days. And although the English law assigns no precise limits, their decisions are in favor of protracted gestation. Some of them have extended the term to three weeks beyond two hundred and eighty days. Such was the decision in the case of Aslop vs. Stacy and also in that of Foster vs. Cooke. I Burrow's Chancery Cases 349, and more recently by the House of Lords in the Gardiner peerage case, when judgment was pronounced by their chan- cellor Lord Eldon, Le Marchant's reports 335. The Scotch law says a child born after the tenth month is a bastard, and it would appear by the following decision that calendar and not lunar months are meant, viz: Lord Gillies, in the case of Sandy vs. Sandy in the court of Sessions, vol. 2, 406, says "that the lapse of nine calendar months and twenty-nine days, is not sufficient to overturn the presumption of the child's legitimacy. IMPOTENCE AND STERILITY. Impotence consists in the incapacity of sexual intercourse: and sterility consists in the inability of procreation, the 01 FORENSIC MEDICINE. power of copulation still existing. Impotence may exist in either sex, but is most common in the male : and ste- rility may be found in either sex, but is oftener met with in the female. There are three classes of causes of impotence and ste- rility. 1. Organic. 2. Functional. 3. Moral. 1. Of impotence and sterility in the male from organic causes. It may be occasioned 1. By deficiency of the or- gans of generation. 2. By malformation of these organs. And 3. By diseases of them or of neighboring parts. While ever the penis is longenongh to enter the vagina, and the urethra is in a state to conduct the semen into this canal, procreation is possible, and consequently impotence does not exist. Absence of the testicles by castration, ex- cept for a few hours after the operation, produces sterility. Congenital absence of the testicle is extremely rare, though their absence from the scrotum is often met with. When the testicles have been removed by castration, if not in very eatly life, we can see the cicatrix. In congenital absence we must rely on the history of the patient, and his general appearance, to ascertain whether they are really absent from the person or only from the scrotum. If the absence from the person be congenital, or if they have been removed in childhood, the character of the male is obliterated, and that of the female assumed. The activity and vigor, the well developed muscular sys- tem, the strong deep voice, the hair on the chin and the breast will always be absent. Yet Marc furnishes an ex- ception in the case of a man in Paris, who had all those marks of effeminacy, yet. was married and had many chil- dren. The retention of the testicles is supposed slightly to impair, but not to destroy the procreative power, upon the principle of physical imperfection, or deficient deve- lopement of the organ. Although the removal of the testicles destroys permanently the procreative power, it does not produce the total extinction of the desire, nor the power of copulation, as may be seen in the castrated horse, the ox, &c. And it is well known that eunuchs, who are castrated and have not the penis amputated, exercise the power of copulation. Monorchides are neither impotent nor sterile unless the testicle is very small and extenuated. In such a case, if a sufficient length of time has been pass- ed in unfruitful matrimony, such a developement must be considered a strong probability. Malformation of the male organs of generation, that FORENSIC MEDICINE. 65 confers impotence, does not so often consist in diminutive as excessive size. Genital organs, though originally deficient in size, even after puberty, are capable of considerable de- velopement, as in Wilson's example. Error loci of the urethra is the most common cause of impotence. It sometimes opens in the perineum; again it opens in the dorsum penis constituting epispadias, but most frequently in the under surface producing hypospadias. Yet with the aid of a syringe the man may make coitus fruitful, and although the law would probably decide this to be im- potence, it is questionable whether the decision would be just. Adhesion of the prepuce to the glans, so as near- ly to close the orifice of the urethra, may pioduce impo- tence. A malformation of the vessicula seminalis, or of the excretory ducts of the testicles may produce impotence, when either of them open into cul de sacs. Organic diseases may be divided into those affecting the penis and those affecting the testicles. Diseases of the penis, may arise from excess or defect of muscular power or nervous energy, the former inducing priapism, the latter paralysis. Priapism produces so vigo- rous an erection as to compress the urethra so that semen cannot pass along it. And defect of energy in the vessels, nerves or muscles qf the genital organs sometimes prevents the influx of blood to the corpora cavernosa in quantity, sufficient to produce erection, and constitutes a species of paralysis of motion, which is curable by local stimulants. Either of these states may produce impotence. Strictures in the urethra so great that the finest bougie can be passed with difficulty may produce impotence. The open- ing of the seminal ducts may be closed by scirrhus disease of the prostrate gland, neck of the bladder, veru monta- num, or the duct itself, all of which produce impotence. Diseases of both testicles, but it must pervade every part of them, for a small portion only of the gland remaining sound may be still capable of secreting semen in sufficient quantity for impregnation—thus scirrhus, cancer, scrofula, and atrophy may produce impotence. Disease of the neighboring parts, as great obesity, scrotal hernia, and hy- drocele may prevent venereal congress, and in rare cases they may obliterate the vessels by compression, all of which may produce impotence. Functional Causes. The procrentive power k confer- red at about fifteen, and continues in vigor to sixty or sixty- five years. Instances of prccocitv are on record by Ryan 9 66 FORENSIC MEDICINE. in which it existed at the fourth year, and one of its pro- traction, in the case of Parr, probably to one hundred and fifty years, and certainly to one hundred and twenty. Im- potence is produced by too great indulgence of libidinous desires, by masturbation, excessive use of ardent spirits, narcotics, excessive evacuations, strict and protracted chas- tity as in monastic institutions.—Injury of the cerebellum. Moral Causes. Strong and violent mental emotions, such as too ardent desire, fear of not being loved or appre- hension of incapability, shame, timidity, surprise, jealousy, hatred, disgust, any thing by which the mind is forcibly ar- rested. IMPOTENCE AND STERILITY IN THE FEMALE. Impotence in the female consists in a mal-formation which prevents copulation—it chiefly exists in the vagina, and consists of a partial or complete occlusion or contrac- tion of it. Sterility depends on mal-formation, absence, or functional derangement in the uterus, ovaria and Fallo- pian tubes, or disease of them, and is much more common than impotence. From what has been said in commenting upon the dif- ferent causes of impotence, we may deduce the following principles: 1. To declare either sex impotent, it is necessary that certain physical causes be permanent mal-formations and not accidental lesions, and be evident to our senses, which art cannot remove, and which present the faculty of exer- cising a fecundating coition. 3. Those causes when rigorously examined, are few in number. The moral causes of impotence ought not to be taken into consideration, as they would serve for an excuse for an individual accused of impotence. DOUBTFUL SEX, OR HERMAPHRODITES. Complete Hermaphrodism exists in vegetables but not in the human family : that is, no individual has ever existed in the human family, capable of both begetting and con- ceiving. The cases that have been mistaken for such, may be divided into four classes. 1. Mal-formations of the urinary and genital organs of the male. 2. Mal-forma- tions of the female generative organs. 3. Males with FORENSIC MEDICINE. 67 such a deficiency in their organs that they have not the character and general properties of the male, and may be called neuters. 4. Where there exists a real mixture of the organs of both sexes, but not so complete as to consti- tute the double organ. The penis of the male answers to the clitoris of the fe- male : the testes to the ovaria ; the scrotum to the labia; and the prostrate to the uterus : and the mal-formation of these parts is the cause of their being mistaken for each other; but no monster has been ever found having a penis and clitoris, a testis and ovarium on the same side, nor testes and ovaria, nor a prostrate gland and a uterus. The case of Rudolphi mentioned by Beck, would ap- pear to be an exception, but being solitary it wants addi- tional support. The English common law, which is binding in this country, is thus laid down by Blackstone and Coke. " A monster having deformity in any part of its body, yet if it have human shape, may inherit. And every heir is either a male or female, or an hermaphrodite, that is both male and female." SIGN'S OF PREGNANCY. There are involved in pregnancy, considered as a medi- co-legal question, fame, virtue, honor, succession of pro- perty, the rights of legitimacy, the judicious treatment of disease, and in criminal cases, the destruction and preser- vation of the unborn child. By the law of England, and the practice of the courts of this country, a criminal condemned to death, though preg- nant, cannot claim delay of execution unless she be quick with child. But in a recent decision in England, a diffe- rent signification is given to the phraseology " quick with child," in civil, to that given to it in criminal cases. By the decisions of the English courts prior to 1810, a child in utero could not inherit property left to it by will as alive at a certain time, nor could it be murdered, nor an execu- tion for murder be arrested, unless gestation has progressed so faras to quickening; but in the case of Hall vs. Han- cock, 15 Pickering 225, it was decided that a child, in civil cases, is considered as being alive from the time of its con- ception, or nine calendar months previous to its birth. And in the case of Regina vs. Wycherly, 8 Carrington and Payne's Reports, 262, decided by Baron Gurney, a new 08 FORENSIC MEDICINE. definition of the term is introduced by a slight alteration in the phraseology. The judge said, "quick with child, is when the child has quickened." In France if a woman prove herself to be pregnant the execution is delayed. Constitutional Signs. Suppression of the menses, irri- tability of the nervous system, erratic pains, partiularly of the face and teeth, oedema, peculiarity in the urine termed kisteine, and Kluges vaginal mark. Sympathetic Affections. Tingling pain in the breasts, areola, increased size and secretion of milk, irritability of stomach, capricious appetite, vomiting and salivation. Uterus. Increase of size so as to rise out of the pel- vis, the existence of a foetus ascertained by internal exami- nation, by ballottement. and auscultation, changes in the os and cervix uteri affecting their form and consistence. Suppression of the menses taken alone is a very equivo- cal sign of pregnancy. Supposed pregnancy before men- struation is not true. The error has occurred from the circumstance that some women discharge for the first two or three periods of menstruation a colorless fluid, which has all the properties of menstruous fluid, except its red color, which is the least important. But pregnancy may take place after an apparent cessation of the menses. A dis- charge resembling the menstruous fluid, and having all its essential properties, in rare instances continues throughout gestation, (but most frequently only during two or three months) and to the seventh month; but this is a vicarious discharge furnished by the vagina. The menses though secreted may be retained by occlusion of the vagina or uterus, accumulate and give rise to the suspicion of pregnancy. It is most frequently retained by an imperforate or scarcely pervious hymen. Kisteine exists in the urine from the first month of preg- nancy, and is considered an infallible sign of this state. When the urine stands from three to five days it become co- vered with an opaque, whitish, opalescent, granular pelli cle, somewhat, resembling what rises in soup when it has been allowed to cool. Something resembling this takes place in the urine of patients laboring under catarrh of the bladder, and phthisis pulmonalis, but there is this diffe- rence, it does not appear so soon after the urine is passed as the kisteine, continues longer, and is converted into mould ; whereas the kisteine, after continuing on the surface for FORENSIC MEDICINE. 60 some days, is evidently precipitated, and soon disapears al- together. Kluges vaginal mark,—this consists of a violet or bluish streak in the vagina extending from the os exter- num to the os uteri ; Parent-Duchatalet found it in each of 4500 cases which he examined. But others have not been able to detect it. Nausea and Vomiting early in the morning, and com- mencing in four to six weeks after the suppression of the menses, and unaccompanied by any other signs of bad health, the vomiting recurring daily until the period of quickening. It is generally moderate, but sometimes be- comes so inordinate as to endanger life by inanition. Salivation—this is sometimes as profuse as salivation by mercury, but is generally moderate, consisting only of an increased flow of saliva. Affections of the Mamma. In one or two months after impregnation there is an uneasy throbbing and fulness, ac- companied with tingling pains felt about the centre of the breasts, and in the nipples. The breasts grow sensibly larger, more firm, the rosy circle around the nipple be- comes altered in color and structure, constituting the areola, which occurs as early as the second month, and is accom- panied by a moist and soft state of the integuments, and sometimes a secretion from the glandular follicles sufficient to stain the woman's inner dress, as well as their enlarge- ment and prominence from the one-sixteenth to the one- eighth of an inch above the surrounding integuments, and in number not less than twelve to twenty. These ap- pearances are more to be relied on than even the areola. At all times in the virgin female breast, there is around the nipple a circle of a deeper rose tint than the surrounding parts, at the end of the second month of pregnancy this color becomes deeper, being tinged with a yellowish or brown- ish hue ; by the fourth month the color has become nearly mahogany in dark complexions, but not quite so dark in the fair; it now forms a circle around the nipple of from one to one and a half inches in diameter, increasing in size with pregnancy, sometimes to the extent of three inches. In the centre of this circle, the nipple is seen partaking more or less of this color, and has become turgid and pro- minent. The absence of the areola, and prominence of the glandular follicles is not a conclusive proof of the non- existence of pregnancy; but their presence, and the ma- hogany color of the areola are good evidence of this state. 70 FORENSIC MEDICINE. As the areola continues for sometime after abortion, we must be careful not to be imposed on by a woman in this state—- and the same caution is necessary in nursing women in whom it exists for a long time after delivery. We may be also greatly embarrassed in our decision by a woman who has been pregnant before, and is submitted to our inspec- tion in a second or subsequent pregnancy. Milk in the breasts is a sign not at all conclusive, for the sucking the virgin breast, even as young as eight years, by an infant, will produce a secretion of milk, and the milk in the breasts of nurses may continue for years after they have ceased to nurse, indeed it has been secreted in large quantities by the breasts of men, and the other symp- toms of pregnancy, up to this period, exist, it may be con- sidered a conclusive sign. Quickening, or the first motions of the child of which the mother is sensible, takes place from the twelfth to the sixteenth week, counting from two weeks from the last menstruation, but sometimes not until the end of gesta- tion, and in very rare cases the woman is not sensible of it at all. We may excite the motion of the foetus by pressing the fingers backwards towards the spine, or by applying the palm of the one hand to the side of the woman while we smartly tap the other side with the fingers of the other hand contracted to a cone, or apply the open hand, rendered cold by immersing it in cold water, suddenly to the bare abdomen. There are two species of motion of the foetus in utero ; one of the living, and the other of the dead foetus, between which we may easily discriminate, the one being the result of muscular motion, the other the impusle communicated to the dead foetus by percussion. State of the os uteri and cervix. Before impregnation it projects into the vagina from one fourth to one half an inch, it is firm and about the size of a man's thumb, mouth closed, and the lips and the depression between them can be ascertained. After impregnation it first pro- jects further into the vagina, is more rounded, the sul- cus appears deeper, it. afterwards becomes more elevated, and inclines backward from the fundus falling forwards, and the finger is now admitted to a considerable depth within the lips and into the cervix. Size of the uterus. The fundus first begins to develope, then the body, and lastly the cervix, the latter does not take place until the end of the sixth month. At the fourth FORENSIC MEDICINE. 71 month the fundus must be found just above the pubis. Du* ring the fifth month half way between the pubis and the umbilicus. At the sixth month it rises to the umbilicus, which from being heretofore depressed, is now brought up- on a level with the surrounding integuments. At the se- venth month it is half way between the umbilicus and sternum. At the eighth month it has reached the ensiform cartilage, and the umbilicus is now pouting. From the middle to the end of the ninth month the fun- dus descends about two inches, and at this time the mouth is at, or not more than an inch below, the sacro vertebral angle, there are now no remains of the cervix, and the lips are obliterated, presenting a thin, soft and relaxed orifice, that will admit the finger with which the membranes may be felt. Ballottement. To perform this operation, the woman should be standing, or she may be placed on her back with her shoulders elevated, two fingers are firmly pressed internally against the anterior part of the cervix and as high up as practicable, the other hand must be applied ex- ternally to the fundus, pressing gently downwards, the fingers which are against the cervix should be now impress- ed against it with a quick and slightly jerking motion upwards, when something will be found to have bounded away from the fingers, upon which it will in three ov four seconds be felt to drop again with a gentle pat. This is equally applicable to the dead as the living foetus, and though we generally succeed in feeling the foetus, we some- times fail. The time to institute this mode of examination is from the fourth to the sixth month, and we should ne- ver fail to empty the bladder and rectum previously to at- tempting it. Auscultation, or applying the ear or stethoscope to the ute- rine region to hear the sounds of pregnancy. There are two sounds, the Placental and the foetal. T he placental sound cannot be heard before the fourth month, it is a cooing sound like that made by blowing over the mouth of an empty vial, accompanied by a rushing noise, and it is synchronous with the beats of the maternal heart. It is al- ways heard at the same part, but sometimes intermits for hours. It is most frequently found over the right Fallopian tube. , The sounds of the foetal heart are nearly double the moth- er's pulse. It can seldom be heard sooner than the fifth month. It is a delicate feeble sound, like a watch heard tick- FORENSIC MEDICINE. ing through a pillow, and is most frequently found half way between the umbilicus and spine of the ilium, oftener in the left than the right side, but is subject to change, particularly from the sixth to the eighth month. When the foetus is dead, neither it nor the placental sound is of any value. No other sound can be mistaken for the fcetal heart, but not so of the placental murmur, for a large vascular tumor of the uterus, an enlarged spleen, or pressing the stethoscope firmly on the iliac arteries will reveal a singular sounds This species of examination requires more skill and care than the exploration of the chest. In using the instrument we should make con- siderable pressure to bring the child and instrument as nearly in contact as possible. Auscultation, like ballottement, rarely fails to reveal the presence of the foetus after the fourth month, if it is living. Substances expelled from the uterus giving the suspicion of pregnancy. There are four varieties, viz: 1. an early ovum, 2. a mole, 3. uterine hydatids, and 4. the membrane of dys- menorrhea. An early ovum is not discoverable in the first month, after this period it may be told by immersion in water for a day or two, and then examing the mass under water with blunt in- struments, and the examination must be continued, at differ- ent times, from three to seven days, before we can satify our- selves; and then we ascertain the existence of the decidua and chorion. Moles are solid fleshy masses; it is a disputed point whe- ther they are the altered remains of a blighted ovum, or a substance sui generis formed by the uterus itself; but no me- dical jurist ought to take any thing expelled from the uterus as proof of conception unless there is positive proof of its being an ovum. The best authorities agree, that if moles are carefully dissected; some remains of the foetus or its ap- pendages will always be found. Uterine Hydatids. Whether these are the products of disease of the uterus or of conception has been, and still is, a fruitful source of controversy. The weight of authority however is in favor of their proceeding from conception, and among others Mad. Bovin has come to this conclusion, after, perhaps the amplest opportunities for observation of any one who has written on this subject. An objection however to this view has been found in the existence of hydatids in the brain and elsewhere ; but they are totally different from those of the uterus, and always spring from serous surfaces, they have never been found in mucus membranes; and hydatids are FORENSIC MEDICINE. 73 not found in the uterus until the ovum is deposited there whose membranes are serous. Dysmenorrheal membrane. The existence of this mem- brane has been considered proof of pregnancy, as it is sup- posed to be the decidua: but it differs from this membrane in being destitute of the foramana for the nutrient vessels with which this membrance is perforated, it is less firm, and (he absence of the transparent membranes of the ovum within it shows that it is not the decidua. Age of the individual. The usual limits at which women begin to conceive in this wide spread country, may be stated to be 18 years, and they cease at 45 or 50. The extremes are 12 to 60 years. Prolapsed uterus will not necessarily prevent conception. Conception without the knowledge of the woman often oc- curs, and conception may take place without even the con- sciousness of sexual intercourse, as is proved in the apparently dead or cataleptic virgin and the Friar. Sexual intercourse without consciousness on the part of the female may take place during hysteria, asphyxia, cata- lepsy, drunkenness, very deep sleep, and under the influence of narcotics in those accustomed to it, but not in the virgin, except in the case of catalepsy, the last degree of drunken- ness, asphyxia and the use of narcotics to the extent of pro- ducing complete narcotism. Hymen, its presence or absence. Although the presence of the hymen may be considered presumptive evidence of vir- ginity, still pregnancy may take place without its rupture. But its absence is no proof of sexual intercourse, as disease may remove it, the rough treatment of infants by their nurses may lacerate it, or it may never have existed, or in so defective a state as not to be detected. EXAMINATION OF THE UTERUS AND ITS APPEND- AGES AFTER DEATH. If the uterus be of virgin size,—that is in length from twenty-six to twenty-eight lines, laterally from seventeen to twenty lines, and antero posteriorly from nine to eleven lines, the parietes of the body four lines in thickness, of the neck from two to three lines—we may be satisfied that impregna- tion has not taken place. And if it is enlarged beyond these dimensions, unless we discover the ovum or some of its ap- pendages, we are not authored to conclude that the woman 10 7i FORENSIC MEDICINE. was pregnant, as the enlargement may have arisen from polypus, or other distending causes besides pregnancy. Corpus luteum. This body presents the appearance in form of the cornea projecting from the globe of the eye, or the segment of a smaller circle superimposed upon a larger. In color it is reddish yellow, and bears on some parts of its body a distinct cicatrix. If we divide it into two sections by a longitudinal cut, we expose an oval body, whose greater axis is one half or five eighths of an inch, and its less from three eighths to one half an inch, its thickness being less, this is the corpus luteum. Its texture is glandular, resembling a section of tiie kidney. Its color is like the size of blood. In its cen- tre there is either a cavity or radiated white cicatrix, according to the period of examination. If made within the first three or four months after conception we find a cavity about the size of a grain of wheat, this cavity is surrounded by a strong white cyst: after this period, and until the disappearance of the corpus luteum, we find the radiated white cicatrix, distin- guishing this body from any other that might be confounded with it. The corpus luteum js vascular, and may be injected from the spermatic arteries. It disappears in about five months after delivery at full term. The presence of a corpus luteum does not prove that a wor man has given birth to a child, nor does it show that she has been impregnated, as was once supposed, it only proves that she has menstruated. The cicatrix on the surface of the ovarium where an ovum has been liberated does not remain for life, but disappears at indefinite periods, and during its ex- istence cannot foe told from cicatrices produced by abscesses, &c. SIGNS OF DELIVERY. Delivery may be concealed with the hope of saving shame, or still more criminally with the intention of destroying off- spring: and when infanticide is charged, the law requires proof of delivery and finding of the child, Or again, deli- very may be feigned for the purpose of obtaining marriage with a paramour; to gratify the wishes of a husband : or to wrest property from the lawful heir. After the expiration of ten days, no traces of delivery, to be relied on as conclusive, are evident: and it is extremely difficult after a week or over four or five days. The signs furnished by the genital organs are very much dependent on the maturity of the ovum. Under two months no enlargement of parts can be satisfactorily ascertained to FORENSIC MEDICINE. exist after two days. In these as in all cases of immaturity, we must examine the mass discharged and if we delect any vestiges of an ovum it is conclusive. Cracks of the abdomen, and silvery lines in the mammae, are only to be lelied on to prove that a woman has become a mother when corroborated by Other signs, because any thing distending the abdomen greatly, will produce the cracks; and it has happened that the silvery lines of the breast have been Occasioned by inflammation succeeding the application of leeches to those parts. Signs furnished by the countenance, (fee. The general appearance of having just recovered from recent indisposition: face paler than usual, eyes depressed and surrounded by a dark circle, pulse somewhat accelerated, skin moist and warm-. Mammae. About the third or fourth day after delivery, sometimes sooner, the breasts become full, tense, sometimes knotty, contain a lactiform fluid, nipples turgid, areola dark. Abdomen, relaxed and rugous, streaks or cracks running from the groins and pubis towards the umbilicus ; the uterus is felt through its parietes contracted and about the size of a child's head at term, and the fundus about three or four inches above the pubis, and the organ inclines towards one or the 6lher side. Internal examination presents a relaxed and di- lated vagina: open and relaxed os uteri, and so dilated as rea- cfify to admit two or three fingers: margins flabby and some- times fissured ; the focha flowing. Laceration of the Fourchette is common, and it sometime occurs in the perineum also. None of those signs however taken individually can be conclusive of delivery ; to render them conclusive they must be taken collectively ; and when they all exist the case is a very strong one. Delivery without consciousness, when the patient is coma- tose, delirious, deranged, under the full influence of opiates or ardent spirits, is not uncommon : and that delivery may take place after the death of the mother, has been abundantly proved, showing that the uterus alone is competent to effect delivery. It has also occurred during natural sleep : and a case is published in Hay's Journal, April 1842, taken from the London Lancet, occurring in a married lady, in which a first child was born in the presence of the accoucher, without the consciousness of the mother, who was awake and conscious of all things else, even to the discharge of the liquor amnii. Examination internally after death. If the examination be made immediately, and the woman have died of hemor- 76 FORENSIC MEDICINE. rhage, the uterus will be found a flattened flabby body ten or twelve inches long, the os uteri so dilated that the hand will readily pass into it: the interior containing large coagula : the internal surface covered with the soft fleecy remains of the decidua, and if the organ be immersed in water, the decidua as flocculent processes adhering to the uterus in great numbers. The place of the attachment of the placenta is distinguished by having less of the flocculi. But if the woman survive for several days, and the examination then be made, the uterus will be found to vary much—in two days it will be found to have contracted to six or seven inches by four—the external surface will be vascular, parietes when cut being about one to one and a half inches thick, firm and displaying the orifices of very large vessels. At the end of a week the uterus will be five or six inches long, less vascular, and diminished about one third in thickness, density increased orifice, of vessels less, color of organ paler. ■A"first delivery is always more easily detected than a sub- sequent one. RAPE. By the law of England rape is the carnal knowledge of a woman against her will, and death is the penalty. All classes of women are equally protected by it. It in- cludes and protects the virgin, the married woman and even the prostitute, because she may at the very moment have determined to reform her former habits. Sir Matthew Hale says, that if the female be under ten years old the act is felony, and death the penalty, although the child consent. But if above ten and under twelve and she consent, it is no rape, but only a misdemeanor, and pun- ishable by imprisonment. The French code extends the term to fifteen years, and punishes the crime committed on a girl of that age with her consent, with hard labor for a limited period. In the different States of this Union the decision of Lord Hale governs as to the age, &c, which constitutes the crime, but the penalty varies in the different States, from imprisonment for a limited time and for life, to whipping, fining, selling, castration and death. Since Hale's decision, and as late as 1828, a law was passed in England in conformity to his decision. It is necessary that the accusation be made early, particularly if a medical examination be necessary, as a FORENSIC MEDICINE. 77 few days may efface all evidences of injury: though the law prescribes no time. Yet public opinion requires an early declaration of the crime, and an accuser, who has postponed her complaint for any unreasonable length of time, is listened to with great caution by a jury. PHYSICAL SIGNS OF VIOLATION. Absence of the evidences of virginity, marks of violence on the arms, breast and the lower extremities : tumefaction or laceration of the pudenda, with effusion of blood and bruises on the other parts of the body : but those signs, or many of them do not apply to married women, nor to those in the habit of sexual intercourse. Hymen. This is a membranous or membrano—carne- ous structure, which is situated at the entrance of the va- gina, and never more than one-fourth of an inch within it, and serves to form a boundary between that passage and the external genitals. It is formed by duplicatures of the lining membrane of the vagina, and is usually of a cre- scentic form, leaving an opening into the vagina at its up- per part. This opening serves as an outlet to (he menses, and in the average of adult subjects is large enough to ad- mit the adult finger sufficiently high up into the vagina, to effect an examination of the os uteri without injury to the hymen. The shape however varies; in some cases it is more or less circular, presenting through its centre a round aperture of three or four lines in diameter. At other times only a part or exclusive portion of the orificial extremity of the vagina, sometimes the superior, at other times the inferior portion of it, is seen to be veiled over with this structure. In some rare cases the hymen is an imperforate circular membrane attached to the edge of the orifice of the vagina in every part, so as to close the canal com- pletely—again it is of this form except that it is finely cri- briform. Another form of it is, when there are two crescental por- tions attached to the more carneous structure of the exter- nal orifice laterally. The structural tissue of the hymen, seems in some measure to vary in different instances. In most foetal subjects it seems to be distinctly membranous, whilst in some others it partakes also of a carneous charac- ter. It is generally, though not always [ruptured in copu- lation. It is sometimes so slender as to be ruptured by the least force in childhood. At others it is so firm as to resist 78 FORENSIC MEDICINE. the intromission of the penis, as in Haighton's remarkable case. It is sometimes congenitally absent or so little de- veloped as not to be seen. Viewed alone, its existence or absence can neither be Considered a test of virginity nor proof of a rape. During menstruation or profuse leucorrhea, the hymen becomes so relaxed as to admit the penis without rupture. Caruncuhe Myrtiformis. There are generally four of those myrtleberry-llke bodies. Velpeati says the two, oc- cupying the lower and upper part of the entrance of the vagina belong to the middle columns of this canal, and are no part of the remains of a ruptured hymen, while the two former exist originally and independently of the hymen, but the latter have no existence unless the hymen has been ruptured. SIGNS OF DEFLORATION. In investigating the charge of defloration, it is neces- sary to take into consideration the age, strength and stale of mind of both parlies concerned. The sexual organs of each should be examined as early as possible, for in a wo- man who has arrived at puberty, the signs of defloration are soon effaced : in children they remain longer. In a virgin, if the examination is made early, the genitals are found lacerated, tumefied and bloody, or inflamed and pain- ful to the touch : the hymen generally ruptured, and some- limes the presence of semen can be detected: besides these We find the other marks of violence heretofore men- tioned. In children the local injury is greater and more evident. But in married women, even a very early exa- mination will fail to afford much assistance, from the pre- viously dilated stale of the parts : yet the marks of violence on the person, aud the discovery of semen will be strong evidence. The injury, apparently done to the genitals of children, should not be too readily taken as signs of rape, as they are subject to a disease presenting the same appearan- ces as defloration, and is generally fatal, several cases of which are reported by Mr. Ward of the Manchester Infir- mary. The venereal disease, if occurring in the female from three to eight days after the rape is alleged to have taken place, and especially.if the man has the disease if now ex- amined, is strong presumptive evidence. But female chil- FORENSIC MEDICINE. 70 dren, up to the age of puberty, are subject to a purulent disease of the genitals, especially during dentition, and when worms are present in great numbers in the rectum, that may readily be mistaken for gonorrhea, which shows the necessity of examining the man. Indeed we should never fail to examine both parties for another reason, that is, to discover whether impotence may not exist. It is sometimes very difficult to detect gonorrhea where attempts are made by men to conceal it, for if urination takes place just before the inspection, the matter will be washed out, and all traces of a discharge be lost, and if the disease have existed for some time, the unassisted eye can discover no traces of inflammation about the meatus. But when the urine has been retained some hours, the dis- charge may be discovered. And if a lens is used, on eveit- ing the lips of the urethra it is seen either florid, with punctuated redness, and a semi-abraded appearance, as if the epithelium were partially removed, or the veins of the mucus membrane will be found enlarged and tortuous. A woman may wound herself as proof of a rape as in a case mentioned by Foederi. The chief point necessary to be proved in an accusation for rape, is the act of coition, and considerable difference exists as to what legally constitutes it. By the English law of 1828, penetration alone, without emission, is declared to be sufficient to constitute rape. But the law previous to 1828 required proof of both pene- tration and emission, and this law governs the decisions of the courts of many of the different States. Emission is generally unknown to married women in their lawful intercourse, and in the case of virgins it is not at all likely, that they would be sensible of emission ha- ving taken place, particularly when we take into consider- ation the state of fright, pain and weakness, into which they are necessarily thrown by the attempt to violate them. In the case of children, it is manifestly impossible that evidence of emission can be obtained. And if emis- sion be necessary to constitute the crime, Eunuchs would always escape. But as the accusation of rape is easily made, and with difficulty rebutted, the proof required ought to be strong. We do not mean to say that a married wo- man, or a virgin, after or before puberty, will not be able to discover that there is a fluid within or about her genitals after her connexion with a man, which did not exist there before the coitus—but how is she to know that it did not 80 FORENSIC MEDICINE. proceed from her own organs, for of the moment of its de- posit we cannot believe she can be conscious. A girl who is sensible of the obligations of an oath, and the consequences hereafter of telling a lie, is a good wit- ness whatever be her age. Assertion, on a death bed of the commission of a rape, is good evidence, if the woman is proved to be really conscious of her danger. Rape, though not impossible, is extremely difficult to commit if a woman can preserve her presence of mind ; yet by long continued perseverance she may be overcome, and the man may succeed. Rape is possible without the consciousness of the wo- man, during the last degree of intoxication, narcotism, or in a fit, in a virgin, but not during natural sleep : but yet it is possible but not probable during a sound natural sleep in a married woman. A man being ignorantly admitted by a married woman to her bed as her husband, and having connexion with her, with her consent while the imposition lasts, is guilty of a rape. Also in a case of forcible abduction, and compulsory marriage, if violation forcibly takes place, it constitutes rape. In Regina vs. Jordon, it was decided that a boy under 14 years of age cannot be convicted of feloniously committing a rape on a girl under 10 years, though the surgeon swore that the boy had arrived at the full state of puberty, and it was also decided that it is not necessary for the hymen to be ruptured to make out the charge of penetration. The part of this decision that relates to penetration has been con- firmed by a more recent decision, in the case of Regina vs. Hughes, by eleven or twelve judges, 9 Carrington and Paine's Nisi Prius reports, 118 and 752. DEATH BY LATENT DISEASES. The objects to be considered in our inquiries on this sub- ject, are 1. What diseases are apt to put on a latent charac- ter and occasion sudden death. 2. by what means may it be proved, in special cases, that they have really been the occasion of death. DISEASES THAT ARE APT TO OCCUR IN A LATENT FORM. Of the head. Sanguinous apoplexy, inflammation of FORENSIC MEDICINE. 81 disease^ Thus it is not unusual for death to take place the membranes of the brain, and of its substance. Clots of blood have been found in the brain, and cysts which formerly contained clots, proving plainly that clots may exist without producing apoplexy, and therefore their ex- istence, without other evidence, should not be considered proof of apoplexy. Inflammation of the membranes of the brain may even run on to suppuration, or to extensive effusion, without any equivocal sign of itsexistence being manifested, though it is rare for this disease to be latent. Inflammation of the substance of the brain very often as- sumes a latent form, particularly the form termed softening of the brain, which runs on to death without its existence being at all manifested until a few hours before death, and it not unfrequently proves suddenly fatal during a state of apparent perfect health. Of the chest. These run an obscure or completely la- tent course much more frequently than those of the head, and among them the most remarkable are pleurisy, pe- ripneumony, organic diseases of the heart and of the great vessels within the chest; of all of which organic diseases those of the heart are most frequent. Indeed sudden death from this affection is much more common than from any other latent disease. Of the abdomen. Of these there are several which run a latent course for a very long time : but there are but few which will remain latent to the last, like many of the dis- eases mentioned under the preceding heads. Ulceration of the membranes of the stomach and intestines ending in perforation—the same disease terminating in the rupture of the gall bladder and biliary ducts. Diseases of the liver and kidneys ; of the coats of the large abdominal vessels and perforation or rupture of them : extra uterine con- ceptions: worms in the intestines accumulating so as to produce epilepsy, or other convulsions. Of the spine. Caries of some part of the vertebral co- lumn. In one variety of it, which terminates in disloca- tion of the processus dentatus of the second vertebra of the neck, instant death may occur, when no suspicion ex- ists of the presence of any disease in the actual seat of the mischief. Although all these diseases may occasion death, still we ought to require some other evidence, besides their existence in a latent state, before we decide that the death is natural: that is we should not terminate our inquiries with the dis- 11 82 FORENSIC MEDICINE. covery of a latent disease. We should always recollect that latent diseases are apt of themselves to prove suddenly fatal under the operation of either slight violence, or of the circum- stances accessary to violence, such as passion, fright, strug- gling, &c. The evidences of the connexion of the morbid appear- ances with the fatal event are, 1. Those marked appearances which indicate that the disease has brought into action one of the proximate causes of death—that derangements of structure, or function, have been incompatible with the continuance of the circu- lation or respiration—as rupture and hemorrhage in aortal aneurism, &c. 2. Certain peculiarities in the morbid appearances which are known, by experience, seldom or never to occur ex- cept death immediately follows—but why we do not know —an example of which is furnished by a recent perforation of the stomach, or the rupture of the gall bladder. 3. Another description of evidence, by which death may be presumptively connected with morbid appearances found in the body where the cause of death is obscure, is derived from the occurrence of symptoms immediately before death, which correspond with the appearances discovered. Thus when an individual dies under symptoms of sud- den dyspnea, and an extensive chronic pleurisy or pe- ripneumony is found in the dead body, death is clearly to be referred to the latent disease. Yet regard must be had to the particular species of violent death, which may hap- pen to be suspected, as symptoms antecedent to death are common both to the natural and violent cause. 4. Before inferring death to have arisen from a latent disease of which traces are found, it is further necessary to determine by as many proofs, as the nature of the case will supply, that violence is improbable if not impossible, and in particular, that the circumstances will not bear out the suspicion of the particular kind of violent death which is imputed. 5. Additional information, throwing light on the ques- tion of sudden death from latent disease, is derived from attending to the collateral conditions under which latent diseases are usually observed to prove suddenly fatal. These conditions are at least three in number. 1. Many cases of latent disease have their symptoms first developed, or even prove suddenly fatal, during the additional constitutional disturbance occasioned by a fatal FORENSIC MEDICINE. 83 suddenly in the early stage of convalescence from other diseases. 2. A second still more common circumstance which con- curs with sudden death from latent disease is some unusual or violent exertion. The general result of the observation now made is, that any circumstance which produces either sudden violent ex- citement, or sudden violent depression of the circulation may cause instant or speedy death, where extensive de- rangement has accumulated silently in any of the impor- tant organs of the body. SURVIVORSHIP. It is of the utmost importance, as regards inheritance, to ascertain which of a number of persons killed by the same accident died first, or survived longest, for the survivor having succeeded although but for an instant, to the property of the other, gives his or her heirs a claim to the inheritance, and the following classes of persons are especially interested. 1. Father or mother and child. 2. Brother and sister. 3. Hus- band and wife. 4. Joint tenants. And 5. Testator and le- gatee. By the civil law of England, when father or mother and child perish together, it is held, if the child be of the age of puberty it shall be considered the survivor, but if it be under puberty that it died first. Age generally. The very young, and the far advanced in age, die sooner than adults, and those in the middle stages of life. Sex. The male survives longer than the female.^ The following cases, Satterthwait vs. Powell from 1st Curtis's Eccles. Reports, occurring in 1819, would appear to controvert this position. A husband and wife perished in the same ves- sel, and there was no proof which died first, the Court, Sir Herbert Jenner says, " the parties in this case must be pre- sumed to have died at the same time," though the counsel urged the ordinary presumption of law as above stated. But in the case of Robert Mundy, of Ireland, who with his wife was drowned in a vessel in 1837, the Court decided "that the wife died first, there being nothing to show that she was the survivor." . . Temperament. By temperament is meant those individ- ual differences which consist in such disproportion of parts, as regards volume and activity, as to modify sensibly the whole 84 FORENSIC MEDICINE. organism, but without interfering with the health. The law recognizes only four temperaments, viz : 1. The phlegmatic, lymphatic or pituitous, in which the colorless fluids are supposed to be too abundant for the solids : the secreting system predominating over (he absorbent. Its characteristics are soft flesh, pale skin, fair hair, weak, slow, and soft pulse, figure rounded but inexpressive, the vital ac- tions more or less languid, the memory treacherous, inatten- tive and vacillating, with aversion to mental and corporeal action. 2. Melancholic. In this the vital functions are feeble and irregularly performed, the skin assumes a deeper hue, the countenance is sullen and sad, the bowels torpid and all the exertions are tardy : the pulse is hard and habitually con- tracted, the imagination is gloomy and the temper suspicious. 3. The Sanguineous. In this the circulating system seems to be predominant. Its characteristics are strong, frequent, and regular pulse, ruddy complexion, animated countenance, firm flesh, light hair, fair skin, blue eyes, great nervous sus- ceptibility, quick conception, ready memory, lively imagina- tion, addiction to the pleasures of the table and amorousness. The diseases of this temperament are chiefly sealed in the circulating system, as fevers, inflammations, and hemor- rhages. 4. The bilious or choleric. This is presumed to be pro- duced by the predominance of the liver and biliary organs in general. The pulse is strong, hard and frequent, the subca- taneons veins are prominent, the skin is of a dark brown color inclining to yellow, hair dark, body moderately fleshy, muscles firm and well marked, passions violent and easily excited, temper abrupt and impetuous, great firmness and in- flexibility of character, boldness in the conception of projects, and untiring perseverance in their fulfilment. The nervous temperament, the most important, is not re- cognized in the legal enumeration, and in fact is rather a se- condary than a primary temperament. The phlegmatic die first, then the melancholic, next the san- guineous, and lastly the bilious. Habit and variety of constitution- Here we comprehend the relative proportions of the principal organs of the body, and its conditions of obesity and leanness. He whose head and chest are disproportioned, that is the former being greatly too large, and the latter very contracted, dies sooner than he whose chest and head are well propor- tioned. FORENSIC, MEDICINE. 85 The fat die sooner than the lean, except in cases of drown- ing, the very fat may be specifically lighter than water, and therefore float when the lean will sink. Disease. The diseased diesoooner, when violence of any kind is inflicted, than the ?ound : and of the sick those labor- ing under typhoid fever die sooner than those having inflam- matory affections ; and among chronic diseases scurvy is pla- ced in the first rank, and after those such as affect the func- tions of respiration, circulation, and those of the brain and spinal mariovv. Moral condition. In danger the timid die sooner than the courageous: this fact however is lessened in value by the circumstance that a particular idiosyncrasy sometimes exists, by which persons die from a slight injury producing lock jaw, 1 o E This last ingredient is always found in opium. All these may be separated by the process employed for obtaining morphia, or its salts. The codeine exists in a qu antity not exceeding one per cent; the narceine and me- 126 FORENSIC MEDICINE. conine in still more minute quantities, so that few chemists have ever seen them. Of these, in a toxicological point of view, the most im- portant are Morphia and Meconic acid. These two ingre- dients appear to exist in combination in opium: and when magnesia is added to a watery solution of opium, an insolu- ble meconate of magnesia is formed, from which the mor- phia, sparingly soluble in water, is taken up by alcohol; or, if we add muriate of lime to the liquid, instead of magnesia, we obtain meconate of lime, as an insoluble precipitate, and a soluble muriate of morphia; which last when purified by several nice chemical manipulations, is obtained in minute white silky crystals. This is the valuable part of opium to the medical practitioner, as it is powerfully hypnotic, andjs less liable to cause headache, nausea, and itching of the skin, than crude opium. Morphia, like the other ingredients of opium, exists in very variable quantities in opium of different qualities. The best Turkey opium usually yields from 6.25 to 7.80 per cent, of purified hydrochlorate of morphia. The amorphous ingredients may be considered asim pedi- ments to the purification of the morphia. Morphia is very insoluble in watery fluids, and it is usual- ly united to acetic or hydrochloric acid, to render it soluble. The hydrochlorate retains its colour and its properties better than the acetate. The Lancashire Black Drop is an impure acetate of mor- phia, of variable strength, and therefore should not be pre- scribed. Bailey's Sedative has no valuable quality which does not exist in muriate of morphia. It is acidulous, but seemingly without spirit, and contains much less meconic acid than laudanum. Codeia or Codeine, has slight alkaline properties. It is not at all hypnotic. Soon after its discovery, I took five grains in tea, which produced no tendency to sleep, but gave rise to intense itching of the skin, that lasted about two hours; and the same effect was afterwards felt by Dr. W. Gregory, and several of his pupils. It is probably to this substance that the irritative effects of opium on the skin are owing. When either this substance or opium is administered in an over-dose, the symptoms are drowsiness and insensibility, but this state is often preceded by a slight excitement: the face assumes a ghastly hue, the jaw falls, the eyelids remain half open, the pupils are strongly contracted ; stupor and FORENSIC MEDICINE. 127 complete coma succeed ; convulsions are rare in adults, but often are seen in inhints. Opium produces its fatal effect, however introduced intoihe system; and even when applied to a raw surface, lias destroyed life. Morphia is stronger than opium, in the proportion of one to six. Orfila has published two cases of poisoning by the salts of morphia. A case of the same kind occurred at Montrose in 1834, in which ten grains of the muriate of morphine proved fatal in ten hours. Two other cases occurred in 1837, one in the county of Stafford, and the other in the county of Lan- caster. In these cases the. acetate was administered in an over-dose by mistake. No less than one hundred and ninety- eight persons were poisoned in England and Wales, in the years 1837 and 1838, by opiates. The principal morbid appearances are great turgescence of the vessels of the brain, and sometimes serous effusion be- tween its membranes, or in its ventricles; but sometimes no morbid appearance can be detected in the head ; the lungs are gorged with blood, the stomach rarely appears inflamed, the blood is found fluid in the heart, and the body runs rapid- ly to decay. Evacuation by the stomach-pump, or by emetics, is the remedy chiefly to be trusted ; and after the patient is roused, we must prevent him from falling asleep while any tendency to stupor is perceived. Compelling the person to walk about, pouring water occasionally into his ears, shaking him, and applying hot water to his legs so as to excite pain, are the means usually had recourse to. Artificial respiration appears to have saved one person wrho was found comatose. No an- tidote is known. The best tests of crude opium are those which show the presence of morphia and meconic acid. The contents of the stomach, in a case of the poisoning with opium, may have the smell of that drug. The whole should be emptied into a clean mortar, and reduced to a thin pulp by the addition of distilled water; acidulate the whole with acetic acid, strain and filter, then reduce the liquor to the consistence ot syrup by a gentle heat; add alcohol, gradually, boil, and filter when cold. The spirituous solution will contain all the morphia. Again, evaporate to the consistence of syrup, and add mag- nesia; this will throw down meconate of magnesia and the morphia in the form of a grayish powder, which may be freed from much of its coloring matter by washing it with cold water, and then with cold proof spirit. The morphia may now be separated from the meconate of magnesia by hot 128 FORENSIC MEDICINE. strong alcohol: concentrate the last solution, which will have a bitter taste, and on adding a drop of nitric acid, it will strike an orange yellow colour, soon passing to golden yellow ; and will give a duck-blue with permuriate of iron. The meconate should be decomposed by hydrochlorate of baryta, which throws down an insoluble meconate of baryta ; from which the addition of very diluted sulphuric acid sepa- rates the meconic acid. This acid has a silky lustre in the state of crystals, and affords with permuriate of iron a very intense red. There is only one source of fallacy in operat- ing with meconic acid from the human stomach, which must be guarded against,—namely, that the sulpho-cyanates of the alkalis precipitate permuriate of iron of a red colour; and some of the secretions, as the saliva, contain a sulpho cyan- ate. If the solution of morphia be strong, there is no danger of mistake ; because of the intensity of the colour produced. Professor Forbes has also shown, that the two solutions af- fect the prismatic spectrum in a different manner; though perhaps this test is less applicable to medico-legal cases, where the quantity of opium is generally very minute.— When the meconate of iron is introduced into Dr. Brewster's Analyzing Prism, so placed that a ray of light may suc- cessively pass through a thicker and thicker column of the fluid, the absorption of the coloured rays of the spectrum takes place from the green rays towards the red, or least re- frangible end of the spectrum ; but when sulpho-cyanate of iron is similarly treated, the absorption commences with the red lays, and proceeds towards the green. In recovering a person narcotised by opium, after the pre- liminary means have been adopted, place the feet in very warm water, and pass a sponge dipped in the same, and as hot as the hand can bear it, over the shoulders, chest and back. Let this be immediately followed by a dash of cold water over the face, or by passing a sponge dipped in it over the chest. Electricity may by small and repeated shocks be used. 2. Hydrocyanic acid or Prussic acid forms the poisonous ingredient in an important class of vegetables. It is yielded by the kernels of the bitter almond, and of several other species of that genus; by the leaves of the cherry-laurel, or Prunus lauro cerasus ; by the Prunus padus ; and proba- bly contained in the seeds of the Pomaceai, and in all vege- table productions having the odour of bitter almonds. The acid, when concentrated, is the most deadly of all poisons ; producing almost instant death, whether swallowed or intro- duced by a wound. FORENSIC MEDICINE. 129 This acid may be obtained in it*s most concentrated form, by passing a stream of sulphuretted hydrogen over bicya- nide of mercury gently heated in a tube. The product must be condensed in a receiver, kept cool by ice or snow and salt. This strong acid is extremely volatile, and its vapour in pouring it from one vessel to another, should be carefully avoided. It is very liable (o decomposition in this strong state ; and is used in medicine much diluted with water, or with alcohol. The German acid varies in strengh from 1 to 10 per cent, of pure acid ; but Keller's hydrocyanic acid contains 25, and Robiquet's no less than 50 per cent. The medical acid of the London and Dub- lin Colleges contains 2 per cent. The medicinal acid of the London and Dublin Colleges contains 2 per cent.; that of the Edinburgh College has a strength of 3.3 per cent. Even the diluted hydrocyanic acid of the apothecary's shop is fatal in a very moderate dose; and the essential oil of bitter almonds is not less so. An infusion of the leaves of cherry-laurel is a very deadly poison ; bitter al- monds have sometimes proved fatal; and the same effect has followed on eating the blossoms of the common peach, Prunus persica, in a salad. When the preparation is con- centrated, the death is very speedy ; the breathing immedi- ately becomes laborious ; convulsive movements of the limbs come on, and in dogs it ends in violent tetanus. Af- ter death the eyes are glistening, the pupils dilated, the muscles of the spinal column stiff, the countenance pale, and often composed, the abdomen drawn in ; the veins of the brain are found to be loaded with black blood, and the blood in the heart and great vessels are generally fluid.— In some instances the blood and cavities of the body have exhaled a strong odour of prussic acid ; and the blood is said occasionally to have exhibited a bluish tint when the strong acid has been administered. The bile has often been observed to be of a dark blue hue in such cases. The essential oil of the-bitter almond is very poisonous : yet it is employed to flavour liqueurs, and other articles of diet, by persons little aware of its activity ; and children are said to have been poisoned by eating macaroons, a sort of sweet-cake, flavored by this oil. Three persons were poi- soned in England by this oil in 1837 and 1838. The distilled water of cherry-laurel, is a very deadly poison. It was by this liquid that Sir Theodosius Bough- ton was destroyed in 1780. Harriet Ricketts, aged fifteeD, 17 130 FORENSIC MEDICINE. in 1838, was poisoned by a decoction of these leaves, sup- posed to have been administered to cause abortion. This case occurredin Essex. The medicinal prussic acid has re- peatedly destroyed life. No less than thirty persons com- mitted suicide by this acid in England and Wales in the years 1837 and 1838. No remedy can be of service in poisoning by this sub- stance, unless instantly administered; but ammonia ap- pears to have a great power in alleviating the symptoms when the quantity of hydrocyanic acid has not been very great. Ammonia diluted with water should be introduced into' the stomach; its fumes sufficiently diluted with air allowed ,to enter the lungs, taking care not to excoriate the air-passages by the too free use of ammonia. Another very powerful antidote is chlorine. It is most advantageous to employ the vapour of water containing about one-fourth part of its volume of chlorine gas. This may be inspired without risk ; it has saved the lower animals, when the poison had been administered for five minutes before its ap- plication, even after the convulsive stage had passed, and that of insensibility had supervened. In Orfila's experi- ments, in ten minutes after inspiring diluted chlorine in this manner, the recovery of the animals was certain. Herbst, of Gottingen states, that dashing cold water on the surface of the body, is a powerful antidote in such cases ; it is most successful before the convulsive stage, but is useful during the spasms. The tests of hydrocyanic acid are certain when we can obtain it in quantity ; but we must look for it in the body, the smell is its best criterion. The stomach and the blood will sometimes have its peculiar odour for more than three days after death; and if the body has been buried within twenty-four hours, the odour will occasionally be cogniza- ble till the eighth day. When we can obtain a little of the liquid acid, nitrate of silver is a very delicate test A white precipitate is formed, which when dried and heated in a tube, gives off cyanogene, a gas that burns with a rose-coloured flame. If we add to the suspected liquid sulphate of cop- per, a rich emerald green solution is formed', and if to ano- ther portion of the liquor we previously add a drop or two of potassa, the test will throw down a greenish salt, which is partially dissolved by hydrochloric acid, leaving behind a cyanide of copper, which yields cyanogen like the precipi- tate of silver. This test will detect prussic acid in 20,000 times its weight of water. FORENSIC VIEDfCINE. 131 But it may be necessary to eliminate the acid from the contents of the stomach ; the method of Lassaigne and Leuret seems well suited for this purpose. If alkaline, neutralize the liquid, after filtration, by sulphuric acid ; introduce it into a large retort, and distil with a water-bath heat, until one-eighth of the whole has passed over. This fluid will contain any hydrocyanic acid which may be pre- sent. 3. Substances yielding Strychnia. The vegetable sub- gtanees yielding this new alkaloid all act in nearly the same manner, and are very poisonous. The alkaloid was first obtained from the Strychnos nux vomica and S. Igna- tii. One nearly similar in its properties is said to be found in the bark of Brucea autidysenterica, to which the name of Brucia has been given. This substance is likewise found in nux vomica united to strychnia. Both are highly poi- sonous, producing convulsions and tetanus; both are in- tensely bitter. Strychnia is used in paralysis, with advan- tage, in doses of from one-eighth to one-fourth of a grain. Now that it is an officinal preparation, it may be employed as a poison ; and there is too sure a substitute, in malicious hands, in the seeds of the two plants from which strychnia was first obtained. A dose of fifteen grains of the powder of nux vomica has been fatal. In «he Parliamentary Report there are three cases of poi- soning by nux vomica in powder, and two by strychnia. Three were accidental, but two were suicides. Mr. Oilier has published an interesting case of death from three drachms of the powder of nux vomica. The symptoms from this powder, and from a much small- er dose of strychnia, are similar. Spasms speedily ensue with anxiety and agitation, the limbs become stiff, the face and hands livid, from the impossibility of respiration, pro- / duced by the fixation of the muscles of the chest. These severe affections come on in paroxysms : the intervals ex- hibit nausea, a feeble pulse, and profuse perspiration; the repetition of the fits destroys life; and the victim seldom lives above an hour. The best remedies,, after evacuation of the stomach, ap- pear to be simple substances chlorine and iodine, as we are assured by Donne of Paris. Where the death has been rapid, there are little or no marks of inflammation to be seen in the stomach ; but when it has been lingering, the stomach and intestines show traces of violent inflammation ; their color is vio- let and incipient gangrene has been observed in some 1:^2 FORENSIC MEDICINE. cases; serous effusion has been found in the head, the blood has remained fluid, and the body often retains, after death the rigidity of the tetanus in which the sufferer died; but in dogs, poisoned by it, the limbs are sometimes relaxed after death. The powder of S. Ignatii is stronger than that of nux vomica : both adhere obstinately to the villous coat of the stomach, and will generally be found there after death.— They may be distinguished by their intensely bitter taste, by becoming orange-red when nitric acid is added ; a hue which soon passes to golden-yellow. The celebrated Javan poison is prepared from the Anti- aris toxicaria and Strychnos tieute, plants belonging to the natural order of Apocyneae : another plant of the same or- der,Cerbera tanghin, is so deadly, that a single seed, it is said, will destroy twenty persons. The wourali or wourara poison of South America is said to be derived from a Strychnos. M. Schomburgh in- forms us, that the Indians prepare this poison chiefly from a plant, which he has named Strychnos toxicaria, a new species of that genus; but the effects of the wourali, espe- cially upon birds, would seem to indicate some other poi- son also in the composition. Waterton and Hillhouse as- sert, that the juice of ants, and fangs of poisonous snakes are added to the wourali poison during its inspissation at a slow heat. The natives of Guyana kill animals by blow- ing, from a long slender tube, a little spiculum of wood, dip- ped in wourali poison. The effect is very deadly, even to large animals. It is fatal to animals in very minute quan- tity when inserted under the skin. The bark of a tree, said to have been brought from South America, has proved poisonous when administered instead of the true Angustura bark, Galipea officinalis, or Bon- plandia trifoliata. But it is now found that the so called False Angustura bark is the bark of the Strychnos nux vomica, and was imported from the East Indies. When we suspect any substance containing strychnia to be in the stomach, digest its contents with alcohol, and concentrate this tincture, which will be intensely bitter; precipitate by ammonia, and this precipitate when a drop or two of nitric acid is added, will become orange-red if any strychnia be present. Hyogcyamus niger. The whole plant is narcotic, espe- cially the roots, which have several times caused fatal ef- fects, by being eaten instead of parsnips. The symptoms are active delirium, in which persons have danced and reeled FORENSIC MEDICINE. 133 about until stupor supervened. A family of six persons were affected in this manner; one of them died on the morning af- ter eating the roots of the plant. In persons fully under this stupor, stimuli cease to rouse, and the eye is insensible to light, or even to being touched. Emetics are the remedies ; but we have no particular tests of this poison. Antidote. Lemon juice plentifully taken. Besides Hyoscyamus, other Solanai are narcotic. This is especially the case with Solanum nigrum and & mam- mosum. Both owe their activity to an alkaloid, Solania which is capable of exciting vomiting, hurried respiration, and stupor. 5. Lactuca virosa is a poisonous plant, with a juice that is highly narcotic, and has the smell of opium. This juice, when inspissated, forms the lactucarium of the shops, which was at first derived from the Lacuca sativa, but is ob- tained in greater quantity, and of precisely the same quali- ty, from L. virosa. Stupor and coma follow an over-dose of lactucarium. Tobacco is a well-known narcotic, of which the detec- tion will be difficult, except by the smell. The oil of to- bacco is combined with nicotine, and is a poison of great energy. It produces speedy coma ; but in the lower ani- mals does not appear to paralyze the heart, as decoctions of the plant are found to do. Those who chew sometimes swallow the juice ; but habit renders it less dangerous than to those unaccustomed to this narcotic. Smoking at first causes dizziness and nausea. Persons are said to have died of excess from smoking tobacco; and a person is stated to have died in Germany from excessive snuffing. 'The infusion of to- bacco, thrown up the anii3, speedily evacuates the bowels ; but an infusion of an ounce or two has been fatal in a few minutes. Externally applied, tobacco is a powerful reme- dy against local rheumatic pains. 7. Atroppa Belladonna, or Deadly Nightshade, is a strong narcotic poison. All the plant is poisonous, especially the leaves and the fruit. The symptoms produced are delirium, dilated pupils, and loss of vision. Sometimes it causes hysterical bursts of laughter, the lips, tongue, and throat • are parched, there is a great sense of sinking, with tremu- lous movements of the hands; but convulsions are rare. Many instances of poisoning have happened from eating the berries and the young shoots. In England, in 1837, two persons were poisoned by this plant. One ate the ber- ries, and another the root, which is more poisonous than the 134 FORENSIC MEDICINE. fruit, 180 French soldiers were poisoned by eating the' berries, in 1813, near Dresden. The body is found, after this species of poisoning, to decay rapidly ; and the seeds and skins of the berries are. often found in the stomach, as they are not easily digested. The active principle is an alkaloid Atropia. Antidote. Lemon juice. 8* Datura Stramonium is another poison sometimes employed on the Continent to facilitate robbery or rape ; and! in this country it has been administered by mistake. I have known two instances of poisoning by the extract of Stramo- nium, taken by mistake for extract of sarsaparilla. In both, there was confusion of ideas, flushed face, delirium, inces- sant talking, and intense headache, but without vomiting. Both recovered. It owes its activity to an alkaloid Daturia, which abounds also in D. tatula. The extract of stramoni- um produces dryness of the fauces, intoxication, and active delirium, with cerebal congestion. Various Umbelliferous plants are poisonous ; such as C&- nium maculatum, ^Ethusa cynapium, and Ctcuta virosa. The roots and leaves contain a poisonous juice, and the symp- toms are those of narcotics, with some degree of irritation. 2. Many authors have spoken of the (Enantha croeata as very poisonous } but Dr. Christison gave it largely to dogs without killing them. A striking instance of its poisonous qualities occurred in Radnorshire, in 1834. Seven cows were killed by eating the root of this plant; and it proved nearly fatal to the dairy maid, who had eaten a small piece of the same root. In Orfila's experiments, it generally killed dogs, by inducing delirium and convulsions. 10. The jEthusa cynapium has been mistaken for pars- ley; it produces dizziness, vomiting, difficulty of swallowing, and numbness of the extremities, with colic and a livid face. 11. Cicuta virosa, according to Linnaeus has proved very fatal to cattle in the neighborhood of Torneau, which in the spring greedily crop the young shoots. It has proved fatal to man, first irritating the fauces, and then producing furi- ous ^delirium, cold extremities, dyspnoea, trismus and death. 12. Conium maculatum owes its activity to an oily alka- line principle, Conia ; which smells strongly like mice, and becomes, though a clear liquid when cold, opaque on being heated gently. In the French armies, accidents often hap- pen, from the soldiers mistaking the leaves for those of pars- ley. An interesting detail of this sort of poisoning occurred to Orfila, when with the French armies at Torrequemada in Spain, in the year 1812. FORENSIC MEDICINE. 135 13. Several of the Ranunculacece are acrid and narcotic, as the Rananculus sceleratus, R. flammula, R. bulbosus, R. lingua, and R. acris, and R. arvensis ; but we have no mode of detecting their poison. R. sceleratus, R. flammu- la, and R. lingua, are among the most poisonous of this genus. They appear to act merely as acrid poisons, inflam- ming highly the fauces and stomach ; and many of the genus are capable of vesicating the skin. 14. Caltha palustris, another plant of this genus, has ivearly similar effects. 15. Aconitum napellus produces delirium and stupor, with burning in the throat, vomiting, and purging. It owes its poisonous .qualities to an alkaloid, Aconitia, which has •lately been introduced into the materia medica, to allay ar- thritic and obstinate rheumatic pains. The dose is one tenth of a grain. It is also used externally. Several instances of accidental poisoning from this plant have occurred in Eng- land, when the shoots have been mistaken for other vegeta- bles. Two such occurred in February, 1837; and two others, which also occurred in that year, are mentioned in the Par- liamentary Report. 16. Helleborus niger is a narcotico-acrid poison of great activity. This is the celebrated Melampodium of our older pharmacopoeias, once much used as a cathartic in mania and melancholia. In larger doses, the plant has proved fatal, pro- ducing delirium and violent convulsions. A drachm of the extract was fatal in sixteen hours, according to Morgagni. 17. Anemone Pulsatilla, or Windflower, is an acrid poison of considerable energy, vesicating the skin, and inflaming the intestines when swallowed. Bulliard states, that a poul- tice of this plant, applied to the leg, produced inflammation, ending in gangrene. A. nemorosa is still more violent. A. prutensis, and indeed the whole tribe, are highly acrid. 18. Clematis vitalba, or Virgin's Bower, and C. flammu- la, inflame and ulcerate the skin. With the first, beggars form factitious ulcers on their legs, to excite commiseration, and extort charity. C, Integrifolio is a highly acrid plant, which is said to have destroyed a vast number of Prince Eu- gene's horses in Hungary. Sedum acre, Stone-crop, has pretty strong acrid qualities, and destroys dogs within a few hours. 20. Fritillaria imperialis has but moderate irritant pro- perties. 21. Cyclamen Europamm was considered as an acrid poison by Boerhaave; and Bulliard states, that it causes 136 FORENSIC MEDICINE. bloody stools, vertigo, convulsions, and death, in the human subject. 22. Plumbago Europse, according to Sauvages, is a vio- lent acrid : and when prepared as a yellow dye, causes head- aches to the workmen. 23. Asclepias gigantea, and A. vincetoxicum, according to Orfila, killed dogs in a day or two, with symptoms of in- flammation of the stomach. 24. The same qualities belong to Hydrocotyle vulgaris, Pastinaca, sativa, P. arenosa, Sselanthus quadragonus, and Phytolacca decandra. 25. Cynanchum. Various species of this genus act very violently on the animal economy, especially C. erectum and C. viminale. 26. Delphinium staphisagria, Stravesacre. The seeds of this ranunculaceous plant are peculiarly acrid, and yielded to Lassaigne and Fenuelle Delphinia, a fusible alkaloid, six grains of which will kill a dog in two or three hours, but when dissolved in an acid, in a few minutes. The symptoms are giddiness, rigidity, and convulsions. The powder of the seeds either swallowed, or applied to a,wound, kill, but less quickly. 27. Chelidonium majus, Greater Celandine. A native papaveraceous plant, which when swallowed, inflames the stomach, and has slight narcotic qualities. 28. Ruta graveolens, Rue. The bruised leaves inflame the skin strongly. The root will cause abortion, with danger of high inflammation, preceeded by dizziness, jactitation of the limbs, and sometimes salivation. The oil is still more violent. 29. Cytisis laburnum. The seeds of this leguminous tree, I have found to be narcotico acrid. Two cases of poison- ing by them, attended with foaming at the mouth, and in- sensibility, have fallen within my observation ; one occurred in 1813, in a boy, who was brought to my house in Liverpool, in a state of insensibility ; the other occurred in Edinburgh, in 1833 ; and was attended by Dr. Omond. Both were re- covered by emetics and ammonia. Since that period, Cheval- lier and Lassaigne have discovered in the seeds Cytisine, a new alkaloid, of a bitter taste, not crystallizable. Eight grains produce vomiting and convulsions. 30. Ervum ervilia and Lathyrus cicera, are two other legumes, natives of France, that are frequently mingled with wheat and rye, in bad seasons, in such quantity, as to produce giddiness, trembling, and a species of palsy, in those who feed on the grain. FORENSIC MEDICINE. 137 31. Piscidia eythrina, Dog-wood tree, is a West Indian and South American legume, possessed of active narcotic qualities. The seeds are used to stupify fish. The juice of the leaves is employed by the natives to poison their arrows. They are intensely acrid, producing burning pain in the primse vise, spasms, and hurried respiration. 32. Digitalis purpurea, Foxglove is the only one of the Scrophularinea much used in medicine. It has a tendency to accumulate in the system, when small doses are long con- tinued. Besides its effects on the pulse, in large doses, it pro- duces vomiting, giddiness, prostration of strength, pulsation in the head, and profuse perspiration : sometimes salivation, di- arrhoea, and convulsions, have preceded death. A man was killed in 1826, in London, by a decoction administered by an empiric ; coma supervened, and he died in twenty-two hours. Digitalis purpurea owes its activity to Digitalia, an alka- loid which may be obtained from it. The chief characteris- tic of digitalis is its extraordinary power in reducing the force and frequency of the pulse ; on which account it is used in medicine, but it is poisonous even in small doses. 33. Menispermum vel Anamirta cocculus. The seeds are imported from India. They contain a gray kernel, which affords about l-100th of picrotoxia, an alkaloid of an intensely bitter taste ; 10 grains will kill a dog in half an hour. The seed have been used to stupify fish, and, it is al- leged, to adulterate beer and porter. Wepfer and Orfila found that the powder of the seeds causes in dogs speedy death, by destroying the irritability of the heart. It is dangerous to mix them with any article of food. Several men suffered from this poison in 1829, near Liverpool: each had a single glass of rum strongly impregnated with Coccullus Indicus ; one died that evening, the rest recovered. The symptoms are vomiting, tormina, and finally deep stupor. 34. Arum maculatum, Wake-robin. A dangerous acrid is contained in its leaves. Orfila gives the cases of three children poisoned by its leaves ; they had incapability of swallowing and convulsions. Dogs are killed by it, without any peculiar symptom, except slight inflammation of the ali- mentary canal. The leaves are very acrid, and soon cause vomiting ; but the tubers of the root, especially when boiled, are nutritive, and the large amylaceous tubers of some of the American species of arum, are prepared as food by the abori- gines. 35. Juniperus sabina, Savine, contains, in its leaves, an acrid oil, in such quantity, that i ounce of their powder will 18 138 FORENSIC MEDICINE. destroy a dog in eighteen hours ; and even when applied to a wound, will kill the animal in two days. The poison is absorbed, for in either way the rectum is inflamed. They yield an essential oil in which the acrid qualities reside. The powder and the oil are deobstruent, and have been adminis- tered to cause criminal abortion ; but they often also destroy the female. In a case of this sort which I examined, the stomach was highly inflamed and corroded in one point; the rectum and uterus were intensely red, and I found the pow- der adherent to the stomach. Another fatal case occurred in Somersetshire in 1837. This person was also pregnant. In several instances the female dies without aborting. 36. Veratrum album, White Hellebore, has been long known to be poisonous, and Pelletier detected in it the alka- loid named veratria. An alkaloid very similar, if not iden- tically the same, was obtained by Couerbe from Veiatrnm sabadilla. He supposed it to be a peculiar alkaloid ; but it is not improbably a compound of veratria with water. The powder of white hellebore root is poisonous to every species of animal. It excites violent inflammation of the primae vise, and injected into a vein, in the smallest quantity, it produces tetanus. Eight persons were poisoned by this powder, accidentally mixed with bread ; their fauces were swelled and painful, their bowels drawn into a knot; they re- covered, but suffered severely. Sometimes blindness, dysuria, dilated pupils, and stertorous breathing, have been observed. 37. Colchicum autumnale, Meadow Saffron. This plant owes its activity to an alkaloid, so similar to Veratria, that they were confounded till lately; but it is now considered distinct, and is termed Colchicia. The root of the plant was once employed as a very drastic purgative ; but it was in dis- use until the preparation sold as the Eau Medecinal d'Hits- son, a celebrated remedy for gout, reintroduced the plant into the meteria medica. The wine or tincture of the root has been used, but that of the seeds is preferable, as more uniform in its strength. The preparation is poisonous in large doses, and produces symptoms very like those from the hellebore. Two persons, in 1838, were killed in Kent, by taking it in- stead of another remedy; and in Surrey, a gentleman died from an over-dose given during a fit of gout. 38. Bryonia alba, Bryony, was once in the list of materia medica, but from its excessive drastic effects, and its uncer- tainty, it has been long exploded. Two cases that occurred in France, are mentioned by Orfila, in which an infusion of the root was fatal in a few hours. FORENSIC MEDICINE. 139 39. Euphorbia. All the genus have a milky juice, which forms Euphorbium, a purely irritant poison. Thi9 substance contains two resins, one of which seems alkaline, the other acid ; both are poisonous, but the last is most active and has been termed Euphorbiine. In Brande's Journal* a fatal case is recorded, where the stomach was gangrened, and tore with the slightest touch. 40. Hippomane. The three species of this genus found in the West Indies yield a milky juice, which is one of the most active acrids known, especially that of Hippomane mancinnella the machineel of our colonies, and H. spinosa the Zombi apple of St. Domingo. It is said that rain fall- ing off the leaves of H. macinella will vesicate the skin. The exhalations from it are alleged to be fatal to those who sleep beneath its shade. This is doubted by Sir J. E. Smith, and denied by Ricord. The juice seems to act as a very violent but simple irritant. 41. Jatropha. This genus contains some very active poi- sons. The seeds of the Jatropha curcas, or physic-nut, when chewed, are first bland, then speedily acrid and burn- ing. They are emetic and cathartic, causing violent tormina, inflammation, and erosion of the coats of the stomach. The inflammation often extends to the peritoneum. Similar ef- fects are produced by the J. multifida and /. gossypifolia. This is chiefly owing to an acrid oil, which appears to be alkaline, and combined with an acid, both of which are con- fined to the plummula and dissepiments. The cotyledons contain a bland oil, but the volatile oil and acid are deadly poisons. 42. Jatropha manihot, or Bitter cassava, has amylaceous roots, the fresh juice of which has been long known to be very poisonous. Some of this juice which I obtained fresh from the West Indies, was distilled by Dr. Christison and by me, and yielded largely hydrocyanic acid, as was first pointed out by Messrs. Henri, and Coutron Charlard. The poison- ous quality is entirely destroyed by heat, and the amylaceous matter forms the farhina or cassava of South America and the West Indies. Farhina is also obtained from the sweet cassava, which most regard as a different species under the name of J. Janipha. The juice of this contains no prussic acid. The leaves of the bitter cassava are longer and nar- rower than those of the sweet cassava. 43. Ricinus Communis, Castor oil plant.— When heat is y Vol. iii. / 140 FORENSIC MEDICINE. employed in pressing the seeds of this plant, the oil obtained is much more drastic and disagreeable than when it is cold- drawn. This is owing to the rind and embryo of the seed, giving out, when heated, an acrid oil, which is not contained either in the cotyledons or is in them diluted by a larger quantity of milder oil. The seeds when swallowed act with great violence, and have sometimes proved fatal. In 1837, a girl of eighteen years of age perished in Liverpool, from eat- ing a few of the seeds of the plant. 44. Croton tiglium, an Indian plant, produces still more drastic seeds, which were once used in the materia medica. Of late years, the oil of the seeds has been employed with advantage.; but, is so powerful that a single drop is a suffi- cient dose. I had a patient, a very delicate lady, who usu- ally took three drops for a dose without inconvenience. In one of the Parisian hospitals, in the year 1839, a dose of two drachms and a half, had been ordered to be rubbed on the abdomen, was by mistake, swallowed. The patient died in four hours, after severe pain in the prima? viae, laborious respiration, and general cyanosis, as in the worst cases of malignant cholera*. 45. Oil of Capsicum.—Thoughtless persons sometimes administer acrid peppers, by way of a joke, to unsuspect- ing individuals. This is not always safe. A man in Sus- sex, died in 1838, from a dose of a mixture of cyanne pep- per and its essential oil in spirits and water, given as a reme- dy for ague. Among the Cucurbitaceas are some acrid poisons. 46. Cucumis colocynthis, which is employed in medi- cine, contains in the medullary part of the fruit, a substance extractable by water, which is an acrid poison. Orfila gives several instances of fatal effects from over doses of this sub- stance, which in one case, produced purging, colic, great abdominal tenderness, retention of urine, and priapism. A woman died in London, in 1828, from a tea-spoonful and a half of the powder of colocynth. Yet the substance, in mo- derate doses, is a valuable medicine, especially in combina- tion with other purgatives. The morbid appearances pro- duced by it are inflammation of the stomach, of the peritone- um, and, in one instance, effusion into the abdominal cavity, a consequence of the inflammation. 47. Momordica elaterium.—The substance called Ela- terium, is procured by the spontaneous inspissation of the juice which exudes, without pressure, from the fruit of this plant. Even in doses of one-tenth of a grain it is violently FORENSIC MEDICINE. 141 purgative; and Orfila found that it speedily destroyed dogs when introduced into the stomach, or into the cellular tissue of the limbs. In the last instance it caused inflammation in the rectum ; but the limb was tumefied and infiltrated with sanguinolent serum. Dr. Mories discovered in the juice an alkaloid to which he gave the name Elaterine. 48. Scilla maritima, though by Orfila reckoned among poisons, is not seemingly an acrid one; it kills dogs when introduced into the stomach, or applied to a wound, but without inflaming the primse viae. 49. Daphne mezereon.—Both the root and berries are narcotico-acrid poisons. A child perished in this city, in 1838, by eating a few of the red berries of this plant.—Linneus states, that twelve berries, given for ague, destroyed a girl in Sweden, and that six berries will poison a wolfe. 50. Daphne gnidium, Daphne thymaloza, and D. lau- reola are also poisonous. 51. Rhus toxicodendron. The leaves of this plant, and those of R. vernix, are acrid poisons of great energy, caus- ing, when swallowed even in a small quantity, inflamma- tion of the stomach. Sphacelus is said to have followed the application of the recent leaves to the skin ; and if they touch the face, enormous tumefaction of the head will take place. The dried leaves are used in palsy in doses of one-half of a grain, or of one grain two or three times a dav- % j • c .u 52. Gamboge, is the gummi resinous exudation ot the Garciniagambogioides, and Hebradendron gambogioides, the last a Ceylon plant, first described by Professor Gra- ham. It is an active poison ; one drachm has proved fa- tal to man ; and it is the active ingredient in certain quack pills, for selling which, verdicts of manslaughter have lately been obtained against six individuals at different times. . . , , i i- ■ i 53. Ipomcea jalapa. The root of this valuable medicinal plant, in an over-dose, must be considered as poison. Cadet de Gassicourt found, that when the powder is rubbed on the abdomen of a dog, it proved fatal by purging, in three days from the commencement of that effect. The active qualities reside in a resin, of which 12 grains will kill a dog. 54. Convolvulus scammonea produces a gum-resin which, though used in medicine, may be considered as an acrid poi- son. It produces violent diarrhoea in dogs. 55. Gartiola officinalis belongs to the same natural fa- mily as Digitalis. It acts as an acrid on the stomach, and 142 FORENSIC MEDICINE. will kill a dog in twenty-five hours. Serious accidents, ac- cording to Bouchner, have happened from this plant. 56. Lobelia lnflata possesses strong narcotico-acrid qua- lities. A quack in America poisoned a man by administer- ing three doses of the powder. It is emetic, and caused in this fatal case severe pain in the abdomen, convulsions, and delirium. L. syphilitica is less violent; but L. longi- flora has often poisoned horses in Spain. 57. Tanacetum vulgare. Tansey contains an essen- tial oil which has strong narcotico acrid qualities. Half an ounce taken by mistake, proved fatal to a lady in New York. 58. Ledum palestre has slight narcotico-acrid proper- ties. It is said to be occasionally mingled in the north of Europe with malt liquor, to increase its intoxicating quali- ties. 59. Nerium oleander.—Morgagni gives a fatal case from the juice of this plant. It appeared to act as a narcotic, and death ensued in nine hours. The extract produces vertigo, debility, and convulsions in the lower animals. 60. Apocynum androsozmifolium, and several other plants of this genus, particularly A. cannabinum and A. venetum, afford a milky juice, which inflames and ulcerates the skin, and seems to be an irritant poison. 61. Cerbera ahouai, is a Brazilian plant, of which the juice is a deadly poison. Tim seeds are used to poison fish. The wood gives out a powerful sort of alliaceous odour when burnt. It is a narcotico-acrid. 62. Cerbera manahs. The seeds are violently emetico- purgative, and are believed by the inhabitants of India to be poisonous. 63. Coriaria myrtifolia. The berries according to Sau- vages, produced violent convulsions and death in a child, within half an hour. 64. Narcissus pseudo-narcissus, Daffodil, has some nar- cotico-acrid powers. Half an ounce of the extract killed a dog in six hours. 65. Anagallis arvensisis slightly narcotic; and so is Mercurialis perennis. 66. Spigelia marilandica is mentioned by Beck as among the poisonous plants of America. It has evidently narcotic qualities, and is said to have caused the death of children in convulsions. 67. Symplocarpus fostida. Skunk Cabbage, is a violent narcotic mentioned by Bigelow. Of the same character is Sanguinaria Canadensis of Bigelow. FORENSIC MEDICINE. 143 68. Poisonous Fungi. Several of this natural order are poisonous, especially those belonging to the general Amanita, Agaricus and Hypophyllum. The poisonous qualities appear to depend on two principles ; one of which is volatile, and disappears on boiling, drying, or macera- ting in a weak acid. To this principle, Le Tellier as- cribes the irritant quality of poisonous mushrooms. The other is not volatile, is soluble in water, unites with some acids into crystallizable compounds, and appears to be an alkaloid now termed Fungia ; on this the narcotic proper- ties of these plants depend. The time in which the symp- toms occur, after the fungi have been eaten, is very vari- ous; often not until twelve or even twenty-four hours. The sufferers are often relieved by vomiting; but if not, the surface becomes livid and cold, violent colic ensues, and death is preceded by delirium and deep coma. The corpse is livid all over, the blood fluid, and sanguine dis- charges are apt to flow from the mouth, nose and eyes. Several French soldiers were poisoned in Napoleon's Rus- sian campaign, from mistaking Amanita muscaria for A. Coesaria. The stomachs of those who died were inflamed and gangrened. Many cases of this species of poisoning have occurred in these islands. A family of three persons perished in Cambridgeshire from mushroom poison in 1837 ; and one individual in Lancashire in the same year. About the same time, three persons of this city were poisoned by eating Agaricus procerus, gathered on Arthur's Seat; but they recovered, after furious delirium, oppressed breathing, feeble pulse, cold surface, and dilated pupils. 69. Secale cornutum.—The ergot of rye produces, when eaten in bread, many of the symptoms of mushroom poi- son. De Candolle ascribes this disease of grain to a fun- gus of the genus Sclerotium; and it has been found to yield a principle resembling Fungia! The tendency of this substance to produce dry gangrene, is generally ad- mitted by German and French writers. There is a learn- ed dissertation on it by Dr. Wiggers, in which its fungoid origin, and its peculiar action in promoting the expulsive efforts of the gravid uterus, seem to be established. In an excellent dissertation on this subject, by Doctor S. Wright, he did not find that it produced gangrene in dogs : nor did it rouse the action of the gravid uterus in the lower animals, except in a single instance; but he proved that it is an active poison, producing paralysis and coma when injected into the veins, inducing emaciation, and depres- 144 FORENSIC MEDICINE. sion of the whole nervous powers, with loss of sight, and diminished animal heat. He found that its activity resides in an oil, which may be conveniently used as a medi- cine to restore action of the uterus in tedious labours, to check hemorrhage and diarrhoea, and as a local application to check bleeding from wounds. The dose is from 20 to 50 drops. 70. Alcohol and Ether may be here considered, as being derived by art from vegetable matter. They are well known narcotics, producing at first intoxication, and after- wards stupor and cerebraf congestion. They are also irri- tants, the stomachs of persons killed by them being often inflamed. When the immoderate use of spirit does not produce death, it may give rise to delirium tremens. The smell of spirit is often perceived in the cavities of the chest, brain and abdomen of those who have died from drinking. The stomach pump and milk are the best re- medies. 71. Nitro-picric, or Carbazotic Acid, a substance obtain- ed by cautious additions of indigo to warm nitric acid, has considerable narcotico-acrid qualities, as was proved by Rapp of Tiibingen on the lower animals. Ten grains in- troduced into the stomach will kill a dog in an hour and a half. The symptoms are, tremors, contortion of the eyes, convulsions, and complete stupor. The stomach is dyed of an intense yellow; and this colour extends to all the tis- sues and coats of the vessels, but does not pervade the brain or spinal cord. Another acid, nearly similar, the Nitro ainlic, is obtain ed from the same materials, in different proportions. 72. Camphor, a concrete essential oil, has pretty strong narcotic qualities. There are two kinds, of camphor known in commerce : the common, produced by distillation from the stem and roots of Laurus camphora; the other found in the interstices of a large forest tree, Dryabalanops cam- phora. This last sort in China bears seventy times the price of the common sort. Camphor, from Mr. Alexan- der's experiments, has considerable energy ; and in fatal cases from an over-dose, the stomach has been found in- flamed. It is best detected by its peculiar odour. FORENSIC MEDICINE. 145 ANIMAL AND SEPTIC POISON. I. Cantharides—An acrid poison is contained in the body of the Cantharis vesicatoria. It is found to reside in a whit- ish matter resembling spermaceti in colour and consistence, which is united to three other marked principles. The first is a green oil, soluble in spirit, but not in water; the second a blackish matter soluble in water, but not in spirit; third a yel- low viscid matter, soluble both in water and spirit. The last is united in the insect with Cantharidine, and renders it solu- ble in water, which is not when pure. The symptoms of poisoning by cantharides are, intense burning heat in the primoe vi-i -%.? , ■-1- C / ry r SSIIIJl / -v^ fl ' / N {A £/ -$. -£^-#S-,< ^•H«i'•k'l'ity '%: w ifl.- f.tffll ■***■ •, 4 mm H#3 WW