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 Principles of medical jurisprudence:desi 
 
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MEDICAL JURISPRUDENCE. 
 
PRINCIPLES 
 
 MEDICAL JURISPRUDENCE: 
 
 DESIGNED FOR 
 
 THE PROFESSIONS OF LAW AND MEDICINE. 
 
 By AMOSJJEAN, 
 
 JOUNSELLOR AT LAW, AND PROFESSOR OF MEDICAL JURISPRtJDENCB 
 IN THE ALBANY MEDICAL COLLEGE. 
 
 NEW YORK: 
 BANKS & BROTHEES, LAW PUBLISHERS, 
 
 No. 144 NASSAU STREET. 
 ALBANY: 475 BROADWAY. 
 
 1873. 
 
■ Entered accord :.g to Act of Congress, m the year 1850, by 
 GOULD, BANKS & GOULD, 
 In the Clerk's Office of tLe Dismct Court of the Northern District of New-YorV. 
 
HON. JABEZ D. HAMMOND, LL. D., 
 
 WHOSE TALENTS, VIRTUES AND MORAL WORTH 
 ENDEAR HIM TO THE PRESENT 
 AND COMMEND HIS NAME AND EXAMPLE TO THE FUTURI 
 
 ©I)t0 Book is Inscribed, 
 
 AS A TESTIMONY OF REGARD AND ESTEEM 
 AND A TOKEN OF GRATEFUL REMEMBRANCE 
 
 33g ttje 2totljor. 
 
PREFACE. 
 
 The topics embraced in the Science of Medical Jurisprudence have been 
 constantly acquiring importance jn proportion as the wants of society have in 
 creased, its resources multiplied, and the refinements of civilization become ex- 
 tended and enlarged. Although its principles have ever lain at the foundation 
 of general jurisprudence, yet their clear ascertainment, and embodiment in a 
 scientific form, have been comparatively recent. Within the last half century, 
 great and important advancements have been made in a knowledge ofthem, and 
 their application to the practical affairs of life. The wants and requisitions of 
 society, in regard to this knowledge, have been furnishing a constant stimulus to 
 the human mind, and inciting it to continued effort in discovering new principles, 
 as well as defining, elucidating, and applying, those that were old. 
 
 The demand of the public, in this respect, is sufficiently evidenced in the mul- 
 tiplication of the means of instruction, that is every where taking place. No 
 medical institution in this country or Europe, could now deem its organization 
 complete, without a department devoted exclusively to an exposition of the 
 facts and principles embraced in Medical Jurisprudence. 
 
 An experience of some eleven years in teaching in this department, together 
 with a knowledge of the wants of the legal and medical professions in regard to 
 it, have led to the compilation of the work now offered to the public. If does 
 not propose to add new heads, or general topics, for discussion ; to deal in origi- 
 nal disquisitions, upon doubtful or unsettled principles , or to offer mere novel 
 ties to those in pursuit of knowledge on its various subjects. The objects chiefly 
 had in view, have been, a methodical, systematic arrangement of the topics 
 legitimately embraced in the department ; and in the treatment of each, a con- 
 densation of the knowledge now possessed ; and an exhibition of it in a clear, 
 natural, and logical order, together with such illustrations as were deemed 
 necessary to make an application of the principles to practice. In the selection, 
 and narration of cases, both multiplication, and minuteness of detail, have been 
 equally avoided ; the object being simply to illustrate, and facilitate the reduc- 
 tion to practice, of the principles embraced in them. By adopting this course, 
 I am enabled, within the compass of a single volume, to state in concise terms, 
 all, or nearly all, the ascertained facts and well settled principles that are im- 
 portant to be known, with a brief statement of the cases that serve to illustrate 
 them : making, at the same time, a reference to the sources from which they 
 
Vl PREFACE. 
 
 were obtained, and where also a greater number of cases, and more minute de- 
 rails of each may be found. 
 
 The materials of the work have been derived from many different sources. 
 Without presuming to enumerate all, I acknowledge myself particularly indebt- 
 ed to Dr. Beck's Elements of Medical Jurisprudence, Dr. Guy's Principles 
 of Forensic Medicine, Mr. Taylor's Medical Jurisprudence, Dr. Smith's 
 Principles of Forensic Medicine, Paris and Fonblanque's Medical Jurispru- 
 dence; and on single topics, Dr. Montgomery's exposition of the Signs and 
 Symptoms of Pregnancy, Dr. Watson on Homicide, Dr. Kennedy on Preg- 
 nancy and Auscultation, Dr. Kay on Asphyxia, Dr. Christison on Poisons, 
 Dr. Prichard on the Different Forms of Insanity, Dr. Corribe on Mental De- 
 rangement, and Dr. Say on the Medical Jurisprudence of Insanity. 
 
 I have been careful as far as possible, in all cases, to make a distinct refe- 
 rence to the source from which the fact, principle, or case stated has been de- 
 rived. I have done this in the hope, not only of possessing the reader with the 
 principle, and a brief outline of the case which illustrates it, but also, at the 
 same time, of placing before him such references as will enable him to make 
 fuller investigations in regard to any point or principle he may be interested in 
 studying. It is not, therefore, the exclusive design of this work, to supersede 
 other and more voluminous works on the subjects embraced in it; but to furnish, 
 in as intelligible and concise a form as possible, the substance of what they 
 contain, with references to them for fuller discussions, and minuter details of 
 cases. At the same time, it aims to be sufficiently full and minute in its expo- 
 sition of facts, principles and illustrations, to possess the mind with such an 
 amount of knowledge as may be necessary for all the general purposes for 
 which it may be required 
 
 Albany, May, 1850. 
 
MEDICAL JUBISPRUDENCE. 
 
 Medical Jurisprudence is that science winch teaches the ap- 
 plication of the practice and principles of Medicine to the eluci- 
 dation and settlement of doubtful questions arising for investiga- 
 tion in courts of law. 
 
 This science, unlike many others, admits of no clear logical 
 arrangement of the topics which compose it. It is not itself a 
 complete whole, to the production of which all the several parts 
 conspire in a natural order. It consists of many different subjects 
 or topics, mostly isolated, and having with each other few if any 
 intimate connexions. It is, however, a matter of convenience to 
 bring together those subjects that are at all related to each other ; 
 and with that view I propose to follow out, as nearly as possible, 
 the following arrangement, which appears less exceptionable than 
 any that has come under my notice. 
 
 All the subjects are included under five general heads or classes. 
 
 The First Class will include questions arising out of the rela- 
 tions of sex. 
 
 Under this head or class will be comprised, 
 I. Impotence and sterility. 
 II. Hermaphrodites, doubtful sex, monsters. 
 
 III. Rape. 
 
 IV. Pregnancy — its signs and indications. 
 V. Legitimacy. 
 
 VI. Delivery. 
 The Second Class will include questions arising out of injuries 
 inflicted upon the organization. 
 
Z MEDICAL. JURISPRUDENCE. 
 
 This will embrace, 
 
 I. Infanticide. 
 II. Wounds. 
 
 III. Poisons. 
 
 IV. Persons found dead. 
 
 The Third Class includes questions arising out of diseases, or 
 affections in the nature of disease, that disqualify both from ex- 
 ercising rights and performing duties, being principally insanity, 
 including all the different forms of mental alienation. 
 
 Tlie Fourth Class includes qusstions arising out of deceptive 
 practices or pretended disqualifications, principally feigned dis- 
 eases. 
 
 The Fifth Class will include miscellaneous questions, such as 
 age, identity, presumption of survivorship, life assurance and 
 medical evidence. 
 
 CLASS I. 
 
 QUESTIONS ARISING OUT OF THE RELATIONS OF SEX. 
 
 The harmonious movements of general society depend much 
 upon the proper regulation of the relations growing out of the 
 distinction of sex. It is these that lay at the foundation of the 
 domestic relations, which are among the first to which we are 
 subject, and the last from which we are exempted ; and are, per- 
 haps, more than ah others, replete with sources of happiness, or 
 means of misery. It is, therefore, that questions arising out of 
 these relations, have attached to them a deep degree of interest, 
 and demand a free investigation and discussion notwithstanding 
 the great delicacy with which they are very properly regarded 
 by the popular mind. Among these questions the first we shall 
 notice has reference to, 
 
 I. IMPOTENCE AND STERILITY. 
 
 These are usually coupled together, and in one respect have a 
 necessary connexion, inasmuch as the existence of the first is 
 always attended by the second as a natural consequence. By 
 Impotence is meant physical incapacity; an inability, from de- 
 
IMPOTENCE AND STERILITY. 3 
 
 fective organization, or some other cause, to perfoim the genera- 
 tive aet. 
 
 Sterility may admit the physical capacity, but leaves the act 
 unattended with any fruitful result. In this view of it, the first 
 is the most generally applicable to the male, the last to the fe- 
 male — although both may be applicable to each. 
 
 The question of sterility, apart from impotence, is seldom or 
 never raised in our courts of law. It is not clear, that in the 
 female there is any means of deciding the question of sterility, 
 except as it forms a part of the question of impotence. 
 
 Questions of impotence may arise in three kinds of legal in- 
 vestigations : 
 
 1 . In suits for divorce : 
 
 2. In accusations of rape : 
 
 3. In cases of contested legitimacy. 
 
 In regard to the first, the law of England (1 Blackstone's Com., 
 440,) admitted impotence as a sufficient cause for an entire di- 
 vorce, or one a vinculo matrimonii, provided it existed before 
 marriage. But if it arose subsequently, it was no such cause 
 Marriage being regarded as a civil contract, having in view the 
 birth and rearing up of children as one of its principal ends, if 
 the incapacity existed previous to its formation, it was of such 
 importance as to be deemed an element of fraud, and hence was 
 sufficient to vacate it. If, on the contrary, it did not arise until 
 subsequently, it could not affect the contract, which was valid 
 and therefore binding in its inception, and one of the ends of 
 marriage, the procreation of children, may have been answered. 
 This doctrine will be found illustrated and applied, in the cases 
 of Briggs VS. Morgan, 3- Phillimore's Ecclesiastical Reports, 425 ; 
 Greenstreet vs. Cumyns, 2 Phillimore, 10 ; Norton vs. Seton, 3 
 Phillimore, 147 ; Brown vs. Brown, 1 Haggard's Ecclesiastical Re- 
 ports, 523 ; and Pollard vs. Wybourn, 1 Haggard, 725. 
 
 The ecclesiastical law of England having never been adopted 
 in this country, it is here pretty generally a matter of statute re- 
 gulation. In this State, the Revised Statutes, 2 vol., 142-3, of 
 1st edition, provides that a marriage contract may be declared 
 void for physical incompetency in either of the parties, whicr 
 
4 MEDICAL JURISPRUDENCE. 
 
 existed at the time of the marriage. This proceeding can only 
 be had by the injured party, against the other whose incapacity 
 is alleged, and must, in all cases, be instituted within two years 
 from the time of the marriage. 
 
 A judicial construction has been put upon this part of the 
 section of our statute, in the case of Bevanbagh vs. Bevanbagh, 
 reported in 5 Paige, 554 ; and also in 6 Paige, 175. This was a 
 case in which an unusually firm, dense and strong hymen pre- 
 sented an insurmountable obstacle to the consummation of thu 
 marriage. 
 
 The principles settled in that case, were substantially the fol 
 lowing : That if there existed the probability of a physical capa 
 city, the court cannot annul the marriage contract ; that the im 
 potence must exist at the time of the marriage, and must be in- 
 curable ; that the party must submit to a surgical examination, 
 if necessary, to determine the fact of impotence ; and that if a 
 slight surgical operation can restore the competency, it must be 
 done, or that a divorce cannot be decreed because it is not done. 
 , An act was passed in Pennsylvania in 1815, providing that if 
 either party, at the time of the contract, was and still is natural- 
 ly impotent, or incapable of procreation, it shall and may be law- 
 ful for the injured and innocent person to obtain a divorce. 
 
 Impotence, if established at the time of the commission of the 
 alleged offence, would be a sufficient defence on an indictment 
 for rape. So", also, in contested questions of legitimacy, the fact 
 of impotence existing at the period of conception of the claim- 
 ant, would be controlling. The examination, therefore, the most 
 generally has to be made, not only as to the fact of impotence, 
 but also as to whether it did or did not exist at a particular time. 
 
 Impotence may exist both in the male and female. It may be 
 either absolute or relative. In the first, there is a total incapa- 
 city ; in the second, the incapacity exists only as between parti- 
 cular parties. Again, impotence may be either organic or func- 
 tional, according as it is produced by physical or moral causes. 
 Questions relative to impotence, seldom arise for Investigation, 
 unless it is absolute and organic, arising from physical causes. 
 
 The three conditions essential to the full and perfect exercis» 
 
IMPOTENCE AND STERILITY. 5 
 
 of the physical capacity, is erection, intromission and ejaculation 
 of the seminal fluid. The first and third of these belong exclu- 
 sively to the male, the second to the female. A fatal defect in 
 one or more of these, must necessarily result in impotence. 
 Ryan's Medical Jurisprudence, 99. 
 
 The physical causes of impotence in the male, or those that 
 are generally productive of it, are — 1. Age; 2. Defect or mal- 
 formation of the penis; 3. Defect or disease of the testicles; 
 4. Constitutional disease or debility. 
 
 1. Age: Youth and old age are equally incapacitated. Prior to 
 the seminal secretion, that is, before the age of puberty, sexual 
 intercourse is either entirely impossible, or certainly as to any 
 productive result. The age at which this occurs, varies with the 
 climate, the food eaten, and mode of life, and probably with the 
 constitutional peculiarities of the individual. 
 
 Any judgment formed in relation to it, must rest mainly on 
 the general conformation of the body, the character of the voice, 
 the growth of the hair, the development of the organs of gene- 
 ration, and the constitutional indications, hereafter mentioned. 
 The young and old have been termed the frozen zones of exist- 
 ence, the intermediate being the torrid zone. Impotence grows 
 out of the infirmity of age as well as the immaturity of child- 
 hood. But at what particular age it supervenes it is impossible 
 to settle upon. It may perhaps be stated as a general rule that 
 the capacity in the male exists from puberty to*the 65th year, 
 but there are so many differences in individual condition as to 
 render any rule that may be laid down of little or no value. In 
 some men the capacity exists to a remote age. Haller pronoun- 
 ces a man of ninety possessed of the capacity. The celebrated 
 Thomas Parr, who outlived nine kings of England, became 
 a father in his one hundred and fortieth year. 
 
 Impotence, from age, became a question in the celebmted Ban- 
 bury Peerage case, which came before the house of Lords in the 
 year 1813. It was there insisted that the ancestor of the 
 claimant could not have been the son of Lord Banbury, because 
 that nobleman was eighty years of age when the child was born. 
 It waf, hovever, clearly recognized in that case, that the law of 
 
6 MEDICAL JURISPRUDENCE. 
 
 England admits of no age at which a man may not become a 
 father. 
 
 It may, therefore, be considered as settled, that neither law nor 
 science can assign any period. in the life of man, when the power 
 of procreation ceases. Each case must be determined upon the 
 circumstances it presents. 
 
 2. Defect or malformation of the penis : 
 
 The entire want of it would produce impotence. When a part 
 remains, it may be difficult to tell, in any given case, whether the 
 physical capacity does or does not exist. The principle deduced 
 from the great number of cases that have occurred seems to bo 
 pretty clearly settled, that if sufficient, of it remains, to admit of 
 introduction within the orifice of the vagina, and there be no im- 
 pediment to the emission of semen, a fruitful intercourse may 
 take place : Guy^s Principles of Forensic Medicine, 54. Several 
 instances have occurred where the glans has been lost, and yet 
 the faculty of procreation has been retained : 1 Paris §• Fon- 
 llanque's Medical Jurisprudence, 202. 
 
 One case is related, where both the corpora cavernosa were 
 destroyed ; but as the urethral canal was preserved, it did not 
 result in impotence. In another case, a musket shot carried 
 away so considerable a portion of the penis, that when the, wound 
 healed, the organ remained curved; and yet it proved adequate 
 to the performance of its functions. Even where, in consequence 
 of disease followed by amputation, there was only a very small 
 protrusion of the organ on pressure, the patient afterwards be- 
 came the father of two children.' Guy's Principles of Forensic 
 Medicine, 54. 
 
 Although not a frequent, occurrence, yet there maybe a pa- 
 ralysis of the muscles of the penis, so as to render it incapable 
 of performing its function. So, also, a continued erection may 
 occasion a temporary impotence; the vigor of the erection so 
 closely shutting up the urethra, as that the powers which throw 
 the semen from the vesiculse seminales, are unable to overcome 
 it. 1 Paris Sf Fonblanque's Medical Jurisprudence, 205. 
 
 There may exist a contracted state of the prepuce or a Phy- 
 mosis, which may so interfere with the discharge of the semen as 
 
IMPOTENCE AND STERILITY. 7 
 
 to constitute impotence ; but as this is capable of being removed 
 by an operation, it cannot be considered as a permanent cause. 
 1 Paris 4r Fonblanque's Med. Juris., 204. 
 
 Size of organ, when much below or above the natural ordina- 
 ry size, has been considered by some as a cause of impotence. 
 Under this head, a very extraordinary case is related by Mr. 
 Wilson, which should induce a great degree of caution in pro- 
 nouncing upon impotence from this cause. 1 Beck's Medical 
 Jurisprudence, 75. 
 
 He says he was consulted by a gentleman as to the propriety 
 of his entering the marriage state, as his penis and testicles very 
 little exceeded in size those of a youth of eight years of age. He 
 was then twenty-six, and had never felt desire for sexual inter- 
 course until he became acquainted with his intended wife, since 
 which, he had experienced repeated erections, attended with 
 nocturnal emissions. He married, became the father of a family, 
 and those organs which, at twenty-six, were so much smaller than 
 usual, at twenty-eight, had increased nearly to the usual size of 
 those of an adult man. Excessive development can scarcely be 
 regarded as a cause of impotence, as it can rarely, if ever, go to 
 the extent to render impregnation impossible. Guy's Principles 
 of Forensic Medicine, 54. 
 
 _ Under the same head is also to be included malformation arising 
 from the unnatural situation of the orifice of the urethra. Some- 
 times it opens in the perineeum, occasionally on the dorsum or 
 back of the penis, and more frequently underneath. 1 Paris # 
 Fonblanque, 203. This is termed hypospadia, and in determining 
 the question in any given case, it will be necessary to ascertain 
 whether the orifice of the urethra is situated in that portion of 
 the penis which would be introduced into the vagina in the act 
 of intercourse. If so, under the principle already mentioned, the 
 party cannot be termed impotent. 
 
 There are a great number of well authenticated cases in which 
 the orifice of the urethra was situated upon the penis, where nol 
 only the physical capacity fully existed, but where the peculiarity 
 itself has been transmitted to offspring. See Guy, 55 ; 1 Beck, 
 71. and number of cases collected in a note. 
 
f» MEDICAL JURISPRUDENCE. 
 
 A much more difficult case to decide is where the urethra 
 opens in the perineum. Dr. John Hunter, in a case of this kind, 
 accomplished the purpose of impregnation by causing the semen 
 to be injected by means of a syringe, previously warmed, into 
 the vagina, immediately after the act of intercourse, and during 
 the existence of the venereal orgasm. 1 Paris fy Fonblanque, 203. 
 This certainly shows that great caution should be practiced before 
 pronouncing a party impotent from the malformation arising 
 from the termination of the urethral canal. 
 
 Instances of impregnation have occurred where the hymen re- 
 mained unbroken, and also where the male organ was not suffered 
 to enter the vagina at all, in which latter cases it is supposed it 
 must have taken place from the mere deposition of the semen 
 upon the vulva. Guy^s Medical Jurisprudence, 56, and authorities 
 there cited. 
 
 3. Defect or disease of the testicle : 
 
 There was once a period in the history of physiology when the 
 testicles were not considered as necessary to virility. From ob- 
 serving that the bull could impregnate the female after castration, 
 Aristotle abandoned the true theory of the function of the testi- 
 cles, and asserted their use to be to serve as weights to hinder 
 the spermatic vessels from being folded up. 1 Paris fy Fonblanque, 
 1 97 - 8. Notwithstanding, however, the authority of the Stagi- 
 rite to the contrary, they are now regarded as essential to consti- 
 tute virility. It is true, nevertheless, that their removal in a 
 healthy state, after puberty, is not immediately productive of 
 impotence. The instance of the bull above mentioned is a case 
 in point. There is little doubt but that sexual intercourse may 
 take place for a considerable period of time after the removal of 
 both testicles. Sir Astley Cooper mentions a case in which a 
 party for twelve months after the loss of the second testicle, had 
 sexual intercourse accompanied with emissions, afterwards inter 
 course without emission, which became less frequent until the 
 expiration of about ten years, when both ceased. Guy's Principles 
 of Forensic Medicine, 56. 
 
 Other instances are also mentioned, going to show that in such 
 cases the capacity may exist after castration, for a longw or 
 
IMPOTENCE AND STERILITY. i) 
 
 shorter period, depending probably somewhat upon the circum- 
 stances, and the age and constitutional strength of the party. 
 The loss of both testicles before puberty, would occasion impo- 
 tence. Their loss subsequently would occasion it; but the ques- 
 tion of time would here occur, which might be one of doubt and 
 difficulty. ' ' 
 
 As impregnation can be but little dependent upon the quantity 
 of semen introduced into the vagina, it may now be considered 
 as well settled that one testicle, if in a healthy state, may be suf- 
 ficient for all the purposes of effecting it. Guy's Med. Juris., 56. 
 
 Another difficulty that sometimes presents itself is, that no tes- 
 ticles are to be found in the scrotum. In such case the first thing 
 to be determined is, whether they have been removed. If such 
 be the fact, and their removal has been accomplished by excision, 
 this will be indicated by the cicatrices that remain. If no cica- 
 trices are found, the next thing to determine is whether they 
 have descended from the abdomen. They are formed in the 
 cavity of the abdomen, where they remain until the sixth month, 
 after which usually they gradually descend towards the abdomi- 
 nal ring, through which they generally pass into the scrotum be- 
 fore birth. Sometimes the descent does not take place until a 
 late period, and in a few instances they remain in the cavity of 
 the abdomen during life. The effect this may have upon the 
 generative power has been formerly a matter of some dispute, 
 '"but it may now be regarded as well settled, that provided they 
 are well developed, and in a healthy condition, their situation in 
 the abdomen, or in the inguinal canal, in which they are some- 
 times found, does not divest them of the power of performing 
 their functions. If, therefore, the testicles are to be found neither 
 in the groin nor in the scrotum, and no cicatrix indicates their 
 excision, a resort must be had to the general appearance of the 
 body, sound of the voice, growth of the hair and other indications 
 of virility, to determine whether or not the capacity exists. 
 
 There are also diseases which affect the testicles, some causing a 
 wasting of their structure, others changing their texture : such, for 
 instance, are the elephantiasis and cynanche parotidea. Gm/s 
 Med. Juris., 57. 
 
10 MEDICAL JURISPRUDENCE. 
 
 So, also, after severe inflammatory action, they may be absorbed 
 by an operation of nature. A severe bruise of the testicles has 
 resulted in their absorption, and thus been productive of im- 
 potence. Chronic inflammation, from any cause, may result In 
 impotence. Cases are sometimes met with, of arrest of develop- 
 ment of the testicles, where in the adult they are no larger than 
 they are ordinarily found to be in a boy of six or seven years of 
 age. Where the process of wasting does not arise from disease 
 of the gland, the testes usually preserve their shape, but feel 
 soft, having lost their elasticity and firmness. 
 
 Any organic disease of the testicles, such as schirrhus, medul- 
 lary sarcoma, &c, will be likely to cause impotence, provided 
 the entire structure of both testicles is affected. There may also 
 exist mechanical causes, such as congenital scrotal hernia, which 
 by pressure upon the spermatic vessels, may prevent the secre- 
 tion of semen, and thus be productive of impotence. 
 
 The observations of Baron Larry, as quoted in the Medico- 
 Chirurgical Review for July, 1831, (see vol. 19, p. 15, 16, 17, &c.,) 
 go to show a most intimate connection between the cerebellum 
 and genital organs. Wounds in the cerebellum, or occipital region 
 of the head, have been found to cause an atrophy in the organs of 
 generation, so far as to render the party impotent. On the other 
 hand, wounds in the genital organs, were found by him to exert 
 a reciprocal influence in the production of atrophy in the cere- 
 bellum and occipital region of the head. 
 
 Instances may occur, in which the structure of the testicle is 
 defective. One instance is given by John Hunter, in which the 
 epydidymis, instead of passing to a vas deferens, terminated in 
 a cul-de-sac. This anomalous structure would prevent the evacu- 
 ation of the semen by the urethra, and thus render the party 
 impotent or sterile. 1 Paris fy Fonblanque's Med. Juris., 201. 
 Sometimes a similar difficulty occurs in the vesiculse seminales,- 
 which, instead of entering the urethra, terminate, after being 
 joined by the vasa deferentia, in imperforated pouches, or cul- 
 de-sacs, producing incurable impotence, lb., 202. 
 
 4. Constitutional disease, or debility : 
 
 There are many diseases which interfere with the generative 
 
IMPOTENCE AND STERILITY. 11 
 
 function. These are generally remarked to be of that character 
 that affect the head and sensitive system primarily, and those 
 which are accompanied with great debility. Such, for instance, 
 are imflammatory and catarrhal fevers. On the other hand, 
 there are some diseases that appear actually to stimulate the 
 genital organs. Such are gout and rheumatism, calculus of the 
 kidneys and bladder, and sometimes during convalescence, from 
 yellow and other fevers. Guy's Principles of Forensic Med., 59 ; 
 1 Beck's Med. Juris., 79. 
 
 The following are enumerated among the injuries and diseases 
 which, from the changes they produce in the system, are ex- 
 tremely likely to produce impotence : " A mutilation, or severe 
 wounds of the sexual organs, carcinoma of the testicles or penis, 
 gangrene of the lower extremities, immoderate evacuations of 
 blood or bile, or of the fceces, scorbutic cachexia, marasmus, 
 peripneumony and hydrothorax, anasarca in its perfect state, 
 (particularly if accompanied with an infiltration into the sexual 
 organs,) nervous and malignant fevers, (particularly if they af- 
 fect thejsrain, and are accompanied with great debility and loss 
 of memory,) all affections of the head and spinal marrow, 
 whether from a fall, blow, wound, or poison, or from internal 
 causes, as apoplexy, palsy, or other comatose diseases. So, also, if 
 affected with leprosy, venereal ozcena, severe cutaneous diseases, 
 or insanity, a reasonable doubt of the tact of cohabitation may 
 be entertained, from the fear the female may be presumed to ex- 
 perience lest she should be contaminated, or from the dread en- 
 tertained of having communication with the individual. 1 Beck\ 
 Med. Jam., 80-81. 
 
 A. habitude of chastity, too long indulged in, may in time ex 
 tinguish the desire, and impair or destroy the power of erection 
 In such cases, the organs decay, like all other corporeal organs, 
 whose functions are not exerted. Ryan's Med. Juris., 101. 
 
 So, also, a habitude of indulgence, long continued, and ex 
 cessive, whether with women or by masturbation, produces the 
 same, or, rather, a much worse result. The state or condition 
 to which this leads, is accompanied by involuntary discharges of 
 semen, which, of itself, occasions great debility, and difficulty or 
 
12 MEJICAL JURISPRUDENCE. 
 
 impossibility of exciting the turgescence of the penis. Dr. Ryan 
 attributes to this excessive indulgence, the fact, often occurring, 
 of want of family in young married persons. Ryan's Med. Juris., 
 102. 
 
 The abuses of narcotics, saline refrigerants, acids, acid fruits, 
 iodine, camphor, and nitre, are enumerated by Dr. Ryan among 
 the causes of impotence, lb., 102. 
 
 Some facts would seem to show that there may be some dis- 
 eases which so change the state of the system, as to produce an 
 alteration in the generative power. Thus Avenzoar had no 
 children during the period of his youth, but became a father 
 shortly after recovering from a violent fever. There was also an 
 artificer who lived twenty-four years with his wife without issue. 
 Shortly after convalescing from illness he became a father and 
 subsequently had many children. 
 
 Where impotence arises from the operation of causes develop- 
 ing themselves through the constitution of the individual, the 
 following are described es the most frequently attending concom- 
 itants. The hair is white, fair and thin. There is no beard, 
 The countenance is pale. The flesh is soft and without hair.- 
 The voice is clear, sharp, and piercing. The eyes appear dull 
 and sorrowful. The form is round, shoulders strait, and per- 
 spiration acid. The testicles are small, withered, pendulous and 
 soft. The spermatic cords are small, the scrotum flaccid, and the 
 gland of the testicles insensible. There is no capillary growth 
 on the pubes. A moral apathy prevails, and great pusillanimity 
 and fear is present on the least occasion. These are the usual 
 indications of impotence or sterility in the male. Ryan, 101. 
 
 The mental or moral causes of impotence have their operation 
 upon the mind ; and by means of the effect they produce there, 
 render the genital organs unfit for the exercise of their functions. 
 They operate only upon the mind of the male, and usually attack 
 one condition essential to the generative act, namely, that of 
 erection. 
 
 The moral causes of impotence are any excessive passion, ex • 
 trerae timidity, alarm or apprehension, disgust, or any other 
 strong working of the imagination, prevailing at the time. The 
 
IMPOTENCE AND STERILITY. 13 
 
 principle seems to be — the prevalence at the time of any one ab- 
 sorbing emotion, or other intense action of the mind, the effect 
 of which is to withdraw the system from the influences and 
 power to which it is subjected in order to the performance of the 
 act. There is perhaps no fact in the animal economy, that de- 
 monstrates more clearly the influence and power of the moral 
 over the physical state of man, than is to be found in the opera- 
 tion of these moral causes. Any ruling idea that for the time 
 absorbs the mind by concentrating upon itself all the mental 
 energy, deprives the organization of the use of that mental ele- 
 ment without which the phenomenon of erection is never ex- 
 perienced. Guy,60 ; Ryan, 102-3; Smith's Forensic Med., 56-7. 
 
 One of the most frequent of these causes is the fear itself of 
 being impotent. This has frequently operated to produce this 
 effect. When the moral state had consumed their desires, or 
 substituted other emotions in their place, men supposed there 
 was no physical power, and they were impotent so long as they 
 supposed themselves so. It was in the operation of these moral 
 causes that the powers of magic and witchcraft, the ingenious 
 charms, and amulets that have been invented, have been ena- 
 bled to produce such successful results. Thus a few obscure and 
 unintelligible words written on paper with the blood of a bat, 
 sowed up with a needle which had been used in making shrouds 
 for the dead, and tied around the neck of a new married man, 
 has produced impotence from a moral cause. Ryan 103. So 
 also among the Athenians, an unsuccessful suitor, on the mar- 
 riage of his rival, by tying the locks of his hair, with a certain 
 form of words, had the power of deferring the bridegroom's hap- 
 piness just as many nights as he tied locks of hair. Smith's 
 Forensic Medicine, 457. It is related that an Archon suffered 
 this calamity during the first month of his marriage. These 
 moral causes can seldom arise for investigation in courts of jus- 
 tice, as they are generally curable, being temporary in their na- 
 ture. 
 
 There seems, however, to have been one moral cause of a per- 
 manent character, and that is aversion. In the case of the Earl 
 of Essex, reported in 1 Har grave's State Trials, 315 : See alsn 
 
14 MEDICAL JLIUSPR,TL^.NVE. 
 
 1 Beck, 69, and Smith 489 . the Earl admitted Ms inability to 
 know the Countess of Essex, bat denied kit) impotence as to 
 other females. So also in a case quoted by Gvy^ page €0, the 
 husband was incapable of emission while cohabiting with his wife, 
 although there was no physical obstacle to prevent it, and the 
 same difficulty was not experienced with other persons, and he 
 had had children by a former marriage. 
 
 The folio wing have been enumerated among the curable causes 
 of impotence. " An atony of the parts, arising sometimes from 
 local disease or external injury, and at others from masturba- 
 tion ; a retraction of the penis, originating from stone in the 
 bladder, or some other urinary disease, a natural phymosis, 
 which sometimes confines the glans in such a manner as to pre- 
 vent the emission of semen ; obliteration of the canal of the 
 uretha, from stricture or other causes ; and a malconformation 
 as to the place of the aperture of the urethal canal. These have 
 all been successfully obviated by modern surgery. 1 Beck 76-7, 
 
 There are several causes of impotence in the female, mostly 
 affecting the second condition, viz : intromission. Some of these 
 causes are incurable and some curable. Among the incurable, 
 are reckoned an obliteration or thickening of the sexual organs 
 so as to prevent any intromission. Thus the vagina and womb 
 have been found closed with a dense fleshy substance, see 1 Beck, 
 81, et seq; the vagina has been found entirely wanting, while the 
 uterus has been present. There may be either a natural or fis- 
 tulous communication of the vagina with the bladder or rectum. 
 A prolapsus or retroversion of the uterus, or a prolapsus of the 
 vagina, although curable in their first stages, may, after a long > 
 standing, become incapable of reduction, and thus incura- 
 ble. A cancer of the vagina or uterus from the extreme pain 
 that accompanies it, becomes an absolute cause. There are also 
 some cases on record of such extreme brevity of. the vagina as to 
 render the female sterile, if not impotent. 
 
 Among the curable causes of impotence in the female are, a 
 dense fleshy substance covering the orifice of the vagina. This 
 substance is most commonly the hymen, preternaturally enlarged 
 and thickened. 
 
IMPOTENCE AND STERILITY. lfr 
 
 This constituted the difficulty in the case of Devanbagh vs. 
 Devanbagh, reported in Uh and 6th Paige, before referred to. 
 This, however, cannot be considered a complete cause of impo- 
 tence, as conception has actually taken place, notwithstanding 
 the obstacle interposed by it. 1 Beck's Med. Juris., 85. 
 
 There may also exist extreme narrowness of the vagina, which 
 is congenital. This may be removed by the use of emollients, 
 and careful dilatation, as the cause first mentioned may by a 
 surgical operation. The occurrence of tumors and callosities, 
 cicatrices remaining after the cure of ulcers, the result of lace- 
 rations after difficult labor, with other accidental cause«, may 
 'also originate nearly the same difficulty in the vagina, which may 
 be cured by the same means. 
 
 In the adult female, adhesion of the labia sometimes takes 
 place as the result of inflammation, or from neglect of accidental ' 
 excoriation^ Even hard labor has sometimes given rise to pre- 
 ternatural union of the labia. 1 Paris fy Fonblanque, 206. 
 
 In children, the labia are sometimes found adhering together, 
 leaving but a small passage for the discharge of urine. In what- 
 ever way the adhesion may be produced, it is easily curable by a 
 slight surgical operation. 
 
 Dr. Ryan arranges all the causes of impotence and sterility 
 in females, under three classes. Ryan's Med. Juris., 106. 
 
 1. Those depending on the organs which receive the male 
 fluid, viz., the genital fissure, the vagina, and the uterus. The 
 difficulties to which these organs are subject, and the impedi- 
 ments usually found in the way of their exercising their functions, 
 have already been considered. 
 
 2. Malformation, or diseases of the organs that transmit that 
 fluid to the ovaries, and re-convey the embryo to the uterus. 
 These are the fallopian or uterine tubes. These may have been, 
 originally, defective in structure, as they have been found with- 
 out any aperture ; or the fimbriated extremity terminating in a 
 cul-de-sac ; or they may have become so obliterated in conse- 
 quence' of peritonea] inflammation, as to lose the power of con- 
 veying the ovum from the ovarium to the uterus. In some cour- 
 tesans, they have become entirely obliterated by the thickening 
 
16 MEDICAL JURISPRUDENCE. 
 
 of their parieties, a consequence of the habitual orgasm in 
 which they have been kept by too frequent excitements. 
 
 3. Malformation, or diseases of the ovaries or organs which 
 supply the germ for fecundation. Paris # Fonblanque, 214. 
 
 Instances of diseased ovaria are very common, and may arise 
 from a great variety of causes. 1 Paris fy Fcnblanque, 214. In- 
 flammation, ulceration, scirrhus, cancer, ossification, calcareous 
 deposit, or tumors in any of these organs, may be the cause of 
 sterility. Ryan, 106. 
 
 Sterility is generally considered as confined to the female. The 
 result of impotence is that the subject of it is also sterile. Steril- 
 ity alone is seldom a matter of enquiry in courts of law. It may 
 result from constitutional debility, leucorrhcea or excess or de- 
 ficiency of the menstrual discharge. Sterility is most frequently 
 attended with corpulency ; this latter arising either from weak- 
 ness of the system, or from want of activity in the ovaria. Spayed 
 or castrated animals generally become fat. 1 Paris §• Fmblanque's 
 Med. Juris., 215. 
 
 So also there may be exhaustion of the uterine system, arising 
 from the practice of too frequent or promiscuous intercourse. 
 Prostitutes seldom conceive ; and young married people, strong, 
 healthy and vigorous, sometimes remain for years without chil- 
 dren. Ibid, 215 ; Ryan, 108. 
 
 There are also other causes of sterility that are little under- 
 stood, as the fact not unfrequently witnessed of females remain- 
 ing sterile for a number of years, and then again becoming fruit- 
 ful, and also of those who are sterile with one husband becoming 
 fruitful with another. 1 Paris fy Fonblanque, 215. 
 
 From a review of the whole subject of impotence and sterility, 
 it will be probably a safe conclusion, that the causes of impotence 
 in either sex are few in number ; that these are physical causes • 
 that they mostly consist of permanent malformations, or acciden- 
 tal lesions, evident to the senses ; and that they are those that art 
 cannot remedy. 
 
 Whenever examinations become necessary to be made, the age, 
 general appearance, habit of body, and state of health, should be 
 noted, and also the diseases with which the individual may have 
 
HERMAPHRODITES DOUBTFUL SEX. 17 
 
 been previously afflicted. The sexual parts should undergo a 
 careful examination ; the urethra of the male should be sound- 
 ed, and the state of the prostate gland ascertained. The object 
 will be to determine the physical causes of impotence, and also 
 the length of time during which they have existed. Guy, 61-2. 
 
 II. HERMAPHRODITES— DOUBTFUL SEX— MONSTERS. 
 
 Inquiries into the subject of Hermaphroditism have occupied 
 some part of the attention of medical jurists, and have found a 
 place in works on medical jurisprudence. The necessity of 
 'having an intimate knowledge of it, will depend much upon the 
 laws under which the people live, especially those which regu- 
 late the descent of property. Where, for instance, the law of 
 primogeniture prevails, and the preference is given to males, as 
 in England, it becomes important to determine the question of 
 sex, in order to regulate the descent of property, or to decide 
 upon its ownership. Here, therefore, it becomes necessary to 
 determine the sex with accuracy; and this subject will have, 
 therefore, attached to it, a great degree of importance. 
 
 In a country like the United States, where institutions are 
 more democratic, where males and females are regarded alike in 
 the descent of property ; where estates are fettered by no entails, 
 and the husband's tenancy by the curtesy, has no dependance on 
 the fact of whether his offspring be a male or female, the subject 
 is comparatively of much less moment. Rightly considered, it 
 is a branch of the great subject of impotence and sterility, as one 
 or both generally result from any very great peculiarities in the 
 formation of sex. 
 
 Hermaphroditism, strictly, means the union of both sexes in 
 the same individual ; the possession in one of the qualities of 
 each, so as to perform the functions of both. Tins is now clear- 
 ly recognized as an impossibility. So far is it from realization in 
 actual fact, that in most or all those cases termed hermaphrodites, 
 there exists the incapacity of exercising the functions of either. 
 
 Several cases of what are termed hermaphrodites, are collected 
 by Dr. Beck, in his chapter on doubtful sex. 1 Beck's Medical Ju- 
 risprudence, 94. As this may legally be regarded, in this coun- 
 
 2 
 
18 MEDICAL JURISPRUDENCE. 
 
 try, a subject of minor importance, I will merely state some 
 general conclusions derived from the cases that have thus far 
 occurred, without entering into any statement of the cases them- 
 selves. 
 
 The causes that lead to sexual peculiarities so abnormal as to 
 create doubt in regard to the real sex of the individual, are of 
 difficult or impossible investigation. They may arise from the 
 arrested development of the organs during the growth of the 
 foetus. Taylor's Medical Jurisprudence, 495. From whatever 
 causes arising, they may, perhaps, all be included in some one of 
 the three following classes. 
 
 1. Male individuals with such unusual formations of the gene 
 rative organs as, in many respects, to resemble the female. 
 
 2. Female individuals with such unusual formations of the 
 same organs as to resemble the male. 
 
 3. Where a mixture of the sexual organs of both sexes is ex- 
 hibited, without either being entire. Guy's Medical Jurisprudence, 
 43. 
 
 1 . The first are called Androgyni. In these cases the ambi- 
 guity very frequently consists in the testes being contained in 
 separate parallel folds of the skin ; in an imperforate penis, and 
 in the urethra opening in the perinseum, on the surface of a blind 
 aperture, having a red and tender appearance, so much so as to 
 be mistaken for the vagina. 1 Beck's Medical Jurisprudence, 100. 
 
 The penis is here considered an enlarged clitoris ; the folds of 
 the skin containing the testes, the female labia ; and the termina- 
 tion of the urethra, the vagina. 1 Beck's Medical Jurisprudence, 
 101. This class of individuals may have the testes and vesiculse 
 seminales perfect ; but the imperforate penis, and the opening of 
 the ejaculatory ducts near or •in the perinseum, must render them 
 impotent. The strong muscular- development, tone of voice, 
 tastes and habits possessed, indicate the masculine rather than 
 the feminine gender. There are, however, not wanting cases in 
 which there is an enlargement of the breasts, and a preference 
 manifested for the society of the male.- Guy's Medical Juris., 44. 
 
 A confinement of the penis to the scrotum, by a particular 
 formation of the integuments, has occasioned the individual to be 
 
HERMAPHRODITES DOUBTFUL SEX. 19 
 
 called an hermaphrodite. In such case a slight incision liberates 
 the restricted parts, and, if the penis is well formed, restores the 
 competency. 1 Beck's Med. Juris., 101 ; Guy's Med. Juris., 44. 
 
 2. The second class mentioned are called Androgyna. One 
 peculiarity, occurring probably the most frequently in this class, 
 is an enlarged clitoris. This is no very unfrequent occurrence 
 in warm climates, but has seldom been found in Europe. 1 Beck's 
 Med. Juris., 193. The clitoris has sometimes been found two 
 inches in length, but has neither prepuce nor perforation, and is 
 therefore easily distinguishable. 
 
 The absence of testicles, presence of a vagina and uterus, oc • 
 currence of menstruation, either or all proclaim the female sex. 
 
 Another malformation belonging to this class is a prolapsus 
 uteri. Several cases are on record of this description, in some 
 of which, the individual claimed to possess the organs of both 
 sexes, and to be able to employ both. On reduction of the pro- 
 lapsed uterus, the difficulty disappears : 1 Beck's Med. Juris. Ij05. 
 Guy's Med. Juris. 45. 
 
 3. The third class embraces those cases in which there is a 
 mixture or blending of the sexual organs without either being 
 entire. Several examples of this class have occurred, and on 
 close examination of them, the predominance of one sex over 
 the other is clearly discernable. 1 Beck's Med. Juris. 94. The 
 principle which has been deduced from the cases that have oc- 
 curred is, that in the two sexes there are organs which corres- 
 pond to each other, and which may be called analogous organs , 
 the penis to the clitoris, the scrotum to the labia, the testes to 
 the ovaria, and the prostate to the uterus ; and that of these 
 analogous organs, no two were ever found together in the same 
 individual. 1 Beck's Med. Juris. 98. 
 
 No monster has been described, having both a penis and a 
 clitoris; nor with a testis and ovarium on the same side — we 
 may venture to say with testes and ovaria ; nor one having a 
 prostate and uterus. 1 Beck's Med. Juris. 98 : Guy's Med. Juris. 46. 
 An ovary has been found on the left side and a testis on the 
 right, and also a case in which was the reverse of this. Some- 
 times the external organs have approximated closely to the fe- 
 
20 MEDICAL JURISPRUDENCE. 
 
 male type, and the internal to the male. In other cases the re- 
 verse of this has occurred. Guy's Med. Juris. 46. 
 
 In cases of doubt or difficulty the following points are entitled 
 to consideration. The growth of the beard and hair on different 
 parts of the body ; the formation of the shoulders and hips ; 
 their relative widths ; the development of the breasts ; the full- 
 ness of the thighs ; the masculine or feminine character of the 
 voice ; the desires excited by the presence of either sex ; the 
 presence or absence of the menstrual or vicarious discharges. In 
 the sexual organs are to be noted the organ corresponding to the 
 penis or clitoris, and whether it is perforate or imperforate ; the 
 form and mode of attachment of the prepuce ; the presence or 
 absence of parts corresponding to the nymphse ; if the labia ma- 
 jora exist, and the presence or absence of the testicles. 
 
 Any openings which may be found to exist must be examined 
 with a sound, to ascertain whether they communicate with the 
 bladder or uterus, or are merely culs-de-sac. Examination 
 should also be made in reference to the hymen and the carun- 
 cute myrtiformes. Guy's Med. Juris. 46. 
 
 An ingenious work on hermaphroditism has been published by 
 M. Geoffry St. Hilaire, a notice of which is to be found in 1 
 Beck's Med. Juris. 108, &c : and Guy's Med. Juris. 46-7. He di- 
 vides the generative apparatus into six different portions or seg- 
 ments, three on a side, which, in several respects, are inde- 
 pendent of each other. The first and second are the deep 
 seated organs, testicles and ovaries ; third and fourth, the mid- 
 dle organs, womb or prostate, and vesicular seminales ; the fifth 
 and sixth are the external organs ; the penis and scrotum, clito- 
 ris and vulva. It is hardly necessary to carry these out into the 
 different classes, as the general result would not, perhaps, be 
 found to be essentially different from what has already been 
 stated. 
 
 The occasional, although very unfrequent, occurrence of mon- 
 strosities, renders it necessary to advert to the subject of monsters. 
 The common law of England in regard to monsters, which is also 
 applicable in this country, is, that a monster which has not the 
 shape of mankind, but in every part evidently bears the resem- 
 
MONSTERS. 21 
 
 blanee of the brute creation ; has no inheritable blood, and can- 
 not, therefore, inherit, although brought forth in marriage. But 
 although it may have deformity of body, yet if it have the 
 human shape, it is capable of inheriting. 2 Blackstone's Com., 246. 
 This, in most cases, will serve to define the duty of the medical 
 jurist. That duty will simply be, to determine whether the 
 shape, the outward appearance, be human ; or whether there is 
 so wide a departure from it, or so great a resemblance to the 
 brute creation, as fairly to exclude it from the human family. 
 In this point of view, the classification of them is of small im- 
 portance, as it is of little consequence whether they are such by 
 excess, or defect, or by alteration or wrong position of parts ; 
 the only use of the classification being to enable the medical 
 jurist to come more satisfactorily to his own conclusions. 
 
 Were the occurrence of monsters much more frequent than 
 they are, many puzzling questions would arise for settlement. 
 It would be a matter of extreme difficulty to determine what 
 precise degree of monstrosity should be required to divest the 
 oeing of his civil rights. There are monsters, for instance, with- 
 out a head, acephalous, — although such could hardly survive 
 birth. There are others, two-headed, dicephalous ; and two- 
 bodied, disomatous. The rule, according to St. Hilaire, (see Tay- 
 lor's Med. Juris., 483,) is, to consider a dicephalous monster, 
 whether it be disomatous or not, as two beings ; and if it have 
 but a single head, under the same circumstances, as one. This 
 rule he grounds upon the performance of the right of baptism 
 in all Christian countries, upon each head, where the monster 
 was dicephalous. There would appear to be as many moral in- 
 dividualities as there are heads. This might give rise to some 
 curious questions in the administration of criminal law. St. 
 Hilaire relates a remarkable case in illustration of this, which 
 he says actually occurred in Paris, in the seventeenth century. 
 A double-headed monster killed a man by stabbing him with a 
 knife. The being was condemned to death, but was not executed 
 on account of the innocence of one of his component halves. 
 
 Dicephalous monsters seldom livelong after birth. One, how- 
 ever, born in Sardinia in 1829, being double from the head to 
 
22 MEDICAL JURISPRUDENCE. 
 
 the pelvis, the left bust being named Christina, and the right, 
 Ritta, lived some -nine months from its birth. The Siamese 
 twins, both dicephalous and disomatous, are still living, posses- 
 sing distinct volitions, but movements simultaneous as if they 
 constituted but a single being. Their separate powers of volition 
 should give each a civil and criminal accountability, and yet no 
 severe punishment could be inflicted upon one without involving 
 the other in the same condemnation. 
 
 As the external shape is the governing consideration, no re- 
 ference is had to the internal conformation. Malformations, 
 transpositions, defects of internal organs, are of little or no con- 
 sequence in a legal point of view. The law, no doubt for wise 
 purposes, disregards those internal deviations in structure from 
 the ordinary normal state, which can only be revealed by dissec- 
 tion after death. 
 
 III. RAPE. 
 
 Rape is the having unlawful and carnal knowledge of a woman 
 by force and against her will. This detestable crime both against 
 the individual and against society, has met with a punishment 
 varying in severity among different nations. The laws of diffe- 
 rent countries in regard to the punishment awarded to this crime, 
 are collected by Dr. Beck, in his chapter upon Rape ; 1 Beck, 
 129, et seq. As the knowledge of these would contribute but 
 little towards enlightening the medical jurist, in regard to what 
 is demanded of him, I shall omit the consideration of them. It 
 may be well enough barely to remark that the punishment 
 awarded has been either death, or a long term of imprisonment, ■ 
 and in some cases a fine and imprisonment, or both. 
 
 In England the punishment for unlawfully and carnally know- 
 ing and abusing any female under the age of ten years is a felony, 
 and subjects to the punishment of death. If committed on one 
 above ten and under twelve, it is a misdemeanor and liable to 
 imprisonment. 
 
 A person committing the crime upon the high seas, but within 
 the jurisdiction of the United States, and not within that of any 
 
RAPE. 23 
 
 particular State, is also deemed guilty of felony, and must suf- 
 fer the penalty of death. Lewis' United States Criminal Law, 557 j 
 and 4 Peters' Stat. 115. 
 
 In the several States considerable diversity prevails. In Mas- 
 sachusetts the punishment is death. In Virginia, New-Hamp- 
 shire, Connecticut, Maine, New-Jersey, Ohio, Illinois, Michigan, 
 and Tennessee, it is either imprisonment for life or a term of 
 years. The period of ten years is specified. In Vermont, any 
 individual exceeding 1 5 years of age, abusing any female under 
 11, either with or without her consent, shall suffer fine and im- 
 prisonment. In Indiana, the age of consent in the female is fixed 
 at 12 years, and the punishment imprisonment for a term of 
 years. In Missouri and Arkansas, the punishment for rape un- 
 der ten years is castration ; in Delaware a fine, standing in the 
 pillory one hour, CO lashes, imprisonment not exceeding two 
 years, and afterwards to be sold as a servant for a term not ex- 
 ceeding 14 years. Guy's Med. Juris. 81. 
 
 In New- York, the Revised Statutes, n. 552, provide that every 
 person who shall be convicted of rape, either 
 
 1 . By carnally and unlawfully knowing any female child under 
 ihe age of ten years, or 
 
 2. By forcibly ravishing any woman of the age of ten years or 
 upwards, shall be punished by imprisonment in the State prison 
 not less than ten years. 
 
 It is also provided that every person who shall have carnal 
 Jcnowledge of any woman, above the age of ten years^ without 
 her consent, by administering to her any substance or liquid, 
 which shall produce such stupor, or such imbecility of mind, or 
 weakness of body, as to prevent effectual resistance, shall, upon 
 conviction, be punished by imprisonment in a State prison not 
 exceeding five years. 
 
 Thus it will be seen that the punishment awarded for the com 
 mission of this crime, although varying in different countries, is 
 in each of them severe. In England, and some of the northern 
 states of the Union, a male under the age of fourteen years is 
 presumed physically incapable of committing the crime, and 
 hence no indictment can be sustained against him In Ohio the 
 
24 MEDICAX JURISPRUDENCE. 
 
 prima facie presumption is the same, but that presumption may 
 be rebutted by proof, that he has arrived at the age of puberty, 
 and is physically competent to commit the crime. Lewis'' United 
 States Criminal Law, 565-6. A female is presumed incapable 
 of consent while under the age of ten years, so that no force is 
 necessary to be proved in any such case. All present aiding and 
 assisting in the commission of tins crime are principal offenders 
 in the second degree. Lewis' United States Criminal Law, 558. 
 
 In the case of Lord Caslehaven : 1 St. Tri. 387 : it was decided 
 that a husband might be convicted of a rape upon his own wife, 
 by assisting another person to violate her. Penetration and 
 emission seem to be necessary to constitute the crime of rape, 
 but after several conflicting decisions in the English courts, the 
 one has come to be regarded as prima facie evidence of the other, 
 and the question of emission is a fact for the jury. In New- York 
 the proof of actual penetration into the body is all the statute 
 requires. 2 R. S. 820, ^ 18. In Illinois, Indiana, Tennessee, 
 Pennsylvania and South Carolina, and probably in most of the 
 other States this is sufficient. Guy r s Med Juris. 81. 
 
 It has been once decided in this State, that force was not ne- 
 cessary for the commission of a rape, but that stratagem might 
 supply its place. Note 1, Wh. C. C. 381. In the case of The 
 People vs. Abbott, 19, Wendell, 192 ; it was held that the prose- 
 cutrix was not privileged from answering questions asked her 
 relative to her previous illicit connexion with the defendant or 
 with others. That it may also be shown that she is a common 
 prostitute, this fact, if true, tending to repel the allegation of 
 force, and laying a foundation for inferring assent on her part. 
 
 It was also held in this case that the evidence should not be limit- 
 ed to the general character of the witness for truth and veracity • 
 but that proof might also be introduced against her general moral 
 character ; and that particular acts and associations indicating a 
 want of chastity may be shown. In the case of The People vs. 
 Hulse, 3 Hill, 318, the court by Bronson, Justice, after showing 
 the extreme probability that some force may have been used 
 sufficient to overcome a resistance so feebly exerted as to have 
 invited, rather than discouraged the continuance of it ; and then 
 
RAPE. "25 
 
 subsequently the operation of some po\> erful motive may have 
 induced the woman to call that a rape which in truth was an 
 offence of a much less odious character, proceed to say that in 
 cases of this character, courts and juries cannot be too cautious 
 in scrutinizing the testimony of the complaining witness, and in 
 guarding themselves against the influence of those indignant 
 feelings which are so naturally excited by the enormity of the 
 alleged offence. That there is much greater danger that injustice 
 may be done to the offender in cases of this kind, than there is 
 in prosecutions of any other character. 
 
 The crime of rape may be committed upon a virgin, a single 
 or married woman, or even upon a prostitute. The latter being 
 also under the protection of the law. 
 
 The circumstances, therefore, are very greatly multipled, under 
 which the medical jurist is required to make his examination 
 and give his testimony. As the person injured is the witness 
 and sometimes the only one, a great many assignable motives 
 may operate upon her mind to make that out a crime in another 
 which will exonerate her from all personal blame. This, says 
 Sir Matthew Hale, is an accusation easy to be made, and harder 
 tt> be proved, but harder to be defended by the party accused, 
 i hough innocent. 
 
 The two main facts to be made out on an indictment for a rape 
 are — 1. Forcible penetration: 2. In case of females over ten 
 years of age, that the force used was against the will of the in- 
 jured party. It is principally in proving or disproving the first, 
 that the testimony of medical witnesses is required. In this en- 
 quiry the main points to which the attention is to be directed are 
 the following : 
 
 1. "What are the marks of violence, if any, discoverable in the 
 organs themselves 1 
 
 2. What marks or indications of actual violence upon the per- 
 sons, either of the prosecutrix or prisoner * 
 
 3. What marks or spots of blood, or stains caused by the 
 spermatic fluid, on the clothes of the prosecutrix or prisoner 1 
 
 4. What evidence of the existence of gonorrhea or siphilis in 
 one or. both the parties 1 
 
26 MED1CA1, JURISPRUDENCE. 
 
 5. The relative age, strength, constitution, habits, situation, 
 circumstances, mental powers and propensities of both the pros- 
 ecutrix and prisoner. 
 
 6. The consideration of some medico-legal questions bearing 
 directly upon the facts in dispute. Each one of these 'will re- 
 quire a brief attention. 
 
 1. The marks of violence in or upon the organs. In case the 
 injured party is young, and has never been married, the question 
 will probably arise as to what are the physical signs of virginity, 
 and what degree of confidence is to be attached to their presence 
 or absence. Among these physical signs are to be ranked, 
 
 1 . The Hymen. There are a number of respectable authorities 
 both for and against the existence of the hymen. It is somewhat 
 varied in its appearance in different females, and this may have 
 led to some misapprehension. It is usually exhibited in the 
 form of a semi-lunar fold, bounding the entrance of the vagina 
 below ; the extremities losing themselves behind the labia minora 
 in the circumference of the aperture of the vagina ; its concavity 
 being behind and its convexity before. Guy's Med. Juris., 66-7. 
 
 Sometimes it presents the form of a circular membrane, per- 
 forated in the centre, dnd adhering by its circumference to the 
 opening of the vagina. At other times, it fills up the entire orifice 
 of the vagina, except a small opening above, corresponding to 
 the meatus urinarius. There is also one other unusual form of 
 it, in which filaments of mucous membrane are found uniting 
 together the carunculse myrtiformes. Guy's Med. Juris., 67. 
 
 Owing to the fact that its free edge becomes relaxed and fold- 
 ed, about the period of puberty, there is reason to believe that, 
 when the rupture takes place, it is chiefly in its folds, or de- 
 pressions ; and that, in this manner, the carunculse myrtiformes 
 are formed. These latter subsequently undergo changes, but 
 rarely if ever entirely disappear. Guy's Med. Juris., 67. 
 
 There can be little doubt, but that the hymen, in some one of 
 its forms, originally exists in the great majority of females. Nor 
 is there any real difficulty in ascertaining its existence, or its re- 
 cent destruction by violence. Its recent destruction would be 
 
RAPE. 27 
 
 evidence of the recent employment of force, and thus furnish 
 one of the essentials in the proof of rape. 
 
 As the carunculse myrtiformes are the remnants of the destroy- 
 ed hymen, their presence would prove the destruction of the 
 hymen at some earlier period. The absence of the hymen must 
 not be assumed as evidence that the female is unchaste. It may 
 have been originally wanting. If not, a number of causes, other 
 than connexion, may have destroyed it. It may have been de- 
 stroyed, if the aperture be small, by the first menstrual iiux, or 
 by the accumulation of other discharges. It may also have been 
 destroyed as the result of accident, or by the intentional intro- 
 duction of foreign bodies, or by the occurrence of disease. 
 
 On the other hand, the existence of the hymen must not be 
 hastily assumed as evidence of chastity. There are several in- 
 stances on record, where sexual intercourse has taken place, and 
 where conception has actually occurred, while the hymen re- 
 mained entire. What is still more extraordinary, instances are 
 cited, where children have been born without destroying it. 
 Guy's Med. Juris., 67-8 ; 1 BecWs Med. Juris., 113. 
 
 It seems pretty evident, therefore, that no very great degree 
 of importance should be attached to the presence or absence of 
 the hymen. 
 
 2. Narrovmess of the vagina. In the virgin state, the only 
 function performed by the vagina, is the transmission of the 
 menstrual flux from the uterus. For this, a very inconsiderable 
 passage is sufficient. Its natural tendency is to narrowness, 
 both from its'own contractility and the pressure of surrounding 
 parts. The turgescence caused by the greater determination of 
 blood to the organs at the period of puberty, would also tend to 
 place the parts in closer contact with each other. Various inno- 
 cent causes may, however, relax and enlarge it ; such as disor- 
 ders to which the parts may be liable, and also a resort to certain 
 practices. In the virgin state, there are usually to be found 
 rugse on the inner surface of the vagina. These are removed 
 by frequent connexions, and destroyed by one or two deliveries. 
 All these are liable to some variation, from the age, state of 
 
28 MEOICAL JURISPRUDENCE. 
 
 health, and temperament of the individual. Smith's Forensic 
 Medicine, 410-11 ; 1 Beck, 115. 
 
 3. Another indication is drawn from the appearance of the 
 carunculse myrtiformes. When red, tumid, and connected to- 
 gether by fleshy cords, they are said to indicate chastity ; .while 
 in the married slate, they are pale, flaccid, and the cords torn 
 asunder. 1 Beck's Med. Juris., 116. 
 
 There are also other indications to be derived from an ex- 
 amination of the organs. These are principally the red and 
 tumified appearance of the labia and nympha?, and rupture of 
 the fourchette. There are also others, but of so equivocal a / 
 character, as not to deserve being mentioned. 
 
 These signs of virginity are the most perfect between the 
 period of puberty and the twenty-fifth year. Ryan's Med. Juris., 
 161. 
 
 There have been various degrees of importance attached to 
 their presence and absence. Each and all of them are undoubt- 
 edly equivocal, but there is a reluctanGe in denying that talcing 
 them all together, there is not some considerable importance 
 to be attached to them. It has been asked, whether all can be 
 entirely wanting, without furnishing any inference that the per- 
 son is unchaste 1 The degree of importance attached to them 
 should probably depend very much upon the circumstances ex 
 isting at the time. 
 
 In regard to the presence or absence of these signs of virginity 
 and the proofs they furnish of penetration by force, the follow 
 ing inferences are obvious : 
 
 1. The younger the subject, the less strong will be the signs 
 of virginity ; but the more marked will be the evidence of vio- 
 lence done to the parts. 
 
 2. The more recent the injury inflicted, the more clear and 
 satisfactory will be its physical indications. 
 
 3. In the case of married women, or those accustomed to 
 sexual intercourse ; or, with the exception of very young sub- 
 jects, where the examination is not made within a very few days 
 after the infliction of the injury, this source of evidenc/3 is of 
 little or no value. 
 
RAPE. 29 
 
 The object to be accomplished by an appeal to this source of 
 proof, is, 
 
 1 . To prove the commission of the crime in subjects so young 
 as to be incapable of giving their consent, and also of being wit- 
 nesses in a court of justice : 
 
 2. To corroborate the testimony of the injured party, after she 
 has attained the age of consent, and sufficient understanding to 
 entitle her to be a witness : or, 
 
 3. To contradict her evidence after the arrival of the period 
 last mentioned. 
 
 After the arrival of the age of consent, the crime of rape is 
 not made out by proof of penetration by force. Another mate- 
 rial element is then wanting, viz., that it was against the will of 
 the injured party. In proving or disproving this, it is obvious 
 very little can be expected of the medical witness. What he can 
 furnish, is derived, principally, 
 
 2. From marks, or indications of violence found upon the per- 
 sons of the prosecutrix ©r prisoner. On the person of the for- 
 mer, these will be found in the rumpled or torn appearance of 
 the dress, and in the shape of bruises, generally on the groins, 
 thighs, knees, arms and chest. The person of the latter may 
 also exhibit bruises and scratches. In reference to these, should 
 be carefully noted, 
 
 1 . Their position. They may be on parts or in positions that 
 would not be exposed to the prisoner, and hence afford evidence 
 that they were self-inflicted, for the purpose of sustaining her 
 testimony. Her willingness or unwillingness to submit to exami- 
 nation, might furnish some indication. 
 
 2. Their appearance, particularly their color, as indicating the 
 period of time that had elapsed since the injuries were inflicted, 
 with the view of comparing this time with the statements of 
 the accuser. The variation of ecchymosed or bruised spots, in 
 color, as time elapses after their infliction, will be noticed when 
 on the subject of wounds. 
 
 It must not, however, be supposed that the presence of bruises 
 or other injuries upon the person of the prosecutrix, is conclusive 
 proof that consent was not given. They may have been, 
 
30 MEDICAL JURISPRUDENCE. 
 
 1. Self-inflicted, with the view to sustain her testimony and 
 to make out the case on the part of the prosecution ; or, 
 
 2. Notwithstanding the violence, the conduct of the female 
 may have been such as to imply consent on her part ; or, 
 
 3. She may have consented after the infliction of the violence 
 The two latter are, perhaps, hardly consistent with a resort to 
 any very great degree of personal violence. 
 
 3. The third source of proof is derived from any marks or 
 spots of blood, or stains that may be caused by the spermatic 
 fluid, on the clothes of the prosecutrix or prisoner. In case of 
 recent injury spots of pure blood, presenting an uniform red 
 color throughout, might be found on the clothes. After suflicient 
 time had elapsed for the first haemorrhage to cease, there will be 
 a muco-sanguinolent discharge, staining the linen but less deeply, 
 and uniformly, leaving a spot lighter in the centre but of a deeper 
 color around the circumference. The co-existence of these with 
 marks of violence would be a corroboration of the charge. Guy's 
 Med. Juris., 73. 
 
 Care must be taken not to confound this with the menstrual 
 discharge. The blood resulting from injuries of this character 
 would be arterial, and the menstrual blood is distinguishable 
 from this — 
 
 1 . By its non-coagulable qualities. As it contains little or no 
 fibrine it is not coagulable. 
 
 2. By its color. It is darker than arterial blood, and does not, 
 like venous blood, change color by exposure to the air. Guy's 
 Med. Juris., 73-4. 
 
 In relation to stains caused by the spermatic fluid, if a fluid is 
 found having a seminal appearance it should be examined under 
 the microscope, and if it be found to contain animalculse, little 
 doubt can remain of its being semen. These animalculee are 
 found in the semen of all male animals which have reached the 
 age of puberty. While in motion, they present a spherical figure 
 with filamentous tails. At rest, or dead, the fluid about them 
 being dried up, they appear more oval with a tapering tail. 
 Guy's Med. Juris., 74. 
 
 These animalculee may be discovered in semen that has be 
 
RAPE. 31 
 
 ^.jme dry, provided it be carefully moistened. They have even 
 oeen discovered in semen that had become pui.*id. Care must 
 be taken not to rub or injure the pieces, as that would destroy 
 their organization. After steeping the stained pieces thoroughly 
 in distilled, water, they may generally be detected by the micro- 
 scope. 
 
 These seminal spots are of a color yellowish or grayish, and, 
 when pressed between the finger and thumb, appear slightly 
 stiff as if starched. They are inodorous, but when moistened 
 give out the seminal odor. Exposed to heat, the spots become 
 of a yellow fawn color, and small whitish spots make their ap- 
 pearance. This effect is said, to be' peculiar to the spermatic 
 fluid. Gunfs Med. Juris., 75. 
 
 A seminal spot placed for some hours in cold distilled water 
 is moistened evenly throughout, and gives out a spermatic odor. 
 The liquid in which it is moistened becomes milky white and 
 flaky, and in its characters or properties is, 
 
 1. Alkaline : 
 
 2. Mucilaginous. It does not coagulate, although it deposites 
 jtwc glutinous flakes : 
 
 3 Evaporated, the residuum becomes semi-transparent, and 
 nhtn agitated in cold distilled, water, divides into two parts, the 
 one greyich yellow, glutinous, and insoluble in water, the other 
 soluble Li water : 
 
 4. The watery solution is yellowish, transparent, giving a 
 white flocculent precipitate with chlorine, alcohol, acetate and 
 sub-acetate c\ lead, and corrosive sublimate. Nitric acid gives it 
 a yellowish tir^e, but causes no precipitate. In all these, those 
 which are the irost peculiar to semen are the change of color on 
 exposure to the fire, and the peculiar odor emitted. Guy's Med 
 Juris., 75-6. 
 
 4. The fourth source of proof is that derived from the exist- 
 ence of gonorrhea or syphilis in one or both the parties. Should 
 venereal infection coincide, in its appearance, with the time at 
 wMch the crime is alleged to have been perpetrated, it would 
 afford, proof of violation. To do this it should appear from the 
 third to the eighth Jay after the crime is alleged to have been 
 
32 MEDICAL JURISPRUDENCE. 
 
 committed. Should it manifest itself immediately after it would 
 have no other influence upon the decision of the case except the 
 proof it would furnish that the female was unchaste. Should the 
 examination be made some days after the injury complained of. 
 and the disease should be found present in the female, it would 
 prove her unchaste, provided it were absent in the accused, but 
 if present in both would be a strong corroboration of the charge.. 
 
 It should be borne in mind, however, that there are discharges 
 from the vagina of young females, especially of children, of a 
 nature entirely different from that resulting from venereal infec- 
 tion. Several instances are on record where mistakes in this 
 respect have come very near resulting in serious consequences 
 See the case of Jane Hampson, as detailed in Ryan's Med. Juris } 
 165, and also in 1 Beck's Med. Juris., 119. 
 
 Sir A. Cooper places much stress upon this, and says that 
 children from one year old and even under, up to puberty, are 
 frequently the subjects of a purulent discharge from the puden- 
 dum, chiefly originating beneath the preputium clitoridis. The 
 nymphse, orifice of the vagina, and the meatus urinarius, are in 
 an inflamed state and pour out a discharge. He supposes he has 
 met with thirty cases of it in the course of his life. When this 
 occurs there is a heat of the parts, slight inflammation, and tliis 
 sometimes increases and goes on to ulceration. Ryan's Med. 
 Juris., 168. 
 
 Dr. Dewees also confirms this statement, and says that we oc- 
 casionally find that very young children have a discharge from 
 within the labia, of a thin, acrid kind, or of- purulent appear- 
 ance. Also that children of a more advanced age have discharges 
 •-if a purulent character, that seem to arise from a morbid action 
 of the mucous membrane of the vagina or labia. This frequently 
 shows itself about the fifth year, and may continue, if neglected, 
 to almost any period. Ryan's Med. Juris., 168. 
 
 If, therefore, on examination, a discharge should be found, 
 the medical witness should make a thorough examination into the 
 nature and causes of it, before he can pronounce it the result of 
 venereal infection. 
 
 This disease has been repeatedly observed by American physi- 
 
RAPE. 33 
 
 cians, and exists independent of external violence or of any sy- 
 philitic aifection. According to Dr. Francis, no case has been 
 noticed among us, where the individual had advanced beyond 
 her seventh year, but this may have been accidental, and should 
 not be relied upon as proving that it does not occur beyond that 
 age. There is, however, no doubt of the fact that its occurence 
 in the very great majority of cases is early in life, and this is a 
 circumstance by no means to be lost sight of by the medical ju- 
 rist. Guy's Med. Juris., 72. 
 
 5. The fifth source of evidence relates to the age, strength, 
 constitution, habits, situation, circumstances, mental powers and 
 propensities of both the prosecutrix and the prisoner. This em- 
 braces a very wide range of proofs, and generally constitutes 
 much of the evidence usually introduced on trials of indictments 
 for rape. It is obvious from the statement of it, that the mere 
 ( medical witness cannot, in virtue of what he derives from his 
 profession, throw much light upon this source of evidence. , 
 
 Medical men, it is true, ought, and most probably do, under- 
 stand much better than others, the precise extent of organic ca- 
 pacity, and the amount of energy and power which are capable, 
 in any given case, of being put forth either by way of subduing 
 or resisting. They cannot only judge more accurately of the con- 
 stitutional capacity, but they can also, better than others, appre 
 ciate the modifying eifect of age, and the influence that may be 
 supposed to be exerted by habits, situations and circumstances. 
 More especially where one of the parties is laboring under the 
 effects of disease, must the medical examiner be relied upon to 
 state what influence or effect that would be likely to exert upon 
 the promptings of desire, and the exertion of physical power. 
 
 Where the strength of the parties is greatly disproportioned, 
 as where a sound healthy adult male is charged with the commis 
 sion of the crime upon a female under the age of puberty, no 
 doubt can be entertained of the possibility of its commission by 
 force. Prior to the period of menstruation, the female not only 
 labors under a great deficiency of bodily strength, but her mind 
 has fewer resources, and far less power and energy of will. 
 
 She is also probably ignorant of the consequences of the acty. 
 
 3 
 
34 MEDICAL JURISPRUDENCE. 
 
 and hence her compliance may be more easily induced by fear. 
 So also if she be infirm in body, or laboring under the effects of 
 disease, while the accused exhibits much strength and vigor, her 
 complaint will be much more readily believed. If her imbecility 
 of mind be such as not only to deprive her of the ordinary re- 
 sources to which other minds of her age can resort, but also to 
 destroy its moral tone, and render her incompetent to judge of 
 the morality of her actions, she cannot be supposed competent to 
 interpose any effectual resistance. 
 
 So on the other hand, if the accuser is a firm, vigorous, 
 strongly constituted female, and the accused is cachectic, or of a 
 weak, sickly constitution, she will hardly, unless under peculiar 
 circumstances, be considered entitled to full belief. Accusations 
 against persons over sixty years of age should in general be re- 
 jected, unless they can be proved to possess an extra amount of 
 strength and virility. 1 Beck's Med. Juris., 122. 
 
 Where the accused and accuser are both in the full possession 
 of health and strength, and of the ordinary amount of physical 
 and mental power, the perpetration of this crime must be of 
 difficult, if not of impossible, occurrence. 
 
 The opinion of medical jurists generally, is against the strong- 
 est probability, if not possibility, of its full and perfect accom- 
 plishment, where, under such circumstances, the woman retains 
 her mental powers unimpaired, and also her bodily, except so 
 far as they may be exhausted by her efforts at resistance. Al- 
 though the attempt may be' made, yet its successful consumma- 
 tion, under these circumstances, must be certainly, to say the least 
 of it, a very rare occurrence. It may, however, be true, that 
 the female may possess less coolness and deliberation in husband- 
 ing her strength, and by an early expenditure of more than may 
 be necessary, in efforts of resistance, sooner produce a state of 
 exhaustion. 
 
 The following are the usual exceptions, where the crime may 
 be perpetrated notwithstanding the parties may approach nearly 
 to a mental and physical equality : 
 
 1. Where narcotics or intoxicating liquids have been adminis- 
 tered to her.: 
 
RAPE. 35 
 
 2. Where she falls into a state of syncope, from terror and 
 exhaustion : 
 
 3. Where many are engaged against her, and in such case, 
 there are usually many marks of injury about her person : 
 
 4. Where she yields under the influence of some severe threat, 
 such as that of death or duress. Taylor's Med. Juris., 462. The 
 crime may be perpetrated under any of these circumstances, 
 none of which furnish any excuse or palliation. 
 
 6. The consideration of some medico-legal questions, bearing 
 directly upon the facts in controversy. Under this head, come 
 up for consideration two questions which have occasionally arisen 
 for discussion in connection with the trial of indictments for rape : 
 
 1 . Can a female be violated during sleep, without her know- 
 ledge 1 This question has been answered in the aflirmative by 
 the medical faculty of Leipsic, and in the negative by the ju- 
 ridical faculty of Jena. It must depend much upon the circum- 
 stances of the case. If the sleep has been caused by narcotics, 
 or by intoxication, or in case of syncope, or excessive fatigue, it 
 is certainly a very possible occurrence, and would sustain the 
 charge of rape. The possibility of it is denied in a case of natu- 
 ral sleep, and where the female is a virgin, Guy's Med. Juris., 77 ; 
 1 Beck's Med. Juris., 148-9. 
 
 It has been supposed possible, even in natural sleep, with fe- 
 males accustomed to sexual intercourse. Indeed, this would seem 
 to be well established, from the fact that there exist cases where 
 pregnancy has resulted from such intercourse had during the 
 sleep of the female. The case, however, must be of very rare 
 occurrence, in which the sleep, when purely natural, can be so 
 profound, as, with such females, to admit the full act of sexual 
 intercourse without their knowledge. 
 
 2. Does pregnancy ever follow rape 1 If it never does, then 
 its subsequent occurrence, with some rare exceptions, would be 
 proof of consent, and would be, therefore, a suflicient defence to 
 an indictment for rape. This might furnish adequate cause to 
 delay the trial of the prisoner until suflicient time had elapsed- 
 to determine whether pregnancy did or did not exist. 
 
 Those who assert that it never does follow, incline to the be- 
 
36 MEDICAL JURISPRUDENCE. 
 
 lief that the venereal orgasm is always necessary to conception j 
 and that the fear, terror, horror and aversion that accompany 
 rape, must effectually prevent its occurrence. It has been sug 
 gested, that notwithstanding the sedative effect- of these passions 
 the orgasm may nevertheless take place, as its occurrence o? 
 non-occurrence is not dependent upon volition. 4 Good's Study 
 of Medicine, 100. 
 
 The more prevailing opinion seems now to be, that the func- 
 tions of the uterine system are independent of the will; and 
 that conception may, therefore, occur, whatever be the volitions 
 of the sexes, or the operation, at the time, of the emotions and 
 passions. The fact that it has taken place when the female was, 
 at the time, under the influence of narcotics, of intoxication, of 
 asphyxia, and in a state of sleep, certainly shows that neither 
 the operations of mind, nor the venereal orgasm, are in any 
 degree necessary to its occurrence. Guy's Med. Juris. , 77 -8 ; 
 1 Beck's Med. Juris., 149 - 50. 
 
 It now only remains to direct the attention to the points of 
 inquiry that should arise,- in cases of alleged rape. 
 
 The complaining party should be immediately inspected, and 
 the time of the inspection compared with that at which the 
 offence is alleged to have been committed. 
 
 The age, size, strength, and general habit should be observed, 
 and any injuries on her person should be compared with the 
 cause assigned for their infliction. The state of the clothes 
 should also be remarked. 
 
 The organs of generation should be particularly examined. 
 It should be remarked whether they are natural in appearance, 
 or swollen, inflamed, abraded or ulcerated ; whether there is any 
 discharge, and, if so, from what part it flows; whether the 
 hymen is present and entire, or ruptured ; whether the carun- 
 cute myrtiformes are visible ; whether the fonrchette is injured, 
 and the vagina enlarged or narrow. Ascertain, if possible, 
 whether the alleged violation took place during the menstrual 
 •period, or while laboring under any debilitating discharge. It 
 would be well, if possible, to ascertain the date and origin of all 
 the marks or indications of violence found, with the view of 
 
RAPE. 37 
 
 determining whether some other cause than that alleged, might 
 not have contributed to their production. Foreign bodies have 
 been sometimes purposely applied to, or' introduced into the 
 parts. 
 
 Every discharge should be carefully observed, collected and 
 examined, to determine whether it is the result of gonorrhoea, 
 Ieucorrhcea, &c. Any spots, apparently of blood or semen, 
 should be tested in the way already alluded to. 
 
 In case death has taken place, the body should be examined, 
 to see whether any bruises, fractures, or dislocations are present 
 It should be ascertained whether any foreign bodies have been 
 thrust into the mouth. If practicable, the spot on which the 
 offence is alleged to have been committed, should be examined, 
 to compare it with the appearances discovered on the body of 
 the female. 
 
 The person of the accused should also be examined, with the 
 view of ascertaining whether any bruises, scratches, or other 
 marks of resistance are discoverable ; whether there are any 
 spots of blood or semen on his linen ; and also what is his size, 
 strength, health, and bodily development. The organs of gene- 
 ration should be examined, to discover whether he is impotent, 
 or capable of producing the amount of injury discoverable on 
 the female ; and also, whether he have the venereal disease, and 
 if so, what is its stage, or how long he has probably had it. 
 Guy's Med. Juris., 78-9. 
 
 IV. PREGNANCY. 
 
 There are few subjects within the range of Medical Jurispru- 
 dence, that gather around them a greater degree of interest than 
 the signs and indications of Pregnancy. Independent of the 
 bearing they have, and the influence they exert upon domestic 
 and social life, the occasions when the investigation of them is 
 rendered legally necessary, are neither few nor unimportant. 
 
 Some occasions exist in England for this investigation which 
 do not in this country. One is that proceeding under the com- 
 mon la-v, where a widow is suspected to feign herself with child. 
 
S8 MEDICAL JURISPRUDENCE. 
 
 in order to produce a supposititious heir to the estate, and thus 
 to defraud the lawful heir. The presumptive heir may in such 
 case have a writ de ventre inspicimdo, by which the sheriff is com- 
 manded to have search made, and the fact determined whether 
 pregnancy exists or not, by twelve matrons in the presence of 
 twelve knights. If the result determine the fact of pregnancy, 
 then she is to be kept under proper guards until she is delivered. 
 If the pregnancy is negatived, the presumptive heir is admitted 
 to the inheritance. 
 
 The most remarkable case illustrating this, is that of Sir 
 Francis Willoughby, reported in Crokes Elizabeth, 566. The 
 practice has been somewhat modified in a recent case, so as to 
 appoint two medical men with two matrons to visit the female 
 every fortnight, instead of the examination to be made by th< 
 jury of matrons in the presence of the knights as was required by 
 the earlier practice. 
 
 Another occasion when it becomes necessary to enquire into, 
 and ascertain the fact of pregnancy, is when a woman is convicted 
 of a capital crime and pleads pregnancy. In such a case, if the 
 fact of pregnancy appeared on the examination, the execution 
 was respited until after the delivery. 
 
 According to the common law of England, in case this plea be 
 made in stay of execution, the judge must direct a jury of twelve 
 matrons, or discreet women, to ascertain the fact ; and if they 
 bring in their verdict quick with child, (for barely with child un- 
 less it be alive in the womb, is not sufficient,) execution shall be 
 stayed generally till the next session, and so from session to ses- 
 sion, till either she is delivered or proves by the course of nature 
 not to have been with child at all. 4 Blackstone's Ccm., 394-5. 
 
 In Scotland, all that is necessary to be proved to have execu- 
 tion delayed, is the fact of pregnancy, no difference being made 
 whether she be quick with child or not. This is also the provi- 
 sion of the French penal code upon this subject. 1 Beck's 
 Med. Juris., 155-6. These provisions have the merit not only 
 of leaning strongly to the side of mercy, but also of being founded 
 upon just and sound physiological principles. 
 
 It is not a little singular that with all the light and knowledge 
 
PREGNANCY. 39 
 
 there is upon that, and other kindred subjects, the late Revised 
 Statutes of New- York, should not have contained mqre enlight- 
 ened provisions on this subject. They provide that in case of 
 pregnancy in a female sentenced to capital punishment, the 
 sheriff shall summon a jury of six physicians, and give notice to 
 the district attorney who has power to subpcena witnesses. If 
 on the inquisition the female is proved to be quick with child, the 
 execution shall be suspended, and the inquisition transmitted to 
 the governor. Whenever he is satisfied that she is no longer 
 quick with child, he is to issue his warrant for execution, or to 
 commute it by imprisonment for life in the State prison. 2 R. S 
 658. 
 
 Quickening, as we shall see hereafter, has no certainty as to 
 the time of its occurrence, but it usually takes place about four 
 months after conception. An infant is the inheritor of real estate 
 from the moment of its conception. In this case, therefore, the 
 law presents the singular anomaly of investing an infant, at its 
 conception, with the inheritance, and the rights appertaining to 
 the ownership of real estate, and yet four months afterwards of 
 executing it unheard for the crime of its mother. 
 
 There is also another case in which the law of England has 
 interfered on the fact of pregnancy being brought to the know- 
 ledge of the court, and that is where a female in this situation is 
 imprisoned. In such case she is admitted to bail to prevent the 
 peril of death to her and her infant. Guy's Med. Juris., 87-8. 
 
 It is not on these important occasions alone that it may become 
 necessary to ascertain the fact of pregnancy. There are many 
 others where its investigation becomes necessary. It may be 
 attempted to he feigned by the unmarried, with a view to extort 
 money ; or to induce a paramour or seducer to marry ; or in an 
 action brought for breach of promise of marriage, she may al- 
 lege pregnancy as a means of influencing the jury in the assess- 
 ment of damages. Guy's Med. Juris., 85. 
 
 The married may also feign it to gratify the wishes of a hus- 
 band, to produce a supposititious heir to the estate, to delay the 
 execution of capital punishment, or to escape from imprison- 
 ment 
 
40 MEDiCAL JURISPRUDENCE. 
 
 There are also motives that may induce its concealment. Both 
 the married and unmarried, particularly the latter, may attempt 
 it to avoid disgrace, or with a view of procuring abortion, or of 
 committing infanticide. 
 
 Thus the occasions are numerous which may require the medi 
 cal jurist to determine the existence or non-existence of this fact. 
 And it must also be borne in mind that he may, and most com- 
 monly is, called upon to do this under the most unfavorable cir- 
 cumstances. It not unfrequently happens in such cases that he 
 cannot rely on a single statement made by the individual who 
 may be the subject of examination ; but, on the contrary, he 
 must be prepared for every species of falsehood and misrepre • 
 sentation. Montgomery's Signs of Pregnancy, 30. 
 
 Under these circumstances, and the pressure of these difficul- 
 ties, the medical jurist will naturally resort to all the sources of 
 proof accessible in questions of this character. These sources 
 are various, and widely different, some depending upon the re- 
 port made or the information furnished him, while others consist 
 in the changes induced and cognizable by the senses. 
 
 The signs and indications of pregnancy are derived principally 
 from-two sources. These are, 
 
 1 . The changes that occur in the constitution of the female, 
 consequent upon conception : 
 
 2. The sensible changes and indications that are caused by the 
 development of the uterine system. 
 
 The first change from the normal state which follows concep- 
 tion, is to be found in the uterine system. There is an imme 
 diate determination of blood to this system. A new principle is 
 introduced, whose modifying influence is to extend through the 
 whole economy. There is a great increase of vascularity in the 
 uterus and its appendages. Its vessels are distended with blood ; 
 its tissues infiltrated with serum ; its bulk increased ; texture 
 softened; fibres separated; and such a remarkable increase of 
 vital action takes place in it, that it is thrown into a state which 
 has been termed k ' analogous to inflammation. Hunter on Gravid 
 Uterus, 82 ; Montgomery's' Signs of Pregnancy, 2. 
 
 Nor is the change limited to the circulating system. The 
 
PREGNANCY. 4] 
 
 nerves of the uterus are observed to increase liotli in number 
 and in size They consequently impart to it a higher degree of 
 sensibility. Their close connexion with the great abdominal 
 plexuses, enables them quickly to diffuse their influence through 
 the general system, which is found soon to sympathize with this 
 local excitement. 
 
 The changes, therefore, effected in the general system, in con- 
 sequence of the uterine development, may be expected to be 
 somewhat marked and decided. It should, however, be under- 
 stood, that, owing to differences of temperament, and organic 
 peculiarities, the varieties in the female constitution are very 
 great, and hence, that although the changes that can be collected 
 from all the varieties are strongly marked and decided; yet 
 when their application comes to be made to any individual case, 
 very many of them may be wanting. 
 
 The round ligaments of the uterus are stretched by its en- 
 largment ; from which, and from the increased sensibility of their 
 nerves, an uneasiness is frequently felt, which extends along the 
 nerves of the thigh, producing numbness, cramp, and considera- 
 ble pain along the limb. These symptoms are often among the 
 earliest indications of uterine irritation. Montgomery's Signs of 
 Pregnancy, 4. 
 
 After pregnancy is somewhat advanced, it is not unusual for 
 the uterus, by its pressure upon the trunks of the veins, to 
 cause anasarcous swellings of the feet and legs, and sometimes 
 varicose veins and hemorrhoidal tumors. As there is also some- 
 times an oedema of the upper extremities and face, there would 
 seem to be, occasionally, a more general cause than the pressure 
 just mentioned. Montgomery's Signs of Pregnancy, 5. 
 
 The increased vascular action produced in the uterus after con 
 ception, frequently extends through the entire system, inducing 
 a somewhat plethoric state of the blood vessels. So, also, the in- 
 crease of nervous irritability displays itself under a variety of 
 forms, rendering the female more excitable, and more subjected 
 to the influence of the emotions and passions, especially those of 
 fear, joy, sorrow, and anger. Many melancholy instances are 
 on record, of the unfortunate results of the influence of these 
 
4i MEDICAL JUItlSPUUDENCE. 
 
 passions upon nervous females, during the period of utero-gesta- 
 tion. Montgomery's Signs of Pregnancy, 12-13-14, et seq. 
 
 The effect of this nervous irritation not unfrequently works a 
 change in the moral temperament, evidenced by depression and 
 despondency, rendering her peevish, irritable, capricious and 
 wayward. This usually disappears, giving place to natural cheer- 
 fulness, as pregnancy advances, especially if it be connected with 
 good bodily health. Montgomery' 's Signs of Pregnancy, 18-19. 
 
 In other cases, the depression deepens with time, and is ac- 
 companied by an apathetic indifference to circumstances and 
 events. Occasionally the cerebral disturbance proceeds so far as 
 to amount to absolute derangement of some one or more of the 
 faculties of the mind, lb., 20. 
 
 In some cases, a great tendency to drowsiness exists, which is 
 so great in degree, that it requires the severest effort to overcome 
 it Montgomery' 's Signs of Pregnancy, 1 50 - 51 . 
 
 An alteration is sometimes to be noticed in the features and 
 expression^ of the countenance, which is termed by the French 
 writers a decomposition of the features. They are observed, 
 especially the nose, to become sharper, and more elongated ; the 
 mouth larger ; the eyes sunk, and surrounded with a brownish 
 or livid areola, having a languid expression. The body, except 
 the breasts and abdomen, becomes more emaciated. Montgomery's 
 Signs of Pregnancy, 150. 
 
 Strange appetites and antipathies are not anunfrequent attend- 
 ant of pregnancy. Longings for revolting articles, and aversions 
 founded on no reason, characterize this condition of the system. 
 Hid, 151-2. 
 
 In some females, pains in the teeth and face are invariable 
 accompaniments of pregnancy. There are also some instances 
 in which dark spots or blotches appear upon the face and other 
 parts of the skin, and they have sometimes been permanent. 
 Ibid, 152-3. 
 
 Some women, during this state, are troubled with frightful 
 dreams, proceeding probably either from disorder of the aliment- 
 ary canal disturbing the irritated nervous system, or from an 
 irregular or undue circulation of blood in the brain. Rid 153. 
 
PREGNANCY. 43 
 
 Another accompaniment that has been mentioned is a peculiar 
 headache, consisting of an acute pulsating pain in the occipital 
 region, accompanied with giddiness on motion, coming on sud- 
 denly and succeeded by inclination to sleep. As headache may 
 be produced by a variety of causes it cannot be much relied on. 
 Ibid, 153-4. 
 
 It has been asserted that the blood of pregnant women always 
 presents the buffy coat and other characters of inflammation, but 
 experience has shown that no reliance can be placed On this as 
 an evidence of pregnancy. In females of full habit, sanguine 
 temperament, and where the pulse is accelerated, the blood may 
 present some of the modified characters of inflammation up to 
 the third or fourth month of utero-gestation. Montgomery's Signs 
 of Pregnancy, 155 — 6. 
 
 Indications have also been sought to be drawn from the appear 
 ance exhibited by the urine of pregnant women. By allowing 
 the urine to stand some thirty or forty hours a deposit is some- 
 times found to take place of white, flaky, pulverulent, grumous 
 matter, being the caseum, or peculiar principle of milk, formed 
 in the breasts during gestation. In many instances the deep 
 color and turbid condition of the urine will prevent the deposit 
 from being observed, but where it is clear, it appears as if a little 
 milk, having been thrown into the urine, had partly reached the 
 bottom, while a part remained suspended and floating through 
 the lower part of the fluid, in the form of a whitish semi-trans- 
 parent filmy cloud. Montgomery's Signs of Pregnancy, 157-8. 
 
 Although Dr. Montgomery seems from his experience, to at- 
 tach considerable importance to this indication, yet it would 
 seem from some specimens of urine submitted to examination, 
 that a white flocculent precipitate, similar to that described, sub- 
 sided spontaneously after twenty-four hours, not only from the 
 urine of pregnant women, but also in equally great quantity from 
 that of a virgin of the age of fourteen, and that of a woman nurs- 
 ing for two months. Dr. Kennedy supposes this indication of 
 no value. Kennedy on Pregnancy and Auscultation, 56 - 7. 
 
 There is also an appearance somewhat different from this, 
 upon which reliance has been placed. The urine, after stand- 
 
44 MEDICAL JURISPRUDENCE. 
 
 ing one or two days, becomes turbid, and in case of pregnancy, 
 fatty globules rise to the surface, forming a pellicle resembling that 
 left on the surface of mutton broth on cooling. This remains 
 swimming on the surface for three or four days, and is termed 
 Kiestein. It breaks up and disappears as the urine becomes 
 putrid. It continues faintly acid until the breaking up, when it 
 developes ammonia. This should not be confounded with the 
 earthy phosphate which forms on the surface of the urine after 
 Jong repose, as that is developed by putrefaction, while this is 
 destroyed by it. Guy's Med. Juris., 92. 
 
 It should, however, be borne in mind, that many accidental 
 causes are capable of altering the condition of the urine ; so that 
 great caution should be exercised in reference to any deduction 
 to be drawn from this source of proof. 
 
 An indication is also sought to be drawn from the state of the 
 pulse. This has been so thoroughly refined upon, that some 
 have professed themselves able to discover from it, not only the 
 faet of pregnancy, but also its period of advancement, and even 
 the sex of the child. Montgomery's Signs of Pregnancy , 158. 
 
 All that can with safety be said on this subject, probably, is, 
 that during the earlier periods of gestation, the pulse is general- 
 ly stronger and more rapid than is natural to the individual at 
 other times. But among the multitude of causes that may ex- 
 cite to increased action, this certainly should have little or no 
 reliance placed upon it. Dr. Osiander has remarked, that during 
 gestation, the uterine artery is enlarged, as is also the vagina], 
 and that the action of the latter is increased, so that its pulsations 
 may be ascertained to be both stronger and harder, and its calibre 
 greater than usual. See Montgomery's Signs of Pregnancy, 1 58 - 9 
 
 Many of the signs and indications already mentioned, are only 
 occasional, but their occurrence during the first pregnancy, ren- 
 ders it more probable that they will be present during the sub- 
 sequent ones of the same individual. There are other signs and 
 indications that are found more generally present. Among the 
 most prominent of these are — 
 
 Suppression of the menses, or catamenia. This is a discharge 
 arising from a secretion from the internal surface of the utejus, 
 
PREGNANCY. 45 
 
 which occurs at periodical, usually monthly intervals, and con- 
 tinuing, with few exceptions, from puberty to the approach of 
 old age. Kennedy on Pregnancy and Auscultation. 
 
 The exceptions are when the functions of the organ are al- 
 tered or suspended, as during pregnancy, nursing, or in a state 
 of disease. 
 
 As a general rule this discharge is suspended during pregnan- 
 cy. But conception may have occurred previous to its com- 
 mencement. Of this there are cases on record. Montgomery's 
 Signs of Pregnancy, 41-2. There are also cases in which women 
 have conceived after menstruation had apparently ceased. There 
 are also cases of somewhat rare occurrence where women have 
 conceived when the menses have been long suppressed in conse- 
 quence of disease. Ibid, 43. 
 
 Some women are very irregular in the returns of these periods, 
 having them delayed beyond the usual intervals. At the period 
 denominated the change of life, they are sometimes suppressed, 
 for two or three months, and then return profusely. Ibid, 43. 
 • Suppression may arise from many causes independent of con- 
 ception. It may be caused by different forms of disease, by ex- 
 posure to cold and hardship, by severe mental emotions, more 
 particularly by that of fear. Ibid, 43. Of this latter there are/ 
 numerous instances occurring, especially in prisons, where fe- 
 males are confined under very unfavorable circumstances. 
 
 In young and recently married females it is not unusual that 
 suppression occurs for two or three periods, the breasts at the 
 same time increasing in size and becoming sensitive. After the 
 lapse of two or three months, what appears an ordinary men- 
 struation occurs, and in tins manner these indications of concep- 
 tion pass away. They are frequently supposed to be miscarriages, 
 and it is not at all improbable that conception really took place, 
 but the ovum soon after perishing, ah the signs and indications 
 passed away. Montgomery's Sig?is of Pregnancy, 4A. 
 
 The high authority of Denman, sustains the rule that " sup 
 pression of the menses is one of the never failing consequences 
 of conception." To this, however, there are certainly excep- 
 tions. There are certainlv instances in which menstruation oe 
 
4(5 MEDICAL JURISPRUDENCE. 
 
 curs once after conception. There are also individuals who 
 menstruate with regularity for more than one period after con- 
 ception. Sometimes for two or three months these menstrual 
 discharges continue. 
 
 There are even cases occurring where the menstrual discharge 
 continues through nearly the whole period of pregnancy. But 
 the most extraordinary of all cases are those in which menstrua- 
 tion has either appeared for the first time after conception, or in 
 which it continued only during pregnancy. Montgomery's Signs 
 of Pregnancy, 49 - 50. 
 
 There are not wanting instances of these most singular and 
 anomalous cases. 
 
 There are some cases in which the secretion takes places, but 
 the discharge is prevented by some obstacle. This obstacle is usu- 
 ally an imperforate hymen. In such cases an accumulation takes 
 place within the uterus and vagina, distending both and giving 
 rise to several of the sympathies which usually accompany preg- 
 ancy. Several instances of tins are stated by Montgomery. 
 Ibid, 51-52. 
 
 It may be well in this connexion to advert to one means of de- 
 ception that may be practiced ; and that is that a female really 
 pregnant may pretend to have her periodical discharges regu- 
 larly and imitate the catamenia by blood. This may usually be 
 detected from the fact that the menstrual discharge contains little 
 or no fibrine, and does not coagulate as the blood does. Kennedy 
 on Pregnancy and Auscultation, 1 5. 
 
 Another constitutional indication which is present in the ma- 
 jority of cases is nausea and vomiting. In some this commences 
 almost immediately after conception. It the most frequently oc- 
 curs between two and three weeks after, and prevails the most 
 during the early periods of pregnancy. In some, however, it 
 does not occur until two or three months after conception, and 
 in others not at all. Montgomery's Signs of Pregnancy, 53. 
 
 Irritability of stomach may occur from a variety of causes 
 other than conception and pregnancy. Suppressed menstruation 
 may give rise to it. It may be caused by many varieties oi 
 disease. One of the principal criteria by which it is recognized 
 
PREGNANCY. 47 
 
 as a sign or indication of pregnancy is, that it is unattended by 
 any form of disease. Its occurrence in the midst of good health, 
 when the appetite is good, and in the early part of the day is 
 looked upon as a sign or indication of some value. Montgome- 
 ry's Signs of Pregnancy, 53-4 
 
 The sympathetic irritation causing nausea and vomiting some- 
 times extends to the salivary apparatus, and produces there such 
 an eifect as to cause a complete and copious salivation. There 
 have been several' well authenticated instances of this, although 
 it cannot be said to be common. It is easily distinguished from 
 mercurial ptyalism by the absence of the peculiar fcetor of the 
 breath, and also of sponginess and soreness of the gums. 
 
 Another source of evidence from which many of the proofs 
 of pregnancy are derived, is to be found in the mammary sym- 
 pathies, winch consist principally of the enlargement and sensi- 
 bility of the breasts; the formation of the areola, and the secretion 
 of milk. These, although in themselves sensible signs, derive, 
 nevertheless, their existence through the constitution, and should 
 therefore, come under that class. 
 
 After conception has taken place, and the menstrual discharge 
 has been suppressed for one or two periods, a change commences 
 in the breasts ; a sensation of throbbing is experienced, accom- 
 panied with a sense of soreness and tingling felt about the centre 
 and in the nipples. This sometimes does not occur until the 
 pregnancy is considerably advanced, but usually commences 
 when about two months of it have become completed. Mont- 
 gomery' 's Signs of Pregnancy, 56 -7. 
 
 At the same time the breasts themselves grow larger and firmer. 
 This not unfrequently causes pain from the tension of the integu- 
 ments. 
 
 All these changes in the breast may result from causes other 
 than conception. They may arise 
 
 1 . From marriage and the habits thence arising. 
 
 2. From becoming fat. 
 
 3. By accidental suppression of the menses, or retention by 
 an imperforate hymen, or other causes capable of distending the 
 uterus. Hid, 56 - 7. 
 
4C MEDICAL JURISPRUDENCii;. 
 
 The enlargement of pregnancy may, in general, be distin- 
 guished from that which arises from becoming fat, by the fact 
 that the breast has greater firmness, and feels knotty and un- 
 even when pressed, and also that a corresponding fullness is not 
 found in other parts of the body. In some irritable habits, 
 swelling and pain in the breasts, accompany each return of the 
 catamenia. 
 
 In such cases, the tension and uneasiness disappears in two or 
 three days, while that caused by pregnancy continues to in- 
 crease, unless the ovum becomes blighted, when the breasts be- 
 come flaccid, and lose their previous appearances. In females 
 of weak and delicate constitution, less changes will occur in the 
 breast, and those at a more advanced period of pregnancy. 
 Neither may they be expected to be found in those who menstru- 
 ate during the early period of pregnancy. Montgomery's Signs 
 of Pregnancy, 57-8 ; Guy's Med. Juris., 89. 
 
 It should be borne in mind, that in some individuals, the 
 breasts are naturally much fuller than in others, and that a great- 
 er fullness may also take place at the turn of life, when the 
 menses are suppressed, and the person grows fatter, and the 
 breasts frequently become full, and sometimes painful. From 
 the fact first mentioned, one obvious inference may be derived, 
 and that is, that it is not the absolute size of the breasts that is 
 to be taken into consideration, but the relative size ; that is 
 their comparative greater size than had formerly been observable 
 in the same individual. 
 
 Another indication very much relied on as affording a proof 
 of pregnancy, is, 
 
 The Areola. This is a circular disc surrounding the nipple 
 and presents the following peculiarities : 
 
 1 . In its dimensions. Its diameter varies with different periods 
 of pregnancy. At its first appearance, it may be about an inch 
 in diameter. It continues to enlarge, until its greatest dimensions 
 may exceed two inches. 
 
 2. In its color. At its first appearance, its color is, in genera] 
 little more than a deeper shade of rose or flesh color, slightly 
 tinged with a yellowish or light brownish hue. As pregnancy 
 
PJBEGNANCY. -19 
 
 advances, the color continues to deepen, assuming a browner and 
 darker appearance. The intensity of the color depends much 
 upon the complexion of the individual, being usually much dark- 
 er in persons with black hair, dark eyes, and sallow skin, than 
 in those of fair hair, light colored eyes, and delicate complexion. 
 In negro women, it becomes jet black, with somewhat of a piu"- 
 ple shade through it. The color of the areola depends on the 
 deposition of an actual pigment between the cuticle and subja- 
 cent skin. In some, the coloring matter is removed after delive- 
 ry ; in others, it remains permanent. Montgomery's Signs of 
 Pregnancy ', 60-65. 
 
 It is peculiar to some young females to have the areola assume 
 a shade of color resembling that often observed around or under 
 the eyes ; and in women of a swarthy hue, it is sometimes found 
 of a dark shade in the virgin state ; while in such, in a state of 
 pregnancy, it becomes of an intensely dark, almost black, color. 
 Mo tgomery's Signs of Pregnancy, C5 -6. 
 
 Great importance has, by some, been attached to the color, but 
 Dr. Montgomery remarks, that pregnancy may exist, and the 
 areola remain deficient in that generally supposed to be its most 
 important distinctive mark, viz., the color. This deficiency is 
 not often met with, except in persons of fair skin, blue eyes, and 
 light hair. But when the color is deficient, the other character- 
 istic changes may be well developed. 16., 63. 
 
 3. In its raised appearance, turgescence, and glandular follicles. 
 The surface of the areola, especially that part of it lying more 
 immediately around the base of the nipple, exhibits a raised 
 appearance; the integument covering it appearing turgescent, 
 soft, and in a moist state. This may be caused by infiltration 
 of subjacent cellular tissue. There is undoubtedly a greater de- 
 gree of vital action going on there, than in the parts around it. 
 lb., 59-61. 
 
 One peculiarity in this raised integument is that it is studded 
 over and rendered unequal by the prominence of glandular folli- 
 cles, which vary in number, usually from twelve to twenty.. 
 They project from the' sixteenth to the eighth of an inch, and are 
 not unfrequently bedewed with a secretion sufficient to damp; 
 
 4 
 
50 MEDICAL JURISPRTJDElfCE. 
 
 and color the woman's inner dress. These follicles are sometimes 
 wanting. Hence their absence should not be considered as con- 
 clusive evidence that pregnancy did not exist, while their pre- 
 sence may be received as convincing proof of previous concep- 
 tion. There is by many, and probably with justice, more im- 
 portance attached to the turgescence of the integument, and the 
 presence of the follicles, than to the color ; those being considered 
 as the principal distinctive mark, between the part during preg- 
 nancy and at other times. Montgomery'' s Signs of Pregnancy, 59, 
 et seq. 
 
 In the centre of the colored circle is observed the nipple, par- 
 taking also of the altered color of the part, and appearing turgid 
 and prominent. Towards the latter period of pregnancy, espe- 
 cially in women of dark hair and eyes, numerous round spots or 
 small mottled patches of a whitish color are to be seen scattered 
 over the outer part of the areola, and for about an inch or more 
 all round, presenting an appearance as if tfie color had been dis- 
 charged by a shower of drops falling on the part. Montgomery's 
 Signs of Pregnancy, 81 -2. 
 
 The earliest period at which these characteristics of the areola 
 appear is at the end of the second month. At this time is ob- 
 servable not only the alteration in color, but also the puffy tur- 
 gescence of the nipple and its surrounding disc, together with a 
 slight development of the little glandular follicles. From this 
 period all these go on increasing in proportion to the progress of 
 the pregnancy, until its full term is completed. At the end of 
 the fourth month its changes in general become perfected or 
 nearly so, when it exhibits the characters previously mentioned. 
 
 Should the fetus become blighted in the progress of the preg- 
 nancy, the mammary sympathies cease, and the changes in the 
 areola decline and fade away. The follicles shrink, and no longer 
 bedew with moisture. So also the breasts become soft and flac- 
 cid, lose their sensibility, and cease to exhibit the enlarged con- 
 dition of the veins. Montgomery's Signs of Pregnancy, 60-63. 
 
 In regard to the conclusiveness of the areola as an indication 
 of pregnancy, there is some difference of opinion. Dr. Mont- 
 gomery, following the authority of Rmellie and William Hunter, 
 
PREGNANCY. 51 
 
 regards it as the result of pregnancy only. Others claim that the 
 enlargement of the mammae, and the discoloration of the areola, 
 are alterations brought about by several' other conditions. 
 
 Various disorders of the uterine system, it is said, will produce 
 an augmentation in the size of the breasts and a darkened areola. 
 Guy's Med. Juris., 91. It may, perhaps, be questionable whether 
 those who doubt its sufficiency as evidence may not have con- 
 fined their attention more to some one of its characteristics, such 
 as its color, than to all its distinctive features. From all the 
 evidence offered, it is difficult to come to the conclusion, but that 
 the true areola, when all its distinctive characteristics are present, 
 is a very clear and satisfactory indication of pregnancy. 
 
 Another usually ranked as an indication of pregnancy is — 
 
 Milk in the breasts. This is popularly esteemed an infallible 
 proof of pregnancy. It is, however, far from being really such. 
 The secretion of milk has taken place under circumstances inde- 
 pendent of pregnancy and even o£ intercourse. It has taken 
 place at almost all ages, having occurred prior to puberty, and 
 after the cessation of the generative faculty. Montgomery's Signs 
 of Pregnancy, 69. There are even well authenticated cases on 
 record, and some of recent occurrence, where this secretion has 
 taken place in the breasts of men, and where they have given 
 suck to young infants. There have been cases where women 
 have had milk in their breasts from one pregnancy to another, 
 and even for whole years together, although they have not nursed. 
 Guy's Med. Juris, 92. 
 
 The secretion may occur from morbid causes that are capable 
 of distending the cavity of the uterus. The indication can really 
 be of no great value, as milk is seldom secreted until after deli- 
 very, and should it happen to be, during the progress of utero- 
 gestation, it is only at so late a period of it, that much more un- 
 exceptionable proof can be afforded from other sources than is 
 properly derivable from this. 
 
 This closes the enumeration of the constitutional signs and in- 
 dications of pregnancy. , It will be obvious, on slight reflection, 
 that the presence or absence of very many of these signs and in- 
 dications, as well as the extent or degree in which they are niani 
 
52 MEDICAL JURISPRUDEt CE. 
 
 fested, will depend much upon the constitutional peculiarities, 
 state of health, temperament, and mode of life of the individual. 
 
 The other class of signs and indications embraces -those changes 
 rendered immediately apparent by the uterine enlargement, and 
 the appearances that are consequent thereon ; including, also, the 
 evidence derived from auscultation. These may be termed, the 
 uterine or sensible signs. ' 
 
 These signs address themselves to three of the senses, viz., 
 the senses of sight, touch and hearing. 
 
 The eye informs us of the enlargement of the abdomen, and 
 also of the state of the breasts, and character of the areola, al- 
 ready considered. The touch acquaints us with the fact of preg- 
 nancy, by external examination, through the abdominal parietes, 
 by internal examination per vaginam, and by ballottement or re- 
 percussion. The hearing brings to us certain sounds resulting 
 from the state of the circulation in the gravid uterus, and the 
 action of the fcetal heart. Montgomery's Signs of Pregnancy, 112. 
 
 1 . Ahdominal enlargement. Subsequent to conception, the ute- 
 rus, becoming developed at its fundus, descends lower into the 
 cavity of the pelvis ; and hence, during the first two months, the 
 abdomen often appears unusually flat, and the umbilicus, at the 
 same time, drawn in and depressed. These changes are in some 
 cases so marked, that some authors place reliance upon them as 
 proofs of pregnancy. Guy's Principles of Forensic Medicine, 93. 
 
 Before the end of the third month, the abdomen becomes per- 
 ceptibly enlarged, and this goes on increasing during the period 
 of pregnancy, accompanied with corresponding changes in the 
 state of the umbilicus. Montgomery's Signs of Pregnancy, 92. 
 
 There are females who, from their height, or some peculiarity 
 of form, exhibit very much less than others, this enlargement of 
 the abdomen. 
 
 In case of the death of the fcetus in utero, the progressive 
 enlargement of the abdomen ceases, and sometimes in such cases, 
 it will appear to diminish. 
 
 Not only are there cases in which there is not a corresponding 
 enlargement of the abdomen, but there are also others, on the 
 other hand, where the enlargement is owing to other causes than 
 
PREGNANCY. 53 
 
 pregnancy. It may result from morbid conditions not affecting the 
 uterus, as disease of tie liver, spleen, ovarian tumor, or ascites ; 
 but in any such case, the length of time the enlargement has ex 
 isted, the diseased condition of the system, the character and 
 situation of the tumor, the state of the umbilicus and breasts, 
 and the want of correspondence in the symptoms and conditions 
 of the case, if it were pregnancy, will furnish sufficient indica- 
 tions. i&., 93. 
 
 They will also generally be sufficient, either alone or in con- 
 nexion with vaginal examination, if the uterus itself be dis- 
 tended. 
 
 In case of the distension of the abdomen with fat, it will be 
 indicated by the soft and yielding condition of the part, under 
 the hand, taken in connexion with the absence of any solid 
 tumor, and also of the ordinary symptoms of pregnancy. 
 
 Ascites may be distinguished from pregnancy, 
 
 1 . By the fluctuation that is present and the absence of any 
 solid tumor, 
 
 2. By the form of the abdomen when standing or lying down, 
 which in case of pregnancy retains about the same degree of 
 prominence, but in dropsy subsides, flattens down, and spreads 
 out. 
 
 3. In dropsy the constitutional disturbance will increase with 
 the increase of size, in pregnancy it will diminish. 
 
 4. In the former, there is much thirst and scanty urine, not 
 in the latter. 
 
 5. In the former, the swelling of the feet is usually prior to 
 that of the abdomen, in the latter subsequent. 
 
 It is, however, possible that both may exist together, in which 
 case the state of the breasts should be examined, particularly 
 the areola, and recourse may also be had to the examination of 
 the uterus per vaginam. Montgomery's Signs of Pregnancy, 95. 
 
 There may also be morbid growths within the uterus, such as 
 moles, hydatids, and membranes produced in dysmenorrhea, 
 which will have the effect not only to distend the uterus, and 
 thereby produce abdominal enlargement, but will also at the 
 
54 MEDICAL JURISPRUDENCE. 
 
 same time give rise to many other of the usual indications of 
 pregnancy. Guy's Principles of Forensic Med., 93. 
 
 These will be more fully considered under the head of sub- 
 stances expelled from the uterus. Another sensible sign con- 
 nected with the enlargement of the abdomen is the 
 
 State of ilve Umbilicus. During the first two 'months this is 
 rather retracted and more depressed than usual. In the third 
 month it becomes restored to its natural state : in the fourth, is 
 found less hollow than before conception ; in the fifth or sixth, is 
 nearly on a level with the surrounding integuments j in the sixth 
 or seventh, completely so ; and towards the close of gestation pro- 
 jects, in most persons, considerably above the surface. Any solid 
 tumor enlarging the abdomen will also have the effect of elevat- 
 ing the umbilicus. Montgomery's Signs of Pregnancy, 97-8. 
 
 Another source of evidence of great value is that derived 
 from 
 
 Quickening and the fcetal motions. The time of quickening is 
 rendered of great importance by the law fixing upon that as the 
 period when the fetus in utero first becomes endowed with life 
 We have already seen what effect the law gave to it when the 
 mother was under judgment of condemnation for some capital 
 crime. We shall hereafter see what a wide difference it makes 
 in reference to injuries inflicted on a fcetus in utero, whether 
 they were inflicted prior or subsequent to the period of quick- 
 ening. 
 
 Physiology, for the clearest reasons, denies the assumption of 
 the law, that at the period of quickening, life is first infused into 
 the foetus. As physiology has here the better right and the 
 clearer reason, we shall allow it to define quickening, which it 
 does by stating that it is the first sensation experienced by the 
 mother of the life of the fetus in utero. Montgomery's Signs of 
 Pregnancy, 75. This definition of quickening subjects this source 
 of evidence to this difficulty, that it is rendered dependant on 
 the statements of the mother. Allowing that these statements 
 are intended to be truthful, she is very liable to be mistaken. 
 Sometimes when the fetal motions are perceptible to the hand 
 of another, the mother has no sensations indicating the existence 
 
PREGNANCY. 55 
 
 of such motions. There are also examples of women, as in the 
 instance of Queen Mary, who have supposed and firmly believed 
 that they have quickened when no such thing had occurred. 
 
 In some instances festal motions, from some cause difficult to 
 explain, become suddenly suspended, without the occurrence 
 of any injury to the child. A strong mental emotion on the part 
 of the mother has had this effect. Montgomery's Signs of Preg- 
 nancy, 81. 
 
 Some have supposed they felt these movements when there 
 was no state of pregnancy existing. 
 
 This naturally leads to an enquiry as to how a deception of 
 this kind can occur, and what are the causes of it. They may 
 arise, 
 
 1. From air in the intestines passing quickly from one part to 
 another : 
 
 2. From the effect of nervous irritability in the female : 
 
 3. By spasmodic twitching of some of the abdominal muscles 
 or a partial contraction of those of the uterus when distended 
 with air or fluid : 
 
 4. From the pulsation of the great arteries, more especially 
 when felt acting on a tumor, as in the case of an enlarged ovary. 
 
 There are two singular facts connected with these deceptions. 
 
 1 . They are perceptible to the female and recognised by others. 
 
 2. At the termination of the imaginary period of gestation 
 there has been an accession of pains strongly resembling those 
 of labor. Montgomery's Signs of Pregnancy, 83 -4. 
 
 It is asserted that some women possess the power of simulating 
 the motions of the child by means of certain actions of the abdo- 
 minal muscles. Instances of this kind must be very rare. One 
 is recorded in the case of Joanna Southcott. Ibid, 84-5. 
 
 Quickening has been very generally supposed to take place 
 when the uterus rises out of the pelvic cavity into that of the 
 abdomen. Kennedy on Pregnancy and Auscultation, 22. 
 
 There is no fixed, uniform time for its occurrence. An idea 
 is of common prevalence that it takes place exactly in the middle 
 of gestation. This is not borne out by experience. It happens 
 from the tenth to the twenty-fifth week, and the greater number 
 
56 MEDICAL JURISPRUDENCE. 
 
 of cases will be found occurring between the end of tlie twelfth 
 and sixteenth weeks after conception. Dr. Hamilton says it 
 takes place at the end of four calendar months after conception. 
 
 After quickening has occurred many of the signs and indica- 
 tions that mark the early period of pregnancy disappear, perhaps 
 owing to the altered position of the uterus. 
 
 When pregnancy is complicated with ascites, the quickening 
 will not occur until a later period, and will be perceived less fre- 
 quently and less distinctly. There are also occasionally the en- 
 tire absence of these movements through the whole period of 
 gestation, notwithstanding the child may be born alive and 
 healthy. These latter cases will be more likely to occur in ex- 
 tremely sluggish and lymphatic temperaments. Montgomery's 
 Signs of Pregnancy, 87-8. 
 
 These movements may sometimes be excited by a sudden ap- 
 plication of the hand, having been previously rendered cold by 
 immersion in water, on to the front of the abdomen. Tins fre 
 quently has the effect to make it start. 
 
 Another method is to apply one hand against the side of the 
 uterine tumor and, at the same time, to impress the opposite side 
 quickly with the fingers of the other hand. At first, and during 
 the fourth or fifth months, the movement communicates only a 
 slight pat or throb, or merely a flutter, which sometimes is more 
 strongly felt at particular times of the day. In the sixth and 
 seventh months the movements are greatly increased in distinct- 
 ness, and in the last two months they not unfrequently cause a 
 distinct elevation of the abdominal parieties, so as to be visible 
 through the ordinary dress of the female. Montgomery's Signs of 
 Pregnancy, 89-90. 
 
 It is necessary to bear in mind that there are two species of 
 movements ; the one is passive, consisting in a mere change of 
 place, and may occur whether the fcetus be living or dead. The 
 other consists in muscular movements, and is therefore only con- 
 sistent with life. The mother is not unfrequently deceived, 
 mistaking the merely passive for active movements. 
 
 The next subject of enquiry may properly be, 
 
 27t« state of the cs and cerinx uteri. In the virgin or unim 
 
PREGNANCY. 57 
 
 pregnated state, the os, and lower portion of the cervix, are found 
 projecting from a quarter to half an inch into the cavity of the 
 vagina. 
 
 The part thus projecting feels firm, is conical in its form, and 
 at its termination in the vagina has a transverse opening, whose 
 lips or margins are firm and well defined. 
 
 At conception and subsequently, all these characters change. 
 The uterus and its appendages become not only much altered in 
 texture but also increased in size and weight. The cervix be- 
 comes fuller, rounder, softer and more elastic. The lips or mar- 
 gins are tumid, softer and less distinct, the orifice feeling circular 
 instead of transverse. These changes, however, do not become 
 very perceptible until the third month after conception. During 
 the three first months the os uteri is lower in the vagina, project- 
 ing forward. When the uterus has risen from the pelvis into 
 the abdomen, its fundus leans forward, in consequence of which 
 the os uteri is directed backward. Its margins are now soft and 
 relaxed, and will admit the finger to a considerable depth into 
 the cavity of the cervix. From this period the os uteri becomes 
 further and further removed from the external parts, so that in 
 the latter part of gestation it is reached with difficulty. The 
 orifice at last is hardly distinguishable, appearing like an opening 
 in a flat surface and without any elevated margin. Montgomery's 
 Signs of Pregnancy, 101-2. 
 
 It is not pregnancy alone that will produce this change in the 
 os and cervix uteri. The os uteri becomes somewhat similarly 
 affected from the irritation of the uterus, caused by the near 
 approach of menstruation. A diseased growth, such as a poly- 
 pus or hydatids, is much more effectual in the production of 
 this change. Although, therefore, other causes than pregnancy 
 may be instrumental in effecting this change, yet the transverse 
 orifice and well defined margins will always afford satisfactory 
 evidence that the uterus is in an unimpregnated state. 
 
 From the state and condition of the cervix uteri, are drawn 
 many important indications, not only as to the fact of the ex- 
 istence of pregnancy, but also as to its progress. During the 
 first four months after conception, the cervix becomes fuller 
 
OS MEDICAL JURISPRUDENCE. 
 
 rounder, softer, and more elastic ; but no particular change takes 
 place in its form or length. In the fifth month, the cylindrical 
 part of the cervix begins to diminish in length, a portion of it 
 becoming a part of the body of the uterus. Thus, as pregnan- 
 cy advances, the uterus continues to enlarge, and at the same 
 time the cervix continues to diminish ; that diminution going 
 on as its successive portions are taken up and become, by their 
 expansion and enlargement, a part of the body of the uterus 
 itself. Montgomery's Signs of Pregnancy, 104. 
 
 Changes in the uterus. The uterus begins to be developed 
 first, at its fundus. Its capacity here is increased, to enable it 
 to receive and accommodate the ovum. It is next developed in 
 the body, and lastly, in the cervix. During the first three months, 
 the degree of development is hardly possible to be ascertained. 
 In the fourth, the fundus may be felt above the anterior wall of 
 the pelvis. In the fifth, it rises half way between the symphisis 
 pubis and the umbilicus. In the sixth, it rises as high as the 
 umbilicus. In the seventh, the fundus uteri may be felt half 
 way between the umbilicus and the end of the sternum. At the 
 end of the eighth, it has risen as high as the ensiform cartilage, 
 and fills the whole abdomen, which is now prominent and tense, 
 with a projection of the umbilicus. In the ninth, the uterus 
 continues to enlarge, but the degree of its increase is not very 
 observable. lb., 107-8. 
 
 During the first four months, the uterus has the feel of a soft, 
 firm, fleshy tumor, not sensitive, and of a smooth surface. From 
 the fifth month, its distinctness is somewhat lost in its greater 
 expansion ; but in the same proportion as its parieties become 
 indistinct, its solid contents become more easily distinguishable. 
 
 These changes in the uterus may be produced by any cause 
 creating a distension of that organ. It becomes, therefore, im- 
 portant, on this account, as well as on every other, to be able to 
 ascertain what are the contents of the uterus, and whether its 
 enlargement is owing to foetal development, or to some other 
 cause. The senses of touch and hearing are those laid under 
 contribution for the purpose of solving the problem as to the 
 true cause of the uterine development. 
 
rKEGNA^Y. 59 
 
 During the first three months, but few indications can b« 
 drawn from the altered state of the uterus. In the fourth month, 
 its changes in the gravid state acquire a distinctness that gene- 
 rally enables the practitioner to recognize them, both externally 
 and per vaginam. Prior to examination per vaginam, the bowels 
 and bladder should be emptied of their contents. The examina- 
 tion is made by the index finger, having been previously im- 
 mersed in oil ; and the object of its introduction into the vagina 
 is mainly to ascertain the changes, if any, that have taken place 
 in the os and cervix uteri. The female should be placed on her 
 side, with the knees drawn up, and kept slightly apart with a 
 pillow. Montgomery's Signs of Pregnancy, 114-116. 
 
 The result of this examination will only show the uterus in a 
 state of enlargement, which may proceed from pregnancy, hyda- 
 tids, polypus, dropsy, accumulated menses, or a schirrhous 
 thickening of the substance of the uterus. 
 
 Ballotement, as the French term it, or repercussion, (the English 
 term,) has been devised to ascertain whether the contents of the 
 uterus are fce'al or not, and in practiced hands, is a means of 
 great value. One mode of doing this, is by placing one hand on 
 the side of the abdomen, (the female lying supine, or on her side,) 
 and making a pressure towards the opposite side, while the ends 
 of the fingers of the other hand impress the uterus in the con- 
 trary direction, by means of which, the foetus may be thrown 
 into contact with the hand, which is kept spread on the abdo- 
 men. If the examination is made while in the supine state, or 
 if made while the female is lying on her side, the fcetus may be 
 felt to drop on the points of the fingers, which should be kept 
 in close contact with the integuments. Montgomery's Signs of 
 Pregnancy, 117. 
 
 Another, which is the internal method, is performed while the 
 female is in the upright position ; or, which is better, if placed 
 lying with the shoulders much raised. The latter better enables an 
 examination of the supra-pubic region. One or two of the fingers 
 are to be introduced into the vagina, and carried forward and 
 upward to the anterior portion of the cervix uteri, as high up as 
 they can conveniently reach, and they must be kept in contact 
 
£0 MEDICAL JURISPRUDENCE. 
 
 with the spot to which they have been applied. The other hand 
 must be placed on the abdomen, over the uterine tumor, which 
 should be pressed downwards, towards the cavity of the pelvis. 
 Immediately upon this being done, the fingers in contact with the 
 cervix should be impressed against it with a quick and slightly 
 jerking motion, upwards, when something will be felt to have 
 bounded away from the fingers, upon which it will, in the course 
 of three or four seconds, be felt to drop again, with a gentle pat, 
 and this proceeding may sometimes be repeated as often as we 
 please, lb., 118. 
 
 This, if satisfactory, is conclusive proof of a fcetus in utero ; 
 but it is impossible to discriminate, by means of it, a living from 
 a dead fcetus. It is best made from the end of the fourth to the 
 end of the sixth month. It has sometimes failed of revealing 
 the fact of pregnancy, although it existed at the time. Care 
 should also be taken not to mistake the movements of the uterus 
 for those of the fcetus, and to avoid that, the fingers should be 
 kept constantly in contact with the cervix. 
 
 We now approach the consideration of another means which 
 the ingenuity of modern times has devised, and brought to a 
 state of comparative perfection, for discovering the uterine con- 
 tents. In this the sense of hearing is employed, and it consists 
 in the application of auscultation, or the use of the stethescope. 
 
 This is applied for the purpose of discovering the existence or 
 non-existence of two facts : 
 
 1 . The souffle or placental sound : 
 
 2. Tlie pulsations of the fatal heart. 
 
 The first mentioned is the one which is first capable of being 
 examined, and may be heard as soon as the uterus is sufficient- 
 ly developed for its fundus to rise above the anterior wall of 
 the pelvis, usually in the fourth month of gestation. Tliis is 
 called the placental sound, from its being supposed to be con- 
 fined to that part.of the uterus to which the placenta is attached. 
 Montgomery's Signs of Pregnancy , 120-21. 
 
 This is described as a low murmuring, or somewhat cooing 
 sound, resembling that made by blowing gently over the lip of 3 
 wide-niouthed phial, and accompanied by a slight rushing noise, 
 
PREGNANCY. • 61 
 
 but without any sensation of impulse. The following peculiari- 
 ties are to be noticed : 
 
 1. It is exactly synchronous with the pulse of the mother, 
 varying with any variation in the maternal circulation : 
 
 2. Its situation varies not during the course of the same preg- 
 nancy : 
 
 3. Its seat in the abdomen varies in proportion to the progres- 
 sive advance of the pregnancy. It will be frequently heard 
 about the fallopian tube of the right side, but may be detected 
 in any of the lateral or anterior parts of the uterus : 
 
 4. It is liable to intermissions. 
 
 The second fact i3 totally different from the first in almost all 
 its characteristics : 
 
 1. It is heard in rapid pulsations, numbering from 120 to 160 
 in a minute ; and if the maternal pulse exceeds the ordinary 
 standard, that of the foetus will remain unaffected. These pulsa- 
 tions, are feeble and delicate, and resemble the ticking of a watch 
 heard through one's pillow at night : 
 
 2. These pulsations are not 5< in general, heard until the end 
 of the fifth month ; and as pregnancy advances, the sound be- 
 comes more and more distinct : 
 
 3. The source of these pulsations being the fcetal heart, then* 
 seat will, of course, vary with the varying position of the fcetus 
 It is, however, the most frequently heard on one side or the 
 other, and more frequently on the left side than on the right. 
 This last mode of examination, if successful, is the most satis- 
 factory of all, as it discloses not only the fact of pregnancy, but 
 also the life of the fcetus. Montgomery- 's Signs of Pregnancy, 
 121-2-3. 
 
 But this benefit is attended by its corresponding disadvantage, 
 that is, if fife be extinct in the fcetus, auscultation is of not the 
 slightest value in determining the fact of pregnancy. Also from 
 the fact that in esse of life both these phenomena are occasionally 
 inaudible, the medical jurist, if he finds them wanting, will not 
 be justified in giving a negative opinion. 
 
 Great nicety is required in the applicatim of auscultation. 
 The placental sound may be imitated art'fjcially as by pressure oi 
 
62 MEDICAL JURISPRUDENCE. 
 
 by disease. Pressing the end of the stethescope over the region 
 of the iliac arteries, may lead to deception in regard to the teta] 
 pulsation. The sounds sought for may sometimes be detected by 
 the naked ear with perfect accuracy, but the use of the steihe- 
 scope is preferable, and when used, the end of the instrument 
 should be pressed down with a considerable degree of force, so 
 as to displace any intermediate fluid, whether air or water, in- 
 tervening between the ear and the source of the sound. Mont- 
 gomery's Signs of Pregnancy, 123-4-5. 
 
 Another evidence of pregnancy has been proposed, and that 
 is a bluish tint of the vagina, extending from the os externum 
 to the os uteri. This discoloration is said to commence as early 
 as the fourth week in pregnancy, to increase till the delivery and 
 to leave only with the lochia. 
 
 It is described as being a violet color, or like lees of wine and 
 very distinct. This must be caused by the increased vascularity 
 of the genital system consequent upon conception, and hence 
 causes, other than pregnancy, that produce congestion of that 
 system must produce these same, appearances. The purple hue 
 of the mucous membrane of the vagina has been perceived at 
 the time of menstruation. Should, however, pregnancy be found 
 to be invariably attended by this appearance, it would be an in- 
 valuable indication as it is found at so early a period of gestation. 
 Montgomery'' s Signs of Pregnancy, 126-7-8. 
 
 The knowledge which it is incumbent on the medical jurist to 
 possess on the subject of pregnancy, is by no means complete 
 without including as a part of it, the examination of substances 
 that, under certain conditions of the uterine system, may be ex- 
 pelled from the uterus. These substances are four in number. 
 1. An early ovum. 2. A mole. 3. Uterine hydatids, and 4. 
 False membranes. When any thing is expelled from the uterus, 
 the proper subjects of enquiry are two in number, viz : Is the 
 substance fetal in its character, and if not, is it the result of 
 conception or not 1 
 
 The main fact to be arrived at is, has there been a conception 
 and state of pregnancy 1 
 
 1 Jin early ovum. A product of conception expelled within 
 
PREGNANCY. 63 
 
 the first month cannot be recognized. If expelled soon after the 
 expiration of that time, it will hardly be recognized except by one 
 acquainted with it, and who will take sufficient time to examine it. 
 When thus expelled it is generally infiltrated with co-agulated 
 blood, and requires to be immersed in water for a day or more, 
 when, by agitation and washing, the coagulated blood must be 
 removed, while with delicate blunt instruments the examiner 
 gently separates the component parts of the mass under water, 
 until its real character may be ascertained. This may require 
 three or four days or even a week. If the examiner fail to dis- 
 cover constituent portions of the foetus in this early period of its 
 development, he may be able to identify the ovum by its mem- 
 branes. Thus it may be covered with the decidua, characterized 
 Dy its soft, rich, pulpy appearance and strong red color, with its 
 rough external surface perforated by small foramina and its in- 
 ternal surface smooth, covering, either partially or completely, 
 the substance under examination. Within this may be found the 
 inner decidua, with its smooth outer surface, and its internal one 
 covered with filaments which receive the arborescent villi from 
 the surface of the chorion. Guy's Med. Juris. , 102-3. These 
 are appearances that characterise the ovum, and are never ex- 
 hibited as the product of disease or of morbid growth. They 
 are, therefore, to be taken as evidence of the fact of pregnancy. 
 
 2. Moles. There is considerable difference of opinion as to 
 what constitutes a mole, and about equally as great, whether it 
 is the result of conception, or an accidental formation of a mor- 
 bid character. The latter question depends very much or en- 
 tirely on the former. According to the most popular opinion, 
 every coagulum of blood which continues long enough in the 
 uterus to assume its form, and to retain only the fibrous part, is 
 denominated a mole. This definition would cover many cases 
 that may exist independent of conception. But in regard to the 
 solid fleshy masses that are occasionally expelled from the uterus, 
 and are more properly termed moles, there is great doubt whether 
 they ever exist except as the result of sexual intercourse. Mont- 
 gomery's Signs of Pregnancy, 134, et seq. 
 
 The safer rule seems to be that suggested bj Dr. Montg miery 
 
64 MEDICAL JURISPRUDENCE. 
 
 that it would not be justifiable to pronounce any such mass ex- 
 pelled from the uterus a proof of pregnancy, unless there can be 
 detected in it either a foetus or some part of it, or some other of 
 the component structures of the ovum ; and even then it might 
 be possible that the placentula might have formerly remained in 
 the uterus in an abortion not much noticed at the time, and thus 
 have given rise to this fleshy structure. 
 
 Portions of placenta appear at times to be long retained in 
 utero, from which they are afterwards expelled in the form of 
 moles, when the women were advanced in life or many years 
 widows. 
 
 3. Uterine hydatids. In regard to these also, there exists much 
 contrariety of opinion, some supposing them not necessarily the 
 result of conception, while others consider them as the product 
 of disease attacking the ovum. The existence of hydatids in 
 utero is always accompanied by the ordinary symptoms of preg- 
 nancy. The balance of authority is very clearly on the side that 
 uterine hydatids do not occur except after sexual intercourse, 
 and as a consequence of impregnation. Still there should be 
 some doubt in pronouncing, unless some constituent part of the 
 ovum can be detected along with them, or in case of an exami- 
 nation after death a true corpus luteum be found in the ovary. 
 It may, however, occur that a female miscarrying in the third 
 or fourth month of pregnancy, the placenta or some portion of 
 the ovum is retained, and long afterwards gives rise to the pro- 
 duction of hydatids. These may be retained for many months, 
 and when they come to be expelled give rise to many unjust sus- 
 picions. The length of time during which they are retained in 
 utero before expulsion has been variously stated. 
 
 In many cases they are not retained longer than seven months. 
 But in many others they have been expelled at ten, eleven, 
 twelve and a half, and fourteen months after conception. It also 
 seems that they may be retained in utero many years. They 
 sometimes are found accompanying an otherwise healthy preg 
 nancy. In one remarkable instance a lady four or five months 
 pregnant expelled a quantity of uterine hydatids, and subsequent 
 
PREGNANCY. 65 
 
 ly, at the proper time, gave birth to the celebrated Beclard. 
 Montgomery's Signs of Pregnancy, 138. 
 
 4. False membranes or those expelled in dysmenorrhea. In dys- 
 menorrhcea the female may have pains resembling those of labor, 
 accompanied by red discharge, and followed by the expulsion of 
 a substance somewhat resembling the decidual covering of an 
 ovum. In these cases, however, the symptoms of pregnancy are 
 not observed, and the occurrences are often habitual with the 
 person at every menstrual period. The substance expelled will 
 be found deficient in many of the characters of the true decidua. 
 It is a morbid product, and is not furnished with a structure 
 such as would only be required for the performance of the office 
 of furnishing nutrition to the ovum. The balance of authority 
 is here very clearly on the side that the production of these 
 membranes is referable entirely to causes independent of inter- 
 course, and they are not therefore the results of conception. 
 
 It may sometimes become necessary to examine the uterus and 
 its appendages after death, with the view of determining the ex- 
 istence or previous occurrence of pregnancy. ■ The first thing 
 that will naturally occur to the examiner in regard to the uterus 
 will be to observe its size and vascularity. If found of its ordi- 
 nary diminutive size it is clearly in a virgin state. If enlarged 
 and vascular, its contents should be carefully examined. If the 
 ovum be detected, or any of its component structures, or any 
 clear and well defined portions of a foetus, no doubt can remain 
 but that pregnancy was present. 
 
 But the uterus may be found enlarged and empty, exhibiting 
 increased vascularity, and several of the changes which accom- 
 pany gestation. Its contents may have been expelled, and the 
 appearances remaining, together with the structural changes that 
 may be present, may be insufficient to enable the examiner to 
 arrive at any clear conclusion as to the fact of pregnancy. We 
 may not be able to derive from the uterus itself a satisfactory 
 answer to the enquiry. But what it fails to furnish may, per- 
 haps, be derived from its appendages. Montgomery's Signs of 
 Pregnancy, 213-14. 
 
 The appendage of most value, and to which reference should 
 
 5 
 
66 MEDICAL JURISPRUDENCE. 
 
 be had in all such cases, is the ovary ; and the attention should 
 be directed to that part of it, if it exist, called the, corpus glandu- 
 losum or corpus luteum. Amid the uncertainties that so con- 
 stantly attend organic phenomena, especially those connected 
 with the mysterious processes of generation, it is truly delight- 
 ful to find any one thing that is fixed, certain, and reliable. It 
 is claimed, that the true corpus luteum is an infallible evidence 
 of conception, and the want of it within certain limits of time, 
 as reliable evidence that there has been no conception. It is true, 
 the medical profession are not all united as to the conclusiveness 
 of this evidence. The whole subject is very thoroughly consider- 
 ed, and the authorities making for and against it, are very ably 
 reviewed in Dr. Montgomery's work on the signs of pregnancy ; 
 and the conclusion he arrives at, from all the authorities, and 
 from his own very extended experience, is to affirm the truth of 
 both of Haller's propositions, viz., the one, that conception never 
 happens without the production of a corpus luteum ; and the other, 
 that the corpus luteum is never found in virgin animals, but is the 
 effect of impregnation. Montgomery's Signs of Pregnancy, 244. 
 
 If this be so, as the strong balance of authority seems to have 
 very satisfactorily settled, it is of the highest importance that 
 the phenomena attending the corpus luteum should be thorough- 
 ly understood. 
 
 The corpus luteum is the place or spot in the ovarium from 
 whence the impregnated ovum has proceeded. The ovum is 
 found, originally, contained in the graafian vesicle, and is sur- 
 rounded by two membraneous envelopes, the outer one of which 
 is the stronger, and gives transmission to several blood vessels, 
 passing to the inner, which is softer and more vascular. 
 
 Immediately upon conception, there is a determination of 
 blood to the ovary and vesicle, the coats of which become per- 
 vaded by a very fine net-work of vessels. The consequence is, 
 that the vesicle itself increases in size, and becomes a kind of 
 temporary uterus, performing an office analogous to that which 
 is afterwards discharged by the uterine decidua, and subsequent- 
 ly still, by the placenta. The ovum is discharged by the burst- 
 ing of the coats of the vesicle. 
 
FKEGNANCY. 67 
 
 After the escape of the ovum, there is a cicatrix, or appear- 
 ance as of a rent imperfectly united. The peritoneal coat around 
 it appears abraded, and a twining of the vessels there is distinct- 
 ly observable. In the centre, there is a cavity filled with coagu- 
 lated blood, and surrounded by a yellowish organised substance. 
 
 The peculiar appearances that mark the corpus luteum are 
 more distinctly observable in the earlier periods of pregnancy. 
 The central cavity is then much more apparent, and there are 
 stronger evidences of vascularity and vital action. 
 
 The true corpus luteum is distinguishable, 
 
 1. By its color. That is a dull yellow somewhat similar in 
 appearance to the buffy coat of the blood : 
 
 2. By its form. That is oval or fabiform : 
 
 3. By its size. This depends on the size of the Graafian vesicle ; 
 upon the rapid or retarded closure of the central cavity ; and 
 upon the degree of vascular activity existing at the time. It is 
 
 , largest during the earlier periods of pregnancy, gradually dimin- 
 ishing afterwards, slowly during gestation, more quickly after 
 delivery. Its size will be found to be in the inverse proportion 
 to the time elapsed after conception. It usually occupies from 
 one-fourth to one-half the area of the ovary. At the end of two 
 months it has been found to measure in length 9 J lines, in breadth 
 8 lines, the central cavity being three lines by two, and the ave- 
 rage thickness of the glandular structure from 3 to 3^ lines. In 
 the sixth month the longer axis was 6 fines, the shorter 5, the 
 thickness 3, and the central cavity 2 by 1. In the ninth month 
 the longer axis was 5 or 6, and the shorter 4 or 5 : 
 
 4. By its structure. This is glandular, presenting a lobulated 
 appearance. Slight convolutions are traceable like a section of 
 a kidney, or that part of the brain called the centrum ovale : 
 
 5. By its vascularity. The vessels run from the circumference 
 to the centre. If the spermatic vessels going to the ovary be - 
 injected, the vessels of the corpus luteum will be filled with color- 
 ing matter : 
 
 6. By the appearances presented at its centre. These are either 
 a cavity or a white line. Up to the end of the fourth month, 
 and sometimes later, is to be found the cavity. It ha? nevr 
 
68 MEDICAL JURISPRUDENCE. 
 
 been found open after the sixth month. The white line is formed 
 by the closure of the inner coat of the vesicle. 
 
 After the termination of the period of gestation, or of the ex- 
 pulsion of the contents of the uterus, the corpus luteum begins 
 to alter in its character, until it is no longer found in the ovary. 
 The exact time of its disappearance is unknown, but it has not 
 been found later than the end of five months after delivery. 
 
 It has been supposed by many that the corpora lutea are per- 
 manent, and that their number indicate the number of concep- 
 tions. This is an error. Their number is always the same as 
 that of the fcetuses lodged in utero in one gestation. There may 
 sometimes be found a greater number of corpora lutea than of 
 foetuses born. In such cases one or more to make up the num- 
 ber are aborted. 
 
 There may be a smaller number of corpora lutea than of fcetuses 
 born, as a single vesicle is sometimes found to contain two ovula. 
 There may, therefore, be twins with but one corpus luteum. 
 
 The birth of a child is not necessarily inferrible from the fact 
 of finding a corpus luteum. The only necessary inference is 
 that conception has taken place. But the ovum may have been 
 blighted or destroyed, or converted into a mole or hydatids. 
 
 A cicatrix on the surface of the ovary must not be mistaken 
 for a corpus luteum, such may occur as the result of inflamma- 
 tion or of small abscesses. - 
 
 The difference of opinion among members of the profession, in 
 regard to the conclusive character of the evidence furnished by 
 the presence of the corpus luteum, has probably originated from 
 the fact that there are sometimes appearances resembling corpora 
 lutea, which have, nevertheless, no other real affinity with the 
 true ones than a similarity in color. These spurious or false cor- 
 pora lutea are supposed to be formed by an accidental or morbid 
 determination of fluids towards a vesicle, by which it becomes 
 distended with fluid, and sometimes bursts and discharges its 
 contents, in which event an external cicatrix is found. 
 
 Sometimes instead of bursting and discharging, the fluid is ab- 
 sorbed. In either case, there is often found deposited on the in- 
 ner surface of the vesicle, a substance resembling the true cor- 
 
PREGNANCY. 69 
 
 pus luteum in color, not more than one sixteenth of an inch 
 thick, much smaller than the real ones, and lacking all their es- 
 sential characteristics, with the single exception of color. 
 
 The following are the principal points of difference between 
 them. The spurious ones differ from the real ones in that. 
 
 1 . There is no prominence or enlargement of the ovary over 
 them: 
 
 2. The external cicatrix is almost always wanting : 
 
 3. There are often several of them found in both ovaries : 
 
 4. There is no trace of vessels to be found in their substance, 
 and hence there is no possibility of injection : 
 
 5. The texture is infirm, never presenting the soft, rich, lobu- 
 lated, glandular appearance of the true corpora lutea : 
 
 6. In form, they are often triangular, or square, or some figure 
 bounded by straight lines. 
 
 7. They never present the central cavity, or the radiated stel- 
 liform white line, which is the 'result of its closure. These 
 several points of difference will enable one to distinguish the 
 spurious from the true, without the danger of confounding them 
 together. 
 
 In regard to the formation of the false corpora lutea, Dr. Pa- 
 terson remarks, that they may arise— 
 
 1. From the bursting and subsequent filling of a vesicle with 
 blood, as in menstruation : 
 
 2. From partial effusion of blood into a vesicle, either with or 
 without rupture of it : 
 
 3. By re-absorption of the fluid of a morbidly enlarged graafian 
 vesicle, giving rise to a puckered cyst : 
 
 4. From effusion of blood into the tissue of the ovary, the 
 apoplexy of the organ : 
 
 5. From tubercular deposits , and, 
 
 6. From cysts filled with yellow, fatty matter. Guy's Princi- 
 ples of Forensic Medicine, 106. / 
 
 On the trial of Angus, reported in 1 Beck, 219, et. seq., it was 
 important, under one count in the indictment, to make out the 
 fact of recent pregnancy. There was much conflict of opinion 
 
70 MEDICAL JURISPRUDENCE. 
 
 in relation to it ; but the discovery of a corpus luteum was. 
 deemed siinicient to settle the question in its favor. 
 
 It remains to consider some questions of a medico-legal charac- 
 ter, that may arise for investigation. Of these, we shall notice, 
 
 1 . The age, or period in the life of the female, within which 
 conception may occur. The limits of the generative faculty in 
 women, are generally those of the function of menstruation. 
 This differs in different climates. Guy, 106. In warmer climates, 
 it occurs earlier than in colder. 
 
 Dr. Montgomery, speaking in reference to the British climate, 
 assigns as their limits the fifteenth and forty-fifth year. Montgo- 
 mery's Signs of Pregnancy, 160. 
 
 Dr. Beck says, that in our climate, a female, not previously 
 barren, cannot, in general, be impregnated under thirteen years 
 of age, nor beyond fifty. 1 Beck's Med. Juris., 182. 
 
 In Abyssinia and Bengal, mothers are found of the age of 
 eleven years. Whatever may be assigned as the general rule, on 
 this subject, it is obvious it can never be received except as sub- 
 ject to many exceptions. These exceptions apply to both the 
 limits of this term. 
 
 About the ytar 1828, a lady was to be seen at the Ballston 
 Springs, who was a grandmother at not quite the age of twenty- 
 eight years. In the Transylvania Journal, vol. 7, 447, is recorded 
 a case of menstruation at one year, and of pregnancy at nine. 
 
 On the other hand, pregnancy seldom takes place beyond fifty ; 
 but instances of a very extraordinary nature have been noticed, 
 in whieh it has been found to occur considerably beyond that 
 period, in women who had formerly borne children. Instances 
 are cited from Capuron and others, by Dr. Montgomery, in 
 which pregnancy occurred at the age of 60. lb., 165. 
 
 A case is mentioned in the Boston Medical and Surgical Jour-'' 
 nal, of a woman at Whitehall, (New-York,) becoming a mother 
 at 64. Guy's Principles of Forensic Medicine, 99. 
 
 From a great number of cases that have been collected, the 
 age of fifty-four has been fixed upon as the probable limit of 
 fruitfulness ; although no one can deny the possibility of its 
 being extended beyond that period, lb., 100 
 
PREGNANCY. 71 
 
 In a recent case argued and decided in the English Coiut of 
 Chancery, a large amount of property hung upon the single issue 
 whether a woman might have a child at sixty years of age. The 
 attorney general challenged the production of a single well re- 
 corded instance of a woman's having a child at that age. No 
 such instance was produced, and he succeeded. Montgomery's 
 Signs of Pregnancy, 165-6. 
 
 There sometimes occurs what has been called a spurious preg- 
 nancy, which should be understood, in order to be able to discri- 
 minate between it and a real one. This is often observed about 
 the turn of life, when the menses become irregular, being not 
 unfrequently suppressed for a few periods prior to their final 
 cessation. The stomach, at the same time, is generally out of 
 order, nausea and vomiting experienced, the breasts enlarge, and 
 often become sensible, and even slightly painful. Sometimes a 
 serous or sero 7 lactescent fluid exudes from the nipples and orifices 
 of the areolar tubercles. The abdomen, at the same time, 
 grows fuller and more prominent ; the enlargement progressively 
 increasing, owing, in part, to a deposition of fat in the integu- 
 ments and in the omentum ; but more, still, to a distension of 
 the intestines, by flatus, which, passing from one part to another, 
 communicates a sensation like that produced by the motions of 
 the foetus. AH this is frequently accompanied with a disturbed 
 state of the nervous system, the woman herself being firmly 
 convinced of her pregnancy. As if to render the delusion com- 
 plete, at the end of the supposed gestation, periodical pains fre 
 quently occur, strongly resembling those of labor. 
 
 Although this generally takes place at the turn of life, yet it is 
 not confined to that period, but has also been met with in young 
 women, and those who had borne children both before and after- 
 wards. Several instances of this are given by Dr. Montgomery, 
 in his Signs and Symptoms of Pregnancy, pages 170-71, &c. 
 
 These phenomena are not even confined to the human species, 
 but have been observed in the lower animals, particularly in the 
 dog species. It cannot, therefore, be attributable to the imagina- 
 tion. 
 
 In cases of this kind, and where it becomes necessary to dis- 
 
72 MEDICAL JURISPRUDENCE. 
 
 criminate, little reliance can be placed upon most of what we 
 have termed the constitutional signs and indications of pregnan- 
 cy. We are to trust, principally, to a careful manual examina- 
 tion, by which the abdomen, however enlarged, is found to be 
 soft, puffy, and compressible ; the umbilicus sunk ; no abdomi- 
 nal tumor ; and the uterus, when examined per . vaginam, i9 
 found unaltered. 
 
 It is sometimes the fact, that pregnancy is found complicated 
 with disease, in such a manner, that much difficulty is experi- 
 enced in determining its existence. This is more particularly 
 the case with those diseases that increase the size of the abdo- 
 men, especially dropsy. The difficulty in deciding, is greater in 
 those cases where the dropsy existed previous to impregnation ; 
 because, in such a case, the system is so disturbed before concep- 
 tion, that the natural sympathies and changes which should fol- 
 low that occurrence, are either prevented from taking place, or 
 are so imperfectly manifested, or actually disguised, by the pre- 
 existing disease, that they are incapable of being recognized. 
 In the majority of cases, however, it supervenes on pregnancy, 
 when its usual indications are more marked, and less doubt and 
 difficulty is realized in forming a conclusion. 
 
 Other cases may present themselves, of an embarrassing char- 
 acter, where the uterus contains morbid growths; such as hyda- 
 tids, and moles. In those cases of pregnancy in which hydatids, 
 or a mole, are formed, many, or most, of its usual signs are 
 generally present, accompanied with irregular uterine discharges, 
 and a distended uterus ; but its contents are not disclosed to us 
 until some of the hydatids, or a mole, are discharged. There are, 
 it is true, several points of discrimination, but they all occasion- 
 ally fail. In many instances of hydatids, the uterus has been 
 observed to acquire, quickly, a size quite disproportionate to the 
 period of pregnancy, and to be at the same time much softer 
 than usual ; but both these circumstances are subject to great 
 variety. Occasionally, also, in the case of hydatids, there is the 
 discharge from the uterus, of an almost colorless watery fluid. 
 Montgomery's Signs of Pregnancy, 180-81. 
 
 The only rule that Dr. Montgomery thinks can be laid down 
 
PREGNANCY. 73 
 
 " with safety, is, " that if the woman, after experiencing the ordi- 
 nary symptoms of pregnancy up to the third or fourth month, is 
 observed to be growing large with unusual rapidity, so that her 
 s&e corresponds to a period much more advanced than her preg- 
 nancy really is, or is supposed to be, and she then becomes affect- 
 ed with irregular discharges from the vagina, sometimes of blood 
 and at other times of water, and, although perhaps the sixth or 
 seventh month has arrived, no motion of a fcatus has been per- 
 ceived by her, nor can it be felt by any mode of manual exami- 
 nation, or re-percussion, but the uterus is ascertained to be dis- 
 tended, and feels as if it were Med with something of a gela- 
 tinous consistence, the case is likely to prove, eventually, one of 
 hydatids. 
 
 But if, in conjunction with the same combination of collateral 
 symptoms, the uterus be found of unusually firm consistence, 
 irregular in form, and painfully sensitive, the case will probably 
 terminate in the expulsion of a solid, or fleshy mole ; but that 
 these can only be received as general rules, liable to very nume- 
 rous exceptious." Montgomery's Signs of Pregnancy, 181-2. 
 
 Another disturbing element, is the formation of tumors, par- 
 ticularly of the hard, fibrous kind, which, if they happen to be 
 large or numerous, very much complicate the condition of preg- 
 nancy, and greatly disguise its result. 
 
 In such cases, a manual examination may detect the fcetal 
 motions, or auscultation may reveal the true nature of the case. 
 All the usual signs and indications of pregnancy must be par- 
 ticularly noticed, especially the mammary changes, and the areola. 
 
 2. A second medico-legal question is, can a woman conceive 
 while in a state of unconsciousness 1 This question was formerly 
 considered while on the subject of rape, and any further discus- 
 sion of it here is deemed unnecessary. From the instances that 
 have actually occurred, it may now be considered as well settled, 
 that with married women, or those accustomed to sexual inter- 
 course, it is possible to have such a connection as shall lead to a 
 fruitful result, while they are in a state of unconsciousness, pro- 
 duced by deep sleep or the action of narcotics upon the system. 
 This effectually disposes of the ancient doctrine, that consent and 
 
74 MEDICAL JURISPRUDENCE. 
 
 pleasurable sensation on the part of the woman, are conditions 
 necessary to conception. It also goes to show further that con- 
 ception, when the physical conditions under which it takes place 
 are complied with, is a result entirely independent of the volitions 
 of the sexes : 
 
 3. A third medico-legal question is, can a woman remain igno- 
 rant of her pregnancy up to the time of delivery 1 Three classes 
 of cases may here be presented. The first will include all those 
 cases where conception occurred without consciousness, and 
 where of course all the symptoms of pregnancy will be likely to 
 be attributed to any cause but the true one. 
 
 The second class includes those where the female has yielded 
 to the solicitations of the male in consequence of solemn assu- 
 rances that, under certain circumstances, connexion may take 
 place without danger ; as in the case of the female who yielded 
 to the solicitations of her seducer in a bath, under solemn assu- 
 rances from him, that, under those circumstances, no conception 
 could take place. In this class there is more or less weakness of 
 intellect. There would be the same tendency as in the other to 
 refer the symptoms of pregnancy to some other cause than the 
 true one. 
 
 In the third class are included all those who are conscious of 
 having been exposed, and are laboring under no delusion in 
 reference to any supposed exemption from the probable results 
 of the exposure. 
 
 Those of the first and second class may be very likely to refer 
 any changes they experience to a state of disease, and thus re- 
 main honestly ignorant of their real condition up to nearly or 
 quite the time of their delivery. Those of the third class may 
 by possibility persuade themselves that the changes are the re- 
 sults of disease, but their consciousness of exposure must cer- 
 tainly give rise to many misgivings in their own minds on the 
 subject. 
 
 A very interesting trial took place in Monroe county, New- 
 York, in 1842, in which the facts as alleged were that Miss Sophia 
 Murdock, a young lady of fifteen years of age, had a single con- 
 uexion with a clergyman, in his study, in his own house, in the 
 
PKEGNANCY. 75 
 
 daytime. She had no connexion with any other, and never di- 
 vulged it until concealment was no longer possible. The ques- 
 tions raised were — 
 
 1. Whether it was possible to have complete connexion with 
 a young virgin on the first attempt, and whether a first and sole 
 connexion could result in impregnation 1 
 
 2. Whether in such case it would not always be attended with 
 pain, and the usual signs of forcible deflorescense 1 
 
 3. Whether a woman could be unconscious of her pregnancy 
 until within five or six weeks of the usual period of gestation, 
 and whether two hundred and ninety-two days intervening be- 
 tween the alleged intercourse and birth of the child, would ren- 
 der an impregnation, at that period, improbable 1 
 
 There was considerable contrariety of medical testimony upon 
 these points. Dr. J. W. Francis stated that both the facts em- 
 braced in the first question were possible. That the second was 
 among the possibilities, but was improbable. In regard to the 
 third, that it was not probable that a woman conceiving for the 
 first time should remain thus unconscious, nor that she should 
 go beyond the nine months, the usual period, as first pregnancies 
 more commonly fell short of it. 
 
 A number of other physicians concurred in stating that there 
 were variations of time in the period of pregnancy, the first, how- 
 ever, being more likely to fall short than to exceed the ordinary 
 time, viz., two hundred and eighty days. That they were aware 
 of no physical impediments that should preclude conception 
 from following the first coition, although the probabilities were 
 against it. That they knew of no reason why conception might 
 not follow when the connexion was forcible, as the mind, in their 
 opinion, had nothing to do with the matter. 
 
 The result was the conviction of the defendant, although an 
 ecclesiastical court subsequently, and after a very full investiga- 
 tion, pronounced a judgment of not guilty. 
 
 There is little doubt but that there are many instances occur- 
 ring, both in the virgin and the married state, in which concep- 
 tion has resulted from a single act of intercourse. So also from 
 the well known fact, that, in some instances, the motions of the 
 
76 MEDICAL JURISPRUDENCE. 
 
 fcetus in utero are never perceived by the mother, and that the 
 ordinary symptoms of pregnancy vary very much in different 
 individual cases, being sometimes many of them obscured, and 
 some not appearing at all ; it may be readily supposed that there 
 may be cases where the female will remain ignorant up to a very 
 late period of gestation. Guy's Principles of Forensic Medicine, 
 %\,et seq. 
 
 4. A fourth medico-legal question relates to the possibility of 
 superfoztation. This is denned as the conception of a second 
 embryo during the gestation of the first, the products of the two 
 distinct conceptions being born either at the same or at different 
 times. This question has a bearing upon legitimacy, and in that 
 view only becomes important to be considered in medical juris- 
 prudence. Upon the possibility of this the medical profession 
 are not probably as much divided in opinion as they once have 
 been. The ancient physiologists were very generally believers 
 in it. In modern times much scepticism is entertained in rela- 
 tion to it. 
 
 Those who doubt, or deny it, urge as reasons, 
 
 1 . That shortly after conception the os tincse, as also the inter- 
 nal apertures of the fallopian tubes, are closed by a thick tena- 
 cious mucus : 
 
 2. That the deciduan membrane, which is formed soon after 
 conception, lines the uterus, and aids in obliterating the openings 
 into its cavity : 
 
 3. That when the uterus is impregnated, the fallopian tubes, 
 instead of running horizontally to the ovaria, lie parallel to the 
 sides, so that if a second embryo were formed within the ovari- 
 um, the tubes could not embrace it in order to convey it to the 
 uterus : 
 
 4. The arrival of a new embryo in the uterus, would prove 
 destructive to the first, inasmuch as the functions which have 
 already been performed for the first conception, would have to 
 be repeated, and an additional decidua and placenta would have 
 to be formed. 
 
 To the first two objections it is answered that neither the mu- 
 cus, nor the decidua, adhere so firmly to the orifices and cells of 
 
PREGNANCY. 77 
 
 the uterus, as to exclude the passage of the aura seminis, or even 
 the semen itself. That the tact of the occasional occurrence of 
 the menstrual discharge during pregnancy proves this. To the 
 third objection it is answered that although this obstacle may- 
 exist in the fully developed uterus, yet that in the early stage of 
 utero-gestation the ovary and fallopian tubes are not in the least 
 prevented from coming into contact with each other, and that it 
 is only during that early stage that superfcotation is alleged to 
 take place. The answer to the fourth objection is, that it is 
 founded too much on assumption alone to require any particular 
 reply. Guy's Principles of Forensic Medicine, 113 - 14. 
 
 In the alleged cases of superfcetation that have, at different 
 times occurred, reference may be made to 1 Beck's Med. Juris., 
 194, et seq. 
 
 One case occurred in Charleston, South Carolina, in 1714, and 
 was that of a negro woman who was delivered of twins within a 
 very short time, the one of which was found to be black, and the 
 other white. This led to an investigation, in which it turned 
 out, that she had been compelled, by threats, to suffer the em- 
 braces of a black man immediately after her husband had left 
 her bed. A case very similar to this occurred in Jamaica, where 
 a negro woman brought forth two children at a birth, nearly 
 of a size, the one being a negro and the other a mulatto. This, 
 on investigation, had the same explanation as the other. These 
 and all others of a like character, are obviously not cases of su- 
 perfcetation, but simply of twins. 
 
 There is also another class of cases where the birth of two 
 children is separated by a short interval, or by an interval cor- 
 responding to their respective size and degree of development, 
 so that the fact that their conception took place about the same 
 time, is by no means excluded. Such, for instance, is the fol- 
 lowing. 
 
 Eight months after the husband's death, the widow was deli- 
 vered of a deformed child, which did not survive its birth. One 
 month and a day thereafter she was delivered of a perfect living 
 child. The husband's relations contested its legitimacy, on the 
 
78 MEDICAL JURISPRUDENCE. 
 
 ground that it was the result of superfcetation, and Zacchias was 
 consulted. 
 
 He decided it to be a case of superfcetation, and supposed that 
 the first was the product of a superfcetation, and conceived a 
 month after the other. There seems little reason for this con- 
 clusion. The most reasonable explanation of this would seem 
 to be, that it was a case of twins conceived at the same time, but 
 of which one was discharged before the other. Guy's Principles 
 of Forensic Medicine, 110-11. 
 
 Very many of the cases recorded as instances of superfcetation 
 belong to the last mentioned class of cases. In cases of twins 
 the growth of one, may, from some cause or other, happen to be 
 retarded, while that of the other proceeds at the usual rate of 
 development. 
 
 There is still another class of cases more difficult of explana- 
 tion. Of these, the following is an instance. 
 
 A woman in Lyons married at 22, became pregnant five years 
 thereafter, but had an abortion at the 7th month, and on the 20th 
 May, 1779. She conceived within one month thereafter, and on 
 the 20th January, 1780, eight months after her delivery, and 
 seven months from her second conception, she brought forth a 
 living child. 
 
 Her delivery at this time was not accompanied with the usual 
 symptoms. No milk appeared. The lochia were wanting, and 
 the abdomen did not diminish in size. An examination was 
 had, when it was declared by Dr. Desgranges that she had a se- 
 cond child in the womb. Three weeks after this delivery, she 
 quickened, and on the 6th July, 1780, five months and sixteen 
 days after the first birth, she was again delivered of another 
 living daughter. The milk now appeared, and she was enabled to 
 nurse. Guy's Principles of Forensic Med. 111-12; 1 Beck's Med. 
 Juris. 196-7. 
 
 There is also another well authenticated case in which t\\ o 
 male children,- both born perfect, were brought forth at an inter- 
 val of nearly three calendar months. There are also other cases 
 to be found in writers on Medical Jurisprudence. The clearest 
 instance is probably that of the woman of Lyons. The instances 
 
LEGITIMACY. 7 9 
 
 are possessed of little value as proving superfcetation, unless the 
 interval between the births is considerable. If the interval be 
 small, it may be accounted for by the difference in maturity be- 
 tween the children. In the instances recorded there has not 
 perhaps been a sufficient amount of observation made upon the 
 size or the mature and immature condition of the children born. 
 The products of the conception may differ greatly in size and yet 
 both be healthy children. 
 
 As an explanation of those cases that seem the most strongly 
 to make out superfcetation, like that of the woman of Lyons, it 
 is urged that there are occasional cases of double uteri, and that 
 this peculiarity of formation probably existed in those remarka- 
 ble cases. There are many instances of the occurrence of these 
 double uteri. A long enumeration of them may be found in 1 
 Beefs Med. Juris. 199-200. They are more numerous than 
 the instances that have been recorded of superfcetation. In some 
 of them, not only were found double uteri, but also double vagi- 
 nee. There is one recorded instance in which superfcetation ac- 
 tually occurred where, on examination, the uterus and vagina 
 were both found double, each vagina having a separate orifice. 
 Other cases may have depended on the same malformation. 
 
 Amid the doubt aud uncertainty that now rests on the subject, 
 the conclusion arrived at by Dr. Beck is probably the safest, viz : 
 that should this doctrine arise in medico-legal cases, we must 
 be guided by the laws of legitimacy, both as to premature and 
 protracted births. The latest born should fall within the legal 
 term, or be excluded from the privileges attendant on it. 1 Beck's 
 Med. Juris. 201-2. 
 
 V. LEGITIMACY. 
 
 Under this head often arise questions of both a difficult and 
 delicate nature. The law of England, and of this country, re- 
 gards the illegitimate as nullius fillius, as possessing no inheri- 
 table blood, and as utterly excluded from any participation either 
 in ancestral honors or property. This wide difference which the 
 
80 MEDICAL JURISPRUDENCE. 
 
 law creates between the legitimate and the illegitimate, invests 
 all questions of legitimacy with a high degree of interest. 
 
 The general rule of the law is, that all children born in lawful 
 wedlock are legitimate. The law, it will be noticed, regards the 
 birth, not the conception, as the test of legitimacy. 
 
 Again the legal presumption is that the husband always has 
 access to the wife, so as to render him the father of any child 
 born in wedlock. This, however, like any other presumption, 
 may be rebutted by proof; and hence in contested questions of 
 legitimacy, it is competent to prove impossibility of access on 
 the part of the husband ; or the fact of impotence ; or any phy- 
 sical defect going to show that the act of intercourse was impos- 
 sible. 
 
 There is one case in which the law inclines particularly to 
 favor offspring on the score of legitimacy. The rule as laid 
 down by Blackstone and Coke is — that if a man dies, and his 
 widow soon after marries again, and a child is born within such 
 a time as that, by the course of nature, it might have been the 
 child of either husband, in that case, he is said to be more than 
 ordinarily legitimate, for he may, when he arrives at years of 
 discretion, choose which of the fathers he pleases. 
 
 There are several occasions where this question will arise ; as 
 where a wife gives birth to a child more than nine calendar 
 months after the absence or death of her husband. The point 
 here to be settled is whether the period of utero-gestation can 
 be so extended beyond the usual time, as to render this the child 
 of the absent or deceased husband. So again a woman at an 
 unusually short period after her marriage may give birth to a 
 child, when the question may arise as to how short a period of 
 utero-gestation a child may be born, possessed of sufficient power 
 to be reared to maturity. Again, it may become necessary, if a 
 child is born in the seventh or eighth month after marriage, and 
 presents the appearance of a child having gone the full term, to 
 examine carefully its state of growth and maturity, in order to 
 draw a conclusion as to what has been the actual period of 
 utero-gestation 
 
LEGITIMACY. 81 
 
 The most important question involved in the consideration of 
 this subject is the duration of pregnancy. This has what is term- 
 ed its usual period, which is nine calendar months, ten lunar 
 months, forty weeks, or two hundred and eighty days. There 
 is, however, a difference between nine calendar months on the 
 one hand, and ten lunar months, forty weeks, or two hundred 
 and eighty days on the other ; as the nine calendar months ma^ 
 consist either of two hundred and seventy-three, two hundred 
 and seventy-four, two hundred and seventy-five or two hundred 
 and seventy-six days, thus falling short a few days of the two 
 hundred and eighty. 
 
 Blackstone says — from what has been said it appears, that all 
 children born before matrimony a^re bastards by law ; and so it 
 is of all children born so long after the death of the husband, 
 that by the the usual course of gestation they could not be begot- 
 ten by him. But this being a matter of uncertainty, the law is 
 not exact as to a few days. 1 Blackstone' 's Com. 456. 
 
 This leaves it as a question of fact to be settled in each con- 
 tested case by medical testimony. In the settlement of this 
 question, one of the limits of this period is clearly ascertainable, 
 viz : that of the birth of the child. The other, that of its con- 
 ception, is, in most cases, involved in a very considerable degree 
 of doubt. 
 
 There are commonly reckoned four means of ascertaining the 
 time of conception. These are, 
 
 1 . Peculiar sensations experienced by the mother : 
 
 2. Cessation of the menstrual discharge : 
 
 3. The period of quickening : 
 
 4. A single coitus. 
 
 No dependence can be placed on the first, for the reasons, that 
 
 . these sensations are not defined, so that those conceiving for the 
 
 first time could recognize them. They are not constant in their 
 
 occurrence in the same female, and they do not take place at any 
 
 particular time. Guy's Principles of Forensic Medicine, 200. 
 
 The second means mentioned is undoubtedly the most relied 
 upon ; but to this there are great objections. Their irregularity 
 in many respects was noticed while on the subject of pregnancy. 
 
82 MEDICAL JURISPRUDENCE. 
 
 At best, there is an interval occurring between the menstrual 
 discharges, of nearly twenty-eight days, on any one of whicfy 
 conception may take place. This shows that although the sup- 
 pression may be evidence of the fact, yet only an approximative 
 result can be arrived at. The time generally assumed, is the 
 middle point of time between the last discharge and the time 
 when it would have again recurred had not pregnancy super- 
 vened. Some calculate from the first week after the cessation. 
 
 As to the third means, the period of quickening, that is much 
 more variable than the one last mentioned. According to the 
 best authorities, it has a range of six weeks, and according to 
 others, of sixteen ; so that it could be very little relied upon as 
 a basis for calculation. 
 
 The fourth, a single coitus, presents, really, the only sure basis 
 of calculation. This, however, must be of very unfrequent 
 occurrence. Dr. Guy has collected seven cases, in all which, the 
 average was found to be two hundred and eighty-four or twu 
 hundred and eighty-five days ; the minimum, two hundred and 
 seventy-three, or two hundred and seventy-six ; the maximum, 
 two hundred and ninety-two or two hundred and ninety-three, 
 The range was found to be sixteen, seventeen, nineteen or twen- 
 ty days. The excess over two hundred and eighty was twelve 
 or thirteen days. Guy's Principles of Forensic Medicine, 201. 
 
 From these few facts, it may be easily collected, that there is 
 no fixed period of utero-gestation, but that all is subject to a 
 greater or less degree of variation. This receives strong addi- 
 tional confirmation from the facts collected, and observations 
 made, by M. Tessier and Lord Spencer, in reference to the period 
 of gestation among animals. These were principally made in 
 reference to the cow and horse, and the results arrived at show- 
 ed that there is much more variation in both these, in the period 
 of utero-gestation, than has ever been noticed in the human 
 species. IJ:,.202-3. 
 
 It furnishes, also, a very good reason why we should expect 
 to find the period of utero-gestation a variable period, that all 
 the functions of the human body, that have been carefully ex- 
 amined, such as the pulse, the respiration, the secretion of urine, 
 
LEGITIMACY. 83 
 
 the cutting of teeth, &c, are all variable, and sometimes vary 
 within wide limits. 
 
 It is also a fact, that those who advocate a fixed period, are 
 unable to agree among themselves as to what that period shall 
 be. Although they all agree that it is fixed, yet each names 
 a different period of time, varying from thirty-seven to forty 
 weeks. Guy's Principles of Forensic Medicine, 203 -4. 
 
 Premature Birth. 
 
 Suspicions are sometimes entertained that the period of birth, 
 and the development of the foetus, do not correspond to the 
 period which ought to have been that of gestation, dating from 
 the time of the marriage, or the return of the husband after a 
 long absence. Some have considered this as embracing the 
 question of viability, or the earliest period of time at which it 
 could be born and reared up. But this question does not appear 
 to arise here. It is the comparison between the state of the in- 
 fant at birth, as to its maturity or immaturity, and the alleged 
 period of gestation, that is here presented to the medical jurist, 
 and upon which his conclusion is to be founded. 
 
 There are some women to whom it is peculiar, always to have 
 tie time of delivery anticipated by two or three weeks, so that 
 they never go beyond the end of the thirty-seventh or thirty- 
 eighth week, for several pregnancies in succession. Montgomery's 
 Signs of Pregnancy, 264. 
 
 This should be borne in mind, as also the further fact that 
 great variety is constantly observable in the size, weight, strength 
 and appearance of children at the full time. Most of them 
 weigh from six to seven pounds, while occasionally we meet 
 with instances where they are double that weight. This should 
 induce a caution in determining, especially where the period has 
 advanced to within a month of its usual termination. The indi- 
 cations of maturity and immaturity will be considered under the 
 head of delivery. 
 
 In 1838, occurred the case of the Rev. Fergus Jardine, before 
 the Scotch Presbytery, which arose upon a charge made against 
 Mr. Jardine, for having committed fornication with his wife be- 
 
84 MEDICAL JURISPRUDENCE. 
 
 fore marriage. He was married on the 3d of March, 1835, and 
 on the 24th of August following, Mrs. Jardine was delivered of 
 a girl. This, reckoning from the day of marriage, was only 174 
 days, or fire calendar months and twenty-one days over. The 
 infant survived nearly seven months and then died. 
 
 The weight of the child at birth was three pounds, but few 
 observations were made relative to its maturity or immaturity. 
 Fourteen medical witnesses, among whom was Dr. Christison, 
 were sworn. It appeared that the mother had menstruated as 
 usual the week before her marriage ; that she was both before 
 and after in a very weak state of health ; that she was herself a 
 seven months child, and that she had a second child which she 
 believed to have been born at the commencement of the eighth 
 month of her pregnancy. The case was a puzzling one to th? 
 Scotch Presbytery, but it finally resulted in their finding the 
 libel " not proven." Guy's Principles of Forensic Med., 208 - 9. 
 
 Dr. Montgomery has thought it important to notice that from 
 the results of accident, or the existence of disease in some of the 
 structures of the ovum, especially in the placenta, the size and 
 external characters of the fcetus may not correspond to the real 
 period of gestation ; and that for the reason, that, in consequence 
 of the diseased condition of the medium of support, an insufficient 
 and unhealthy nutrition is afforded to the child, by which both 
 its growth and natural development are retarded so much, that, 
 at a given period, it will be found to present appearances properly 
 belonging to a much earlier period of intra-uterine life. Mont 
 gomery's Signs of Pregnancy, 259. 
 
 Protracted Gestation. 
 
 Many cases have arisen in the course of judicial proceedings, 
 involving the question whether the period of gestation had a 
 fixed limit, or was capable of being protracted beyond the usual 
 term ; and in some cases the further question how far such pro- 
 traction could, by possibility, reach. 
 
 The opponents of protracted gestation urge, that the laws of 
 nature on this subject are immutable ; that the fcetus, at a fixed 
 period, has received all the nourishment of which it is susceptible 
 
LEGITIMACY. 85 
 
 from the mother, and becomes, as it were, a foreign body ; that 
 married females are very liable to error in their calculations ; 
 that the decision of tribunals in favor of protracted gestation 
 cannot overturn a physical law ; and finally, that the virtue of 
 females in these cases, is a very uncertain guide for legal decisions. 
 They deny that experience shows that the children of old people 
 are any longer in coming to maturity than any others. 
 
 . They deny also that grief and the depressing passions possess 
 or exercise any delaying power, insisting that they are more apt 
 to produce abortion than protracted gestation. They urge that 
 married women, usually basing their calculations upon suppres- 
 sion of the menses, may be mistaken from the fact that they may 
 be suppressed not only from disease, but also from affections of 
 the mind, or accidental causes which do not immediately impair 
 the health ; while the increase of volume in the abdomen may 
 originate from this, or from numerous other causes. They also 
 suggest a difficulty in distinguishing a delayed child from one 
 that is born at nine months, as the evidences of delay or pro- 
 traction, so far as regards the appearances about the child, do not 
 seem to be clearly settled. 1 Beck's Med. Juris., 461 -2. 
 
 In answer to these, besides the arguments already alluded to, 
 it is urged that experiments prove that the impregnation of the 
 ovum does not take place immediately upon the act of inter- 
 course, but that a greater or less portion of time elapses between 
 that act and the communication of the vivifying influence to the 
 germ in the ovary ; leaving it probable, almost certain, that a 
 variety of physical, and perhaps moral causes, may operate to 
 cause delay in the impregnation. 
 
 After impregnation the ovum is transferred from its seat in 
 the ovary along the fallopian tube into the cavity of the uterus. 
 Here also it is urged that every successive step in the progress 
 of this transfer is liable to interruption. The ovulum may lie 
 deeper than usual in the substance of the ovary. The texture 
 of the latter may be thickened and indurated. There are also, 
 says Mr. Burns, some causes that we cannot explain or discover, 
 that have the power of retarding the process, the woman carry- 
 ing the child longer than nme months ; and the child when born 
 
86 MEDICAL JURISPRUDENCE. 
 
 being not larger than the average size. How long, he remarks, 
 it is possible for labor to be delayed beyond the usual time, can- 
 not be easily ascertained. 
 
 It is also urged that the weight of authority in the medical 
 world is decidedly in favor of the possibility of protracted gesta- 
 tion. Among the names found in favor of it are those of Buffon, 
 Burns, Capuron, Denman, Desormeaux, Dewees, Fodere, Gardien, 
 Haller, Hamilton, Harvey, W. Hunter, La Motte, Lebas, Leroy, 
 Levret, Mauriceau, Merriman, Murat, Petit, Richerand, Roussel, 
 Smellie, Velpeau, and Zacchias, besides many others of no incon- 
 siderable authority. Montgomery's Signs of Pregnancy, 269-70, 
 and 271. 
 
 Petit informs us that many faculties of medicine, forty-seven 
 celebrated authors, and twenty-three physicians and surgeons, 
 concluded pregnancy might be protracted to the eleventh or 
 twelfth month. 
 
 It is also urged that the laws of most civilized countries admit 
 the possibility of protracted gestation, thus showing that legis- 
 lators, and the common sense of the community, have favored 
 this idea. Thus the law of France provides that the legitimacy 
 of a child born within three hundred days after the death or 
 departure of the husband shall not be questioned, and one born 
 after that lapse of time may have its legitimacy contested. 
 
 The Prussian civil code declares, that an infant born three 
 hundred and two days after the death of the husband shall be 
 considered legitimate. 
 
 The Scotch law provides that to fix bastardy on a child, the 
 husband's absence must continue till within six months of the 
 birth, and a child born after the tenth month is accounted a 
 bastard. 
 
 The English and American law fixes no precise limit, but 
 whenever the question has arisen for judicial determination, the 
 decisions have always favored the possibility of protracted gesta- 
 tion. Montgomery's Signs of Pregnancy, 277. 
 
 There are some very extraordinary cases on record, which 
 have been adjudged to be cases of protracted gestation. In 1638, 
 a female brought forth a child one year and thirteen days after 
 
LEGITIMACY. 87 
 
 the death of her husband. She had labor pains during the 
 whole previous month, and the parietal bones of the infant at 
 birth were united. She had previously borne seven children, 
 and had always been irregular in her calculations. The medical 
 faculty of Leipsic being consulted, replied that there might be a 
 frigidity of the genital organs, so as to cause a slow increase of 
 the foetus ; and that the long continuance of the labor pains 
 proved this to be a preternatural case. They decided that the 
 offspring was legitimate. 1 Beck's Med. Juris., 458. 
 
 A great number of cases are cited by Dr. Montgomery, and 
 by Dr. Beck, in his chapter on legitimacy ; the former princi- 
 pally from the statements of physicians and the works of medi- 
 cal writers, and the latter of cases that had arisen for investiga- 
 tion in judicial proceedings, all going to demonstrate the possi- 
 bility of protracted gestation. The former remarks, in reference 
 to the cases cited by him, that those appear to carry with them 
 the fullest demonstration of their truth, in which the ordinary 
 term was not extended by more than three or four weeks. 
 Montgomery's Signs of Pregnancy, 271. 
 
 A brief reference to a few cases that have been judicially in- 
 vestigated, in which this question has arisen, and also on questions 
 of contested paternity, will conclude the present subject. 
 
 The case of Foster and others vs. Cook, reported in 3 Brown's 
 Chancery Cases, 349, occurred in the English Court of Chancery. 
 " Cook died on the 15th January, 1780, and on the 9th Novem- 
 ber next following, (forty-three weeks wanting one day,) his 
 widow was delivered of a son. This posthumous child was held 
 to be the heir at law." 
 
 The case termed the Gardner Peerage Case, is a leading case on 
 this point, and much more celebrated than any other". The facts 
 briefly are, that Capt. Gardner, afterwards Lord Gardner, married 
 Miss Adderly in 1796. They lived together until 30th January, 
 1802, when he went to the West Indies, and returned to England 
 on the 11th July following. For some time before, and during 
 ills absence, Mrs. Gardner carried on an adulterous intercourse 
 with one Henry Jadis. On the 8th December, 1802, Mrs. Gard- 
 ner was privately delivered of a male child, which was christen- 
 
88 medical ju:rispb.ude:nxe. 
 
 ed by the name of the paramour, and brought up and treated as 
 his son. Capt. Gardner subsequently obtained a divorce on the 
 ground of the adultery of his wife, and married again. He suc- 
 ceeded to the peerage in 1808, and died in 1815, leaving a son 
 by his second marriage, who was a minor. In the year 1824, 
 this son presented his petition to the King, praying to be entered 
 on the Parliament roll as a minor Peer. In this he was opposed 
 by Henry Fenton Jadis, alias Gardner, who claimed to be the 
 eldest son of Lord Gardner, and therefore entitled to the peer- 
 age. 
 
 In this case there were two principal questions proposed to the 
 medical witnesses : 
 
 1. Could a child, born on the 8th December, have been the 
 result of sexual intercourse either on the 30th January, or an- 
 terior to it, being 311 days 1 
 
 2. Could a cMld, born on the 8th of December, and living to 
 manhood, have been the result of sexual intercourse on or after 
 the 11th of July, a period of 150 days, or two or three days short 
 of five calendar months 1 
 
 Thus, if the child were legitimate, he must have been either a 
 five months child, or a three hundred and eleven days child. 
 The first alternative was abandoned, there being no evidence to 
 show its immaturity at the time of its birth. In regard to the 
 second, involving the question of protracted gestation, there 
 were several medical gentlemen examined, many of whom were 
 then the most distinguished accoucheurs in London. Of the 
 seventeen that underwent examination, five gave their opinion 
 in favor of a fixed period of pregnancy, although each one fixed 
 upon a period of different length from every other. The other 
 twelve gave their opinion in favor of protracted gestation. 
 Their different opinion's are given somewhat at length in 1 Beck's 
 Elements of Medical Jurisprudence, 463, et seq. 
 
 The weight of medical testimony was decidedly in favor of pro- 
 tracted gestation, but the decision was made to turn upon other 
 questions, viz., the concealment of the birth from the husband, 
 and the well established fact of the adultery of the mother. The 
 son of Lord Gardner by the second marriage obtained the peerage. 
 
LEGITIMACY. 89 
 
 Vexed and difficult questions sometimes arise in consequence 
 of a widow marrying a second time, almost immediately after the 
 death of the first husband. She may, in such case, be delivered 
 ,)f a child within ten months from the time of her husband's 
 leath, and then the question would arise, to which husband 
 would the infant belong ? The Romans endeavored to avoid this 
 juestion, by forbidding the widow to marry until after the ex- 
 piration of ten months, and subsequently, until the expiration 
 )f twelve months. 
 
 As neither the English nor American law has any such pro- 
 rision, a question of that kind arising, must be solved on physi- 
 )!ogical principles. 
 
 Li the reign of Richard II., a woman immediately after the 
 leath of the first husband, took a second, and had issue born 
 ibrty weeks and eleven days after the death of the first husband. 
 ] t was held to be the issue of the second husband. 
 
 Another case is stated in Hal-grave's Notes, and also in Croke 
 Jac, 686 : " Thecar marries a lewd woman, but she doth not 
 cohabit with him, and is suspected of incontinency with Dun- 
 comb. Thecar dies ; Duncomb within three weeks of his death, 
 names her ; and two hundred and eighty-one days and six- 
 l een hours after his death, she is delivered of a son. Here it 
 was agreed, 
 
 1 . If she had not married Duncomb, without question, the issue 
 should not be a bastard, but should be adjudged the son of 
 Thecar : 
 
 2. No averment shall be received that Thecar did not cohabit 
 with his wife : 
 
 3. Though it be possible that the son might be begotten after 
 the husband's death, yet being a question of fact, it was tried by 
 a jury, and the son was found to be the issue of Thecar. 
 
 The case of John and Jacob Redlion vs. Woolverton, as quoted 
 in 1 Beck, 484, from Hazard's Register of Pennsylvania, 7, 363, 
 is an American case of some interest. The plaintiifs were 
 brothers of Christian Redlion, deceased, upon whose death with- 
 out issue, they were entitled, under the will of Michael Redlion, 
 their father, to a considerable sum of money. Christian, the 
 
90 MEDICAL JURISPRUDENCE. 
 
 deceased, Avas married to Catharine Stout in the spring of 1825, 
 and died on the 5th November of the same year. Catharine, his 
 widow, married Thomas Woolverton, the defendant, on the 16th 
 of March, 1826 ; and on the 15th of September., 1826, she had a t 
 son born, who survived. The question was, who was the father, 
 the first or second husband"? The first husband committed 
 suicide, and from his death to the birth of the child was ten 
 months and fourteen days, while from the marriage with the 
 second husband to the birth, was only six months. The cause 
 was decided in favor of the plaintiffs, the child being considered 
 as the issue of the second husband, or at least not as the issue 
 <>£ the first. 
 
 It has been suggested that the resemblance of the child to its 
 supposed father, might be a valuable means of determining its 
 paternity. This, however, on examination, will turn out to be 
 a very uncertain source of evidence to be relied upon. 
 
 Although, as a general rule, there is little doubt but that fea- 
 tures and physical forms, as well as mental and moral characteris- 
 tics and peculiarities, are transmissable from parents to children j 
 yet they do not always show themselves in the next succeeding 
 generation. Instances are not unfrequent, of the reappearance 
 of both the physical and mental and moral peculiarities of pa- 
 rents, in the second and even the third generation of their suc- 
 cessors. In cases of very marked resemblance, that fact should 
 undoubtedly be taken into consideration in determining the 
 question of paternity. But if there were no such resemblance, 
 it should not be considered as equally conclusive testimony on 
 the other side, as the resemblance might be greater to a more 
 remote ancestor, and that either on the side of the father or 
 mother. 
 
 It is however stated, that much reliance can be placed upon 
 the fact of color, to prove paternity ; that when the appearance 
 of the child evidently proves that its father must have been of a 
 different race from the husband, as when a mulatto is born of a 
 white woman whose husband is also white, that must afford a 
 clear indication of parentage. There is, however, a singular 
 fact in relation to this, related in Fowler's work on hereditary 
 
L£&it11»*CY. 91 
 
 decent, 34 V Two white parents in New Jersey had a child 
 bearing unstpiSocal icarks of African race and blood. It had 
 the flat nose, thick lips, curly hair, and dark skin of a mulatto. 
 It came near creating difficulty in the family, until, on visiting 
 a town in France where the family of the wife had resided for 
 several generations, it was found that her- great grandfather was 
 an African. Thus, although the peculiarities of that race had 
 disappeared in two or three generations, yet it again reappeared 
 , very unexpectedly in this fifth generation. 
 
 The case of The Commissioners of the Almshouse vs. Whistelo, 
 which was tried in New-York in 1808, and will be found report- 
 ed in 3 Wheeler's Criminal Cases, 194, was one not less curious 
 in its facts than in the discussions contained in it. 
 
 Lucy Williams, a mulatto woman, was delivered, on the 23d 
 of January, 1807, of a female bastard child, which became a 
 public charge. She charged it upon Alexander Whistelo, a black 
 man. Upon the production of the child, it was found that its 
 color was somewhat dark, but lighter than the generality of 
 mulattoes ; and that its hair was straight, and had none of the 
 peculiarities of the negro race. 
 
 The woman in this case made oath that the defendant was the 
 father of the child, but she admitted that a white person on one 
 occasion had been in bed with her, and she had connexion with 
 him. Physicians were sworn to the number of fourteen, several 
 of whom stood high in the foremost ranks of the profession. 
 With the single exception of Dr. Mitchell, they were very unani- 
 mous in the opinion that by the laws of nature, the defendant 
 could not be the father of the child ; and in their judgment, he 
 was not. Dr. Mitchell admitted that it presented an anomaly 
 in its appearance, but was nevertheless inclined to the opinion 
 that the paternity was rightly charged. The whole proceedings 
 on the trial, and especially the examination of Dr. Mitchell, and 
 the summing up the cause by the celebrated Sampson, are in the 
 highest degree amusing, and possessing a lively interest. The 
 mayor, De Witt Clinton, gave the opinion of the court in favor 
 of the defendant, deciding against the express oath of the woman. 
 
92 MEDICAL JURISPRUDENCE. 
 
 on the strength of the medical testimony, and the fact that she 
 had sworn to her having connexion with a white man. 
 
 VI. DELIVERY. 
 
 The last subject included under the first general division or 
 class, embracing the consideration of things growing out of the 
 sexual relations, is Delivery. It becomes necessary to under- 
 stand this principally with the view, not alone of being able to 
 recognize it on its occurrence, but also of detecting cases of con- 
 cealed and pretended delivery. 
 
 The first may be undertaken for the purpose of destroying the 
 offspring immediately after birth, or of hiding the shame of the 
 individual by preventing a public exposure. 
 
 The motive prompting to the second may be various. It may 
 be done 
 
 1 . To produce a supposititious heir to an estate, 
 
 2. To influence the feelings of a paramour with a view to mar- 
 riage, or 
 
 3. To satisfy the wishes or appease the anger of a husband. 
 In relation to concealed delivery, the physician in suspected 
 
 cases, should make enquiries as to the following points. 
 
 1 . What are the proofs of previous pregnancy 1 And this en- 
 quiry should be conducted particularly in reference to the sensi- 
 ble signs and indications of pregnancy, particularly enlargement 
 of the abdomen, and whether such enlargement was connected 
 with any apparent disease. 
 
 2. To the proofs of recent delivery hereafter noticed. 
 
 3. To the connection between the supposed period of delivery 
 and the state or condition of the child found as to its maturity or 
 immaturity. 
 
 Pretended delivery usually presents itself, 
 
 1. Where the female has never before been pregnant, or 
 
 2. Where one or more deliveries have previously occurred, or 
 
 3. Where there has been an actual delivery and the female 
 substitutes a living for a dead child. 
 
 The first is the most easily detected. There are signs of real 
 
DELIVERY. 93 
 
 delivery which cannot be feigned. "An enlargement of the orifice 
 of the uterus, and a tumefaction of the organs of generation 
 should always be present ; and if wanting are conclusive against 
 the fact." 1 Beck's Med. Juris., 213. A case is mentioned by 
 Dr. Male, in winch a physician was called to a pretended labor, 
 and a dead child was presented to him, but there was no pla- 
 centa. On examining he found the os tincse in its natural state, 
 nearly closed, and the vagina so much contracted as not to admit 
 the hand. It turned out to be'a case of deception, the object of 
 which was to appease the wrath of her husband. 
 
 Another case is also mentioned by Dr. Beck. 1 Beck, 214, in 
 which the physician was enabled to detect the deception from the 
 following named facts : 
 
 1 . The infant produced instead of being 53 hours old as stated, 
 presented every appearance of being from five to seven days old. 
 
 2. The cord had evidently been secured by some one under- 
 standing it. 
 
 3. The breasts presented no enlargement, nor any marks of 
 the secretion of milk. 
 
 4. There were no linese albicantia on the abdomen. 
 
 5. There was no discharge from the vagina which was con 
 tracted and the labia natural. 
 
 6. The mouth of the uterus was neither tumefied nor irregu- 
 lar. 
 
 7. The uterus itself was light and easily raised, and had the 
 feel of perfect contraction. 
 
 The fraud was subsequently confessed. 
 
 In regard to the second, the difficulty in determining is some- 
 what increased, especially if the examination is not made within 
 eight or ten days, ' while in reference to the third, that can only 
 be decided by physical proofs, unless some persons have been 
 present at the delivery. 
 
 The following are the principal questions that arise for discus- 
 sion under this head. 
 
 1. Can a woman be delivered and be, at the time, unconsci- 
 ous of it ; and can she remain unconscious after the occurrence 
 of such an event 1 
 
94 MEDICAL JURISPRUDENCE. 
 
 2. Can a woman, if alone at the time of the delivery, prevent 
 her child from perishing after the event. 
 
 3. What are the signs and indications of recent delivery, and 
 within what time should the examination be made ] 
 
 4. Are there any, and what diseases, the effects of which may 
 be mistaken for the traces of a recent delivery 1 
 
 5. Are there any signs or indications by which it may be de- 
 termined, whether a woman has ever borne a child, although at 
 a period remote from that of the examination 1 
 
 6. What is the possible number of children that may be pro- 
 duced at one birth 1 
 
 7. Under what circumstances, and by what means is it moral- 
 ly, legally and medically proper, to induce premature labor ? 
 
 8. The changes that occur in the fcetal state and the signs of 
 maturity or immaturity of the child. 
 
 9. An enquiry into the state necessary to enable a new born 
 infant to inherit, including the question of viability. 
 
 10. What are the signs and indications of the life or death of 
 the child before or during delivery 1 
 
 11. Delivery after the death of the mother and Caesarian 
 operation. 
 
 12. In case of the death of the mother, what are the signs and 
 indications of delivery that may be revealed by dissection 1 
 
 It will be perceived that here are grouped together a great 
 number of subjects of investigation, nearly all of which may be- 
 come important in reference to the perpetration of frauds and 
 impositions ; in cases of alleged infanticide ; and in questions 
 relating to the descent of property. We shall treat them briefly 
 in the order stated. 
 
 1 . Can a woman be delivered, and be at the time unconscious 
 of it, and can she remain unconscious after the occurrence of the 
 event 1 
 
 The first part of the question must be answered in the affir- 
 mative under peculiar circumstances. These may be 
 
 I. The influence of narcotics or ardent spirits. In 1G41 the 
 Countess de Saint Geran, was delivered of a boy whilst stupified 
 by narcotics. On awaking in the morning she found herself 
 
DELIVERY. 95 
 
 bathed in blood and the infant gone. Her relations had done it 
 from interested motives. 
 
 2. Its occurrence is also possible, without consciousness, in 
 cases of coma, delirium, and puerperal convulsions. A case is 
 mentioned by Dr. Cheyne, where a female was delivered of a 
 living child during an attack of apoplexy. 
 
 3. It has even occurred during sleep, two cases of which are 
 cited by Dr. Montgomery. The one was a case of great respec- 
 tability, being the wife of a peer of the realm, who was actually 
 delivered in her sleep. The other case is stated on the authority 
 of Dr. Douglass. Guy's Principles of Forensic Med., 120 ; Mont- 
 gomery's Signs of Pregnancy , 313. 
 
 4. It has also occurred during suspended animation, or even 
 after the death of the mother. This is certainly an extraordinary 
 fact, but it rests on high authority. It is attested by Fodere, 
 Buffon, Bichat, and others. Guy's Med. Juris., 120 ; Montgomery's 
 Signs of Pregnancy, 312 ; 1 Beck's Med. Juris., 228. 
 
 Dr. Sloyer of Mulhausen, has given an account of a female 
 dying in labor, who was put on the bier for interment, and while 
 there, an infant was suddenly born. This must be owing to the 
 independent contractile power of the uterus, and shows the con- 
 i,. nuance of the nervous and muscular, after the cessation, or 
 reparation from the organism, of the sensorial power, which lat- 
 ter is what constitutes death. 
 
 Thus the possibility of this event is clearly shown, but it must 
 occur under peculiar circumstances, and it may well be doubted 
 whether it can ever occur during a natural sleep to a woman in 
 her first pregnancy, or to any one unless she have borne many 
 children, and have naturally a very easy delivery. 
 
 But in relation to the second branch of the question, it is hardly 
 possible, under any of these circumstances, that a woman can be 
 afterwards ignorant that she has been delivered. This cannot 
 happen except in cases of mental alienation or disturbance lasting 
 through a considerable period of time. An extraordinary case 
 of this kind is related by Dr. Montgomery, in which the woman 
 lost her power of recollection for the preceding six months, her 
 
9(5 MEDICAL JURISPRUDENCE 
 
 delivery occurring during that time. Montgomery's Signs of 
 Pregnancy , 311-12. 
 
 2. Can a woman, if alone at the time of the delivery, prevent 
 her child from perishing after the event 1 
 
 This question has its most important bearing on the subject 
 of infanticide, and is by many medical jurists discussed in con- 
 nexion with that subject. The answer to it would probably be 
 in the affirmative, if the mother were self-possessed, and had 
 enjoyed her ordinary health and strength, unless under peculiar 
 circumstances. Thus if the delivery be early and very rapid, 
 there may be such a conformation of the pelvis, and so powerful 
 an action of the uterus, that the membranes and foetus are sud- 
 denly expelled together. In such case the child might fall, and 
 its death ensue, if she remained unassisted. So also it is possibL i 
 that a woman may be taken in labor and delivered while passing 
 her feces. Instances of this have occurred but rarely if at all 
 in a first pregnancy. The delivery may also be attended with 
 haemorrhage, fainting or convulsions, and the female be unable 
 to assist her offspring. The child may also have its face to the 
 sacrum, and be delivered with it downwards ; in which position 
 it cannot breathe unless it be turned ; and a very slight cause 
 suspending respiration at its very commencement, would have 
 the effect to destroy it. The infant from weakness at birth, may 
 perish for want of warming and other applications. 1 Beck's 
 Med. Juris., 229, et seq. 
 
 It is also obvious that the infant may perish without any de- 
 fault of the mother, when the umbilical cord has not been tied 
 after being cut, broken or torn. In reference to all this, the 
 principle laid down by Dr. Beck (see 1 Beck, 232,) is undoubt 
 edly true, viz : " That every woman is more or less acquainted 
 with the time when she is to be in labor, and that it is her duty 
 never to be so far alone as to render assistance accidental." 
 
 3. What are the signs and indications of recent delivery, and 
 within what time should the examination be made 1 
 
 The following are relied upon as the signs and indications of 
 recent delivery : 
 
 1 . Face paler than usual, eyes depressed, and surrounded by 
 
DELIVERY. 97 
 
 a slightly brownish circle ; the expression of the countenance 
 resembling that of a person recovering from a slight indisposition ; 
 the pulse somewhat accelerated ; the skin soft-, warm, and 
 relaxed, with a moisture having a peculiar and sometimes un- 
 pleasant odor. 
 
 2. The breasts, if examined the third or fourth day after de- 
 livery, will be found full, tense and hard or knotty, and if pressed 
 will yield a lactiform fluid. The nipples appear turgid, and the 
 areola fully developed as hereinbefore described. The first se- 
 cretion of the breasts has generally a yellow color, is thick, tena- 
 cious and ropy, and coagulates by heat, acids and alcohol. Mont- 
 gomery's Signs of Pregnancy, 303. 
 
 3. The abdomen is full, its integuments relaxed, or thrown 
 into folds ; the skin remarkably moveable on the subjacent mus- 
 cles. The light colored, broken streaks or cracks are present, 
 called the linese albicantia. These are the most numerous from 
 the groins andpubes towards the umbilicus, which is often found 
 projecting and of a conical form. The uterus does not imme- 
 diately contract and resume its original form', and hence if the 
 hand be pressed over the pubic region, a tumor is felt, produced 
 by the imperfectly contracted uterus, which is about the size of 
 the head of a new born child, and rises three or four inches 
 above the brim of the pelvis, inclining more to one side than the 
 other. 
 
 4. The external parts of generation are swollen and sometimes 
 contused or torn, especially after a first or a difficult labor ; and 
 they also partake of the relaxed state of the internal parts. The 
 vagina is greatly relaxed and dilated, its internal surface ren- 
 dered smooth, its natural rugse being obliterated by the recent 
 distention of its tissues. ' If examination be made shortly after 
 delivery, the orifice of the os uteri is found in such a patulous 
 state that its margins cannot be distinctly recognized, as they ap- 
 pear to be merely the continuation of the vagina itself. 
 
 The state and condition of the uterus and os uteri must be 
 made by an examination per vaginam. The first is found very 
 much enlarged, and its identity with the abdominal tumor is es- 
 tablished. The latter is found gaping open so wide in a woman: 
 
 7 
 
98 MEDICAL JURISPRUDENCE. 
 
 recently delivered, that two or three fingers might be introduced 
 into it with ease. Its margins are flabby and much relaxed, and 
 often feel as if divided by several small fissures. 
 
 5. Laceration of the perineum. In the case of delivery for the 
 first time, it frequently happens that the fourchette is torn, and 
 sometimes the rent extending backwards divides the perineum 
 to a greater or less extent. This, however, is simply a contin- 
 gency that may or may not happen according to circumstances. 
 
 6. The lochia. This is a sanguineous discharge flowing from the 
 ruptured blood vessels in the interior of the uterus. It is not, 
 therefore, like the last, an occasional, but a constant attendant, 
 commencing from the time of delivery, and continuing for a pe- 
 riod varying between four or five days to as many weeks. Thif 
 discharge generally continues red for the first three or four days, 
 then becomes nearly colorless or acquires a brownish or greenish 
 hue, from which it is sometimes called the green waters, and af- 
 ter a week or eight days it generally altogether ceases. 
 
 This fluid is best known by its peculiar odor, by which it is 
 distinguished from menstruation, leuchorrhcea, or other morbid 
 discharges. It has been spoken of as resembling ' fish oil,' while 
 others call it a sour smell, and the peculiar odor of it, as stated 
 by some, it is impossible to destroy. Montgomery's Signs of 
 Pregnancy, 303, et seq ; Guy's Med. Juris., 117 ; 1 Beck's Med. 
 Juris., 207-8. 
 
 In relation to the time, within which examination should be 
 made, in order that any reliable evidence can be drawn from 
 these signs and indications, it is extremely difficult to fix upon 
 any general rule. Owing to differences in constitution, states of 
 health, and habits of life, there is great diversity observable 
 among women in regard to the time required in recovering from 
 a delivery. While some require scarcely a day, others are en- 
 feebled for weeks. Still as there is a period in all when the parts 
 return to their natural state, and all the indications of recent de- 
 livery disappear, and it is extremely desirable to have some rule 
 stated, the term of eight or ten days has been fixed upon by the 
 majority of writers, beyond which an examination can disclose 
 nothing possessing any value as evidence. After thst period the 
 
DELIVERY. 99 
 
 signs become so equivocal as, if relied upon, very often to lead 
 to error. 1 Beck's Med. Juris., 209. 
 
 4. Are there any, and what, diseases whose effects may be 
 mistaken for the traces of a recent delivery 1 
 
 In regard to the first indication mentioned, it must be obvious 
 that many diseases will render the face paler than usual, give ac- 
 celeration to the pulse, and probably cause the other appearan- 
 ces mentioned to be presented. As to the other signs and indi- 
 cations, it is remarked by Paris and Fonblanque, that " dropsi- 
 cal discharges from the uterus, uterine hcemorrhage, the expul- 
 sion of a mole, hydatids, or polypus j or the removal of any of 
 those diseases which constitute what has been termed a false con- 
 ception, have been said to occasion effects which simulate the 
 signs of parturition. There are some signs common both to the 
 diseases in question, and to the delivery, but there are at the 
 same time others that exclusively indicate the occurrence of the 
 latter ; the irruption of fluids from the womb, menorrhagia, and 
 leucorrhcea, may mimic the lochia! discharge, but they will not 
 remain nor will they present that characteristic odor by which 
 the latter is so pre-eminently distinguished. So again, the re- 
 laxation of the soft parts may be the consequence of disease as 
 well as of delivery, while the paleness of the visage is the usual 
 concomitant of profuse evacuation ; but then the distention of 
 the vagina, and the state of the neck of the uterus, and the ab- 
 sence of all contusions, lacerations and discolorations will obviate 
 the possibility of deducing any erroneous conclusioa from these 
 phenomena. The wrinkles and marks upon the abdomen may 
 certainly follow any considerable change in the reduction of its 
 bulk, whether it be the result of parturition, ascitic discharges 
 or the absorption of fat ; but we may easily disarm such signs of 
 their treachery, by a previous enquiry into the state of the wo- 
 man's health, and into that of her robustness and general strength. 
 Burns, also remarks, that other circumstances may concur in 
 confirming the opinion of the practitioner, as, for instance, if the 
 patient give an absurd account of the way in which "her bulk 
 suddenly left her, ascribing it to a perspiration, which never, in 
 a single night, can carry off the size of the abdomen at the end 
 
100 MEDICAL JURISPRUDENCE. 
 
 of a supposed pregnancy. 1 Paris §• Foriblanque's Med. Juris. , 
 254-5. 
 
 From these remarks will arise the obvious reflection, that no 
 inconsiderable degree of importance must be attached to the con- 
 currence of a great number of the signs and indications of de- 
 livery. As Chaussier very well remarks, there is no disease or 
 affection, besides parturition, which can possibly produce the 
 whole series of signs above described. Montgomery's Signs of 
 Pregnancy, 305. 
 
 It may be proper here to remark that it is not every pregnancy 
 that terminates in a delivery. A woman may be pregnant and 
 the fruit of her womb may be blighted at any period of gesta- 
 tion. Notwithstanding that, it may be retained in utero, until the 
 full time is accomplished, while the size of the abdomen happen 
 ingj from some other accidental cause, to continue increasing. 
 until the expulsion of the blighted ovum occurs, the woman may 
 be suspected of having brought forth a child. Strange as it ma y 
 appear, when even the full term of utero-gestation has been ac- 
 complished, and the life of the foetus has been distinctly recog- 
 nized, it has not been followed by the birth of a child. Dr. 
 Montgomery gives a remarkable case of this kind occurring in 
 his own practice, and also quotes one from Morgagni. Mont- 
 gomery's Signs of Pregnancy, 300 - 1 . Upon the strength of these 
 cases he very properly remarks, that these demonstrate the im- 
 perfection of the rule of law concerning concealment of birth, in 
 order to prove which, it is held sufficient to ascertain, that there 
 has 'been a pregnancy, or a delivery ; for in those cases pregnan- 
 cy was clearly ascertained, the motions of the child were strongly 
 felt, and the full term of gestation was accomplished, and yet no 
 child was born, lb., 302. 
 
 5. Are there any signs or indications by which it may be de- 
 termined whether a woman has ever borne a child, although at a 
 period remote from that of the examination 1 
 
 There is, probably, little under this head of enquiry that can 
 be possessed of much real value to the medical jurist. The fol- 
 lowing indications are chiefly collected from Paris and Fon- 
 blanque ; but they very properly remark, that singly, they can 
 
DELIVER V. 
 
 furnish but very slender evidence; and should they even all 
 occur together, they must be regarded as affording only a strong 
 presumption of the fact. 
 
 1 . The loss of the signs of virginity : 
 
 2. The orifice of the uterus has not its usual conic figure ; its 
 lips are unequal, and it is more open than in those who have 
 never borne children : 
 
 3. There is a roughness of the abdomen, the parietes of which 
 are also more expanded and pensile : 
 
 4. There are small, white, and shining lines running on the 
 surface of the abdomen, the linsea albicantia : 
 
 5. The frsenum of the labia obliterated : 
 
 6. The breasts are more flaccid and pendulous, and the lines 
 on their surface are white and splendid : 
 
 7. The nipples are prominent, and the color of their discs 
 brown. 1 Paris # Fonblanque's Med. Juris., 256. 
 
 6. What is the possible number of children that may be pro- 
 duced at one birth 1 
 
 Paris and Fonblanque say, that according to the most accurate 
 estimates, twin cases, on an average, occur about once in ninety 
 labors ; and triplets are considered more rare. They are stated 
 not to take place more than once in three thousand times. The 
 occurrence of four at a birth is so rare an event, that no calcu- 
 lation has been formed upon the subject. Dr. Osborne states 
 that he has distinctly traced as many as six foetuses in an abor- 
 tion. 1 Paris §• Fonblanque's Med. Juris., 259. 
 
 7. Under what circumstances, and by what means, is it moral- 
 ly, legally, and medically proper, to induce premature labor 1 
 
 The means by which premature labor may be effected, belong 
 entirely to the medical profession. In cases where this became 
 necessary, the practitioner would be held responsible for a resort 
 to the best means the profession had it in its power to furnish. 
 The most certain, efficient, and generally resorted to, are me- 
 chanical. It is well known, that premature labor may be in- 
 duced by a mechanical operation. 
 
 The most difiicult medico-legal question is, to determine under 
 what circumstances it is proper or necessary to bring on prema 
 
102 MEOICAL JURISPRUDENCE. 
 
 ture labor. Cases occur of a pelvis so distorted that a fuL 
 grown fcetus cannot pass through without mutilation, and in 
 which this operation may be performed with perfect safety to 
 the mother, and sometimes to the child also. Dr. Denman re- 
 lates, that in 1756, there was a consultation of the most eminent 
 men at the time in London, to consider of the moral rectitude, 
 and the advantages which might be expected from this practice, 
 and that it met with their general approbation. 1 Paris # Fon- 
 blanque^ s Med. Juris., 271. 
 
 Mr. J. Barlow had recourse to this practice, in cases of dis J 
 torted pelvis, eighteen times in five women ; the result of which 
 was, that all the women recovered, and of the children thus 
 brought into the world, six were dead and twelve born alive, 
 some dying soon after birth, one living ten months, and five were 
 living at the time the account was published. His method con- 
 sisted in exciting premature labor early in the seventh month of 
 pregnancy Ibid., 272. 
 
 Dr. Hull, as quoted by Paris and Fonblanque, doubts the pro- 
 priety of resorting to this practice in any deformed woman, be- 
 fore the crotchet has been found necessary, and employed in a 
 previous labor. He says, it has happened in a number of in- 
 stances, that where the perforator and crotchet have been resort- 
 ed to in the delivery of the first child, the women have subse- 
 quently been delivered of one or more living children at the rail 
 time. 
 
 Dr. Merriman observes, that a regard to his own character 
 should determine the acteoucheur not to perform this operation, 
 unless some other respectable practitioner has seen the patient, 
 and has acknowledged that the operation is advisable. 1 Paris fy 
 Fonblanque 's Med. Juris., 273. 
 
 It; would seem as if the law ought to interpose no obstacle to 
 resorting to this practice, at any period of gestation, for the pur- 
 pose of saving the life of the mother ; and yet the legislation of 
 this State is of a character to throw a degree of distressing em- 
 barrassment upon this question. The statutory provisions at 
 present in force, are to be found in the act passed May 13th, 
 1845, Session Laws, 285 ; the first section, however ', being amend- 
 
DELIVERY. 103 
 
 ed by an act passed at the next session. That first section, as 
 amended, substantially prohibits every person from administer- 
 ing to any woman pregnant with a quick child, any medicine, 
 drug, or substance, or from using any instrument or other means, 
 with intent to destroy such child, unless the same shall have been 
 necessary to preserve the life of the mother ; otherwise, in case of 
 the death of the child or mother, it should be manslaughter in 
 the second degree. 
 
 The next section prohibits every person from administering to 
 any pregnant woman, or prescribing for such woman, or advising 
 or procuring any such woman to take any medicine, drug, sub- 
 stance or thing whatever, or from using or employing any instru- 
 ments or other means whatever, with intent to procure the mis- 
 carriage of any such woman ; and prescribes the punishment to 
 be, imprisonment in a county jail not less than three months nor 
 more than one year; 
 
 It will be perceived that there are at least two marked differ- 
 ences between these two sections. In the first, the woman must 
 be pregnant with a quick child ; in the second, she may merely 
 be pregnant without having quickened. In the first is contain- 
 ed the exception of its necessity to preserve the life of the mother; 
 in the second there is no such exception. We are, therefore, re- 
 duced to the sad humility of admitting, that by the legislation of 
 this State, in all cases of distorted pelvis, or other anomalies of a 
 kindred character resulting from malformation or disease, the 
 physician, in order himself to escape the consequences of vio- 
 lated law, must delay affording relief to the mother until the 
 period of her quickening, when perhaps it would come too late ; 
 and then he may be safe in affording it, if it be necessary to pre- 
 serve her life. Legislatures are much better versed in the mise- 
 rable tactics of party, than in the well settled and permanent 
 laws of physiology. What ..tends, in a peculiar manner, to sub- 
 ject this to animadversion, is, that a section of this act repeals a 
 statutory provision previously existing, in which the same ex- 
 ception was contained in the second section above mentioned as 
 in the first, which of course would entirely remove the objection 
 
104 MEDICAL JURISPRUDENCE. 
 
 above made to that section. The act of 1845 was, therefore, not 
 only sinning against light, but knowledge also. 
 
 It may be urged, it is true, that the act of the physician being 
 to save the life of the mother, is done with no criminal intent, 
 and therefore can no more be considered illegal, than a surgical 
 operation. But the section alluded to, does not, in terms, re- 
 quire a criminal intent. It only requires the intent to procure the 
 miscarriage; and this intent is certainly that of the physician 
 whose only object is relief to the mother. Besides, if this is an 
 implied exception, why express it in the previous section 1 Its 
 insertion in one section and omission in the next, ought, in jus- 
 tice to the Legislature, to have some meaning attached to it. 
 
 8. The changes that occur in the foetal state, and the signs of 
 maturity and immaturity of the child. 
 
 It is important, in reference to many questions connected with 
 Medical Jurisprudence, that the medical jurist should be enabled 
 to trace the progress of foetal life, and to understand the changes 
 it undergoes while in its intra-uterine state. The following brief 
 outline, designed to sketch off the most striking characteristics 
 of that progress, is collected mainly from the works of Drs. Beck 
 and Guy. 
 
 It requires some period of time, and, (if the human subject is, 
 in this respect, analogous to some species of the brute creation,) 
 some days must elapse, before the impregnated ovum is convey- 
 ed through the fallopian tube into the uterus. It is generally 
 stated to require some twenty days to elapse, before a denned 
 ovum, containing a denned embryo, can be discovered in the 
 uterus. It has undoubtedly been seen earlier, and within twelve 
 days from conception. It has been even said to be visible only 
 eight days after impregnation. In two weeks, the embryo mea- 
 sures one-twelfth of an inch ; in three, one-tenth ; and in four, 
 three to five lines. At this last mentioned time, it is of the size 
 of a large ant, a bailey-corn, or a house fly. Its weight is now 
 about twenty grains. Its form resembles that of a serpent ; a 
 swelling indicating the head, while the other extremity is slender 
 and terminates in the umbilical cord. A cleft indicates the 
 mouth, two black points the eyes, the liver occupies the whol* 
 
DELIVERY. 105 
 
 abdomen, the bladder is large, while the members begin to appear 
 as nipple-like protuberances. 
 
 At six weeks very considerable changes are found to have 
 taken place. Its length varies from seven to ten lines. Its 
 weight from forty to seventy-five grains. The face is now dis 
 tinct from the cranium. The head appears distinct from the 
 thorax. The apertures of the nose, mouth, eyes and ears are 
 perceptible. The hands, fore-arms and fingers are distinct. Legs 
 and feet are near the anus. The umbilicus is disiinct. The 
 placenta begins to be formed. The umbilical vesicle is large. 
 There are even points of ossification in the clavicle and maxillary 
 bone. 
 
 At two months another series of changes present. Length 
 about two inches, weight from three to five drachms. We have 
 now the rudiments of the nose and lips. The arms and legs are 
 detached from the trunk. The anus is marked by a dark spot, 
 and the clitoris or penis is apparent. We can discern the rudi- 
 ments of the lungs, spleen and supra-renal capsules. The pla- 
 centa begins to assume its regular form ; the umbihcal vessels 
 are becoming twisted. There are points of ossification in the 
 frontal bone and .in the ribs. 
 
 At three months, the length varies from two and a half or three 
 to six inches ; its weight from one and a half to two and a half 
 ounces. The head has now a considerable volume ; the mouth 
 is closed ; the fingers separated. The eyes are shut ; the eyelids 
 adhere together. The head is longer and heaviei than the rest 
 of the body ; the umbilical cord is formed ; the genitals are dis- 
 tinct, the penis or clitoris relatively very large ; the nymphse are 
 projecting and the labia are thick. The two ventricles of the 
 heart are distinct. The placenta is completely isolated. 
 
 At four months, the length is from five to six, seven or eight 
 inches ; the weight from five to seven or eight ounces. The ex- 
 ternal parts are now all developed except the hair and nails. 
 The main characteristics now are, that the skin is rosy and dense ; 
 the mouth large and open ; genital organs and sex distinct ; gall 
 bladder beginning to appear ; meconium in duodenum ; coecal 
 valve visible ; umbilicus placed near the pubes ; points of ossifi- 
 
106 MEDICAL JUB.ISFKUDENCE. 
 
 cation in the inferior part of the sacrum ; the great relative pro- 
 portion of the fluid of the membranes disappears, and the i'cetus 
 nearly fills the cavity of the uterus. 
 
 At five months, length from seven to nine inches ; weight from 
 five to seven ounces. The volume of the head is yet compara- 
 tively great. The brain is pulpy and is destitute of circumvolu- 
 tions or furrows. Heart and kidneys are voluminous ; nails are 
 now distinct j hair begins to appear ; skin is without sebaceous 
 covering ; the gall bladder is distinct j points of ossification in 
 the pubis and os calcis ; the germs of the permanent teeth are 
 perceptible. 
 
 At six months, the length is from nine to twelve inches ; the 
 weight between one and two pounds. The skin now begins to 
 present the appearance of a fibrous structure, and some traces of 
 fat are found under the integuments. The head now begins to 
 become smaller in comparison with the body. It is still large 
 and soft and the fontanelles expanded. The brain acquires more 
 consistence but is still easily dissolved. The eyelids are still ag- 
 glutinated. The scrotum is slightly developed in males, and of 
 a bright red color ; the testicles are still in the abdomen. In 
 females the vulva is projecting, and the labia separated by the 
 protuberance of the clitoris. The face is of a purplish red ; the 
 hair is white or silvery ; sebaceous covering beginning to appear ; 
 meconium in the upper part of the large intestines ; lungs small 
 and compact ; liver very large and situated near the umbilicus, 
 and of a dark red color ; the gall bladder contains insipid serous 
 fluid ; the bladder is hard and pyriform, and has a very small 
 cavity. Points of ossification are in the four divisions of the 
 sternum. The middle point of the body is at the lower end of 
 the sternum. 
 
 At seven months, the length is from twelve to fourteen inches, 
 the weight from two to four pounds. The skin is now of a rosy 
 hue, thick and fibrous, and covered with sebaceous matter. The 
 eyelids no longer adhere together. The cerebral mass becomes 
 more consistent, and its surface a little furrowed. The meconium 
 increases in quantity and occupies nearly the whole of the large 
 intestines. The hair on the head is longer and takes a deeper 
 
DELIVERY. 107 
 
 hue. The nails acquire more firmness. Vulvuke conniventes 
 are beginning to appear. The gall bladder begins to contain bile. 
 Point of ossification is in the astragalus. The middle point of 
 the body is a little below the end of the sternum. 
 
 At eight months, the length is from fifteen to seventeen inches, 
 and the weight from four to five pounds. The skin is now paler, 
 has acquired more density, is covered with fine short hairs, and 
 with a sebaceous envelope. The nails are firmer and reach to 
 the extremity of the fingers. The membrana pupillaris disap- 
 pears. The testicles descend into the internal ring. The lungs 
 are of a reddish color ; the liver preserves nearly its former rela- 
 tive size, but is more remote from the navel. The fluid in the 
 gall bladder is of a yellowish color, and has a bitter taste. The 
 point of ossification is in the last vertebra of the sacrum. The 
 middle point of the body is nearer the umbilicus than the 
 sternum. 
 
 At nine months, or the full term, the length varies from seven 
 teen to twenty inches, the weight is six and a half pounds. The 
 head is covered with hair frequently an inch in length. The 
 skin is covered with sebaceous matter. The membrana pupil- 
 laris is absent. The bones' of the cranium touch each other with 
 their membranous margins, the fontanelles becoming smaller. 
 The nails become more solid and are prolonged to the extremity 
 of the fingers. The white and gray substances of the brain are 
 distinct, and the circumvolutions on its surface are* more nume- 
 rous. The cerebellum and the basis of the cerebrum have ac 
 quired a remarkable consistence. The lungs are redder and 
 more voluminous ; the liver descends to the umbilicus ; the testes 
 have passed the inguinal ring, and are frequently found in the 
 scrotum. The head measures longitudinally from four to four 
 and a quarter inches, and between the parietal protuberances 
 from three and an half to four. Point of ossification is in the 
 centre of the cartilage at the lower end of the femur ; the os 
 hyoides is not yet ossified ; four portions of occipital bone remain 
 distinct ; the external auditory meatus is still cartilaginous. The 
 bladder contains urine. The meconium is found at the termina- 
 tion of the large intestine. The digestive apparatus, the heart 
 
108 MEDICAL JURISPRUDENCE. 
 
 and the lungs, are in a condition to commence extra-uterine life. 
 The middle of the body is at the navel or a very little below. 
 
 The following are the changes that occur in the brain. " Al 
 the fourth week the mass corresponding to the head in the em- 
 bryo is transparent, containing a limpid fluid. At the seventh 
 and eighth weeks the form and disposition of the brain and spinal 
 cord can be distinguished. The dura mater may be also observed 
 adhering to the inner surface of the skull. During the third 
 month, the tubercula quadrigemina, the optic thalami, and cor- 
 pora striata are developed ; and in the eleventh week, the cere- 
 bellum and the hemispheres were recognised. At the fourth 
 month, the tuber annulare and the pituitary gland were observed. 
 The corpus callosum, in the sixth month, is only half as long as 
 the hemispheres of the brain. The choroid plexus is formed in 
 the seventh month, and the corpora olivaria do not protrude till 
 between the sixth and seventh, but the corpora pyramidalia are 
 fully formed a month sooner ; and in both, the protrusion is 
 owing to the development of cineritious matter. It is not till 
 near the termination of pregnancy, that the cineritious substance 
 is formed in the spine, or even very manifestly in the convolu- 
 tions of the brain. 1 Beck's Med. Juris., 245 ; Guy's Principles 
 of Forensic Medicine, 126-7. 
 
 The relative proportions between the cerebrum and cerebellum 
 become changed as pregnancy advances. At five months, the 
 proportion is as 18^ to 1 ; at eight months, as 13/ ? to 1 ; and 
 at the full time, as 12| to 1. 
 
 The following exhibits the results of Beclard's observations on 
 the foetal skeleton : 
 
 At two months, length of skeleton, four inches and three lines ; 
 spine, two inches. 
 
 At three months, length of skeleton, six inches ; spinal pro- 
 portion, as two and two-thirds to six. 
 
 At four months and a half, length of skeleton, nine inches ; 
 spir_e, four inches. 
 
 At six months, length of skeleton, twelve inches ; spine, five 
 inches. 
 
DELIVER?. 109 
 
 At seven and a half months, length of skeleton, fifteen inches ; 
 spine, six and one-third inches. 
 
 At nine months, length of ikeleton, eighteen inches ; spinal 
 proportion, as seven and three-fourths to eighteen. 
 
 Each vertebra is formed by three principal points of ossifica- 
 tion ; one anterior, forming the body or solid part of the bone, 
 and two lateral, constituting the apophysaical masses, which, 
 uniting with the former, complete the annular structure. 1 Beckys 
 Med. Juris., 246. 
 
 Both the weight and length of the fcetus, at the time of delive- 
 ry, have been the subjects of many observations. Considerable 
 discussion on these subjects will be found in 1 Beck's Med. Juris., 
 247, et seq., and Guy's Principles of Forensic Medicine, 127, et 
 seq. The weight is found to differ considerably, owing, proba- 
 bly to a variety of causes. The weight varies in different na- 
 tions ; or, what is more probable, in the different races of men 
 as identified by ethnography. It varies in the two sexes ; and it 
 varies according to the health, habits, and peculiar idiosyncra- 
 cies of the parents. 
 
 -In France, the weight is less than in England. The average 
 weight in the former, according to Camus, and also to a great 
 number of observations subsequently made at Paris, is six and 
 one-quarter pounds. From a great number of observations made 
 in England, and from the results of Dr. Joseph Clark's enquiries, 
 it appears that the far greater proportion weigh from five to 
 eight pounds; that the average weight of male children was 
 seven pounds five ounces and seven drachms ; and that of fe- 
 male, six pounds eleven ounces and six drachms; and that, 
 taking the average, weight of both sexes, twelve males are as 
 heavy as thirteen females. 
 
 It is stated as a probable fact, that in this country the average 
 weight exceeds seven pounds. This was the opinion both of 
 Professor Dewees, and also of Professor Willoughby. Instances 
 of much greater weights are on record. Several are given of 
 *welve pounds, twelve and three-quarters, thirteen pounds thir- 
 teen ounces, fourteen pounds ; two by Dewees, of fifteen pounds ; 
 one of sixteen and a half, in New- York. The largest weight. 
 
110 MEDICAL JURISPRUDENCE. 
 
 recorded by Billard is twenty-seven pounds. 1 Beck's Med. 
 Juris.., 250; Guy's Principles of Forensic Medicine, 129. 
 
 On the other extreme, in one instance, a child at the age of 
 six weeks, weighed but two and a half pounds, with its clothes 
 on. Two cases have occurred in Brooklyn, (N. Y.,) in one of 
 which, a child born at the full time weighed one pound and nine 
 ounces, and lived five months. The other child weighed, at birth, 
 but one pound, and lived five weeks. The smallest weight among 
 several thousand children recorded by Billard, is two pounds thir- 
 teen ounces and four drachms. Guy's Principles of Forensic Medi- 
 cine, 129. 
 
 In cases of twins, the united weight is generally greater than 
 where there is a single foetus, although their individual weight is 
 less. The average weight' of twelve twins was eleven pounds 
 the pair, or five and a half each. Among four hundred and forty- 
 four pair weighed in Paris, the average weight was four pounds 
 each, and the extremes were three and eight pounds. 
 
 In a case which occurred at Fairfield, (N, Y.,) there were four 
 children born, which all lived a day. Their aggregate weight 
 was eleven pounds fourteen ounces. In Glastonbury, (Ct.,) 
 triplets were born, whose united weights was eighteen pounds. 
 Still-born children are generally heavier than those born alive. 
 
 There is about as much variety in the length of a fcetus born 
 at the full time, as in its weight. 
 
 Roedere, from his examination, concludes that the average 
 length of a male is twenty inches and a third, and that of a fe- 
 male nineteen inches and seventeen eighteenths. Dr. Dewees 
 once delivered a child that measured 27 inches. Both the weight 
 and length, and general dimensions of the fcetus will be more or 
 less dependent upon the age and vigor of the mother, her mode 
 of life, the diseases to which she may have been subject, and 
 probably the climate in which she fives. 1 Beck's Med. Juris., 253. 
 
 In drawing inferences relative to the maturity of the fcetus 
 from its length, a good deal of reliance is placed upon the rela- 
 tive position of the centre of the body. The greater the relative 
 length of the superior over the inferior parts of the body, the 
 younger and more immature the fcetus. The equilibrium be- 
 
DELIVERY. HI 
 
 tween the upper and lower parts generally occurs at the time of 
 birth, at which time the navel will be at the middle of the body 
 or nearly so. lb. 252. 
 
 The characters that mark the maturity of the child are the 
 following as quoted from Fodere & Capuron, by Dr. Beck and 
 Dr. Guy. 1 Beck's. Med. Juris., 253 ; Guy's Principles of For- 
 ensic Med., 212. The abihty to cry as soon as the child reaches 
 the atmospheric air, or shortly thereafter, and also to move its 
 limbs with facility, and more or less strength ; the body being 
 of a cleai red color ; the mouth, nostrils, eyelids, and ears per- 
 fectly open ; the bo^es of the cranium possessing some solidity, 
 and the fontanelles not far apart ; the hair, eye brows, and nails 
 perfectly developed ; the free discharge of the urine and meco- 
 nium in a few hours after birth ; and finally, the power of swal • 
 lowing and digesting, indicated by its seizing the nipple, or a 
 finger placed in its mouth. 
 
 The signs of immaturity are the following : 
 
 The length and volume of the infant much less than those of 
 an infant at full term : it does not move its members, and makes 
 only feeble motions ; it seems unable to suck, and has to be fed 
 artificially ; its skin is of an intense red color, and traversed by 
 numerous bluish vessels ; the head is covered with down, and 
 the nails are not formed ; the bones of the head are soft, and the 
 fontanelles widely separated ; the eyelids, mouth and nostrils are 
 closed ; it sleeps continually, and must be preserved by artificial 
 heat ; and lastly, it discharges its urine and meconium imper- 
 fectly, and often after a long interval. 
 
 As additional signs of immaturity, may be mentioned the 
 presence of the membrana pupillaris, the position of the centre 
 of the body already mentioned, the non-descent of the testicles 
 from the abdomen, the large size of the head as compared with 
 the body, the great prominence and deep red color of the parts 
 of generation, and the total absence or scanty deposit of sebace- 
 ous matter on the skin. Guy's Principles of Forensic Medicine, 212. 
 
 9. An enquiry into the state necessary to enable a new bom 
 infant to inherit, including the question of viability. 
 
112 MEDICAL JURISPRUDENCE. 
 
 To enable the infant to succeed to property according to the 
 Roman law, it was necessary that it should be perfectly alive. 
 An old French law ordained that it should live an hour, and be 
 able to see the four walls and ceiling of the chamber before it 
 could inherit. It was subsequently altered, directing that it 
 should cry. The present French law simply directs, that in or 
 der to succeed it must be born viable, and the word life, or being 
 born alive, is construed to mean complete and perfect respira- 
 tion. 
 
 In England, the question of life or death at birth, and of 
 ability to inherit at birth, arises frequently in those cases where 
 a man claims as tenant by the curtesy of England. 
 
 This is denned by Blackstone and substantially by Coke, to be 
 " where a man marries a woman, seised of an estate of inheri- 
 tance, and has by her, issue born alive, which was capable of 
 inheriting her estate. In this case he shall, on the death of his 
 wife, hold the lands for his life, as tenant by the curtesy of Eng- 
 land." 2 Blackstone's Com., 127. 
 
 This feature has also been adopted into American Jurispru 
 dence, in those States where the English common law has been 
 adopted as the law of the land. It forms a part of the Juris- 
 prudence of this State. 
 
 The most important question that has arisen under this, is as 
 to what constitutes being born alive. Some have said it must be 
 heard to cry, but this is a mistake. Crying, indeed, says Black- 
 stone, is the strongest evidence of its being born alive ; but it is 
 not the only evidence. Coke says, " if it be born alive it is suf- 
 ficient, though it be hot heard to cry, for peradventure it may 
 be born dumb. It must be proved that the issue was alive ; for 
 mortuus exitus, non est exitus ; so the crying is but a proof 
 that the child was born alive, and so is motion, stirring and the 
 like. Coke's Institutes, lib. 1, Chap. 4, §35-30 a. These doc- 
 trines are sustained in Dyer's Reports, 25, and in Fame's Case, 
 reported in 8 Coke's Reports. 
 
 In the case of Fish or Fisher vs. Palmer, tried in the Court of 
 Exchequer, at Westminster Hall, in 1806, the question arose di- 
 rectly whether the infant was still born at birth. The physician 
 
DELIVERY. 113 
 
 who was deceased at the time of the trial, had declared an horn 
 before the birth that the child was alive, and a warm bath hav- 
 ing been prepared under his directions, the child, when born, 
 was given to the nurse to be immersed in it. It neither cried, 
 nor moved, nor showed any symptoms of life ; but while in the 
 water, there twice appeared a twitching and tremulous motion 
 of the lips. Upon being informed of that, the physician directed 
 the attendants to blow into its throat, but no other signs of life 
 were ever exhibited. 
 
 The facts thus presented led to considerable discussion. Two 
 physicians give it as their opinion that the twitching and tremu- 
 lous motion could not have happened, had the vital principle 
 been quite extinct, and they, therefore, inferred that the child 
 was alive. Dr. Denman thought the child was not alive. He 
 drew a distinction between uterine and extra-uterine life, and 
 attributed the motion to the remains of the former. The jury 
 empanneled to try the case found that the child was born alive. 
 
 This decision has elicited considerable discussion. Its correct- 
 ness has been very properly questioned on sound physiological 
 grounds. These convulsive motions, it has been said, merely 
 show that the muscular fibre has not yet lost its contractility. 
 Even still born infants are sometimes observed to open their 
 mouths, and extend their arms and legs. It has been suggested 
 that it may be merely the relaxation of a contracted muscle, or 
 the stimulus of the atmospheric air on a body unaccustomed to 
 it. 1 Beck's Med. Juris., 260. 
 
 The looseness of the law on this subject was very extensively 
 discussed, on an appeal to the Minister of Justice in France, by 
 Chaussier . He dwelt on the insufficiency of the signs relied upon ; 
 that the pulsation at the umbilical cord, and the spouting of 
 Wood from it when cut, only proved the fluidity of the blood and 
 that some action was left in the vessel. That the evacuation of 
 the meconium should not be deemed a sign of life, nor does he 
 admit the position of Lord Coke, that the deaf and dumb can- 
 not cry, but he asserts that experience and observation show 
 that they do cry when perfectly alive. He insists that the proofg- 
 of life in disputed cases should be positive and manifest, such as- 
 
 S 
 
114 MEDICAL JURISPRUDENCE. 
 
 the high red color and warmth of the skin ; a free and full res- 
 piration, sharp and continued crying, a motion of the heart and 
 limbs, and these continuing for some time. See 1 Beck's Medical 
 Juris., 261 -2. 
 
 The Scotch law absolutely requires, that, as a proof that the 
 child was born alive, it shall be heard to cry ; and in one case, 
 where the child breathed, raised one eyelid, and expired in the 
 usual convulsions about half an hour after its birth, but was not 
 heard to cry, it was decided that the tenancy by the curtesy was 
 not made out. 1 Beck's Med. Juris., 362. 
 
 In a case which occurred at Turin, in 1818, the Csesarian 
 operation was performed after the death of the mother, the child 
 was still alive, but died at the end of thirteen minutes, and A?as 
 not opened. The facts evidencing life Avere, that motion of its 
 legs and feet were discovered during, and after the operation ; 
 it opened its hands, which were closed ; blood sprung out of the 
 umbilical cord on being cut, and pulsations were felt in the cord, 
 the carotid arteries, and region of the heart ; water being poured 
 on its head in administering baptism, a motion of the lips and 
 mouth was perceived, and an impression which produced an in- 
 spiration ; the natural heat remained ; after having lived about 
 thirteen or fourteen minutes, some drops of blood came from 
 its nose, it became pale, stretched its limbs, closed its eyes and 
 died. A commission named by the faculty of Strasburgh, found 
 no difficulty in this case, in finding that the child lived a life 
 which rendered it capable of succeeding ; that the operation had 
 rendered it thus capable, and that it had really breathed. 1 Beck's 
 Med. Juris., 263. 
 
 A case somewhat involving this question, occurred in this 
 State, in 1830 — the case of Marselis vs. Thalhimer, reported in 
 ■2 Paige, 35. The question related to the disposition of proper- 
 ty, as between the widow and the heirs of the deceased husband. 
 She claimed one-third, under the statute of distribution, and the 
 remainder as heir of her child, which was born two months 
 after the death of the husband, which was full grown but had 
 never breathed. It was claimed that a child in ventre sa mere 
 was a life in being, both as regarded its own benefit and that of 
 
DELIVERY. ] 15 
 
 other persons ; and that, upon establishing the fact of birth, the 
 legal presumption was, that it was born alive, until the contrary 
 appeared. The court decided against any legal presumption of 
 life at birth, laying down the doctrine, that the existence of life 
 at birth was a fact which, like any other, should be proved by 
 the party seeking to claim any benefit from it ; that the evidence 
 given before the surrogate did not prove that the child was born 
 alive, and that prior to birth, the presumption of life in the 
 child was merely for its own benefit, and contingent upon its 
 subsequent birth alive, and that the rights of others must remain 
 unaffected, no such presumption existing in their favor. 
 
 In connexion with this subject, should be briefly considered 
 the question of viability, (as the French term it,) that is, the 
 earliest period of gestation after which a child is considered 
 capable of living, or sustaining an independent existence. This 
 means " an aptitude for extra-uterine life, characterized by the ma- 
 turity of the infant, the good conformation of the principal organs 
 of the economy, and the healthy state of those organs at the 
 epoch of birth." The true question presented in any enquiry 
 of this character, is the earliest period of gestation at which a 
 child has been born, and has survived its birth so long as to 
 prove that there was no physical obstacle to its attaining the 
 kdult age. Guy's Principles of Forensic Medicine, 209 - 10. 
 
 If a child survive its birth a week or ten days, that may fair- 
 ly be considered as evidencing the fact that it was born viable. 
 
 It is universally admitted, that a child may be born at the 
 seventh month of utero-gestation, and live to manhood. It has 
 been supposed by many, that the chance of living is greater at 
 seven than it is at eight months of gestation. But recent expe- 
 rience seems to contradict this. 1 Beck's Med. Juris., 257. 
 
 The difficulty, therefore, can only exist in reference to periods 
 of time anterior to six months. It is now considered a safe posi- 
 tion to take, that a viable child cannot be born before five calen- 
 dar months, or one hundred and fifty days after conception. 
 Guy's Principles of Forensic Medicine, 210 ; 1 Becks Med. Juris., 
 255. 
 
 There are., some extraordinary instances, in which it is said 
 
116 MEDIC \L JURISPRUDENCE. 
 
 ehildren have been born at an earlier period of gestation, and yet 
 been reared. Fortunio Liceti was said to be born at four and 
 a half months, and to haye lived to the age of eighty years. 
 Such cases are not perfectly reliable, as a mistake may have been 
 made in the calculations. A very extraordinary case is men- 
 tioned by Dr. Rodman, (the particulars of which are given in 
 Guy, 213,) in which the mother was delivered of a living male 
 infant, and, as she was confident, at less than nineteen weeks 
 from the time of conception. Neither its weight, nor the length 
 of its body, could be ascertained until it was three weeks old- 
 It was then found to be thirteen inches in length, and weighed 
 one pound and thirteen ounces. At the age of four months, its 
 functions were all regular, and at five was doing well. A case 
 is also related by Dr. Outrepont, of Bamberg, the particulars of 
 which are also to be found in Dr. Guy, 215-16, in which, a,s 
 was pretty clearly ascertained, the child was born at the expira- 
 tion of twenty-five weeks after conception. 
 
 Dr. Francis has given an instance of a male foetus, born at the 
 twentieth week of gestation, which lived one hour, and weighed 
 one pound six drachms ; its length being ten inches. He also 
 gives another cage of a foetus born in the twenty-third week of 
 pregnancy, which survived. The means resorted to for the pur- 
 pose of rearing children of early birth, makes probably some 
 difference in the numbers who survive. 
 
 10. What are the signs and indications of the life or death of 
 the child before or' during delivery 1 i 
 
 This may become an important enquiry, where the succession 
 to an inheritance is questioned, or where, in a criminal proceed- 
 ing,the object is to punish for maltreating a pregnant woman, by 
 means of which her offspring is supposed to have died. It is 
 also impprtant, in its bearing upon the subjects of Abortion and 
 Infanticide. 
 
 The three great facts from which the life of the foetus is in 
 fcrred during pregnancy, are — 
 
 1 . The good health of the mother : 
 
 2. The progressive increase of the abdomen in size : 
 
 3. From the motion of the foetus, either as exr«»neneed by 
 
DELIVEHY. 117 
 
 the mother, or ascertained in any of the ways heretofore alluded 
 to. Each and all these may he deceptive, as will be apparent to 
 any one who properly understands the signs and indications of 
 pregnancy. 
 
 The evidence of life during delivery is also lacking in the 
 elements of certainty. The proofs enumerated as relied upon 
 for that purpose are, 
 
 1. The limpidity of the waters : 
 
 2. The regularity of the pains, and their gradual increase in 
 strength : 
 
 3. The pulsation of the heart and umbilical cord Of the foetus, 
 or the pulsation at the anterior fontanelle : 
 
 4. The swelling, tension,, and elasticity of the presenting part. 
 These, taken all together, are considered as furnishing strong 
 
 evidence of life during delivery ; although separately, they are 
 comparatively of little value. 1 Beck's Med. Juris., 234. 
 
 In regard to the indications of the death of the fcetus, re- 
 ference must be had to the causes that may have produced it, 
 such as the general state of health and condition of the mother ; 
 the excesses of which she may have been guilty ; the passions to 
 which she may have been subject, and the good or bad influences 
 that may have been brought to' bear upon her. 
 
 The signs of death during pregnancy are, 
 
 1. A want of motion in the child, the uterus feeling as if it 
 contained a dead weight : 
 
 2. The navel is less prominent than it should be : 
 
 3. The milk recedes, and the breasts become flaccid : 
 
 4. The mother feels a sense of lassitude and coldness, accom- 
 panied with headache and nausea. 1 Beck's Med. Juris., 235. 
 
 These may all prove more or less deceptive, and separately 
 are of little force. The marked presence of. them all would be 
 regarded as furnishing a very clear indication. The death of 
 the fcetus sometimes occurs without exciting any general or local 
 disturbance; the health of the mother remaining good, and 
 nothing to excite suspicion except the suspension of the ordinary 
 proofs of progressive pregnancy. Auscultation may here be 
 practiced generally with success by those who'lia^e a correct 
 
118 MEDICAL JURISPRUDENCE. 
 
 understanding of it. The pulsation of the foetal heart would 
 clearly settle the question in favor of life, but the absence of any 
 evidence of it would not so clearly indicate death. 
 
 When the fcetus is actually dead and long detained in the 
 uterus, putrefaction generally takes place. In such case the 
 membranes loose their vitality, and blackish fetid discharges are 
 present. 
 
 The signs during the progress of delivery of the death of the 
 fcetus are, 
 
 1 . Absence of motion and fetid discharges : 
 
 2. An cedematous or emphysematous feel of the presenting 
 part : 
 
 3. The skin is soft and easily torn : 
 
 4. The bones of the cranium lose their natural connexion 
 and vacillate on one another : 
 
 5. The umbilical cord is found without pulsation and some- 
 times withered and rotten. 1 Beck's Med. Juris., 236-7. 
 
 The medical jurist should, however, be cautious and not pro 
 nounce hastily upon the sufficiency of these proofs. Dr. Blun- 
 dell conceives that none should be relied upon except the three 
 following : 
 
 1 . The cuticle coming away from the head in large flakes, de- 
 squamating as from dead bodies : 
 
 2. The bones of the cranium being detached from each other, 
 and floating, as it were, in the mollified brain : 
 
 3. The umbilical cord cold, brown, flaccid, and destitute of 
 pulsation for half an hour or an hour. 
 
 These three ought certainly to be regarded as furnishing clear 
 if not conclusive evidence of death, during the progress of de- 
 livery. 
 
 11. Delivery after the death of the mother and Csesarian ope- 
 ration. 
 
 This is an operation by which a fcetus is extracted from the 
 uterus of the mother through a wound, made for that purpose, 
 in the abdomen. It has generally been supposed to be termed 
 Csesarian, from the circumstance that to it Julius Ceesar is said 
 to have owed his life. This operation is more generally per- 
 
DELIVERY. 119 
 
 formed on the eastern continent, particularly in France, than in 
 England or this country. The life of the woman there is not 
 always sacrificed. But it generally is in England and this country 
 1 Paris fy Fonblanque's Med. Juris., 275-6, 7. 
 
 Indeed the operation both here and in England, is seldom or 
 never resorted to, unless in case of the death of the mother, or 
 in desperate cases where her death is inevitable. How long after 
 her death the child may survive in utero is an unsettled que3tio». 
 Twenty-four or even forty-eight hours have been mentioned, but 
 the more sensible writers affix to that statement simply a note 
 of admiration ! Ibid, 280. 
 
 The legal effect of the Caesarian section in England and in this 
 country, when performed, as it most generally is, upon the dead 
 mother, is that it destroys the tenancy by the curtesy. One 
 condition of that is that the issue must be born during the life 
 of the mother, and therefore, says the great commentator, if the 
 mother dies in labor, and the Caesarian operation is performed, 
 the husband in this case shall not be tenant by the curtesy : 
 Because at the instant of the mother's death, he was clearly not 
 entitled, as having no issue born, but the land descended to the 
 child while he was yet in Ms mother's womb ; and the estate, 
 being once so vested, shall not afterwards be taken from him. 
 Hence, in a reference out of chancery to the justices in the case 
 of one Reppes, of Northumberland, upon whose wife the Caesarian 
 operation was performed, she having died in labor, they resolved 
 that he should not be tenant by the curtesy, for it ought to begin 
 by the birth of the issue, and be consummated by the death of 
 the wife. 2 Blackstone's Com., 128 ; 2 Paige's Rep., 35. 
 
 In 1 Beck, 264, a case is related of a wife who died of a violent 
 illness in the seventh month of gestation. A quarter of an hour 
 after her death an infant was taken from her by the Caesarian 
 operation. The father claimed to be its heir. The point was, 
 whether the child was alive when it was extracted. The proof 
 was, that after its extraction it was carried into a cold cellar, 
 that it had opened its eyes, and made some slight motions. 
 Zacchias was consulted in the case, and gave it as his opinion 
 that the child was alive when extracted ; that the inotions ob- 
 
120 MEDICAL JUK.ISPKUDE1S-CE. 
 
 served were mechanical, and the effect of the cold air upon the 
 body. The decision was given in conformity with this opinion. 
 
 12. In case of the death of the mother, what are the signs and 
 indications of delivery that may be revealed by dissection 1 
 
 The appearances presented on dissection will of course vary 
 much according to the period of time intervening between de- 
 livery and the post-mortem examination. The attention will of 
 course be directed almost exclusively to the uterus and its ap- 
 pendages. Should the examination take place immediately after 
 delivery, the changes will be great and easily perceptible. The 
 uterus is found resembling a large flattened pouch from nine to 
 twelve inches long, its mouth open, its parieties soft and relaxed, 
 its cavity containing coagulated blood, and its internal surface 
 covered with the remains of the decidua. The marks of the 
 attachment of the placenta are often visible, and are known by 
 exhibiting a dark color, so much so as to resemble gangrene. 
 The vessels of the uterus, especially that part to which the pla- 
 centa was attached, are very large and numerous. The uterine 
 appendages, the fallopian tubes, round ligaments, and surface of 
 the ovaria are extremely vascular, so much so, that they have a 
 purplish appearance. The spot from which the ovum escaped 
 is more vascular than the rest of the ovarian surface. This state 
 of these appendages continues until the return of the uterus to 
 its unimpregnated state. 1 Beck's Med. Juris., 216 ; Guy's Prin- 
 ciples of Forensic Medicine, 119; Montgomery's Signs of Preg- 
 nancy, 314. 
 
 When time has been suffered to elapse after the delivery, and 
 before the examination takes place, changes wilL be found to 
 have occurred in the uterus proportioned to the length of that 
 time and to the energy with which the organ may have exerted 
 its contractile powers. An examination made within a day or 
 two after a delivery at the full time, will find the uterus about 
 seven or eight inches. long and four broad, its internal surface 
 being vascular, and frequently presenting patches of a purplish 
 color. Its substance is from an inch to an inch and an half 
 thick, and of nearly the consistence of museular fibre. 
 
 At the end of a week the uterus has diminished to a length of 
 
DELIVERY. 121 
 
 between five and six inches. After a fortnight it does not ex- 
 ceed five inches in length. Its vascularity is also very much 
 diminished, and the thickness of its parieties reduced about one- 
 third. But this reduction is accompanied by a corresponding 
 increase in density of structure, and the orifices of the vessels 
 are much less distinct, and the color of the muscular substance 
 is paler. 
 
 These changes in the uterine system depend not only on the 
 time that has been suffered to elapse after delivery, but also on 
 the period of gestation at which the contents of the uterus have 
 been expelled. 
 
 In a delivery occurring, for instance, in the sixth month, the 
 uterus will be found as small two or three days after it takes 
 place, as it would at the end of two or three weeks at the full 
 time. 
 
 After the third week no examination of the uterus will be 
 likely to afford much information. It requires about four weeks 
 to elapse before the return of the uterus to its original unim- 
 pregnated condition. But any alterations that may be observed 
 to take place in it towards the conclusion of tins period, are too 
 liable to have been induced by contingent causes, to allow of our 
 attaching value to them as proofs of delivery. Montgomery's 
 Signs of Pregnancy, 315 -16. In examining the ovaria the at- 
 tention will of course be directed to the enquiry, whether a cor- 
 pus luteum is to be found or not, as the actual finding of one or 
 more of these bodies, is to be regarded as undoubted evidence 
 of a conception having taken place. The discussion relative to 
 these bodies was pretty fully gone into when on the subject of 
 pregnancy. 
 
 A valuable summary of many things connected with delivery 
 is thus given by Dr. Montgomery. Montgomery's Signs of Preg- 
 nancy, 317-18. 
 
 1. The signs of delivery are most distinct after the birth of »a 
 full grown child, and least so, when the uterine contents have 
 been expelled at an early period of pregnancy. 
 
 2. The proofs are more distinct in proportion to the recency 
 of the delivery, and any examination made after the lapse of ten 
 
122 MEDICAL JURISPRUDENCE. 
 
 days from the time of the delivery, is not likely to afford satis- 
 factory information ; the most decisive signs, in general, disap- 
 pearing within a week. 
 
 3. The third or fourth day, generally, presents the results of 
 delivery very distinctly, the condition of the breasts being then 
 most remarkable, from the active secretion of milk. 
 
 4. A first delivery is more easily detected than subsequent 
 ones. 
 
 5. We cannot, safely, rely on any of the signs of delivery 
 viewed separately, but, must consider them collectively, their 
 mutual relation and correspondence with each other, and with 
 the other collateral circumstances of the woman's case and his- 
 tory. 
 
 6. The chief points of attention ought to be the state of the 
 uterus, the external parts, and of the breasts. 
 
 7. There are certain physical signs which, when present, are 
 sufficient to establish a negative decision ; such are, for instance, 
 a perfect hymen, or an imperforated state of the parts. 
 
 8. But, on the other hand, a woman may have borne children 
 and no one mark remain, by which the fact of delivery could be 
 proved, after the lapse of even a few weeks. 
 
 9. A woman may be delivered while in a state of insensibility, 
 or even during deep natural sleep ; so that her child may perish, 
 merely from want of attention, and without any moral delin- 
 quency on her part. 
 
 10. A woman may be naturally pregnant, and the life of her 
 child ascertained, and yet, child birth may not occur ; the child 
 perishing and being decomposed, before the time of delivery. 
 
 This brings to a close the first class, including questions aris- 
 ing out of the relations of sex. These questions were properly 
 first considered, not only because many of them lay at the foun- 
 dation of being, but because the problems involved in very many 
 of them require first to be solved, before we can be adequately 
 prepared to enter upon the topic that will first present itself in 
 the next class, viz : the deeply interesting and important one of 
 Infanticide. 
 
INFANTICIDE. 123 
 
 CLASS II. 
 
 QUESTIONS ARISING OUT OF INJURIES INFLICTED UPON THE 
 ORGANIZATION. 
 
 The questions arising in this class can only be exceeded in the 
 frequency of their occurrence, by their immense magnitude and 
 importance. There is, probably, neither one of the classes, into 
 which I have divided the general subject, that presents questions 
 more interesting in themselves, or to the public, than this, or 
 those which the public are more interested in having thoroughly 
 understood. Among these, it will be proper to select for con- 
 sideration, 
 
 I. INFANTICIDE. 
 
 The investigation of the questions included under this .head, 
 very naturally succeeds the class of questions we have just been 
 considering. Several of the topics we have already discussed, 
 are clothed with an importance they would not otherwise possess, 
 in consequence, simply, of the bearing they have on the subject 
 of infanticide. The questions which arise here for discussion, 
 will be perhaps the more advantageously considered, under the 
 following heads : 
 
 1. The legal provisions in reference to this crime, and the 
 bearing they have upon the points necessary to be investigated 
 and determined : 
 
 2. At what period of gestation is the fcetus to be considered 
 as endowed with life % 
 
 3. Has a fetus in utero been destroyed, and what are the 
 proofs of it, as derived — 1 . From an examination of the reputed 
 mother ; and, 2. From an examination of the fetus 1 The latter 
 embracing two subjects of inquiry — 1. Whether it be a fetus 
 that is really expelled 1 and, 2. If so, what is its probable age 
 and cause of expulsion 1 
 
 4. What are the means by which abortion may be produced ' 
 
124 MEDICAL JURISPRUDENCE. 
 
 5. Has the child attained that size and degree of maturity 
 which would enable it to maintain an independent existence 1 
 
 6. Was the child born alive 1 and what are the organs or sys- 
 tems of vessels that can furnish proofs relative to this enquiry 1 
 
 7. What proofs are afforded by the circulating system 1 
 
 8. What proofs are derived from the respiratory system 1 
 
 9. What is the value, objections, and method of using the 
 hydrostatic test 1 v 
 
 10. What inferences relative to life, are to be deduced from 
 the state of the diaphragm, discharge of the meconium, and 
 state of the bladder 1 
 
 11. If born alive, how long did the child survive its birth 1 
 
 12. How long has the child been dead 1 , 
 
 13. Is the child really that of the prisoner, the reputed mother 1 
 Has she been recently delivered, and how do the signs of delive- 
 ry correspond as to time with the appearances exhibited by the 
 child'? 
 
 14. What are the different modes by which the life of the 
 child may have been destroyed 1 
 
 15. What are the various criminal modes usually resorted to 
 for the purpose of destroying life, and the proofs that evidence 
 them? 
 
 16. What are the natural or accidental modes by which the 
 life of the child may have been destroyed 1 
 
 17. What are the principal points to which the attention 
 should be drawn, and the most approved methods to be pursued 
 in the making of examinations in cases of alleged infanticide 1 
 
 1. The legal provisions in reference to this crime, and the 
 bearing they have upon the points necessary to be investigated 
 and determined. 
 
 It is a subject of deep interest to the student of general his- 
 tory, or to any one desirous of acquainting himself with tfcft 
 elements of human progress, to investigate the history of infaii' 
 ticide, and enquire into the ideas and practices of different nar 
 tions, ancient and modern, in reference to it. The prevalence 
 of these ideas and practices; their universality among ancient, 
 and generally among savage and barbarous nations ; the gradual 
 
INFANTICIDE. 125 
 
 entertainment of more and more correct ideas, as nations moie 
 civilised and of more purely natural and elevated moral feelings 
 have appeared and exerted their influence in the world's history; 
 all point to this as an excellent barometer by which the feelings 
 of men in different nations and ages may be tested, and their 
 progress in reference to correctness of ideas and purity of feelings 
 and principles ascertained. 
 
 The limits I have prescribed to myself do not permit me to go 
 into this history, but those who would feel an interest in such 
 an enquiry may profitably refer to the very excellent chapter on 
 Infanticide by John B. Beck, M. D., in 1 Beck's Med. Juris., 271, 
 et seq. The same necessity of consulting brevity will compel me 
 to omit all reference to the laws on this subject of ancient and 
 modern nations, confining myself simply to a brief statement of 
 the laws of England and this country. 
 
 Blackstone thus states the English law on this subject. " If a 
 woman is quick with child, and, by a potion, or otherwise, kill- 
 eth it in her womb, or if any one beat her, whereby the child 
 dieth in her body, and she is delivered of a dead child, tills, 
 though not murder, was by the ancient law homicide or man- 
 slaughter. But the modern law doth not look upon this offence 
 in quite so atrocious a light, but merely as a heinous misdemeanor. 
 But if the child be born alive, and afterwards die in consequence 
 of the potion or beating, it will be murder." 1 Blackstone' s Com., 
 129, and note. 
 
 In 1803 was passed what was called the Ellenborough act, 
 which enacted in substance that any person wilfully and mali- 
 ciously administering or taking any medicine, drug or substance, 
 or using or causing to be used any instrument with intent to 
 procure the miscarriage of any woman, not being, or not being 
 proved to be quick with child at the time, and all counsellors, 
 aiders and abettors, shall be declared guilty of felony, and be 
 liable to fine, imprisonment, public whipping and transportation 
 for a term not exceeding fourteen years. The same act also 
 provided that if the same thing was done after quickening it 
 should be punished with death. Other acts were subsequently 
 passed, the last of whicb, viz., 1 Vict. Cap., 85, enacted that 
 
126 MEDICAL JURISPRUDENCE. 
 
 whosoever with intent to procure the miscarriage of any woman, 
 shall unlawfully administer to her or cause to be taken by her, 
 any poison or other noxious thing, or shall unlawfully use any 
 instrument, or other means whatsoever, with the like intent, 
 shall be guilty of felony, and being convicted thereof shall be 
 liable, at the discretion of the court, to be transported beyond 
 the seas, for the term of his or her natural life, or for any term 
 not less than fifteen years, or to be imprisoned for any term not 
 exceeding three years. 
 
 It will be observed that by the provisions of this statute, the 
 absurd distinction between women quick and not quick with 
 child is not retained. 
 
 The legislation of New- York, in reference to the causing or 
 procuring abortion, is embraced in three sections, one of which 
 provides substantially that the wilful administration to any preg- 
 nant woman of any medicine or substance, or the employment 
 of any instrument or other means with intent to procure mis- 
 carriage, shall be punished by imprisonment in a county jail, 
 not less than three months nor more than one year, Session Laws 
 of 1845, 286, § 2. In this provision it will be perceived the dis- 
 tinction of quick or not quick is omitted. 
 
 Another provision embracing the case of a woman quick with 
 child, and providing in the same terms against the administration 
 of any medicine or substance, or the employment of any instru- 
 ment or other means, with intent to destroy the child, and con- 
 taining the exception of the necessity of the prescription or ope- 
 ration to preserve the life of the mother, and provides, that in 
 case of the death of the child, or of the mother, it shall be deemed 
 manslaughter in the second degree, Session Laws of 1845, 28, § 1 ; 
 the punishment for which is imprisonment in the state prison 
 not less than four nor more than seven years. 
 
 An additional section still provides that the wilful killing of 
 an unborn quick child, by any injury to its mother, which would 
 be murder if it resulted in her death, shall be manslaughter in 
 the first degree, the punishment of which is imprisonment in the 
 state prison for not less than seven years. 
 
 These are the statute provisions of this state on the subject of 
 
INFANTICIDE. 127 
 
 abortion. The case of The People vs. Jackson, 3 Hill, 92, decides 
 that under an indictment for producing an abortion of a quick 
 child which is felony, the prisoner may be convicted though it 
 turn out that the child was not quick, and the offence, therefore, 
 a mere misdemeanor, as stated in the statutory provision first 
 mentioned. 
 
 The laws of Connecticut provide that the administering any 
 noxious or destructive substance to procure the miscarriage of a 
 woman quick with child, shall be punished by imprisonment in 
 the state prison during life, or for such other term as the court 
 shall determine. Revised Laws of Connecticut, 1 52. 
 
 The legal provision in Ohio, makes the same distinction in 
 relation to the mother's being quick with child or not as the 
 laws of New- York, and there is also the same exception contained 
 in them, but the punishment inflicted is less severe. 
 
 The laws against the murder of the new born infant are much 
 more severe. In almost all civilized countries they inflict capi- 
 tal punishment. In England an act was passed in the reign of 
 James I. rendering the drowning or secret burying of an infant, 
 which if born alive would have been a bastard, prima facie evi- 
 dence of murder, and subjecting the mother to the penalty of 
 t/eath, unless she could prove that the child was born dead. 
 This cruel law was modified in 1803 by the passage of an act 
 declaring that women tried for the murder of bastard children 
 should be tried by the same rules of evidence and presumption 
 as are allowed to take place in other trials of murder. Annexing, 
 however, a penalty, or authorising the court to inflict one, in 
 case of acquittal, upon the mother who was proved secretly to 
 have buried, or otherwise endeavored to conceal, the birth of her 
 child ; which penalty was the committing to gaol or the house 
 of correction for any time not exceeding two years. 
 
 In most or all the states of the Union trials for destroying the 
 life of the new born infant are subject to the same rules and con- 
 ducted on the same principles as trials for murder, and if found 
 guilty the offender is subjected to the same penalty. The law 
 upon broad general principles recognizes no difference between 
 destroying a life that is capable of sustaining an independent 
 
128 MEDICAL JURISPRUDENCE. 
 
 being, however early it may be in its career of existence, and 
 taking away the same life at any subsequent period. All the 
 attending circumstances, therefore, such as concealment of birth, 
 secretly drowning or burying the body, would be so many facts 
 going to show the criminal intent of the party; but such facts 
 would not alone prove such intent, as they may be accounted for 
 upon other reasons. 
 
 Irrespective of the effect which the concealment of the birth 
 or death of a bastard child has upon a trial for infanticide, such 
 concealment itself has been made either a felony o<r a misdemean- 
 or, and variously punished, in most of the states of the Union. 
 The states of New- York, Massachusetts, Vermont, Connecticut, 
 New-Jersey, New-Hampshire, Georgia, Illinois and Michigan all 
 have enactments on this subject, the punishment prescribed be 
 ing generally fine and imprisonment. 
 
 In this state the endeavor privately to conceal the death of \ 
 bastard child is a misdemeanor, and is punishable by imprison- 
 ment in a county jail, not exceeding one year. Laws of 1845, 
 286, §4. A second conviction of the same offence subjects to 
 imprisonment in a state prison for a term not less than two, or 
 more than five years. Ibid, § 5. 
 
 It will be readily perceived that the great distinction made by 
 the law between the being quick and not quick with child, renders 
 it a point of primary importance to determine what quickening 
 is, and what shall be the evidence of it. The guilt or innocence 
 of the physician in his attempt to save the life of the mother is 
 made to depend upon it. 
 
 So also, whether the same act be manslaughter in the second 
 degree, or a mere misdemeanor, is dependent upon the fact of* 
 pregnancy with a quick child, or pregnancy without it. 
 
 This precise question arose and was discussed in the case, Rex 
 ps. Philips, 3 Campb. R. 74. The medical witnesses, examined 
 en that trial, differed as to the time when the foetus may be stated 
 to be quick, and to have a distinct existence ; but they agreed 
 that in common understanding, a woman is not considered to be 
 quick with child till she has herself felt the child alive and quick 
 within her, which happens with different women in different pe- 
 
lNiANTICIDE. ]19 
 
 riods of pregnancy, although most usually about the sixteenth or 
 eighteenth week after conception. Lawrence J, held in that case, 
 that a woman could not be considered quick with child, until she 
 had felt the child alive and quick within her. 
 
 This construction put upon the words of the statute, probably 
 explains them hi the sense in which the legislature used them, it 
 being undoubtedly designed to fix upon that period of gestation, 
 when the clearest evidences of fcetal life were furnished. It is 
 certainly, unfortunate, that the law has created a distinction, 
 which all sound physiology repudiates, and that it has fixed upon 
 a fact, in relation to which the female herself may be mistaken, 
 a fact that in some instances never occurs during the whole pe- 
 riod of pregnancy, and one in which the cause of its occurrence 
 is still a matter of dispute, doubt and difficulty among the medi- 
 cal profession ; many, of whom, allege that it depends upon 
 changes in the position of the womb, and that it has no necessary 
 connexion with the child's movements. It is presumed, however, 
 that the existence of life in the foetus being the great object of 
 enquiry, the testimony of those who actually witnessed the fcetal 
 movements, would be received in evidence of the fact of life, 
 equally as well as the sensations of the mother. 
 
 2. At what period of gestation is the foetus to be considered as 
 endowed with life 1 
 
 This, as a legal question, will be answered by the period of 
 quickening. This the law has fixed upon, because the fcetal 
 movements which impart to the mother the sensation of quicken- 
 ing, are the first clearly marked and well defined evidences of 
 life. Physiology, however, returns a different answer. It con- 
 siders quickening as a mere adventitious event. It looks upon 
 life as entirely consistent with the most profound foetal repose and 
 consequent inaction. It asks what is the state of the fcetus prior 
 to the period of quickening. Is it alive or dead 1 
 
 If ai' ve, then it does not become first endowed with fife at that 
 period. If dead, where are the evidences of it ; putrefaction 
 and df composition, which are always the inevitable consequences 
 of the extinction of the vital principle. It urges home the well 
 settled fact, that foetuses do actually die in utero prior to quicken- 
 
 9 
 
130 MEDICAL JURISPRUDENCE. 
 
 ing, and that when such an event happens, all the signs of death 
 are present. 
 
 In the present state of the law, it is unnecessary to discuss 
 this as a question of physiology, and accordingly we shall not 
 discuss it. It may be affirmed, however, that upon sound phy- 
 siological principles, the embryo possesses vitality from the very 
 moment of conception. 
 
 3. Has a fcetus in utero been destroyed, and what are the 
 proofs of it as derived. 1 . From an examination of the reputed 
 mother ; and 2. From an examination of the fcetus 1 The latter 
 embracing two subjects of enquiry. 1. Whether it be a fcetus 
 that is really expelled ; and 2. If so, what is its probable age and 
 cause of expulsion 1 • 
 
 The above embraces many distinct points of enquiry all grouped 
 together, because they are all intimately connected with each 
 other. With the single exception, however, of the cause of 
 expulsion, which is involved in the next subject of enquirj, 
 these have all been made, and the questions discussed in the con- 
 SJrteration of the general subjects of Pregnancy and Delivery. 
 
 It will be, therefore, entirely unnecessary to pass them again 
 under consideration, and we shall accordingly proceed to the next 
 subject of enquiry. 
 
 4. What are the means by which abortion may be produced 1 
 These may be either natural or artificial, the latter of which 
 
 can only be criminal ; and hence it will devolve on the medical 
 jurist, the necessity of ascertaining whether the miscarriage is 
 owing to the operation of causes purely natural, or has been ef- 
 fected by artificial, and therefore, criminal means. 
 
 The natural causes are either predisposing or exciting, the one 
 having a remote, the other an immediate efifect. The first may 
 affect either the female or the ovum. The females most liable are 
 those of a plethoric, irritable, nervous habit or temperament. 
 Excessive, or irregular menstruation andleucorrhcea, or attacks 
 of syphilis, scurvy, asthma, dropsy, or any malignant disease, 
 may beeome predisposing causes. So also malformations of the 
 pelvis, tight lacing, all diseases of the uterus and its appendages. 
 Rigidity of the uterus, as in those becoming for the first time 
 
INFANTICIDE. 131 
 
 pregnant at an advanced age, and relaxed condition of the cervix 
 uteri may lead to it. Immoderate venereal indulgence, by enfeeb- 
 ling the uterine organs may also predispose, and a habit of mis- 
 carriage is a very common and very powerful predisposing cause. 
 One miscarried twenty-three times at the third month. Another 
 related by Heberden, see Guy, 136, miscarried thirty-five times. 
 
 The cause of the difliculty is frequently in the ovum. Disease 
 may exist in any part of it, in the membranes, placenta, foetus 
 itself. Velpau states, that of upwards of 200 embryos expelled 
 before the third month, at least one-half were diseased. It may 
 be important, therefore, to examine what is expelled, and if any 
 distinct traces of disease are observable, a strong probability, in 
 the absence of all contrary proofs, will arise that the miscarriage 
 is owing to natural causes. 
 
 The exciting or immediate causes of miscarriage are also very 
 numerous. Among them are enumerated all strong and sudden 
 actions of the muscles of the abdomen, in efforts of expiration, 
 as coughing,, straining, violent exercise as dancing ; profuse dis- 
 charges from the bowels, or from the uterus itself; blows, and 
 all the various forms of mechanical injury. 
 
 The effect produced by these exciting causes, will almost alto- 
 gether depend upon whether there is any predisposing cause in 
 the case. In the absence of all predisposing causes, and when 
 the female and ovum are in a healthy and sound state, exciting 
 causes alone are rarely sufficient to produce a miscarriage. In 
 appreciating their effect, therefore, reference should be had to 
 the presence or. absence of any predisposing cause, and, if pre- 
 sent, that circumstance should have great weight in influencing 
 the conclusion arrived at. 
 
 The intentional and criminal means of causing miscarriage, 
 with the view of destroying the fetus in utero are of two kinds, 
 viz : General and local ; the one acting through the maternal con- 
 stitution, the other by direct application to ,the abdomen or 
 uterus. 
 
 Among the constitutional means may be enumerated, 
 
 1 . Venesection, This has come down from antiquity, and has 
 high authority to sustain it. The popular belief attributes to it 
 
132 MEDICAL JURISritUDEKCE. 
 
 a great degree of force. This, however, is a popular fallacy. 
 Instances are not wanting where venesection" during pregnancy 
 has been resorted to 48, 80 and even 87 different times, without 
 at all interrupting the progress of pregnancy, or preventing de- 
 livery at the full time. Dr. Rush states the case of one woman 
 whom he bled 11 times in 7 days during her pregnancy ; of an- 
 other who was bled 13 times, and of a third who was bled 16 
 times, while in the same condition, and yet they all recovered, 
 and were delivered of living and healthy children. 
 
 It may, however, be very true that there are states and con- 
 ditions of the system when blood letting may prove injurious to 
 the foetus. In a full state, or an irritable habit of body, or where 
 there is great debihty produced by disease, it may very possibly 
 be fatal to the fcetus. 
 
 It cannot, however, be possessed of any real value as an abor- 
 tive agent, and the general impression, that it is more effectual 
 if taken from the foot, is a sheer popular fallacy. Nor, under 
 ordinary circumstances, does any bad effect result from the appli- 
 cation of leeches to the anus, inside of the thighs, or the vulva. 
 1 Beck's Med. Juris., 312-13; Guy's Principles of Forensic 
 Medicine, 137. 
 
 2. Emetics. The agency of emetics in producing a miscarriage, 
 is both affirmed and denied by respectable authorities. The 
 nausea and vomiting that very generally accompany pregnancy, 
 are attended with no bad result in their effect upon the foetus. 
 The vomiting thus caused is, perhaps, less severe than that 
 which is induced by emetics ; besides, it the most usually occurs 
 during the first period of pregnancy., when its effect is very 
 trifling. The spasmodic contraction of the diaphragm and ab- 
 dominal muscles which occur during the act of vomiting, if 
 very severe and long continued, may no doubt endanger the 
 safety of the fcetus, and sometimes expel it. 
 
 3. Cathartics. The effect to be attributed to these, in their 
 action on the contents of the uterus, will no doubt be found to 
 depend much upon the state and condition of the woman at the 
 time of their administration, and also upon "the nature and ener- 
 getic qualities of the purgative given. If the female be of a 
 
INFANTICIDE. 133 
 
 nervous, irritable habit, or if the purging should be carried too 
 far, or continued too long, or if the article used be very drastic 
 in its nature, or if it be of a character to act particularly on the 
 rectum, there may be danger of its proving fatal to the fetus. 
 Purgatives of a different character, administered under other 
 circumstances, and in other and different states of the female 
 system, would probably have little if any effect upon the fcetus. 
 
 4. Diuretics. This class of agents has been enumerated among 
 abortives, but there seems no good reason for ascribing to them 
 any such effect. Nitre has, in one instance, when taken in a very 
 large dose, produced abortion. So, also, Cantharides have, not 
 unfrequently, been administered for that purpose; but they 
 often, and perhaps the most frequently, fail in producing any such 
 effect. 
 
 5. Ernmenagogues. Under this term are included those sub- 
 stances that are supposed to exert a specific action upon the 
 uterine system. It is no doubt true, however, that many of 
 these fail in producing that effect. Pennyroyal and Polygala 
 seneka are included, and have been made use of as abortive 
 agents, but no very certain effect of this seems to be attributable 
 to either of them. They do not therefore require any particular 
 notice. Mercury is included in this class, and formerly, it was 
 regarded as an abortive agent, in its crude state. It was soon 
 ascertained that large quantities of this substance might be taken 
 by pregnant women with impunity. Calomel is the preparation 
 supposed to exert a specific influence upon the uterine organs. 
 As calomel is a medicine of frequent use in medical practice, it 
 would be strange if occasions 'did not often present themselves, 
 where its employment would be deemed necessary during the 
 state of pregnancy. This has occurred so freqently, and its 
 effect has been so harmless in reference to the foetus, that but 
 little force is now attributed to it as an abortive agent. 
 
 The Juniperus sabina, savine, is an article that has higher claims 
 than any yet mentioned, as an abortive agent. It has been rank- 
 ed as an abortive, from the time of Galen. In some cases, it 
 exerts that quality ; in others, not. In a case which occurred in 
 New- York, sixty drops of the oil of savine were taken every 
 
134 MEDICAL JURISPRUDENCE. 
 
 morning for a week, for the purpose of procuring abortion, in 
 the sixth month of pregnancy. The symptoms induced were, 
 a violent pain in the abdomen and region of the uterus. A still- 
 born fetus was expelled, which was followed the third day after, 
 by the death of the female. On dissection, the uterine organs, 
 as also the pelvic viscera generally, were found in a high state 
 of inflammation. To this, and its constitutional effects, the mis- 
 carriage was in this instance attributed, and not to any specific 
 influence over the uterus. In another case violent vomiting 
 occurred, and, after some days excruciating pains, which were 
 followed by abortion, dreadful hs&morrhage from the uterus, and 
 death. As this is a well known popular agent for the procuring 
 of miscarriage, its use is quite frequently resorted to, and many 
 deaths result from its improper administration. It is not, how- 
 ever, by any means, certain of producing the effect attributed to 
 it. In a case related by Fodere, a girl in the seventh month of 
 pregnancy, took a glass of wine in which was mixed a large dose 
 of powdered savine. On taking the drug, she felt a burning 
 heat, accompanied with hiccough and vomiting. This was follow- 
 ed by a violent fever, which continued fifteen days. She re- 
 covered, and at the end of two months was delivered of a healthy 
 child. 
 
 Secale cornutum, (spurred r$e, ergot,) is a medicine possessing 
 the remakable property of exciting the muscular fibres of the 
 uterus to contract upon it's contents. It was first brought into 
 notice in this country in 1807, and very soon acquired a high 
 reputation for accelerating the process of parturition. It was 
 soon observed that in many cases where it was employed, the 
 children did not respire until an unusual time after the birth, and 
 in some cafces, they Were irrecoverably lost. Its high reputation in 
 producing abortion soon became very generally established It 
 was alleged by some, that the power of the ergot was limited to the 
 period of delivery, and that the uterus must acquire its full de- 
 velopment and expansion, before it could operate to produce the 
 uterine contractions. From experiments made upon animals, 
 and from other facts that have been collected, it is rendered very 
 evident that it possesses the power of causing abortion at any 
 
INFANTICIDE. 135 
 
 period. One case is cited, where it was produced at the fourth 
 month of pregnancy, by administering twelve grains of the ergot. 
 There are, however, many instances on record, in which con- 
 siderable doses of the ergot, often repeated, have failed in pro- 
 ducing the desired effect. Dr. Condie states, that he knows of 
 instances where it was employed to the extent of several drachms 
 a day, without exerting the least effect upon" the uterus. In all 
 these cases, gestation continued to the full period, and the fe- 
 males were delivered of living children. He states also some 
 cases where pains actually ceased under its use, and labor did 
 not occur until several weeks afterwards. 
 
 Upon the strength of these and other facts and reasonings, 
 much difference of opinion now exists in reference to the abor- 
 tive powers of this agent. The general opinion, however, seems 
 to be, that although it occasionally fails, yet that it more frequent- 
 ly produces its abortive effect. 
 
 There are two or three other agents enumerated as possessing 
 abortive powers, such as Actsea racemosa, Digitalis, &c. ; but 
 they are of so doubtful a character in this respect, that it will 
 be unnecessary to dwell upon them. 
 
 The local or mechanical means, consist either of external vio- 
 lence applied to the abdomen or loins, or of instruments introduced 
 into the uterus. 
 
 In regard to the first mentioned, it is undoubtedly true, that 
 wounds or injuries of a severe character, when applied either to 
 the abdomen or loins, may produce a miscarriage. It is equally 
 true, that unless there exists the predisposition, they will not be 
 likely to produce this effect, unless they are of a character so 
 severe as to endanger the life of the mother. Where this result 
 is effected by blows upon the abdomen, a considerable haemor- 
 rhage precedes the death of the fetus. The records of criminal 
 jurisprudence are not deficient in cases where the death of the 
 mother has been shown to have been caused by resorting to 
 these violent means to procure abortion. 
 
 In 1811, a man was executed for the murder of his wife. 
 She was pregnant, and he had attempted to induce abortion by 
 elbowing her in bed, rolling over her, &c, in which he succeed- 
 
136 MEDICAL JURISPRUDENCE. 
 
 ed not only in procuring abortion, but along with it, also, the 
 death of the unfortunate woman. 
 
 In another case, a female in the last month of her pregnancy, 
 was struck on the abdomen by her husband. An extensive de- 
 tachment of the placenta caused the immediate death of the 
 foetus, and that of the mother also, in fifty-one hours afterwards. 
 
 In criminal investigations of this kind, one point to be proved 
 is knowledge on the part of the accused, of the fact of pregnan- 
 cy. It will also be proper to enquire and ascertain whether the 
 injury was of so severe a character as to entitle it to be consider- 
 ed the sole cause of the fatal result ; and also whether there was 
 not a predisposition existing, or some precautions omitted, or 
 imprudence practiced, that might have aided in bringing about 
 the result. 1 Beck's Med. Juris., 322. 
 
 Instances have not unfrequently occurred, where females have 
 jumped from a considerable height, ran up and down stairs with 
 great rapidity, struck themselves over the abdomen, and rolled 
 themselves over the floor till exhausted, for the purpose of pro- 
 curing abortion, and all without success ; showing very clearly, 
 that unless the predisposition exist, it is a very difficult matter to 
 procure it by these means. Guy's Principles of Forensic Medir 
 cine, 142-3. 
 
 The other local and violent means consist in the introduction 
 into the uterus, of an instrument for the purpose of rupturing 
 the membranes, and thus bringing on premature action of the 
 womb. 
 
 In some cases where this villainous practice has been resorted 
 to, abortion has been produced by means of it, while in others 
 the child has been born alive ; and in all of them, the mother's 
 life has been either sacrificed or greatly endangered. The object 
 has generally been to rupture the membranes, and thereby in- 
 duce a premature action of the uterus, by means of which its 
 contents would be expelled. This is of more difficult accom- 
 plishment, the earlier the period of gestation at which it is unde- 
 taken. It is in such cases that the uterus has generally been 
 seriously, and often fatally injured. 
 
 I)r. William Hunter undertook to puncture the membranes in 
 
INFANTICIDE. 137 
 
 a young woman in -the third month of her pregnane}' , but un- 
 fortunately injured the neck of the uterus so much as to destroy 
 the life of the mother. 1 Beck's Med. Juris., 325 ; Guy's Prin 
 ciples of Forensic Medicine, 143. 
 
 A case occurred in New-York, in which a silver catheter was 
 introduced, by which the os tincse was wounded, and the mem- 
 branes ruptured, but without the expulsion of the fcetus. In 
 fifteen days afterwards, she had violent pains, which ceased on 
 the expulsion of a fcetus of four months, which was hastened 
 by the administration of ergot. 
 
 A case occurred in Vermont a few years since, of one Norman 
 Cleaveland, who, for the purpose of procuring abortion, intro- 
 duced a sharp-pointed instrument into the vagina, which caused 
 the immediate death of the woman. A post-mortem examina- 
 tion disclosed six places in which the neck of the uterus had 
 been punctured, each puncture being from half an inch to three- 
 fourths of an inch wide, and appearing to have been made by a 
 two-edged instrument, like a lancet. The iliac vein was also 
 wounded, and the abdomen filled with coagulated blood. The 
 prisoner was convicted and sentenced to be hung, but the sen- 
 tence was afterwards commuted to five years imprisonment in 
 the states prison, Guy's Principles of Forensic Medicine, 143. 
 
 Occasionally all or nearly all the means now enumerated have 
 been emploj r ed without producing the desired result. The fol- 
 lowing case is related by Dr. Wagner, of Berlin. A young wo- 
 man at seven months had employed savine and other drugs to 
 procure a miscarriage. She next had a strong leather strap, (the 
 thong of a skate,) tightly bound round her body. The paramour 
 then knelt upon her, and compressed the abdomen with all his 
 strength. He next trampled on her person while she lay on her 
 back. As all these failed to produce the effect desired, he took 
 a sharp pointed pair of scissors, and proceeded to perforate the 
 uterus through the vagina. Much pain and haemorrhage en- 
 sued but did not last long. The woman's health continued 
 unimpaired, and about the regular time she produced a living 
 child without having upon it any marks of external injury 
 /Md.,143-4. 
 
138 MEDICAL jUiUStkUDENCE. 
 
 la one extraordinary case sulphuric acid was injected ints the 
 vagina to cause a miscarriage. The most violent inilammation 
 of the parts immediately occurred, accompanied with adhesion 
 of the os tincse, and the formation of a dense membrane over it. 
 The delivery was first attempted by incisions made into the neck 
 of the uterus ; afterwards the Caesarian operation was performed, 
 but the mother and child both died. 1 Beck's Med. Juris., 325- 
 6 : Guy's Principles of Forensic Medicine, 144. 
 
 The practice of producing abortion has long since been re- 
 duced to a system, and thus carried on in New- York. Some 
 trials that have taken place there within a few years, disclosed 
 that the usual method resorted to for this purpose, is the intro- 
 duction of a sharp pointed instrument within the os uteri, and 
 by this means puncturing the membranes. Two or more females 
 there have been extensively engaged in the business, and who 
 have employed physicians to perform the operation, whose names 
 and persons are kept concealed from the patient, thus avoiding 
 all chance of detection. From the disclosures made on the trials 
 no doubt remains, but that the life of the unfortunate woman 
 has been frequently sacrificed, yet the perpetrators of these vil- 
 lainous practices have hitherto escaped the merited punishment. 
 Guy's Principles of Forensic Med., 144, ctnd note. 
 
 From the results of experience thus far, it seems quite Well 
 settled, that there is no one certain medicine that can be admin- 
 istered, or even means that can be resorted to, that is certain 
 and infallible in all cases in the procuring of abortion ; that the 
 most certain of medicines is probably the ergot, and the most in- 
 fallible means, the introduction of sharp pointed instruments into 
 the vagina and the rupturing the membranes ; that those which 
 are the most certain of either, are also the most sure to injuri- 
 ously affect, or more generally to destroy, the life both of the 
 foetus and the mother ; that it is no uncommon thing for both to 
 fall a sacrifice, and that sometimes the mother dies while the 
 foetus is preserved. Nothing short of doing great violence to the 
 maternal system, either by the administering of substances that 
 are poisons, or the resort to such acts of violence as are of a 
 character in all likelihood to prove fatal, can ever be expected 
 
INFANTICIDE. 1 39 
 
 to reach, destroy, and expel the foetus, •without producing the 
 death of the mother, unless a strong predisposition to abortion 
 exists. What renders this practice more cruel, uncertain and 
 hazardous, is, that the great majority of cases in which it is re- 
 sorted to, are those who are the victims of seduction, where 
 pregnancy has occurred fof the first time, where it is unknown 
 whether any predisposition exists or not, and where the woman 
 is ignorant and confiding in her sacrifice of life. It should, there- 
 fore, be constantly borne in mind, that there is here a high and 
 stern morality, that should stimulate the medical profession to 
 the exercise of their utmost effort and ingenuity, with the view 
 to master and disclose the secrets of these villainous practices, 
 the more villainous, because they are very generally conceived 
 in fraud, practised in deception upon innocent and unsuspecting 
 victims, and result the most commonly in the destruction of two 
 lives at once. 
 
 The following is a brief summary of the principal points to be 
 attended to in cases of abortion. 
 
 1 . The substance expelled from the uterus, the supposed pro- 
 duct of conception, must be examined with the view to determine 
 whether any rudiments of the fcetus can be discovered in it, and 
 if it be a fcetus, to ascertain its age and state of advancement in 
 maturity. 
 
 2. There must be an examination of the reputed mother, 
 whether she be alive or dead. In this examination two points 
 are to be kept m view : 
 
 1 . The means and agencies, whether constitutional or local, or 
 both, that have been resorted to, for the purpose of procuring 
 the miscarriage : 
 
 2. Whether any predisposition to abortion exists, and if so, 
 how much of the result is attributable to that, and how anuch to 
 the means and agencies made use of. With a view to the former, 
 the general state of health of the mother must be enquired into, 
 and whether she has had previous abortions, and if so, whether 
 they occurred at or about the same period of gestation. In case 
 of the death of the female from the means employed, the state of 
 the uterus and other organs must be examined. 
 
140 MEDICAL JURISPRUDENCE. 
 
 5. Has the child attained that size and degree of maturity 
 which would enable it to maintain an independent existence 1 
 
 All the essential elements that compose this problem have 
 already been under our consideration. Under the head of de- 
 livery will be found a discussion in regard to the maturity or 
 immaturity of the child at birth. It is unnecessary to repeat 
 here what has already been stated. The data from which our 
 conclusions are derived in reference to the solution of this pro- 
 blem, are the length and weight of the fcetus ; the relative posi- 
 tion of the centre of its body ; the proportionaTdevelopment of 
 its several parts as compared with each other, especially the head 
 as compared with the rest of the body ; the greater or less degree 
 of growth of the hair and nails ; the condition of the skin ; the 
 presence or absence of the membrana pupillaris ; and in the male 
 the descent or non-descent of the testicles. Dr. Beck and other 
 medical jurists are clearly of the opinion that in a medico legal 
 point of view, no child ought to be considered as capable of sus- 
 taining an independent existence until the seventh month has 
 been fully completed. Accordingly they maintain that if it can 
 be proved that the child which is the subject of investigation, 
 has not attained this age, no charge of infanticide ought to be 
 entertained. 1 Beck, 332. 
 
 6. Was the child born alive 1 and what are the organs or sys- 
 tems of vessels that can furnish proofs relative to tins enquiry 1 
 
 1. What is the meaning of the term born alive 1 The condi- 
 tions of live birth are not satisfied when a part only of the child 
 is born. The whole body must be brought into the world, and 
 after this event the child must be alive. Rex vs. Poulton, 5 
 Can: # Payne, 329 ; 7 C. # P., 814. The circulating system 
 must also be changed, and it must have an independent circula- 
 tion. Rex vs. Enoch, 5 C. # P., 539 ; Rex vs. Wright, 9 C. # P., 
 154. It is not, however, necessary that there should have been 
 a separation of the umbilical cord. The cord may still connect 
 the child with its mother, and yet the killing of it will constitute 
 murder. Rex vs. Crutchley, 1 C. # P., 814 ; Rex vs: Reeves, 9 C. 
 # P., 25. 
 
 We may hereafter enter more particularly into the discussion 
 
INTANTICIDE. 14] 
 
 of what constitutes life and death. It is only necessary here to 
 say with Dr. Beck, 1 Beck, 332, " that we judge of life only from 
 its effects, and declare that being as enjoying it, who performs 
 the functions considered essential to it." These functions are 
 termed vital, and, in discussing the subject of infanticide, may 
 be considered as four in number, viz., the cerebral, sanguineous, 
 respiratory and digestive. Each one of these is performed through 
 the medium of a distinct organ or system of organs. The cere- 
 bral is performed through the medium of the brain, spinal mar- 
 row, and various systems of nerves; the sanguineous, thiough 
 the heart and blood vessels ; the respiratory, 'through the lungs ; 
 and the digestive, through the entire alimentary tube. The 
 mutual and reciprocal action of all these, however, define a being 
 in the full possession of all his powers of life, and have no appli- 
 cation to that life which is foetal and intra-uterine. This life is 
 marked with its peculiarities, among which the most striking are 
 that both the cerebral and respiratory functions are found to be 
 dormant, the respiratory having no existence whatever, and the 
 nervous no other than what is necessary to foetal growth and 
 development. As the fact of birth stamps no peculiar changes 
 upon either the cerebral or digestive systems, we are to look to 
 other sources for indications of the new kind of life upon which 
 the foetus then enters. These are found in the circulating and 
 respiratory systems. 
 
 7. What proofs are afforded by the circulating system 1 
 
 The sources of proof here are, 
 
 1. The character of the blood. Bichat announces as the result 
 of many experiments made by him, and the dissection of many 
 human foetuses, that there is really no difference in appearance 
 between the arterial and venous blood of the fcetus ; that the 
 blood taken from the aorta and the vena cava, or from the carotid 
 artery and jugular vein, is in all respects the same, without the 
 slightest degree of apparent variation. In this he is also con- 
 firmed by Velpau and Autenreith. 
 
 Others deny the truth of this position, and affirm that there is 
 a difference in appearance between the arterial and venous blood. 
 The experiments, however, by which they propose to test this, 
 
142 MEDICAL JURISPRUDENCE. 
 
 or those related by Dr. Jeffrey and suggested by Mr. Carr, do 
 not appear to be conclusive upon the question,, unless they are 
 performed upon a still-born child. The examinations they pro- 
 pose are of the umbilical cord after birth, when, if the child were 
 born alive, we should of course find the same kind of change 
 which respiration constantly produces in the blood of the adult. 
 As there is no power in the fetal lungs, or provision in the fcetal 
 system, if we disconnect it from the placenta, to change the cha- 
 racter of the blood from venous to arterial, it would seem from 
 authority as well as reason, that no perceptible difference should 
 be found to exist between that contained in its arterial and ve 
 nous systems. 
 
 As foetal blood is destitute of fibrous matter, the coagula formed 
 by it is much less firm and solid than that which results from 
 adult blood. 
 
 There is also generally supposed to be a difference between 
 the appearances presented by each on exposure to the action of 
 the atmosphere. Foetal blood when coagulated presents a brown 
 red, and, on exposure to the atmosphere, does not become florid, 
 like blood from the adult. There are observed running over the 
 brown mass filaments of a red color, which give it a veined ap- 
 pearance. This also has been controverted, but upon doubtful 
 experiments. 1 Beck's Med- Juris., 334. 
 
 There is also, according to Fourcroy, a difference in the chemi- 
 cal composition of fcetal and adult blood. In the former the 
 coloring matter is darker, and the blood is no| so susceptible of 
 taking the brilliant red shade, on exposure to the atmosphere. 
 The former also contains no fibrous matter. Its coagula more 
 resemble gelatinous matter. It does not contain phosphoric acid. 
 Its proportion of serum is much larger than is to, be found in 
 adult blood. It has also been observed that the red globules of 
 fcetal blood are much smaller than those of the adult. 1 Beck's 
 Med. Juris., 335, 
 
 2. Another thing to be regarded is the condition of the heart 
 and blood vessels. The festal circulation has many very interest- 
 ing peculiarities. The great object to be attained, and the motive 
 that governs in all its arrangements, is to avoid the double cir- 
 
INFANTICIDE. 143 
 
 culation, or that which takes place through the .'ungs, after the 
 establishment of respiration, and yet by means of mechanism 
 peculiarly adapted to its purpose, to ensure the circulation 
 through every part and texture of the fetal system. To accom- 
 plish this the arrangements are as simple in design, as they are 
 complete in their performance. 
 
 The right and left auricle are brought into direct communica- 
 tion with each other by means of a septum or partition, about 
 the size of the mouth of the inferior cava, called the foramen 
 ovale. Through this the blood, poured into the right auricle 
 from the ascending cava, passes directly into the left auricle, its 
 return being prevented by the closure of a thin transparent falci- 
 form valve, situated on the side of the left auricle. This, there- 
 fore, is always found open in the fcetal state, but after the estab- 
 lishment of respiration it gradually closes. Its closure is clear 
 evidence of life and respiration at birth, but its being open is not 
 clear evidence of the contrary. Its successive changes in closing 
 will be considered under another, head. 
 
 i 
 
 Another peculiarity is the ductus arteriosus. This passes di- 
 rectly from the pulmonary artery, entering the aorta just below 
 its arch. In the foetus it is larger than the aorta itself, and is a 
 contrivance by which the blood, after being thrown from the left 
 ventricle into the trunk of the pulmonary artery, is made to avoid 
 passing into the lungs, by being conveyed directly through it 
 into the aorta. This, therefore, in the fcetal state, is always 
 found open and filled with blood. After birth it becomes oblite- 
 rated and changed into a ligament. The same principle applies 
 here as in the foramen ovale. If found closed, it is evidence 
 that the child was alive at birth. If open it is not inconsistent 
 with life as its closure is gradual, as will be more particularly 
 noticed under another head. 
 
 Another festal opening is the ductus venoms, coming off from 
 the umbilical vein, and opening into the vena cava ascendens. 
 It is large enough to admit a common sized probe, and is the 
 'passage through which the blood passing through the umbilical 
 vein goes directly to the cava and then to the right auricle of the 
 heart. In the fcetal state this is always found open and contain 
 
l-ii MEDICAL JURISPRUDENCE. 
 
 iug blood. After respiration it becomes collapsed, after a while 
 impervious, and is finally converted into a ligament. If oblite- 
 rated, it is proof of respiration and life, but as this change requires 
 considerable time, its being found open is no evidence of still 
 birth. 
 
 The umbilical vessels consist of two arteries, being continua- 
 tions of the iliacs, and a vein. The office of the former is to 
 carry the blood of the fcetus to the placenta ; that of the latter, 
 to convey the blood from the placenta to the fcetus. After birth, 
 these vessels also become obliterated, and converted- into liga- 
 ments. Their obliteration is gradual, but takes place sooner 
 than the other fcetal openings. When closed, the proof is con- 
 elusive that the child has lived subsequent to birth. When open, 
 it furnishes no proof to the contrary. 
 
 The deductions to be drawn from the umbilical cord, and from 
 the cicatrization of the umbilicus, come more properly to be con- 
 sidered in another connexion. 
 
 3. Another enquiry connected with the circulation, is the dis- 
 tribution of the blood in the different organs of the body. From 
 the great difference in the mechanism of the circulation, we 
 might be led to expect a different distribution in different organs. 
 There are two organs in which this difference in distribution is 
 particularly observable, and these are the liver and the lungs. 
 The former is much larger prior to birth than afterwards. As 
 the reverse of this occurs in the case of the lungs, it is supposed, 
 with much reason, that the one increases at the expense of the 
 other, and that the liver is the reservoir from which are furnish- 
 ed the supplies that, after the establishment of respiration, go to 
 increase the weight and swell the volume of the lungs. It has, 
 therefore, been suggested, that some relative proportion between 
 the weight of the liver, as compared with that of the body, 
 both prior and subsequent to birth, might furnish some indica- 
 tion in reference to the fact of life or death at the moment of 
 birth ; but the experiments made with the view of settling the 
 truth of this, do not seem to have resulted in any satisfactory 
 conclusion. The inferences, therefore, to be drawn from the 
 distribution of blood in the liver, are not of much practical im- 
 portance. 
 
INFANTICIDE. 145 
 
 Much more is to be said in reference to tlic Jungs. The 
 change produced in them by respiration and life, is great and 
 immediate. Prior to the establishment of this, no more blood was 
 sent to the lungs than was necessary to contribute to their growth. 
 Immediately subsequent, the whole mass of blood is made to 
 pass through them, for the purpose of oxygenation. They are, 
 therefore, distended and filled with blood, and this is caused as 
 the result of respiration. One great test, therefore, by which 
 is to be resolved the doubt whether respiration, and consequent- 
 ly life, existed subsequent to birth, is to ascertain whether the 
 lungs are found filled with blood or empty. The means by 
 which this is to be determined are two in number : 
 
 1 . Cutting into the substance of the lungs with a Icnife or sharp 
 instrument. If respiration has filled the lungs with blood, a free 
 effusion will follow the incision ; otherwise, little or no blood will 
 flow out. 1 Beck's Med. Juris., 349. 
 
 2. Ascertain the weight of the lungs. Lungs that have respired 
 will be heavier than fcetal lungs, by as much as the weight of 
 the blood which is found in them as a consequence of respira • 
 tion. By simply weighing them, therefore, other things being 
 equal, this question would seem to be easily determined. This 
 is called the static test. To render this at all available, it is ne- 
 cessary either that some standard weight of the lungs be fixed 
 upon, or that their weight in the two cases be compared with 
 that of some third body, by which means we could arrive at the 
 relative difference between them. In reference to the first, it 
 has been proposed to ascertain the greatest weight which fetal 
 lungs ever attain, which would be the standard weight with 
 which those submitted to examination must be compared. In 
 case the latter exceeded the former in weight, it was evidence 
 that respiration had taken place ; if they fell below, that it had 
 not. It was accordingly assumed, that the extreme weight of 
 the fetal lungs, a weight which they never exceeded, was eleven 
 hundred and seventy grains. Chaussier, however, among one 
 hundred and four cases of still-born children, found five in 
 which the weight exceeded eleven hundred and seventy grains ; 
 one being eleven hundred and seventy three, another twelve hnu~ 
 
 10 
 
146 MEDICAL JURISPRUDENCE. 
 
 dred and eighty-two, another twelve hundred and ninety-seven, 
 another thirteen hundred and forty-three, and one very ex- 
 traordinary one of sixteen hundred and thirty-seven. On 
 the other hand, it has been ascertained, that the lungs which 
 have respired do not, in a large proportion of cases, weigh as 
 much as is here assumed as the standard. The real value of 
 this test, therefore, must, on the whole, be very much circum- 
 scribed. When the weight of the lungs in question exceeds 
 eleven hundred and seventy grains, it is pretty conclusive evi- 
 dence that respiration has taken place. But when it falls short, 
 as it does in a large proportion of cases, that evidence can only 
 be comparative and presumptive. 1 Beck's Med. Juris., 350-51. 
 
 Another test of much celebrity, is Ploucquefs test, as it is 
 termed, which is founded on the relative weight of the lungs as 
 compared with that of the whole body. The experiments made 
 by M. Ploucquet, led him to state, as a general conclusion, that 
 before respiration, the lungs were one-seventieth the weight of 
 the whole body ; after respiration, one-thirty-fifth ; in other 
 words, that respiration doubled the weight. 
 
 To the sufficiency of this test, several objections have been 
 proposed ; as, that there is no fixed proportion between the 
 weight of the lungs and that of the body. M. Ploucquet seems 
 to have deduced this conclusion from too limited a number of 
 experiments. He made only three ; two upon still-born children, 
 and one upon a living child. In one of the still-born, the lungs 
 as compared with the body, weighed as one to sixty-seven; in 
 another, as one to seventy; while in the one born alive, the 
 weight was as two to seventy, or one to thirty-five. The results 
 of a great number of experiments made since, go to show, that 
 if any fixed proportions exist, they are very different from those 
 announced by Ploucquet. Hartmann makes the proportion to be, 
 in an infant which has not breathed, as one to fifty-nine, and in 
 oue which has, as one to lorty-eight. 1 Beck's Medical Jwispru- 
 dence, 352-3. 
 
 Other experiments make the proportion in the case first men- 
 tioned, to be as one to fifty-seven ; and in the other, as one to 
 thirty-eight. 
 
INFANTICIDE. 147 
 
 Other objections have been urged against it, which are unne- 
 eessary to be here alluded to, as on the whole, there does not 
 seem to be much value to be attached to this test. It would be 
 well, certainly, to compare the weight of the lungs with that of 
 the body, in any case of doubt or difficulty, and to ascertain the 
 proportion. This, taken in connexion with other facts and 
 proofs, may be of importance, but alone, can be of little value. 
 
 4. One additional fact, derived from the circulation, may be, 
 the presence of ecchymosis or extravasation of blood on the body of 
 the child. The true ecchymosis, presenting a slight tumor, and 
 variegated discoloration of the skin, produced, as it is, by a rup- 
 ture of small vessels, and bloody effusion from them into the 
 cellular tissue, can only be found where the circulation was at 
 the time existing. It has been suggested, that the gas generated 
 by putrefaction may be sufficient to burst the veins, and that 
 thus an outlet may be furnished to the blood, that may be insen- 
 sibly carried along from more distant parts ; so that considerable 
 appearance of extravasation might be presented. To this it is 
 answered, that by attending to the circumstances accompanying 
 putrefaction, and the actual appearances presented by the body, 
 it would be easy to determine whether or not the effusion was 
 owing to this cause. 1 Beck?s Med. Juris., 359-60. 
 
 These marks of violence clearly established, and of so severe 
 a character, and so inflicted, as not to have occurred during 
 birth, may prove the death of the child even before respiration 
 was established. A child may live after its birth without breath 
 ing long enough to have its life destroyed by violence. Its head 
 may be suddenly dashed against the wall, its larynx compressed, 
 or strangulation produced by tightening a ligature thrown around 
 its neck, all before a single respiration has taken place. Guy's 
 Principles of Forensic Medicine, 149 - 50. 
 
 It may be important, therefore, to have the means of deter- 
 mining, independent of a resort to the respiratory system, 
 whether a death has been criminally produced or not. These 
 means are two in number, the one being negative, the other 
 positive. 
 
 The negative consists in the appearances presented by the 
 
148 MEDICAL JURISPRUDENCE. 
 
 body of a child which has died and undergone maceration in the 
 uterus. This subject has already been in part alluded to, under 
 the head of the signs or indications of life or death before or 
 during delivery ; although what was there said, had more direct 
 reference to the putrefactive process. In addition, it may be 
 observed, that the body, in such case, will appear shrunken and 
 flaccid in every part; the chest and abdomen flattened; the 
 ribs visible through the skin ; the ilia prominent ; the extremi- 
 ties soft and attenuated ; the head soft and yielding ; cuticle on 
 the hands and feet white, thickened and wrinkled ; the cutis it- 
 self discolored ; the abdomen exhibiting a mottled appearance, 
 blending a rose and ash color ; skin a brownish red ; the parts 
 of generation a deep red color ; the head and face partaking of 
 the same, although in a' less degree; the entire surface covered 
 with a soapy fluid, so that it easily eludes the grasp ; the cellular 
 membrane infiltrated with a reddish serosity, containing in parts 
 of it a substance resembling gooseberry jelly ; the cavities filled 
 with an abundant sero-sanguinolent fluid, and the viscera tinged 
 with a reddish brown color, displaying their minute structure. 
 These appearances will be the more strongly marked the longer 
 the foetus has lain in the uterus after being divested of life. 
 They are distinct from the effects of putrefaction, and none of 
 the odor of that process will be present. They will only be clear- 
 ly presented where the foetus, divested of life, has lain for some 
 time in the uterus, and will not be perceptible if the death occur- 
 ed but a short time before the expulsion. Guy's Principles of 
 Forensic Medicine, 149. 
 
 The positive proof of death, prior to respiration, having re- 
 sulted from violence, is derived from the ecchymosed appearances 
 before mentioned. The circulation is,' of course, kept up in the 
 foetus, although rather languidly, and any severe injury during 
 the continuance of it, cannot fail to leave its impression. The 
 principles upon which our judgment should be based, are the 
 same as in case of injuries to adults, which are to be consider- 
 ed under the head of wounds. A case is related by Devergie 
 of infanticide in an infant that had not respired, proved by the 
 
INFANTICIDE. 149 
 
 existence of extensive wounds and marks of great violence on 
 the head, with copious effusion of blood. 
 
 8. What are the proofs derived from.the respiratory system 
 in reference to the fact of life or death at birth "? 
 
 In this system exists the most important source of evidence in 
 reference to the above enquiry. The passage from fcetal to adult 
 life is marked by nothing more strongly, than by the changes 
 which take place in the entire respiratory apparatus. What 
 gives peculiar value to these changes, as connected with the solu- 
 tion of this problem, is that they are immediate. This feature 
 renders them altogether superior in importance to those which 
 occur in the circulating system. The latter are so gradual as to 
 divest them of very much of their value. 
 
 The assertion, however, that the changes are immediate should 
 be received with some qualification. The commencement of res- 
 piration is a more gradual process than may be at first supposed. 
 It is rarely, if ever, fully completed in a few respirations, and 
 sometimes requires many hours, days and even weeks, to ren- 
 der it complete and perfect. Guy's Principles of Forensic Medi- 
 cine, 153. 
 
 The changes effected by respiration are principally to be no- 
 ticed in the thorax and lungs. 
 
 1. As to the thorax. This, even on a very cursory examina- 
 tion, presents a wide difference in its appearance when examined 
 previous and subsequent to respiration. If no respiration has 
 taken place, it appears flattened, and as if it were compressed. 
 The general size of it is small, and its internal capacity very 
 much diminished. Its size and capacity are both adapted to the 
 altered position and small size of the fcetal lungs which are con- 
 tained within it. The diaphragm is also found raising high up 
 into the thorax. 
 
 The act of respiration by increasing very considerably the size 
 and volume of the lungs, and altering somewhat their position, 
 throws the thorax out and renders it rounded and arched. Its 
 internal capacity is enlarged in all directions. The diaphragm 
 will be found depressed instead of rising high up into the thorax. 
 It has been proposed to ascertain the dimensions of the thorax 
 
t 50 MEDICAL JURISPRUDENCE. 
 
 by actual measurement, in order to derive the utmost from tins 
 source of evidence. It is supposed, however, that occular in- 
 spection will be the best guide, and that a little experience in 
 making examinations will insure the arriving at safer conclusions 
 than to trust simply to measurements. 1 Beck's Med. 'Juris., 
 360-61. 
 
 2. In regard to the lungs. These being the great organs, of 
 respiration, in them we might reasonably expect to find the 
 greatest amount and variety of changes. These have reference 
 to many different points. 
 
 1 . The volume or size of the lungs is very much increased. This 
 is owing principally to the distension of the air cells with air. 
 The change produced in the external appearance of these organn 
 by respiration or artificial inflation, is generally alone sufficient 
 to enable any one to determine whether either had taken place 
 or not. The effect, of course, will vary according to the degree 
 of either. The air cells are irregularly grouped, angular in form, 
 and situated in the substance of the lung. Occasionally they are 
 ibund in groups of four, arranged in a perfectly regular and sym- 
 metrical manner ; but more commonly they are irregular in 
 shape. 
 
 The smallest quantity of air, however introduced, serves to 
 develope some of the air cells on the surface of the lungs. When, 
 therefore, these air cells appear developed, it is a fair proof of 
 the admission of air, either by inspiration or artificial inflation. 
 Of the different parts of the lungs, the edges and concave sur- 
 face of the upper lobe of the right one, admit the air the most 
 readily, and hence are the first that indicate that respiration or 
 artificial inflation has taken place. Guy's Principles of Forensic 
 Medicine, 151. 
 
 Many modes have been proposed to ascertain the precise 
 amount of increase in volume in different cases. Among these 
 that proposed by Daniel, is perhaps the best, but that seems not 
 to be possessed of much practical utility. 
 
 The principle upon which he proceeded was, that if a solid 
 body be plunged into a vessel of water, it will cause the water 
 to rise in the vessel just in proportion to the quantity displaced. 
 
INFANTICIDE. 15] 
 
 He proposed, therefore, to ascertain the different heights to 
 which water in a vessel could be made to rise by putting into it 
 lungs which had respired, and lungs which had not. As the 
 lungs which had respired would not sink, he recommended that 
 they should be placed in a wire basket, the volume of which 
 should be ascertained, and which might afterwards be deducted 
 from the volume of the lungs. The principal objection seems to 
 he, that it does not appear that any conclusions can be drawn 
 from the absolute volume of the lungs, which can be depended 
 upon with any degree of certainty. 1 Beck's Med. Juris., 362. 
 
 2. There is also a difference in the relative situation cf the 
 lungs. Those lungs which have performed fully the function of 
 respiration, will be found covering completely the sides of the 
 diaphragm as well as its arch. Those which have performed sim- 
 ply an imperfect respiration, will be found occupying the lateral 
 portions of the thorax. Where no respiration has taken place, 
 they occupy only a small place at the upper and posterior part of 
 the thorax, leaving the pericardium and the diaphragm, to a 
 great extent, uncovered. 76., 362. 
 
 3. There is also a difference in the shape of the lungs, before 
 and after respiration. Prior to respiration the lower margin of 
 the left upper, and right middle lobes are sharp and pointed, 
 while subsequent to that act they become rounded and obtuse. 
 1 Becks Medical Juris., 362. This is owing to the effect pro- 
 duced on their shape by the distension of the air cells. 
 
 4. Another point of difference between lungs which have res- 
 pired, and those which have not, is in their color. Prior to respira- 
 tion, the lungs are of a bluish red, deep violet, or brownish red 
 color. This is subject to some slight variation. It is important to 
 bear in mind, that an exposure to the atmosphere for a very short 
 time, will materially change the color, so that all the observation 
 that is bestowed upon this point, should be immediately upon the 
 opening of the thorax. Lungs that have respired are of a pink- 
 ish red hue, which becomes lighter in proportion to the degree 
 and extent to which that process has been carried. After a brief 
 exposure to the air, the light red tint is changed to a bright scar- 
 let. Where respiration is imperfectly established, the lungs fre- 
 
152 MEDICAL JURISPRUDENCE. 
 
 quently exhibit a mottled appearance, especially about the ante- 
 rior surfaces and margins, the light red being intermixed with 
 the livid foetal hue, and being slightly raised above the general 
 surface of the organs. Taylor's Med. Juris., 357. 
 
 The presence of disease in the lungs greatly modifies their ap- 
 pearance in respect to color. Where death has resulted from 
 sanguineous engorgement of the lungs in children, the color will 
 be of a dark brown, although respiration may have been going 
 on for several days. 1 Beck's Med. Juris. , 363. 
 
 There is not, however, any great degree of certainty to be at- 
 tached to the circumstance of color. Mr. Taylor says, I have 
 known a child to live twenty-four hours, respiring feebly, and 
 on examining the body, the color of the lungs was identical with 
 that of the organs in the foetal state. The variation in color, al- 
 though a usual, is not a necessary consequence of enjoying life. 
 Bernt says, that artificial inflation of the lungs never produces 
 the scarlet tint of natural respiration. In this statement he is 
 contradicted by Mr. Taylor, who says, that the circumstance of 
 the lungs having a pinkish red color, is no infallible criterion of 
 the child's having lived and breathed, for the artificial introduc- 
 tion of air by a tracheal tube or otherwise, in the attempt to re- 
 suscitate a still born child, is attended with the same physical 
 change. Taylor's Med. Juris., 358. 
 
 5. The consistence or density of the lungs, is another distinguish- 
 ing feature upon which considerable reliance is placed. In the 
 foetal state and anterior to respiration, the lungs are dense and 
 solid, having much of the consistence and feel of the fiver. They 
 have no crepitus either under the pressure of the finger, or when 
 cut into with a knife. After respiration a considerable change 
 takes place. They then become soft and spongy, and a crepitus 
 is observed on pressing or cutting into them. This is owing to the 
 presence of air in the air cells. 1 Beck's Med. Juris., 363. On 
 the surface are observable slight furrows obscurely marking the 
 division of the lobules. When the lungs are full of blood these 
 are scarcely visible, but when comparatively empty they are 
 more distinct. Guy's Principles of Forensic Medicine, 151. 
 
 Although this difference in consistence and density, between 
 
INFANTICIDE. 163 
 
 lungs that are foetal and those that have fully respired, is suffi- 
 ciently marked, yet there is one difficulty which tends to embar- 
 rass its application, and that is, that putrefaction, to some ex- 
 tent, and artificial inflation to the entire extent to which it may 
 be carried, produces, in this respect, the same result as natural 
 respiration. There is also to be considered the degree to which 
 either may be carried. A small quantity of air, however intro- 
 duced, developes some of the air cells, particularly those situated 
 on the surface of the lungs. The right lung, and especially the 
 edges and concave surface of its upper lobe, admits the air most 
 readily. lb., 151. 
 
 The appearance presented by the developed air cells will de- 
 pend much upon whether the lungs are fresh and filled with 
 blood. If they are so, the position of these cells will be marked 
 by brilliant vermilion spots. In lungs containing less blood the 
 color is fighter. When examined some days after the death of 
 the child, their vermilion hue will have disappeared, and they 
 will be found of a light rose color. 
 
 The distinctive marks by which artificial inflation may be dis- 
 tinguished from natural respiration, will be considered hereafter. 
 Dr. Beck has remarked, ( 1 Beck, 364,) that incisions into lungs 
 v-rhich have actually respired, are 'followed by a greater or less 
 flow of blood, while in artificial inflation this is not the case. 
 Mr. Taylor (Taylor, 3G2-3,) says, there is no perceptible diffe- 
 rence in the quantity of blood existing in the pulmonaiy vessels 
 of children, which have died without respiring, and those which 
 lived and respired some time after birth. He remarks that after 
 respiration, the excess of blood is distributed tlirough the minute 
 capillary vessels of the lungs, and that the pulmonary trunks, 
 being thus almost divested of blood, furnish no evidence of res- 
 piration or the contrary. He also remarks, that the same obser- 
 vation will apply to the presence of blood in the substance of 
 the lungs ; that in performing the experiment, on several occa- 
 sions, of cutting into lungs that had respired, and those that had 
 not, he could perceive no well marked difference. This point is 
 undoubtedly to be determined by experiment, but it ought cer- 
 tainly to Ye very fully made, before we finally reject a position 
 
154 MEDICAL JURISPRUDENCE. 
 
 that seems very reasonable, viz : that after the mass of blood haa 
 commenced circulating through the lungs, there is a greater quan- 
 tity to be found in them than there was when only sufficient was 
 sent there to contribute to their nourishment and growth. 
 
 6. The specific gravity of the lungs as a distinguishing charac- 
 teristic. Tins falls under the next topic or head of enquiry. 
 
 9. What is the value, objections, and method of using, the 
 Hydrostatic test 1 
 
 This celebrated test, or the changes upon which it depends, 
 was first suggested by Galen. It was first brought into view as 
 connected with the subject of forensic medicine about the time of 
 Morgagni. The early writers on Medical Jurisprudence say noth- 
 ing of it. The work of Zacchias is silent on the subject. Haller 
 notices it and some of its difficulties. 
 
 It is important first to understand the principle upon which 
 this test depends. When a solid body is plunged into a fluid, it 
 occupies a space in that fluid exactly equal to its own magnitude. 
 The quantity of fluid then, so displaced, either equals in density, 
 and consequently in weight, the solid which displaced it ; or on 
 the contrary, one of the two must weigh more than the other. 
 In the last case, which is most common, the quantity by which 
 the' heavier body surpasses the lighter, is called the specific weight 
 or gravity. If a body is heavier than the fluid in which it is im- 
 mersed, it will sink to the bottom by its specific gravity. If 
 lighter than the same bulk of the fluid, a part of it will swim, 
 and the remaining part which is immersed, displaces a quantity 
 of fluid, which weighs exactly as much as the whole of the solid 
 body. ' 
 
 To this test the lungs are submitted, with the view of ascer- 
 taining whether they are specifically heavier or lighter than an 
 equal bulk of water. Festal lungs, as we have seen, are much 
 more dense than those which have respired. The greater the 
 density of a body, other things being equal, the greater its spe- 
 cific gravity. Hence as a general rule, whenever they are placed 
 in water, being specifically heavier, they will sink to the bottom 
 of the vessel. Lungs that have respired, having their air cells 
 expanded, have a greater volume and less density. When, there- 
 
INFANTICIDE. 155 
 
 fore, they are placed in the sfluid their diminished density and 
 increased dimensions, as a general rule, render them specifically 
 lighter than water j and hence, when placed in it they will float. 
 The necessary inference, therefore, is that if lungs which are 
 subjected to this test sink in water they are foetal, and that the 
 child, therefore, must have been still born. When they float, 
 they have respired, and that the child, therefore, must have been 
 born alive. 
 
 This test is certainly recommended by its great simplicity, and 
 the ease and facility with which it may be resorted to. It is on 
 many accounts the most interesting and important ever proposed 
 for the determination of a medico-legal question. It gathers its 
 importance both from the numerous controversies to which it has 
 given rise, from the purpose to which it is to be applied, and the 
 high value usually assigned to it. 
 
 It should be premised that in strictness this test furnishes no 
 direct proof, as to whether the child was born alive or dead. It 
 points only to the fact of respiration, and goes to show in any 
 given case whether that has taken place or not. It is true, the es- 
 tablishing the fact of respiration, is one of the means of proving 
 the existence of life. But there are also other means of proof. 
 The crying of the child, for instance, has been admitted as evi- 
 dence of live birth on trials for infanticide. Taylor's Medical 
 Jurisprudence , 364. 
 
 The objections that have been urged against the conclusiveness 
 of this test, as proving either life or respiration, or the lack of 
 it, have been of a two-fold character. First, that the lungs may 
 float and yet the child may have been still born, and second that 
 they may sink, and yet the child have been born alive. These 
 objections will be considered in their order. 
 
 1. The first objection in the first class, is ; that lungs which 
 have not respired may be rendered specifically lighter than water, 
 in consequence of having undergone the putrefactive process ; 
 and may, therefore, float when placed in it. The effect of pu- 
 trefaction upon the lungs in reference to their specific gravity is 
 not so clearly settled. 
 
 It seems singular, that any doubt should exist in reference to a 
 
156 MEDICAL JURISPRUDENCE. 
 
 fact apparently so easily proved. Still some assert that putrefac- 
 tion renders them specifically heavier than water, and that they 
 will sink instead of floating. Dr. Guy details some experiments 
 made by Mm in the winter of 1839, in which, he says, that he 
 found, in some instance, the lungs of still born children, whet 
 placed in water, as soon as they began to give out a putrefactive 
 odor, began also to leave the bottom of the vessel, and gradually 
 rose to the surface, where they remained for many days, and then 
 slowly sank to the bottom- In other instances, large air vessels 
 were formed on the surface of the lungs, but not in sufficient 
 number to give buoyancy to them ; whilst in others, though the 
 lungs gave out a strong putrefactive odor, there was no develop- 
 ment of air vessels, and no tendency to rise to the surface, nor 
 did they ever become buoyant either in the water in which they 
 had stood, or in clear water. He admits that it is not easy to 
 explain this remarkable difference, but he entertains no doubt, 
 that when the lungs contain a large quantity of blood, whether 
 in their entire texture, or only in a part of it, putrefaction takes 
 place more readily, and the formation of gas is carried to a 
 greater extent. Guy's Principles of Forensic Med., 164. 
 
 From the experiments detailed by Dr. Beck, (1 Beck, 366-7) 
 it seems pretty clear that where the lungs are in the incipient 
 stages of putrefaction, they are rendered specifically lighter than 
 water, and in that condition will float, although no respiration 
 has ever taken place. This, therefore, will constitute a valid 
 objection to the test, unless some means exist of distinguishing 
 between the two cases. There are several of these means. 
 
 1 . Lungs remaining in the thorax of a still born child are very 
 slow in undergoing the putrefactive process. While in this 
 situation they resist this process longer than any other part of 
 the body except the bones. 1 Beck's Med. Juris., 369. The 
 lungs have presented a perfectly sound natural appearance, when 
 the body had become quite putrid, when the scalp and bowels 
 were distended with air. If, therefore, the rest of the body, es- 
 pecially the bowels and soft parts, which soonest putrify, are 
 perfectly free from that process, it is fair to presume that the 
 floating of the lungs does not arise from that cause. 
 
INFANTICIDE. 157 
 
 2. Another means is-derived from the fact that the putrefac- 
 tive process, and the gases which are generated by it, are con- 
 fined to the surface of the lungs ; and hence by cutting into the 
 centre of the lung, a portion can generally be obtained free from 
 the touch of putrefaction. If the floating proceed from respi- 
 ration, the internal part will be more likely to float than the sur- 
 face. 
 
 3. Another criterion is derived from the appearance of the 
 air-bubbles on the surface of the lungs. Air-bubbles which re- 
 sult from respiration, are hardly visible to the naked eye ; but ' 
 those which result from putrefaction are large, and run in lines 
 along the fissures between the component lobuli of the lungs. 
 It is therefore an easy matter to distinguish the one from the 
 other. 
 
 4. A still further method of distinguishing, is in the greater ease 
 and facility with which the gases developed by putrefaction can 
 be extracted from the lungs. It is only necessary to squeeze in 
 the hand any portion of the lungs containing gases of this de- 
 scription, and they will be so completely extracted as that the 
 portion, if from the lungs of a still-born child, will immediately 
 sink in water. No compression, short of complete disorganiza- 
 tion, can force the air out of those lungs which have respired 
 so effectually as that they will sink in water. 1 Beck's Med. Juris., 
 368 ; Guy's Principles of Forensic Medicine, 166. 
 
 From all these, it appears very clear, that no real difficulty can 
 exist that will prevent the medical jurist from distinguishing 
 between the air-bubbles of respiration and thosewhich result 
 from putrefaction. 
 
 A far more difficult case to determine is, whether lungs which 
 are actually putrid have respired or not. Medical jurists are not 
 agreed as to the possibility of accurately solving tbis problem. 
 
 Those who take the aflirmative, propose two characteristics. 
 The first is, the existence of crepitus. They affirm that lungs 
 which have respired, although undergoing the putrefactive pro- 
 cess, have, nevertheless, a crepitus on being cut into, while those 
 which have not respired, and float merely as the result of putre- 
 faction, have no such crepitus. Another criterion, to which they 
 
158 MEDICAL JURISPRUDENCE. 
 
 attach greater weight, is, that in those lungs which havb respired, 
 after pressing out the matter developed by putrefaction, the lungs 
 themselves will float in water, while those which have not, after 
 being subjected to the same compression, will sink. 1 Beck's 
 Med, Juris., 369 -70. 
 
 2. Another, under this class of objections, and which is some- 
 what more formidable than that just considered, is, that lungs, 
 although from a still-born child, may be made to float from 
 artificial inflation. 
 
 It must be here observed, in the first place, that the artificial 
 inflation must be practiced before the lungs are removed from 
 the thorax. In the accomplishment of this, there is no incon- 
 siderable amount of difficulty — the mucus frequently filling the 
 fauces of a new-born child ; the resistance necessarily made by 
 the thorax and diaphragm ■ and the obstacles tending to prevent 
 the introduction of a pipe into the glottis, are all difficulties in 
 the way of artificial inflation, aDd so strong as, by many, to be 
 deemed insurmountable. There are many authorities that deny 
 its possibility. Heister, Hebenstreit, Rcederer, and Brendel, par* 
 ticularly the latter, are all opposed to it. A late writer, Dr. Al- 
 bert, denies that the organs, while lying in the chest, can be so 
 filled with air, either by the mouth or by means of a tube, as to 
 be rendered buoyant in water. In performing this experiment 
 several times, he never found a trace of air in the air-cells, and 
 he is therefore clearly of the opinion, that the objection itself 
 has no foundation. The experiments related by Mr. Taylor, re- 
 lative to the same point, serve to throw much doubt on the sub- 
 ject. In some cases, inflation was effected by a tube ; in others, 
 by the mouth. In one case, only about one-thirteenth part of 
 the structure of the lungs had received air. In another, not a 
 trace of air was found in the lungs, it having passed entirely into • 
 the abdomen. In another, although the attempts were continu- 
 ed for upwards of half an hour, not a particle of air was found 
 to have penetrated into them. In another, no air had entered 
 the lungs ; and in another still, a small portion was found to have 
 penetrated into them, which, however, was readily forced out by 
 compression. Taylor's Med. Juris., 369 - 70. 
 
INFANTICIDE. 159 
 
 In all these cases, artificial inflation was resorted to for the 
 purpose of resuscitating the child ; and it should be borne in 
 mind, that, for a medico-legal purpose, this is the only motive 
 worth considering that would be likely to lead to artificial infla- 
 tion. The motive of convicting the mother of the crime of 
 murder, by resorting to the artificial inflation of the lungs of 
 her still-born child, is so remote as not to be entitled to any 
 consideration. This, therefore, together with all attempts arti- 
 ficially to inflate, in order to raise an objection to the hydro- 
 static test, should be thrown entirely out of view- in our esti- 
 mate of the force of this objection. The authorities in favor of 
 the possibility of artificial inflation, may have arrived at their 
 conclusions from attempts of the last mentioned character. Al 
 tliough, therefore, these authorities are numerous, and some of 
 them very high, and although its possibility is generally admitted, 
 yet the almost insurmountable obstacles in the way of it, very 
 much weaken the objection, and reDder it really of very little 
 practical force. 
 
 Admitting^ however, as medical jurists generally do, the force 
 di' the objection, what are the answers that can be made to it 1 
 
 1. Recourse is recommended to be had to the static test, 
 upon the principle that if the inflation arise from natural respi- 
 ration, the inflow of blood into the lungs will increase their abso- 
 lute weight, which is ascertained by this test. 
 
 2. The second means of discrimination is based upon the fact 
 above mentioned, viz., the change in the circulation consequent 
 upon respiration. Artificial inflation can produce no change in 
 the circulation. If, therefore, tho arteries and veins which cir- 
 culate the great mass of blood through the lungs, are found in a 
 state of vascular distention, it is a fact going to show that respi- 
 ration and pulmonary circulation have taken place. If, on the 
 contrary, they are destitute of blood, and .in a collapsed state, 
 artificial inflation is the more probable. 
 
 3. Pressure. It is asserted by Beclard, that the lungs of a still- 
 born child, which are made to float by artificial inflation, may, 
 by pressure, be deprived of all the air introduced into them ■ 
 while in lungs that have respired, this is impossible. There is 
 
ItO MEDICAL JURISPRUDENCE. 
 
 much contrariety of opinion in regard'to the sufficiency of this 
 criterion. The experiments of Professor Bernt, as also those of 
 Professor Mendel, of Breslau, lead to a contrary conclusion. It 
 was introduced into England by Mr. Taylor and Mr. Jennings. 
 The former concludes that air introduced by artificial inflation 
 may be expelled by compression, if the experiment be properly 
 performed, and the pressure continued a sufficient length of time. 
 The latter states that air introduced into the lungs by artificial 
 inflation, may be expelled by pressure, so that the lungs -will 
 sink in water ; and that after respiration, the air cannot be ex- 
 pelled from the lungs, without completely breaking down the 
 structure of every part of the organ, so but what they will still 
 continue to float. Mr. Taylor says, it must be admitted, that 
 there are no means of distinguisliing feeble respiration from arti 
 ficial inflation. That in both these cases, the physical character* 
 of the lungs will remain unaltered, and the pressure will iu 
 neither case destroy their buoyancy. 
 
 Dr. Guy says, that his own experiments have proved that 
 lungs completely distended by artificial inflation cannot be made 
 to sink by a degree of pressure short of that which will destroy 
 the texture of the lung ; and that lungs so distended with air 
 differ from those which have breathed completely only by re- 
 quiring somewhat more pressure to make them sink. Guy's 
 Principles of Forensic Medicine, 167. 
 
 Thus he concludes, that where portions of lungs which have 
 been inflated, are submitted to the same amount of pressure 
 with portions which have respired, the only difference observable 
 is one of degree, neither portion sinking till its texture is de- 
 stroyed ; but a less amount of destruction being necessary in the 
 former than in the latter. Ibid, 168. 
 
 It follows, therefore, that pressure does not distinguish imper- 
 fect respiration from" imperfect inflation, nor complete inflation 
 from complete respiration. In conditions intermediate betweeen 
 these two extremes, if, on submitting the buoyant portions of the 
 lungs to pressure, the air contained in the air-cells can be expelled, 
 and the lungs be made to sink without destroying or injuring 
 
INFASTICIDK. 161 
 
 their texture, we may be justified in stating that such portions 
 of lung have been inflated. 
 
 4. Incompleteness of inflation. Art, it is saidj can never 
 completely inflate the lungs by the ordinary means, while they 
 remain in the thorax. The right lung is more easily inflated 
 than the left; and after strong attempts at artificial inflation, 
 there will, it is said, remain the lower extremity of the left lung 
 in its original collapsed state, and which will therefore float but 
 imperfectly if at all. This is in all probability true, but jt seems 
 to admit of a ready answer, viz., that the same difficulty in per- 
 meating the extreme parts of the left lung, exists in imperfect 
 respiration as in artificial inflation. It seems proved by the ex- 
 periments of M. Portal and others, that the air-cells of all parts 
 of the lungs are not simultaneously distended with air on the 
 commencement of respiration ; that the inflation commences in 
 the right lung, and, after extending through that, gradually em- 
 braces the left, and continues until every part of that becomes 
 also distended. There is, therefore, little if any force in this 
 answer, which was first suggested by M. Marc. 1 Beck's Med. 
 Juris., 373. 
 
 3. Another objection belonging to this class is, that there may 
 be an emphysematous condition of the lungs which may make 
 them float in water, although respiration has never taken place. 
 To constitute a valid objection, the emphysema can only be form- 
 ed by some peculiar action of the tissues themselves ; because, if 
 the air be introduced through the air-tubes by natural respira- 
 tion, it is not emphysema ; and so, also, if its introduction be 
 owing to artificial inflation, it then belongs to the objtction under 
 that head. Such seems to be the general understanding in rela 
 tion to emphysema. 
 
 It sometimes happens, says Dr. Cummin, that infants suffei 
 violence in the birth ; the labor, perhaps, being tedious, and the 
 mother malformed. The sides of the chest may be so pressed 
 against the substance of the lungs as to do those organs injury ; 
 they become inflamed and puffy, containing air in large vesicles 
 on their surface, and that is what is termed emphysema. It has 
 been observed, that when it has become necessary to extract an. 
 
 It 
 
162 MEDICAL JURISPRUDENCE. 
 
 infant by the feet, especially if the pelvis is narrow, the lungs, 
 or portions of them, have floated, although the child certainly 
 never had breathed. No appearances of putrefaction have, in 
 such cases, been discoverable upon the body of the infant. 
 Hence Lecieux has endeavored to explain it, by supposing that 
 the lungs have suffered a sort of contusion ; that an effusion of 
 blood has taken place into their tissue, which, by undergoing a 
 change, had given rise to the formation of some bubbles of air, 
 and thus produced the buoyancy of some part of the lungs. 
 
 Dr. Guy is disposed to regard this as the incipient process of 
 putrefaction, and remarks, that it is probably the most apt to 
 occur in parts of the body filled with fluid, as in lungs simply 
 congested, or in the cases of pulmonary apoplexy, which are apt 
 to occur in children delivered after tedious labor, or extracted by 
 instruments. He compares it to the case of effusion of blood on 
 the brain, which can cause the rapid formation of gas under the 
 membrane, before putrefaction has commenced so as to be re- 
 cognized by its ordinary signs, and of this he says he has seen 
 two well marked instances. Guy's Principles of Forensic Medi- 
 cine, 163. 
 
 If this be but the incipient process of putrefaction, this objec- 
 tion may be considered as merged in that first mentioned. The 
 air, thus formed, may, according to Chaussier, be easily pressed 
 out by squeezing in the hand the portion of the lung in which 
 it is found, and, after being thus squeezed, it will float in water. 
 1 Beck's Med. Juris., 374. 
 
 4. It has been urged as a further objection, that the head of 
 the child may be first born ; that when the mouth is protruded, 
 it may breathe, and loose its life before its birth is finally com- 
 pleted. 
 
 Although the occurrence of this fact is by some denied' to be 
 possible, yet there is undoubted evidence going to show not only 
 the possibility of its breathing, but also of its crying, while in 
 this situation. Its breathing may, in this manner, be tolerably 
 perfect, while yet within the empire of intra-uterine life. This 
 must, however, be an event of such rare occurrence as hardly to 
 justify here a very full discussion of the force and effect to be 
 
INFANTICIDE. 163 
 
 given to it. Three things may be briefly remarked in relation 
 to it : 
 
 1 . The event itself is of very unfrequent occurrence : 
 
 2. Whenever it does occur it indicates such a capacity in the 
 passages of the mother as to afford the best possible chance of 
 its being born alive : 
 
 3. When its death occurs it will generally be owing Cither to 
 the natural debility of the child, to pressure on the umbilical 
 cord interrupting the fcetal circulation, to the cessation of labor 
 pains, to unusual shortness of the umbilical cord, to a preter- 
 natural enlargement of the body of the child, or to a tumor on 
 some part of its body, mechanically interrupting parturition. 
 These are many of them causes that will be apparent on exami- 
 nation, and hence will themselves indicate the cause of death. 
 
 To these may also be added the fact — that although several 
 instances are on record of the occurrence of this event, yet it is 
 rare indeed that a death has ever taken place prior to delivery. 
 There is not, therefore, much force to be attributed to the ob- 
 jection. 
 
 5. It has been further objected that a child may respire while 
 ret in the womb, and before any portion of it is delivered. 
 
 To this it may be answered, that respiration while in the womb, 
 ind prior to the rupturing of the membranes, may be safely pro- 
 nounced a physical impossibility. There is no well authenticated 
 Instance of this upon record. 
 
 ' Respiration may occur while the head of the chid is in the 
 vagina, but it must either be in delivery by the feet, when the 
 whole body but the head is protruded, or in the case of a head 
 presentation, while the head is in the passages, after the mem- 
 branes are ruptured, and when a hand is introduced to accelerate 
 a tedious labor. The first could not well occur in medico-legal 
 practice. And the second is of no appreciable value as an ob 
 jection, as the introduction of the hand implies the presence and 
 agency of the accoucheur or some one present assisting in the 
 delivery. So also have there been instances, although extremely 
 rare, where respiration has taken place in the uterus itself, after 
 the rupture of the membranes, in the case of a face presentation ; 
 
164 MEDICAL JURISPRUDENCE. 
 
 the mouth of the child being at the os uteri, and the passages 
 being dilated by the introduction of the hand of an attendant, 
 the finger entering the mouth of the fcetus. Face presentations 
 are of very rare occurrence, it being ascertained from observa- 
 tions made at the Hospital of Maternity at Paris, that one in 
 three hundred deliveries was a fair average of the frequency of 
 this kind of presentation. The peculiar circumstances of dilata- 
 tion of the passages, and communicating with the mouth of the. 
 fcetus would be probably of still rarer occurrence. In addition 
 to all this it must be remarked that all the respiration that can 
 possibly take place in these situations must be of so extremely 
 imperfect a character, provided death occurs before delivery, as 
 to render the objection of small moment ; and if the child sur- 
 vive, and respiration be fully established, as seems to have been 
 generally the case, it falls entirely to the ground. 1 Beck's Med. 
 Juris., 379, et seq. ; Taylor's Med. Juris., 375 - 6 ; Guy's Principles 
 of Forensic Medicine, 174-5. 
 
 2. There is also another class of objections of quite a different 
 character from those already considered. These are to the effect 
 that a child may have been born alive, notwithstanding the lungs 
 sink in water. 
 
 The first and most formidable objection urged under this class 
 is, that the child may have breathed, and yet the lungs, in con- 
 sequence of diseases of various kinds, may have their specific 
 gravity so increased as to cause them to sink in water. Along 
 with this may also be considered the further objection, that the 
 respiration may have been of so incomplete and imperfect a cha- 
 racter as that the lungs shall not have been rendered sufficiently 
 buoyant to float in water, although the child was born alive. 
 The former may possibly be the cause of the latter, or the latter 
 may exist without the former. 
 
 The fact must be admitted that the lungs of adults are liable 
 to be so affected by disease, as to render them specifically heavier 
 than water, so that they will sink when placed in it. Peripneu- 
 mony, tubercular formations, inflammation of the lung, a. sphir- 
 rous condition, may all have that effect. 
 
INFANTICIDE. 1C5 
 
 It is to be borne in mind, however, that most of the diseases 
 tending to hepatise or indurate the lungs, or to effect such a 
 change in their structure as to render them specifically heavkr 
 than water after the occurrence of respiration, arise the most 
 commonly from some functional derangement of those orgar.s, 
 and so far as that is a cause, could have no existence while they 
 remained in a fcetal state. The causes that would result in the 
 production of such diseased affections must, in that state, certain- 
 ly be less numerous, although no one Can doubt • the possibility 
 of their occurrence. 
 
 Disease may supervene after the establishment of respiration 
 in cases that may become subjects of medico-legal enquiry, but 
 these must necessarily be of very rare occurrence, and when it 
 does take place would still more rarely affect the whole lung, so 
 that portions of it would still remain having sufficient inflation 
 to float in water. Guy's Principles of Forensic Medicine, 161. 
 
 Diseases that are the most likely to influence or change the 
 condition of the lungs, in reference to their specific gravity, are 
 those which tend to consolidate the air cells, as hepatisation and 
 schirrous. There may be also in some cases cedema or congestion. 
 In the latter case the cause of their sinking would be obvious. 
 So also a hepatised portion of lung may be known by its greater 
 firmness on being cut with a knife, and the impossibility of arti- 
 ficial inflation. Taylor's Med. Juris., 364. 
 
 The answer made to this objection by Dr. Beck, 1 Beck, 386, 
 is, " that the objection takes it for granted that the child has 
 breathed ; whether feebly or vigorously is a matter of no conse- 
 quence. Some part, therefore, of the lungs must contain air, and 
 although the quantity of it may be too small to cause the whole 
 of the lungs to float, yet if they be divided into a number of 
 pieces, and any of them remain On the surface, there can be no 
 hesitation about the conclusion to be drawn. Fodere states 
 that he frequently made experiments upon lungs that were schir- 
 rous, or had congestions of blood, and he uniformly found, that 
 although they sunk when put into water entire, yet, when cut 
 into pieces, some Of them always floated." The same answer is 
 also given to the objection that the respiration may have been sc 
 
166 MEDICAL JURISPRUDENCE. 
 
 feeble and imperfect that the lungs may not have received a suf 
 iiciency of air to make them altogether float in water. 
 
 There is, however, a class of cases as stated by Mr. Taylor, in 
 which the lungs show no signs of disease, but appear after respi- 
 ration simply to retain their fcetal condition. It differs from 
 hepatisation, because they may be artificially inflated, which they 
 are not susceptible of in the case of hepatisation. Life may con- 
 tinue many hours and even days, after respiration is established, 
 and yet the lungs exhibit no indication of it. Taylor's Medical 
 Jurisprudence , 364. 
 
 The explanation of this is no very easy matter. Dr. E. Joig, 
 of Leipsig, supposes that the act of parturition and the duration 
 of the process, materially affects the system of the child ; that if 
 either, as a result of that, or of original weakness or defect in the 
 fcetal constitution, the first inspirations made are feeble or im- 
 perfect, the organs of respiration will become only partially dis- 
 tended, the remaining portions still retaining their fcetal condi- 
 tion. This he considers as really a diseased state, and calls it 
 " atelectasis," incompleteness of expansion. He supposes that 
 children born after a very easy and rapid delivery are liable to 
 it, and thus that it may be found in a mature as well as an im- 
 mature child. It may arise from long continued pressure on the 
 head during delivery ; or from haemorrhage from the cord ; from 
 all the causes that produce asphyxia in a new born child even in 
 a slight degree ; in fine from any cause tending very much to 
 weaken the vital powers of the child before its actual birth. 
 When, from any of these causes, only a part of the lungs become 
 distended, the child may not afterwards acquire sufficient strength 
 to fill the remaining portions, and thus may live on for hours or 
 days or possibly weeks with this imperfect respiration, becoming 
 occasionally convulsed, until it finally dies from exhaustion. 
 Those portions of lung not distended become afterwards consoli- 
 dated or hepatised, losing all traces of their vesicular structure. 
 Taylor's Med. Juris., 365. 
 
 A case is mentioned by Mr. Taylor of a child who died, at the 
 age of six months, as was supposed from suffocation. The whole 
 of the inferior lobe of the right lung, so far as color, density and 
 
INFANTICIDE. 1 67 
 
 structure were concerned, was precisely like the lungs of a foetus. 
 No air had penetrated into it, and its vesicular structure was 
 perfectly destroyed. The whole lung floated in water, but the 
 foetal part, on being separated, immediately sank. This was 
 considered a case of atelectasis. Another case is mentioned by 
 Dr. Albert of a child that died thirty-six hours after its birth, 
 the right and lower lobe of the left lung, being found in the foetal 
 state, and immediately sank when immersed in water. Taylor's 
 Med. Juris., 365. 
 
 This condition of the lungs may be more frequent than has 
 generally been supposed. Professor Bernt relates a case of a 
 seven months' child that died two hours after birth, and when 
 its lungs were divided and placed in water, every fragment sank. 
 Remer reports another in which the lungs both entire and di- 
 vided, sank in water, although the child survived its birth four 
 days. Orfila found, in a child that had lived eleven hours, every 
 portion of the lungs when divided, to sink on immersion. In 
 three other cases, two of mature children, the subjects having 
 survived birth four, six and ten hours, the lungs sank when di- 
 vided. Other instances are mentioned by Daniel, Schenk and 
 Osiander. Rid, 366. 
 
 The greater number of these instances were probably of pre- 
 mature children ; but recent observations have shown that it is 
 by no means confined to them. Mr. Taylor mentions two in- 
 stances as having occurred under his own observation, the one 
 of a mature male child in which the lungs sank in water although 
 the child had survived its birth for the period of six hours ; the 
 other of a female twin, which survived twenty-four hours, and 
 although the lungs were divided into thirty pieces, yet every 
 piece, on being subjected to the test, sank. Taylor's Med. Juris., 
 366. 
 
 The question may here arise, as to what is the exact value of 
 the hydrostatic test, in trials for infanticide. On this subject 
 the opinions of men, especially of the medical profession, have, 
 at different times, considerably varied. Dr. William Hunter 
 threw much doubt upon the sufficiency of the test to prove life 
 or death at birth. Later authorities, particularly Dr. Beck, 
 
168 MEDICAL JURISPRUDENCE. 
 
 maintain that the test is capable of proving whether the child 
 has been born alive or not. In the actual administration of the 
 law, its sufficiency has always been viewed with doubt and dis- 
 trust. It is no longer considered conclusive either in England 
 or Germany. Guy's Principles of Forensic Medicine, 170. 
 
 The law in this country requires not merely presumptive, but 
 actual proof that the child was born alive. The legal presump- 
 tion is, that the child was born as it is found, viz., divested of 
 life. 
 
 To rebut this presumption nothing short of clear, positive 
 proof is sufficient. To assume the position that such proof is 
 afforded by this test alone is certainly not sustainable. It may 
 be fairly reckoned as one among the proofs going to show whether 
 respiration has occurred or not in the case on trial. From the 
 establishment of the fact of respiration, or its absence, arises an 
 inference of very considerable weight in relation to the fact of 
 life or death at birth. 
 
 It only remains to point out the method, or to give some prac- 
 tical directions relative to the manner of applying this test. 
 
 1. Before removing the lungs from the thorax care should be 
 taken to note the general size and configuration of the thorax, 
 whether it present a flattened or arched appearance ; the position 
 of the lungs within the thorax, more particularly their relative 
 situation to the diaphragm and pericardium ; their volume, shape, 
 color, and whether any evidences of putrefaction be present. 
 
 2. Tie the aorta and vena cava near the heart, cut beyond the 
 ligature, divide the trachea, and remove the lungs, together with 
 the heart, from the thorax. Care must be taken not to injure 
 the texture of the lungs, or that of the surrounding organs. 
 
 3. Before proceeding to cut into them a thorough examination 
 must be made of their surface. This examination is important. 
 If the surface be found of a uniform color, and the substance of 
 a uniform firm texture, like that of the adult liver, it indicates 
 that respiration has not taken place. If it is found mottled with 
 spots of a bright vermillion hue, or of a rose color, and these 
 spots contain developed air cells, then respiration or artificial 
 inflation has taken place. The extent of these spots, and the 
 
INFANTICIDE. 169 
 
 number of cells so developed, will measure the extent to which 
 one or the other of these processes has been carried. These 
 appearances will usually be so well marked, that the eye can 
 detect the signs of the admission of air into the lungs where the 
 quantity is too small to render any portion of their texture buoy- 
 ant. Guy's Principles of Fwensic Medicine, 172-3. Air which 
 is the product of putrefaction is clearly distinguishable from this 
 It is situated in the cellular membrane, and may be removed by 
 the slightest pressure of the finger. The ecchymoses which are 
 occasionally, although very rarely, seen on the surface of the 
 lungs, are nearly of the color of the lungs themselves, and are 
 distinguishable by having no traces of a developed texture. Ad- 
 ditional observation should also be made with the view to deter- 
 mine the fact of putrefaction, and whether any indications of a 
 diseased condition be present. 
 
 4. Provide a convenient vessel containing pure fresh water, 
 unimpregnated with any saline matter, the temperature to be 
 that of the surrounding atmosphere. This is a matter of some 
 importance, because the specific> gravity varies with the tempe- 
 rature. If the water be too hot, it will expand the lungs and thus 
 tend to make them float ; if too cold, it may contract the air cells, 
 expel some of the air and thus give them a tendency to sink. 
 Saline matters give the water a greater specific gravity, and im- 
 part to it a buoyancy that the pure fresh water does not possess. 
 1 Beck's Med. Juris., 289. 
 
 5. Place the lungs, together with the heart, in the vessel of 
 water, and observe whether they float or sink ; and if the former, 
 whether above the surface of the water or under it ; and if the 
 latter, whether they do so rapidly or gradually. 
 
 6. They should then be taken from the water, the pulmonary 
 vessels tied, the lungs separated from the heart and weighed. 
 
 7. Next replace the lungs, without the heart, in the water, and 
 see whether they float or sink, and in what way. 
 
 8. The two lobes should then be separated from each other. 
 Each one of them should be subjected to the test in the same 
 manner as both had been. It should be carefully noticed whether 
 
170 MEDICAL JURISPRUDENCE. 
 
 there is any difference in their floating or sinking, and which, if 
 dither, floats or sinks the most readily. 
 
 9. Each lobe should then be divided into a number of pieces, 
 some of which should be taken more from the surface and others 
 from the centre, taking care to keep separate the pieces from 
 each lung. 
 
 10. While cutting into the lungs, care should be taken to ob- 
 serve whether there be any crepitus, whether the pulmonary 
 vessels are charged with blood ; or whether there be any traces 
 of disease. 
 
 11. Subject each piece to the test, and observe whether they 
 all float or sink, and whether readily or not, and keep separate 
 those that do, from those that do not. 
 
 12. If any float, submit them to a firm pressure between the 
 thumb and finger, or in a twisted cloth, or mould them with the 
 thumb in the palm of the hand. Then replace them in the 
 water and observe whether they still continue to float. 
 
 13. In all unskilful attempts to inflate the lungs of a child 
 through the mouth, air is introduced in considerable quantity 
 into the stomach. There should be, therefore, an examination 
 of that organ, with the view of ascertaining whether there is in 
 it any contained air. The absence of it would tend to prove 
 that artificial inflation had not been practised. Guy's Principles 
 of Forensic Medicine, \14t. 
 
 10. What inferences relative to life are to be derived from the 
 state of the diaphragm, discharge of the meconium, and state of 
 the bladder'? 
 
 The state of the diaphragm is essentially modified by the act 
 of respiration. Previous to .that act, it is found high up in the 
 thorax. As soon as respiration commences, the dilated lungs 
 require more room, and the cavity of the chest must necessarily 
 enlarge itself in every direction. From being compressed and 
 flattened, it becomes elevated and arched. The necessary con- 
 sequence is, that internally the diaphragm descends. The best 
 mode of measuring the elevation or depression of the diaphragm, 
 is by the corresponding ribs. 1 Beck's Med. Juris., 391. 
 
 The discharge of the meconium shortly after birth, if the child 
 
INFANTICIDE. 171 
 
 is born alive, affords another indication of life at birth. This is a 
 dark, pitchy matter, contained in the intestinal canal of the 
 fcetus. It is considered by many to be bile collected in the fcetal 
 liver, and propelled from that organ into the intestinal canal by 
 the compression sustained by the liver on the commencement of 
 respiration. The same compression, it is supposed, afterwards 
 expels it from the intestinal canal. It has been asserted, that 
 there is no instance in which infants born at the end of the ninth 
 month have ever suffered this evacuation previous to their birth, 
 but there is at least one instance to the contrary, mentioned on 
 the authority of Denman. Ibid, 391. 
 
 As to the state of the bladder, it contains a considerable quan- 
 tity of urine prior to birth. If found empty, it would raise a 
 presumption that the child had been born alive, and had lived 
 sufficiently long to pass its urine by its own efforts. This is not, 
 however, deemed of much value. A child may possibly void 
 its urine before birth, or it may be born alive and die before 
 doing it. It would, therefore, be unsafe to place reliance upon 
 that, especially when unattended by other proofs. 1 Beck's Med. 
 Juris., 391 -2. 
 
 1 1 . If born alive, how long did the child survive its birth 1 
 
 The indications of the time which has intervened between the 
 birth of the child and its death, are derived principally from the 
 changes which take place in the organs of circulation, in the state 
 of the umbilical cord, and in that of the skin. It may become 
 desirable to ascertain this period of time in order to connect the 
 deceased child with the supposed mother, or for other purposes 
 included in the general investigation. 
 
 The peculiarities of the fcetal circulation have already been 
 briefly alluded to. It is principally in the gradual closure of the 
 fcetal openings, which occurs on the change in the circulation 
 which takes place at birth, that the proofs of this intervening 
 period of time are to be sought. These changes will be noticed : 
 
 1. In the umbilical arteries and vein. The change in these 
 becomes sooner manifested than in any other of the fcetal peculi- 
 arities of circulation. The umbilical arteries, which are continu- 
 ations of the iliacs, and whose office it is to carry the blood of 
 
172 MEDICAL JURISPRUDENCE. 
 
 the foetus to the placenta, are the soonest obliterated. Still, their 
 obliteration is gradual, and is accomplished by a continual dimi- 
 nution in their caliber, and an increase in the thickness of their 
 coats, more especially in the immediate neighborhood of the 
 umbilicus. This is observable at the end of the first twenty four 
 hours. At the end of two days, these changes extend from the 
 umbilicus, embracing a greater part of the length of the arteries ; 
 and at the end of the third day, reach nearly to their termination 
 in the iliacs. The degree and extent of their obliteration will 
 therefore afford some indications of the length of time the child 
 has survived its birth. 1 Beck's Med. Juris., 343 ; Guy's Prin- 
 ciples of Forensic Medicine, 177. 
 
 The changes proceed somewhat slower in the umbilical vein, 
 the office of which is to carry the blood from the placenta to the 
 foetus. Very little change is observable in this during the first 
 three days after birth, except that a slight contraction is noticed 
 to take place. On the fourth day, this is more marked j and on 
 the fifth, it is generally complete. Indications of the desired 
 period of time may be collected from comparing the more rapid 
 obliteration of the umbilical arteries with the slower obliteration 
 of the vein. 
 
 2. The ductus venosus, the office of which is to convey a por- 
 tion of the blood of the foetus directly from the umbilical vein to 
 the ascending cava, and through that to the heart. The establish- 
 ment of respiration so changes the circulation that this organ is 
 soon found in a collapsed state and empty of blood. The period 
 at which this change takes place is variable. In twenty infants 
 who had lived three days, this duct was found empty and oblite- 
 rated. 1 Beck's Med. Juris., 341 -2. 
 
 The changes that take place in it are generally found to be the 
 next that succeed those of the umbilical vein. 
 
 3. The ductus arteriosus. The office of this, in the foetal state, 
 is to convey a large portion of the blood sent into the trunk of 
 the pulmonary artery directly into the aorta. The succession of 
 changes by which this becomes divested of blood and converted 
 into a ligament, usually next succeeds those of the ductus veno 
 sus. This succession has been made the subject of close ibves 
 
INFANTICIDE. 173 
 
 tigatiou by Professor Bernt, of Vienna, and hence is known as 
 the Vienna test. The vessel itself is about half an inch in length, 
 cylindrical, and as large as the pulmonary artery. According :o 
 the observations of Professor Bernt, a very few respirations pro- 
 duce the effect of destroying the shape of the vessel, and of 
 causing it to contract towards the aorta. 1 Beck's Med. Juris., 
 339-40; Guy's Principles of Forensic Medicine, 178. It then 
 assumes the shape of a truncated cone, the base of which is to- 
 wards the pulmonary artery, and the apex towards the aorta; 
 although he says sometimes the contrary of this is observed. If 
 the child has survived its birth for some hours, or for a day, the 
 cylindrical shape is again resumed, but very much diminished 
 both in length and diameter. If life has continued for some 
 days, or a week, the duct becomes wrinkled and shortened to the 
 length of a few lines, while its diameter becomes diminished from 
 the size of a goose quill to that of a crow quill. At the same 
 time, there will be found to be a corresponding increase in the 
 diameter of the branches of the pulmonary artery. At the 
 eighth day, the duct is obliterated in half the children; and 
 about the ninth or tenth, in all of them. 
 
 Some experiments have been subsequently made by others, 
 particularly by Orfila, with the view of testing the correctness 
 of Professor Bernt's conclusions. In eight cases detailed by Or- 
 fila, only four were found to present the appearances stated by 
 Bernt. Considerable doubt is thus thrown upon the strict accu- 
 racy of the Vienna test. Nevertheless, this duct ought to be 
 examined whenever it becomes desirable to ascertain the pro- 
 bable length of time the infant has survived its birth. 1 Beck's 
 Med. Juris., 340-41 ; Guy's Principles of Forensic Medicine, 178. 
 
 4. The foramen ovale. This is a septum between the right 
 auricle and the left, its office being to afford a passage for a part 
 of the blood directly from, the right to the left auricle. This, in 
 the great majority of cases, is the ftetal- opening that last closes. 
 The time of its closure is found to be extremely variable. Its 
 final closure leaves a depression called the fossa ovalis. In one 
 out of eighteen infants of a day old, it was found closed. So, 
 also, in four out of twenty-two of two days old ; in three out of 
 
174 MEDICAL JURISPRUDENCE. 
 
 twenty-two of three days old ; and in two out of twenty-seVen 
 of four days old. No precise period can be fixed for the oblite- 
 ration of this aperture. It sometimes continues open for years, 
 and there are some cases on record where it has never closed, 
 and yet no dangerous consequences have resulted to the indi- 
 vidual. 
 
 Professor Bernt, of Vienna, has here also called the attention 
 of medical jurists to a succession of changes, preceding its final 
 closure, which he supposes will indicate the period the child has 
 survived its birth. These changes consist principally in the 
 position of the aperture of the foramen. Anterior to respiration, 
 this is found at the lowest part of the valve. As soon as respi- 
 ration commences, it is gradually turned towards the right. It 
 moves upward on the right side, until, after revolving around the 
 right edge of the valve, it is found at the upper instead of the 
 lower side of it. Here it usually disappears. These changes, 
 according to Bernt, not only indicate the existence of respira- 
 tion, but also the different periods of time during which it has 
 continued. 
 
 Although there is, no doubt, something in this succession of 
 changes, yet there is probably much less of regularity than is 
 here stated ; and so much accuracy is required in order to de- 
 rive any safe conclusions from them, that to the generality of 
 physicians it must be possessed of little value. It may be, how- 
 ever, useful in confirming other tests, and ought not, therefore, 
 to be entirely disregarded. Beck's Med. Juris., 337-8 ; Guy's 
 Principles of Forensic Medicine, 178. 
 
 5. The umbilical cord. This comprises the umbilical arteries 
 and the umbilical vein. In the child recently born, the cord is 
 fresh, firm, round, and of a bluish color. Its vessels contain 
 blood, and its size varies according to the quantity of gelatinous 
 fluid it contains. The changes which occur in it, and which in- 
 dicate the longer or shorter continuance of life, are — 
 
 1 . The withering of the cord. This commences at the ligature, 
 and gradually extends to the .umbilicus. The time of its com- 
 mencement is various, sometimes beginning directly after birth, 
 sometimes not until some hours have elapsed, but being rarely 
 
INFANTICIDE. 175 
 
 delayed longer than thirty hours, or two days, or at the farthest 
 three days. Thus the withering of the cord takes place from the 
 first to the third day alter birth. 
 
 2. The desiccation or drying of the cord. It first assumes a 
 reddish brown color, becoming semi-transparent. It then ex- 
 hibits a flattened, shriveled appearance, finally becoming trans- 
 parent, and, of a color resembling parchment. Its vessels are 
 obliterated, and it becomes tortuous and dry. The commence- 
 ment of this process dates from one or two to four days after 
 birth. The period at which it becomes complete varies from 
 one to five days, the most usual period being three days. 
 
 This desiccation is a vital process. This is inferred, because 
 the portion of the cord beyond the ligature, which is attached to 
 the placenta, does not desiccate, but decomposes and putrefies like 
 any other dead matter ; and also, because the desiccation ceases 
 as soon as life ceases ; because it does not desiccate at all in a 
 foetus which is born dead ; and because, on the dead subject, the 
 cord undergoes a real putrefaction, which is altogether different 
 from this desiccation. 
 
 3. The separation or dropping off" of the cord. The period 
 after birth at which this takes place is very various. From the 
 fourth to the fifth day after birth, is the ordinary period at which 
 the cord falls off, although it sometimes happens sooner and 
 sometimes later. As a genera] rule, then, the cord withers during 
 the first day ; desiccation commences at the end of the first, and 
 is complete on the third day. Between the fourth and fifth days, 
 the cord drops off. All this must of course be liable to nume- 
 rous variations and exceptions. 1 Beck's Med. Juris., 346, et seq. ; 
 Guy's Principles of Forensic Medicine, 178-9. 
 
 It has also been remarked, that during the process of desiccation, 
 there is a red or inflammatory circle formed around the umbilicus. 
 This is regarded as the result of vital action, and hence as af- 
 fording an indication that the child was born alive. It would 
 seem, however, to be more frequently absent than present. I 
 has also been present in still born children. It cannot, therefore, 
 be regarded as furnishing much evidence either by its presence 
 or absence. 
 
176 MEDICAL JURISPRUDENCE. 
 
 4. Cicatrization of the umbilicus. This is the last change which 
 occurs, and. takes place usually from the tenth to the twelfth day. 
 The general inferences to be drawn from this source are the fol- 
 lowing. If the cord be found withered, the child must have 
 lived from a few hours to three days ; if desiccated, from one to 
 five days ; if it have fallen off, from one to seven days ; and if 
 the umbilicus have cicatrized, from ten to twelve days. 1 Beck's 
 Med. Juris., 348 - 9 ; Guy's Principles of Forensic Medicine, 179. 
 
 Another source of proofs indicating the length of time the child 
 may have survived its birth is derived from changes in the skin. 
 There is a process of exfoliation of the epidermis which commen- 
 ces on the abdomen, and extends from thence successively to the 
 chest, groins, axillse, intercapular space, limbs, and finally to 
 the hands and feet. The skin sometimes comes off in layers or 
 scales, and sometimes in the form of a dust. This process va- 
 ries in the time of its commencement, and also in its progress! 
 It sometimes begins when the child is but a day old, and occa- 
 sionally is delayed until the third or fourth day. It continues 
 sometimes for thirty days, and, often in feeble and delicate 
 children for two months. It is a vital process, differing from the 
 separation of cuticle, which occurs as a consequence of putre- 
 faction. Guy's Principles of Forensic Medicine, 179 -80. 
 
 The following is a brief summary of the appearances that may 
 be expected to be presented during some of the first days next 
 succeeding the birth, and which indicate the period of time which 
 has elapsed since that event. 
 
 After twenty-four hours. Skin firm and pale, or less red 1 than 
 at birth. Umbilical cord somewhat shriveled. Meconium dis- 
 charged. Lungs generally more or less distended with air. Um- 
 bilical vessels, ductus venosus, ductus arteriosus and foramen 
 ovale all open. 
 
 From the second to the third day. Skin possesses a yellowish 
 tinge, epidermis sometimes appearing cracked, a change which 
 precedes exfoliation. Umbilical cord brown and withered. 
 
 From the third to the fourth day. Skin more yellow, evident 
 exfoliation of the cuticle on the chest and abdomen; Cord desic- 
 cated, of a brownish red color, flattened, semi-transparent and 
 
INFANTICIDE. , 177 
 
 twisted, sometimes the red or inflammatory circle around the 
 umbilicus. But this has been met with in children still born. 
 
 From the fourth to the sixth day. Cuticle separating in the form 
 of minute scales, or of a fine powder. Umbilical cord separating 
 from the abdomen usually on the fifth day. The process of sepa- 
 - ration is — that the membranous coverings become first detached, 
 then the arteries and afterwards the veins. The fcetal openings, 
 the ductus venosus, ductus arteriosus, foramen ovale and um- 
 bilical vessels in the majority of cases found closed. 
 
 From the sixth to the twelfth day. Cuticle desquamating on the 
 extremities, cicatrization of the umbilicus generally complete by 
 the tenth day after birth. There is sometimes an oozing of mu- 
 cus from the cord which retards the formation of the cicatrix. 
 Taylor's Med. Juris., 380-81. 
 
 From all this we may be safe, perhaps, in deriving the follow- 
 ing inferences. 
 
 1. That the closure of the fcetal openings, or of any one of 
 them, is clear proof that the child was born alive, and had con- 
 tinued to live for some hours at least, and more than one day. 
 
 2. Their being found open affords no proof that the child was 
 born dead. 
 
 3. From the succession of changes noticed in the closing of 
 the ductus arteriosus and the foramen ovale, from the different 
 appearances exhibited by the cord, and from the changes which 
 take place in the skin, some conclusions may safely be drawn 
 as to the length of time the child has survived its birth ; although 
 from the great variations noticed in these changes, it will be im- 
 possible to fix the time with any precision, or to make any other 
 than general statements in reference to it. 
 
 12. How long has the child been dead 1 
 
 It may become important to settle this question in reference to 
 the reputed mother. Suppose it ascertained that she was deliver- 
 ed at a certain known time, the time a child had been dead, taken 
 in connection with the period, if any, that had elapsed between 
 its birth and death, would become a material question to settle. 
 
 The question last under investigation can only be settled by a 
 reference to the changes that take place jnthe Hving body ; the pre- 
 
 12 
 
178 MEDICAL JURISPRUDENCE. 
 
 sent, by reference to those which occur in a body divested of 
 life. The solution of this question involves the examination of 
 the putrefactive process. This will be made a subject of sepa- 
 rate discussion hereafter, and to that discussion reference must 
 be had in the settlement of this question. 
 
 All the causes, heat, humidity, access to air, that conspire to 
 hasten on the putrefactive process in the adult, produce the same 
 effect on the body of the infant. It has been remarked that the 
 body of the infant putrefies more rapidly than that of the adult. 
 It parts with its animal heat very fast, and the rigidity which fol- 
 lows is as great, and lasts as long in the infant, as in the adult. 
 
 Accurate experiments are yet wanting to determine the length 
 of time occupied by the several steps of the putrefactive process, 
 in infants and adults respectively. All that can safely be said 
 now on this subject is — that, other things being equal, the pu 
 trefactive process is more rapid in infant, than adult bodies, and 
 this should be taken into consideration in any question of this 
 kind that may be presented. Guy's Principles of Forensic Medi- 
 cine, 183; Taylors Med. Juris., 381. 
 
 13. Is the child really that of the prisoner, the reputed mo- 
 ther ? Has she been recently delivered, and how do the sign' 
 of delivery correspond, as to time, with the appearances ex- 
 hibited by the child 1 
 
 The answer to the second question would furnish some means 
 of answering the first. Most, or all of the subjects of enquiry 
 involved in the second, have already been made matters of disr 
 cussion, and need not be here repeated. 
 
 In reference to the first question, the attention should be di- 
 rected to ascertaining the duration of the pregnancy, and com- 
 paring this with the probable age of the fcetus, No mere exami- 
 nation will be likely to acquaint one with the duration of preg- 
 nancy. To ascertain that, the probable age of the foetus should 
 be compared with the appearances the female exhibits, and the 
 account given by her of its duration. 
 
 The nature of the delivery may also be enquired into with the 
 view of ascertaining whether it was natural or laborious. If the 
 latter, there might be marks of injury upon the child. The re- 
 
INFANTICIDE. 179 
 
 ported age of the infant should be compared with the changes, 
 which the parts of the reputed mother may have undergone since 
 her delivery, to ascertain as to their agreement or disagreement. 
 Its probable age may also be compared with the state of the gen- 
 ital organs of the mother as to marks of injury or recent delivery. 
 Watson on Homicide, 284 - 5. There may be also circumstances 
 of a moral nature involved in this enquiry, with which the medi- 
 cal jurist, as such, has no concern. 
 
 14. What are the diiferent modes by which the life of the 
 child may have been destroyed 1 
 
 This question assumes that several previous ones have been 
 proved. It assumes that an infant, divested of life, is produc- 
 ed ; that its birth is ascertained, so far as to connect it with its 
 mother, whose conduct in relation to it whether innocent or 
 criminal is the subject of investigation. It assumes also that 
 proof has been furnished that it was born alive, otherwise no oc- 
 casion would exist of enquiry into the modes by which its life 
 may have been destroyed. This, therefore, is one of the last en- 
 quiries presented in infanticide. 
 
 These modes of death may be very various, but they may all 
 be ranged under two classes, viz., those which are criminal and 
 those which are accidental. As it may, in every case, be neces- 
 sary to discriminate to which of these two the death is owing, it 
 becomes important to examine both somewhat in detail. 
 
 15. What are the various criminal modes usually resorted to 
 for the purpose of destroying life, and the proofs that evidence 
 them? 
 
 Some of these modes are unattended with any external appear- 
 ances indicating a resort to violence. In such cases as there is 
 nothing clearly indicating a resort to destructive means, it may, 
 and more probably will, be impossible for the medical witness to 
 say whether the death was brought about intentionally or not. 
 Such, for instance, is 
 
 1. Suffocation. Here, slight changes only will be effected. All 
 that is commonly noticed is lividity about the head and face, and 
 slight congestion in the lungs. This mode of death may occur 
 either prior to respiration or subsequent to it. A child may be 
 
180 MEDICAL JURISPKCDENCE. 
 
 born so enveloped in the membranes as to be suffocated before 
 it is liberated, and where for many minutes, it has shown strong 
 signs of life. So, also, immediately on being born, it may faH 
 into the midst of discharges, or on a soft bed, or may be prevented 
 by some similar obstacle from breathing at all. An infant, 
 especially prior to respiration, may be easily destroyed by suffo- 
 cation. 
 
 So also after the commencement of respiration, and when the 
 pulmonary tests may show the establishment of that function, 
 life may be destroyed by suffocation, which may be either acci- 
 dental or intentional. The child after breathing, may fall into 
 fluid discharges, or be overlaid in bed, or have its mouth ob- 
 structed by accumulations of mucus, and thus its death, from 
 suffocation, may innocently occur. So also its death may crimi- 
 nally be brought about by placing wet cloths over its mouth, or 
 thrusting them into it, or by allowing the child to remain closely 
 compressed under the bed clothes, or by its head being thrust 
 into straw, feathers, or such substances. An examination ought 
 always to be made of the mouth and fauces to ascertain if any 
 foreign substances, such as wool, straw, feathers, &c, are to be 
 found there sufficient to indicate the cause of death. In the case 
 of the Queen vs. Mortiboys, tried in 1841, the body was discovered 
 in a box containing wool, was lying on its abdomen with its face 
 raised and mouth open, a small quantity of fine flocks of wool 
 was found in its mouth, and a comforter had been passed twice 
 round the neck, having been tied the second time in a single 
 knot over the chin. The ligature had produced no mark around 
 the neck either externally or internally. The brain was con- 
 gested. The pulmonary tests showed respiration or inflation of 
 the left lung. Death was referred to obstructed respiration, 
 caused partly by the ligature, and partly by the wool, but prin- 
 cipally by the latter. The prisoner was acquitted. Taylor's Med. 
 Juris., 385-6. 
 
 2. Drowning. A woman may cause herself to be delivered in 
 a bath, the child being forcibly retained under water until its 
 life was extinct. In such case no evidence of the mode of death 
 would be found upon the body. If the drowning be subsequenl 
 
INFANTICIDE. 181 
 
 to the commencement of respiration, then precisely the same 
 questions will present themselves, as in the case of persons found 
 dead from drowning, and the same indications of death, from 
 that cause, are to be sought for in the organism of infants as in 
 those of adults. These questions and indications are subsequent- 
 ly discussed. 
 
 3. Cold. Death from cold, as we shall see hereafter, leaves few 
 traces' upon the organization. The evidence is mostly circum- 
 stantial. The situation in which the body is found, the season 
 of the year, the temperature of the air, &c, are all matters to 
 be considered. The body should be examined to ascertain if ' 
 there is not some other cause of death to be found. A new born 
 infant is no doubt more easily affected by a low temperature than 
 an adult, and its death is, therefore, more readily effected by ex- 
 posure to cold. Taylor's Medical Jurisprudence, 387 ; 1 Beck's 
 Med. Juris., 397. 
 
 4. Starvation. It is not clearly settled how long a new born in- 
 fant is enabled to exist without food. Foedere says the neglect 
 of it for twenty-four hours is not unattended with danger. This 
 mode of death necessarily implies that life has been for some time 
 enjoyed, and in this case, therefore, all the tests that go to es-. 
 tabiish the fact of life, should be resorted to in the first place. 
 The signs of death by starvation are the same in the infant as in 
 the adult, and will, therefore, find a more appropriate place for 
 consideration hereafter. Generally starvation will also be found 
 accompanied with exposure, but whether they are wilful or ac- 
 cidental will be a question of fact for the jury. Taylor's Med 
 Juris., 387 ; 1 Beck's Med. Juris., 397-8. 
 
 5. Wounds, fractures and injuries of various lands. Under this 
 head is included a very numerous class of agencies, which are 
 probably among those the most frequently resorted to for the pur- 
 pose of destroying the life of the new born child. In case wounds, 
 contusions or other injuries are found upon the body of the child, 
 the same questions substantially will arise, as in the case of per- 
 sons found dead from that cause. Some additional questions 
 arise, growing out of the peculiarity of the case. One of these 
 is, whether the injury ->ccurred in the course of labor. Until 
 
182 MEDICAL JURISPRUDENCE. 
 
 quite recently the general supposition has been, that fractures 
 of the cranium in new born children were always indicative of 
 violence. It was not supposed possible that there existed any 
 cause, prior to delivery, that could produce such an effect. It 
 is now, however, well settled that fracture of the bones of the 
 cranium may be produced during labor. A case is related by 
 Siebold, of a woman with a very narrow pelvis, who was de- 
 livered by the efforts of nature alone, of a well formed still born 
 female infant, having three fissures in the left parietal bone, and 
 one in the left frontal bone. Michaelis also reports the case of 
 a woman with a well formed pelvis, who was delivered of a child 
 alive at birth, but which expired shortly afterwards, and on the 
 right parietal bone, which during birth had been diverted under 
 the promontory of the sacrum, there were found no less than 
 five fractures. A number of cases of fractures that occurred 
 during labor, are collected by Dr. Schworer, and altogether a 
 sufficient number have been observed to establish clearly the 
 possibility of their occurrence. Taylor's Med. Juris., 389 ; Guy's 
 Principles of Forensic Med., 190. 
 
 The fractures, thus arising, are generally observed to be slight, 
 commonly presenting merely the appearance of a fissure in the 
 bone, usually commencing at the sutures and extending down- 
 ward for about an inch or less into the body of the bone. They 
 are accompanied with extravasation of blood in the same manner 
 as fractures produced after birth. The question that will here 
 occur is, whether there are any points of distinction that will 
 enable the medical jurist to discriminate between those which oc- 
 cured during delivery, and those which were produced at a sub- 
 sequent period. No very satisfactory answer can be given to this 
 question. No other difference can be expected than one in de- 
 gree ; these fractures, as already remarked, being generally slight, 
 and those which are the result of violence, inflicted with the in- 
 tent to kill, being usually much more severe, extensively lace- 
 rating the scalp ; the bones being driven in, and the brain pro- 
 truded. 
 
 A question, however, may arise whether even the latter class 
 of injuries, may not have arisen from the suddenness of the la 
 
INFANTICIDE. 183 
 
 bor, the expulsion of the foetus by the violent contractions of 
 the uterus, so that its head coming in contact with a hard sub- 
 stance, as the floor or pavement, may have thus been the inno- 
 cent cause of their production. In order that such a result should 
 be brought about, it is important, if not necessary, that the wo- 
 man should be delivered while in the erect posture. Although 
 this is by no means common, yet there are instances of its oc- 
 curring, sufficient certainly, to establish the possibility of it. 
 The question of its possibility occurred in a case mentioned in 
 the American Journal of Medical Science, vol. 17, p. 329, in which 
 there was a contrariety in the medical testimony upon that point. 
 As it, however, appeared that instances of that kind of delivery 
 had actually been witnessed, no doubt seems to have been enter- 
 tained but that it was a possible occurrence and might, therefore, 
 take place. Many cases of that kind are mentioned by writers. 
 See Guy, 188 ; Ryan, 142, &c. 
 
 From the numerous experiments and great number of cases 
 collected by Dr. Klein, it would seem that fractures of the crani- 
 um, under, these circumstances, must be of very rare occurrence, 
 He reports one hundred and eighty-three cases, in which the 
 women were rapidly delivered while sitting, standing, or inclined 
 on the knees, the child falling either on the ground floor, or on 
 bare boards, or the pavement, and yet out of the whole number, 
 there was only one instance in which the child was killed, and, 
 so far as could be ascertained by external examination, there 
 was no case in which the bones of the cranium were fissured or 
 fractured. Of these instances one hundred and fifty were de- 
 livered standing. He asserts that there was not one infant in 
 the kingdom of Wurtemburgh, who had experienced this acci- 
 dent Whose skull was fractured, and that all recovered. Ryan's 
 Med. Juris., 142 ; Guy's Principles of Forensic Medicine, 189-90. 
 The experiments made by Chaussier upon the dead bodies of 
 children would seem to lead to a different conclusion. Fifteen 
 still-born children were allowed to fall perpendicularly, and head 
 foremost from a height of eighteen inches on a stone floor. In 
 twelve of the number one or other of the parietal bones was 
 broken. The fractures were greater in proportion as the lengtb 
 
184 MEDICAL JURISPRUDENCE. 
 
 of fall was increased. There are two points of difference in the 
 two cases. In the first the direction in which the body is pro- 
 jected is more oblique, and the fall is not so instantaneous. 
 
 Whether these are sufficient to explain the difference in the 
 result or not, it is perhaps difficult to say ; but as the cases col- 
 lected by Dr. Klein are precisely those in which the question 
 would arise in trials for infanticide, they will have much more 
 confidence attached to them than the experiments of Chaussier. 
 It will follow then that instances in which fractures occur from 
 this cause are very rare, although the possibility of their occur- 
 rence is clearly established. Whenever a suspicion that this 
 may have been the cause of death exists, examination should be 
 had into the circumstances both anterior and subsequent. The 
 volume of the infant's head may be compared with the dimen- 
 sions of the pelvis. The duration of the labor should, if possible, 
 be ascertained ; the position of the woman when the infant was 
 expelled ; the height of the fall ; the substance with w T hich the 
 head might have come in contact ; and particularly the state of 
 the umbilical cord, which, in such a case, ought to be ruptured 
 either at the placenta or umbilicus, and not in the middle, while 
 its extremity should present the sign of laceration. Ryan's Med. 
 Juris., 142 - 3. 
 
 The somewhat peculiar requirements of the law have thrown 
 considerable embarrassment in the way of medical testimony. 
 According to the decisions in the English courts a child is not 
 considered living in law, so that its destruction can be murder, 
 until its body is entirely born. Taylor's Med. Juris., 388. 
 
 Several cases on this point are collected in Taylor, 377. In 
 Rex vs. Brain, it was held that a child must be wholly in the 
 world in a living state to be the subject of murder. In Rex vs 
 Sellis, Mr. Justice Coltman held, that to justify a conviction for 
 child murder, the jury must be satisfied that the entire body of 
 the child was actually in the world in a living state, when the 
 violence was offered to it. This doctrine is perhaps more clearly 
 expressed by Baron Parke in a case of infanticide tried in 1841, 
 reported in Guy's Hospital Reports, April, 1842. He charged 
 the grand jury that " with respect to all cases of infanticide, there 
 
INFANTICIDE. 185 
 
 Is a degree of doubt whether the infant has been born alive. 
 The law requires that this should be clearly proved, and that the 
 whole body of the child should have come from the body of the 
 parent. If it should appear that death was caused during de- 
 livery, then you will not find a true bill." It should be here, 
 however, remarked, that the law regards the time at which the 
 death occurred, in fixing the character of the crime, and not that 
 at which the act was committed. The following case reported 
 in Archhold, 345, will illustrate this. A man by the name of 
 Senior was tried in 1832 for manslaughter, in killing an infant 
 by inflicting injuries on it at its birth. The evidence showed 
 that when the head of the child presented, the prisoner, who 
 practiced midwifery, by some mismanagement, fractured, and 
 otherwise so injured the cranium, that it died immediately after 
 it was born. The point was here taken that as the child was 
 not born at the time the wounds and injuries were inflicted, the 
 prisoner could not be guilty. The judge held that as the child 
 was born alive and died, the case might be one of manslaughter. 
 This opinion was afterwards sustained by the other judges. 
 Thus the criminality is made to depend upon the period at which 
 the injuries proved fatal, and not upon the period at which they 
 were inflicted upon the body of the child. 
 
 It must be easily seen that it will be difficult, if not impossible, 
 for a medical witness to satisfy an enquiry as to whether the 
 whole body of the infant was born or not at the time of the in- 
 fliction of the injury ; because the fact as to whether the body 
 was in part or wholly born would make no difference as to the 
 appearance of the wounds. The most legitimate inferences de- 
 rivable from them are whether they were inflicted during life or 
 after death, and whether the whole body was in part or wholly 
 born at that time can make no difference. 
 
 In addition to the questions already stated, the medical witness 
 will be expected to state whether, in his opinion, the wounds 
 were inflicted before or after birth ; whether they were in fact 
 the cause of the death ; and whether they originated in accident 
 or criminal design. These questions all arise for discussion in 
 
186 MEDICAL JURISPRUDENCE. 
 
 the case of persons found dead, and to that head the further 
 consideration of them is referred.' 
 
 A mode of death that has been sometimes resorted to with 
 success, is the introduction of sharp pointed instruments in different 
 parts of the lody. Some time since, a midwife was executed in 
 Paris for murdering several children by plunging a needle into 
 the head, while it was presenting at the os externum. A similar 
 murderous practice is mentioned by Brendel and Belloc. Sharp 
 pointed instruments, as a means of destroying life, have been 
 thrust into other parts of the child, such as the temples, inner 
 canthus of the eye, spinal marrow, the neck, the thorax, about 
 the region of the heart, and the abdomen. Sometimes, also, 
 down the throat, and up into the rectum. 1 Beck's Med. Juris., 
 398-9 ; Taylor's Medical Jurisprudence, 388 ; Guy's Principles oj 
 Forensic Medicine, 186. 
 
 In cases of this kind, dissection is the only means likely to re- 
 veal the cause. Where suspicion is entertained that an instru- 
 ment has penetrated the brain, the head should be thoroughly 
 shaved ; when, upon examination, it will present a slight ecchy- 
 mosis around the puncture. Pressing this into the substance of 
 the brain, the nature and extent of the injury will be ascertain- 
 ed. The same course must be pursued in punctures which are 
 discovered in other parts of the body. 
 
 Another mode of death sometimes resorted to, is luxation and 
 fracture of the neck. This is accomplished by forcibly twisting 
 the head of the child, or pulling it backwards. In these cases, 
 the vertebrae are fractured, the ligaments ruptured, and death 
 produced by the injury inflicted upon the spinal marrow. The 
 local derangements will, in such cases, reveal the cause of death; 
 the position of the head, the fracture of the first or second ver- 
 tebrae, and the extravasation of blood among the cervical muscles, 
 the latter, more particularly, showing that the violence was com- 
 mitted upon a living subject. 1 Becks Med. Juris., 401. 
 
 This form of injury cannot take place prior to the delivery of 
 a part of the child, and is therefore evidence of intentional vio- 
 lence. It may, however, occur before the entire delivery. 
 
 6. Strangulation. This is not an unfrequent form of child 
 
INFANTICIDE. 187 
 
 murder, and in its investigation are presented many difficult and 
 embarrassing questions. In the first place, it may be stated that 
 the general signs or indications of death from strangulation are 
 essentially the same in the infant as in the adult, but there are 
 several questions arising in the former case, which do not in the 
 latter. But although in the adult a red and swollen appearance 
 of the face and head is indicative of death from strangulation, 
 yet in the infant such appearances must not be hastily assumed 
 as affording such clear indications. In natural births, nothing is 
 more common than for the head and face of the infant to appear 
 swollen and of a deep color at birth, which gradually disappears 
 in a few days, if the child live. 
 
 Where appearances indicate that strangulation has been the 
 mode of death, the first question, perhaps, which would natural- 
 ly present itself, would be, whether that had been effected by 
 the accidental twisting around the neck of the umbilical cord, 
 or whether it was the intentional act of the mother. When the 
 cord happens to be long, it sometimes occurs that during delive- 
 ry, it becomes accidentally twisted around the neck of the infant 
 so tight as to cause death by strangulation. It has been by some 
 supposed, that, in such case, there would be no livid or ecchy- 
 mosed mark or depression on the neck, such as indicates death 
 in the adult from this cause. To this, however, it is answered, 
 that this is not a constant, although an usual accompaniment of 
 death in the adult from this cause ; and also, that it is now as- 
 certained that the umbilical cord may produce a livid or ecchy- 
 mosed depression. Taylor's Med. Juris., 391. 
 
 Still, the fact remains certain, that when the mark is found to 
 be deep and much ecchymosed, with extravasation of blood be- 
 neath it, accompanied with ruffling or laceration of the skin, it 
 cannot proceed from the umbilical cord, but must be attributed 
 to other means. Ibid, 392. 
 
 Here, also, it should be observed, that the legal requirements 
 are of such a character as to render death, by the accidental 
 twisting of the umbilical cord, a matter of difficult if not of 
 impossible occurrence. The rule has already been adverted to, 
 that the entire and complete birth of every part of the child 
 
188 MEDICAL JURISPRUDENCE. 
 
 must be effected before it could be considered as. legally alive. 
 Another rule has also been laid down, which, although not in all 
 respects inconsistent with the one just mentioned, is nevertheless 
 a very different one. That is, the rule announced by Justice 
 Parke, in the case of Rex vs. Enoch, Archibald, 367 : " that there 
 must be an independent circulation in the child, before it can be 
 accounted alive." This occurs upon the establishment of res- 
 piration, when the blood no longer passes from the mother to 
 the child. It may .take place when it is half born, and if it be 
 taken as the only test of life, would, in that respect, conflict with 
 the rule above mentioned. However that may be, let either or 
 both rules be adopted, it is quite obvious, that after the estab- 
 lishment of an independent circulation, or after the entire birth 
 of the child, the accidental twisting of the umbilical cord around 
 its neck so as to produce strangulation, would be a very rare 
 and difficult occurrence. 
 
 Cases have occurred, in which the umbilical cord has been 
 made use of as a means of strangulation. Taylor's Med. Juris., 
 391-2. 
 
 Thus a case of this kind is stated : The umbilical cord was 
 twisted once around the neck, passed under the left arm, over 
 the shoulders, a.id round the neck again, forming a noose or 
 knot ; which, pressing upon the throat, must have caused stran- 
 gulation, as the tongue was protruded, and there were other 
 clear indications of the child's having been strangled. The 
 hydrostatic test showed that the child had respired. Taylor's 
 Med. Juris., 3Q2. 
 
 The other questions that arise, the principal one of which is, 
 whether the strangulation was the cause of death, or intended 
 merely to conceal that cause, belong equally to Infanticide and 
 persons found dead, and require, therefore, no discussion here 
 It should, however, be remarked, that, so far as the external 
 marks of strangulation are concerned, there is no difference in 
 the appearances, whether the constriction takes place during life 
 or immediately after death, and while the body is yet warm 
 Ibid, 393. 
 
 Strangulation may also be effected by the pressure of the fin 
 
INFANTICIDE. 189 
 
 gers on the throat, in which ecchymosis may be found corres- 
 ponding with the cause. 
 
 7. Poisoning. This is a form of death rarely resorted to in cases 
 of infanticide. A case is mentioned by Mr. Taylor, as the earli- 
 est he had ever known, in which the child was. two months of 
 age. Arsenic was administered, and the child died in three 
 hours and a quarter. This could hardly be termed a case of 
 infanticide. If cases of this kind should occur, the rules to be 
 observed in the examination of the stomach and intestines, and 
 the substances contained within them, are the same for the in- 
 fant as for the adult, and may therefore be referred to the sub- 
 ject of poisons. 
 
 8. Intentional neglect of tying the umbilical cord. It has been 
 a matter of much dispute whether the tying the umbilical cord, 
 in case it be either cut or torn, is a necessary precaution to save 
 the life of the infant. By those who deem it unnecessary, it is 
 urged, that the umbilical vessels, whether cut or torn, have a 
 sufficient contractile power to prevent any great loss of blood ; 
 that in other animals, this tying of the cord is unnecessary, and 
 therefore it must be useless in the human species ; and finally, 
 that as, in some surgical operations, the arteries contract sponta- 
 neously, so they should have a similar contraction in the cord. 
 To the first, it is answered, that it is but another mode of say- 
 ing, that, under such circumstances, a fatal haemorrhage does not 
 take place. To the second, that there are points of difference 
 between the structure of the human cord and that of animals. 
 In animals, the umbilical vessels are full of rugae or folds ; the 
 cord is also smaller than in the human species ; and when the 
 animal is born, the vessels are in a manner closed by a kind of 
 cellular structure. Besides, in them, the cord is never cut, but 
 is torn asunder, which gives to the vessels a strong tendency to 
 contract. To the third, it is answered, that arteries of small 
 size may contract, but in those of the same magnitude as the 
 umbilical, fatal haemorrhage may result from not securing them. 
 
 There are, however, some instances on record going to show, 
 that fatal haemorrhage may result from a neglect in tying the 
 umbilical cord. There are also a number of other cases men- 
 
190 MEDICAL JUB.ISPRCDENCE. 
 
 tioned by M. Klein, in which the cord was ruptured, and in 
 some cases close to the abdomen, without being attended by fatal 
 umbilical hgemorrhage. The mere absence of the ligature should, 
 therefore, never be taken as affording, of itself, conclusive evi- 
 dence of death by haemorrhage. 1 Beck's Med. Juris., 393, etseq. 
 The following are enumerated as the indications of death by 
 haemorrhage from the umbilical cord : 
 
 1. Paleness of the surface, with a peculiar waxy appearance : 
 
 2. Paleness and want of color in the muscles of the internal 
 viscera : 
 
 3. Absence of the usual quantity of blood in the heart and 
 blood vessels. It is not necessary to raise an inference of this 
 kind, that the vessels should be found entirely empty. It is said 
 that if three ounces of blood can be collected, it may be pre- 
 sumed that the child has not died of haemorrhage. 
 
 9. Causing the child to inhale air deprived of its oxygen, or 
 gases positively deleterious. This is a species of suffocation, and 
 might have been included under that head. It occurs when the 
 child, as soon as it is born, is shut up in a tight box, and thus 
 excluded fiom the atmosphere. Infants are in general less able 
 to sustain the deprivation of oxygen, than adults. In one case, 
 one was suffocated by some drunken men repeatedly blowing 
 out a candle and holding the wick under its nose. In such cases, 
 the absence of any other assignable cause of death, together with 
 the circumstances under which the child is found, may furnish 
 the means of arriving at conclusions as to the way by which 
 death has been effected. 
 
 16. What are the natural or accidental modes by which the 
 life of the child may have been destroyed 1 
 
 There may be reckoned three classes of causes which may, 
 either at the time or immediately subsequent to delivery, result 
 in producing the death of the infant, without any blame being 
 attached to the mother or any one else. These'are — 
 
 1. Certain accidental circumstances occurring either during, 
 or immediately after delivery, such as the following : The child 
 sometimes comes into the world in a state of supination, and 
 
INFANTICIDE. 191 
 
 may loose its life in consequence of not being removed from that 
 state. 1 Beck's Mel. Juris., 404. 
 
 The manner in which death is produced from this cause, is 
 that the mouth of the infant is so closely applied to the bed- 
 clothes, or 'other substances in its way, or is so completely im- 
 mersed in the pool made by the uterine discharges, as entirely to 
 prevent the occurrence of respiration. 
 
 The labor may also be so sudden and rapid, that the child may 
 loose its life from that cause. There are instances on record, 
 where the expulsion has been so sudden, that the child has been 
 thrown out on the floor, or in the utensil under a night-chair. 
 The labor, in such cases, may very probably be attended with 
 faintings or convulsions of the mother, so as to render her in- 
 competent to afford any assistance to the child. 1 Beck's Med. 
 Juris., 405. 
 
 In such cases, the child may die from the injury, or expire 
 from suffocation. It is obvious, however, that although these 
 are cases of possible occurrence, yet their probability is very re- 
 mote, and when they do happen innocently, there is generally 
 sufficient evidence to be gathered from all the attendant facts and 
 circumstances. 
 
 There may be accidental hsemorrhage from the umbilical cord 
 prevailing to a sufficient extent to destroy the life of the child. 
 We have already seen that there may be an intentional neglect 
 to tie the umbilical cord. This haemorrhage may occur from an 
 accidental rupture and neglect properly to tie it. It should be 
 borne constantly in mind, that those cases which are the most 
 likely to become subjects of medico-legal examination, are the 
 very ones in which we should expect to find the greatest degree 
 of ignorance on the part of the mother. A case involving this 
 question arose in the Queen vs. Dash, in 1842, referred to in 
 Taylor, 383. There was no doubt in that case but that the child 
 had breathed, and that its death had been caused by hsemorrhage 
 from the lacerated umbilical cord. The .medical witness testified 
 that the cord might have been torn through by the weight of 
 the child during labor, and the jury acquitted the prisoner on 
 
19'i, MEDICAL JURISPBUDENrir 
 
 the ground that she might have been ignorant of the necessity, 
 or not have had the power, to tie the cord. 
 
 The child may die from compression of the cord during labor. 
 In the case of a foot or breach presentation, the cord, under 
 strong uterine contraction, may be so compressed, as to arrest 
 the circulation between the mother and the child, which would 
 result in the death of the latter. So also during delivery, the 
 cord may become twisted around the neck of the child, and f hus 
 prove the cause of its death. This latter has sometimes pro- 
 duced death before parturition. This is not properly strangula- 
 tion, as it occurs before the es>TaDhshment 01 respiration. It is 
 simply the arrest of the circulation. 
 
 A child may also die from prematurely tying the umbilical 
 cord. It is well known that circulation by the cord and respire >- 
 tion are vicarious functions. That both cannot exist together, and 
 that the one must cease before the other can become established. 
 It is accordingly laid down as a principle, that the cord should 
 never be tied, or divided, until respiration has become perfectly 
 established. Dr. Dewees states, " that he has seen several in- 
 stances of death, and this of a painful and protracted kind, from 
 the premature application of the ligature." Its too hasty appli- 
 cation, in such cases, has been followed by breathlessness and 
 lividity of countenance. 
 
 The death of the child may also be caused by a protracted de- 
 livery. This may result either from an injury being inflicted on 
 the head during the violent contractions of the uterus, or to an 
 interrupted circulation before respiration is established. In either 
 case, a child, if delicate and feeble, may die from exhaustion. 
 
 So also death may arise from the debility of the child. This 
 would be the most likely to occur in a premature birth. In such, 
 existence may continue for several hours with a very feeble res- 
 piration, and then death may supervene. These cases may ge- 
 nerally be recognized by a want of development in the body, and 
 evident signs of immaturity. 
 
 2. The second class of causes embrace all congenital malforma- 
 tions of organs of such a character as to produce death at birth 
 or soon afterwards. 
 
INFANTICIDE. 193 
 
 These malformations, in order to be fatal, must be of large 
 and important organs. Those of the heart and vascular system 
 may be — a congenital opening between the two ventricles ; the 
 heart consisting only of one auricle and one ventricle ; the aorta 
 arising from both ventricles ; and the pulmonary artery impervi- 
 ous at its origin. There may also be malformations of the. res- 
 piratory organs ; of the alimentary canal ; the stomach, and the 
 intestinal canal, especially that part of it constituting the rec- 
 tum. 1 Beck's Med. Juris., 409, et seq ; Taylor's Med. Juris., 
 384. It is not at all important to go into a minute consideration 
 of these, because if they are of so marked, and severe, a cha- 
 racter, as to be entirely inconsistent with the continuance of life 
 at birth, they will be obvious, and present themselves as the 
 cause of death on a very slight examination. 
 
 3. The third class includes various diseases, either congenital, 
 or occurring immediately after birth. Those which are of so se- 
 vere a character, as to prevent the establishment of new vital 
 processes at birth, or to render the continuance of any such im- 
 possible, have their seats in three of the most essential organs, 
 viz : the heart, lungs and brain. 
 
 In regard to the first, there are none on record that result in 
 the destruction of life so suddenly, as to raise any questions of 
 a medico-legal nature. Guy's Principles of Forensic Medicine, 
 183. 
 
 There is, however, the Morbus caruleus, cyanosis, or blue disease, 
 formerly attributable to the foramen ovale remaining open after 
 birth, which sometimes produces death in a few hours. Besides 
 the peculiar color of the skin during crying, or any other effort, 
 from which the name is derived ; the symptoms are — disordered 
 circulation, disturbed respiration, diminished temperature, some- 
 times accompanied with laborious breathing, fainting, palpita- 
 tion, and suffocation. It is during the prevalence of these latter 
 symptoms, that life is endangered and not unfrequently lost. 
 
 Diseases of the lungs may be hepatization, pulmonary apoplexy, 
 pulmonary tubercles, cedema, and cedema lardariforme, being a 
 mixture of cedema and schirrhus. These may either affect the 
 entire structure of the lungs, or any part of them. Where the 
 
 13 
 
194 MEDICAL JURISPRUDENCE. 
 
 entire structure is affected, life can continue but fo a very briel 
 period, and in such cases the pulmonary tests wil? jenerally de- 
 cide that no respiration has taken place. Whert the disease is 
 partial, the medical witness may be required to state what agency 
 it had in the production of death. These cases cm seldom be 
 attended with much difficulty ; as the presence of \ke disease, 
 whether affecting the whole organ or only a part ci it, will be 
 apparent on examination. That peculiar condition 01 ihe lungs 
 termed atelectasis, consisting in imperfect expansion, is not here 
 included, as that probably depends on a defect of innervation, 
 and not on disease. 
 
 The brain and spinal marrow may become diseased from ac- 
 cumulations of fluid and morbid softening. The accumulation 
 of serum must be very considerable, and the morbid softening 
 prevail to a great extent, in order to be either of them the cause 
 of death. It must, however, be remembered, that the brain of 
 the foetus is naturally softer and much more vascular than that 
 of the adult, which should be fully taken into consideration in 
 the investigation of medico-legal questions bearing upon this 
 point. 
 
 " All these diseased affections are of rare occurrence, and when 
 they are found to be present, it is rarely to such a degree as to 
 affeet the question of infanticide. It is only when they exist in 
 a marked form and to a considerable extent, that they can be 
 received in explanation of the early death of the child." Guy's 
 Principles of Forensic Medicine, 185. 
 
 It is children of a relatively large size, as compared with that 
 of the pelvis, that are the most likely to perish in the birth. 
 One general fact must here be kept in mind, and that is, that 
 among legitimate children, according to statistical tables extend- 
 ing over a series of years', and embracing not less than eight mil- 
 lions of cases, the proportion of still-born varies from one in 
 eighteen to one in twenty. Among illegitimate children the 
 proportion is one in eight or ten, which is certainly a very im- 
 portant circumstance. Taylor's Med. Juris., 382 ; Guy's 'Prin- 
 ciples of Forensic Medicine, 186. 
 
 17. What are the principal points to which the attention should 
 
INFANTICIDE. 195 
 
 be drawn, and the most approved methods to be pursued in the 
 making of examinations in cases of alleged infanticide 1 
 
 1. The attention should be directed to the body of the child. 
 That should be weighed and measured, the position of its centre 
 ascertained ; its size should be noted, the condition of the umbili- 
 cal cord, whether it be torn or cut ; the dimensions of the head 
 and thorax ; every thing relating to its external appearance, 
 shape, conformation, condition as to putrefaction, spots, ecchy- 
 mosis, &c. 1 Beck's Med. Juris., 418 ; Guy's Principles of Foren- 
 sic Medicine, 193. 
 
 2. Any marks of violence on the surface of the body must be 
 carefully inspected, with the view of determining, if any be pre- 
 sent, whether they might have been produced during birth, or 
 resulted from accidental causes acting after birth, or were inflicted 
 by design. The mouth, fontanelles, orbits, &c, should be care- 
 fully examined for wounds inflicted by sharp pointed instruments. 
 In order to examine the mouth, an incision may be made from 
 the under lip to the top of the sternum, and another along the 
 lower edge of the inferior maxillary bone ; after which the in- 
 teguments may be dissected back. Divide the lower jaw at its 
 symphysis, and separate the two portions. By bending the head 
 back, a view of the cavity of the mouth may be obtained and the 
 position of the tongue examined. Attention should be directed 
 to the mouth to ascertain whether any and what foreign matters 
 are to be found in it. In this connection also the larynx and 
 trachea should be laid open and examined, together with so 
 much of the oesophagus as can now be seen. 
 
 3. Divide the ribs and sternum in the ordinary manner, a 
 scissors being the more convenient instrument. After examin- 
 ing the configuration and size of the thorax, and laying it open, 
 its contents should be carefully observed. The general appear- 
 ance, position and color of the lungs should be noted. It should 
 be observed whether they are of a uniform liver color and com- 
 pact consistence throughout, or spongy like the adult lung, or 
 mottled with developed air cells, as in imperfect respiration. 
 Divide the trachea near the lungs, tie the aorta and vence cavse, 
 and cut them beyond the ligature. Remove the lungs from the 
 
196 MEDICAJ, JURISPRUDENCE. 
 
 thorax, and see if there are any parts of a lighter color than the 
 rest, observing whether the structure of the lung itself is devel- 
 oped in those parts, and carefully distinguishing the developed 
 air cells from air contained beneath the pleura, the result of pu- 
 trefaction. The lungs should now be subjected to the static and 
 hydrostatic tests, in the manner already directed. The heart 
 should also be thoroughly examined, to see whether the auricles 
 and ventricles are filled with blood, and particularly what is the 
 state and condition of the ductus arteriosus and foramen ovale. 
 
 4. Attention may next be directed to the abdomen. To do 
 this continue the first incision down to the lower part of the 
 sternum, and from this point make an incision, through the in- 
 teguments, to the spine of the ilium on each side. Turn down 
 the triangular flap thus made, and examine and tie the umbilical 
 vessels. The first thing to be observed is the diaphragm. Ex- 
 amine the extent of its arch towards the thorax. Observe the 
 condition of the ductus venosus, whether it be pervious or con- 
 tain blood. Tie the vessels leading to the liver, separate them 
 beyond the ligature, take out the liver and weigh it. After 
 having tied the two ends of the intestinal canal remove it, to- 
 gether with the stomach. Observe whether there be any appear- 
 ance of inflammation in any part of the canal, and if so, particu- 
 larly if the stomach exhibit any evidence of inflammatory action, 
 test its contents with a view to the discovery of poison. It 
 should be observed whether there is any evidence of the com- 
 mencement of the putrefactive process. The contents of the 
 stomach should also be examined to see whether there are in it 
 any foreign substances, going to show that the child had been 
 fed. The intestines should undergo a like examination to. deter- 
 mine the presence or absence of meconium. The state of the 
 gall bladder and urinary bladder, particularly of the latter, should 
 be examined to see whether they are empty, or if not, how full 
 they may be of contents. 
 
 . 5. As injury causing death is sometimes inflicted on the spine, 
 it becomes necessary to direct the attention to that part. It 
 should be ascertained whether there is any dislocation or frac- 
 ture of the vertebra?. To make a more perfect examination, a 
 
INFANTICIDE. 197 
 
 longitudinal incision should be made from the occiput to the 
 sacrum, the muscles being separated and turned back. Divide 
 the vertebrae on each side by means of strong scissors. Remove 
 the posterior part of the spine, and the whole canal will be ex- 
 posed for examination. 1 Beck's Med. Juris., 420. 
 
 C. Attention may next be directed to the head. Make an in- 
 cision from the lower part of the frontal bone, quite down to the 
 second or third cervical vertebras, and another at right angles to 
 this, from ear to ear. Dissect back the integuments thus di- 
 vided, and the cranium will be completely exposed. Examine 
 the bones of the skull both at the vertex and base, to see if there 
 be any fractures, punctures or wounds. Separate the bones by 
 a scissors passed along their membranous connexion with each 
 other, and then remove them. The brain and its 'membranes 
 should now be examined, to see whether they are in a healthy 
 condition, or whether there is any effusion of blood or serum. 
 If any puncture or wound appear upon the cranium, that por- 
 tion of the brain immediately beneath it must be the subject of 
 careful examination. 
 
 7. Attention must also be directed to the suspected female, to 
 iscertain whether she has been recently delivered, and how long, 
 and whether the signs of delivery correspond with the appear- 
 ances discovered on examination of the child. Should the re- 
 sult of this examination render it clear that the female is the 
 mother of the child, it may become necessary to enquire into the 
 state of her mind, with the view of determining whether she be, 
 in fact, a responsible agent. It should be borne in mind, that 
 puerperal insanity is, by no means, a rare disease, and that it 
 sometimes takes the form of homicidal mania, theatening the 
 life of the child. It is true, this species of insanity does not 
 usually supervene sooner than the third day after delivery, and 
 sometimes not for a fortnight ; yet there are exceptions. 3 Paris 
 8f Fcmblanque's Med. Juris., 129. 
 
 An interesting case in which this question arose, is reported in 
 1 H: P. C, 36. It occurred in 1668, at Aylesbury. "A married 
 woman of good reputation being delivered of a child, and not 
 having slept many nights, fell into a temporary phrenzy, and 
 
19? MEDICAL Jt'RISPRUDENCE. 
 
 killed her infant in the absence of any company ; but, company 
 coming in, she told them she had killed her infant, and there it 
 lay. She was brought to jail presently, and after some sleep 
 she recovered her understanding, but marveled how or why she 
 came thither. She was indicted for murder, and upon her trial, 
 the whole matter appearing, it was left to the jury with this di- 
 rection, that if it did appear that she had any use of reason when 
 she did it, they were to find her guilty ; but if they found her 
 under a phrenzy, though by reason of her late delivery and want 
 of sleep, they should acquit her ; that had there been any occa- 
 sion to move her to this fact, as to hide her shame, which is ordi- 
 narily the case of such as are delivered of bastard children, and 
 destroy them; or if there had been jealousy of the husband 
 that the child had been none of his ; or if she had hid the in- 
 fant, or denied the fact, these had been evidences that the phren- 
 zy was counterfeit ; but none of these appearing, and the honesty 
 and virtuous deportment of the woman in her health, being known 
 to the jury, and many circumstances of insanity appearing, the 
 jury found her not guilty." 
 
 These are the principal points and methods to be pursued in 
 the investigation of questions of Infanticide. 
 
 II. WOUNDS. 
 
 All the topics to be discussed under this head, can be best 
 presented in the following order : 
 
 I. Definition. What is included under the term 1 
 II. Division into two main classes : 
 
 1 . Those unaccompanied by solution of continuity, in- 
 cluding all contusions, fractures, concussions, dislocations 
 and sprains : 
 
 2. Those accompanied by solution of continuity, in- 
 cluding all incised, lacerated, punctured, sword and gun- 
 shot wounds. 
 
 III. Wounds as they affect the several parts and systems of 
 
 the body. 
 
 IV. General medico-legal questions that may arise in the in- 
 
WOUNDS. 199 
 
 vestigation of all wounds, however or whenever inflicted, inclu- 
 ding the legal principles applicable to this head. 
 
 I. Definition. What is included under the term wound ? 
 
 This term must have a different meaning attached to it, in 
 legal medicine, from what it has in surgery. In the latter, it is 
 more generally understood as being confined to those organic 
 lesions that are accompanied by solution of continuity. In the 
 former, it is much more comprehensive, embracing every species 
 of injury inflicted on the body by mechanical agents. 2 Beck's 
 Med. Juris. ,178 ; Guy's Principles of Forensic Medicine, 446. 
 
 Some difference of opinion has arisen in relation to what is 
 really included under the term wound, which has sometimes 
 created embarrassment in medico-legal examinations, and even 
 in the framing of indictments. Dr. Watson, in his work on 
 homicide, page 18, says, that " in legal medicine, under the term 
 wound is to be included every local alteration of any part of 
 the body, produced by violent means, whether the cause has 
 been directed against the body, or the body against the wound- 
 ing cause." Hence he says, " we refer to wounds, incisions, lace- 
 rations, contusions, concussions, fractures, dislocations, sprains 
 and burns, whether by fire or by escharotics." 
 
 This is a more comprehensive definition than is generally 
 adopted. The law, as expounded by the English and American 
 courts, asserts that in order to constitute a wound, the skin 
 should always be broken or injured. It excludes burns, whether 
 produced by heated metals or corrosive liquids, although they 
 would seem to be included in the above definition. So, also, 
 would the definition exclude the fracture of a bone which was 
 unaccompanied with a solution of continuity. Taylor's Med 
 Juris., 232. 
 
 I shall adopt the first definition given, which is that of Dr. 
 Guy, viz., that every species of injury inflicted on the body by me 
 chemical means or agents, is, in a medico-legal sense, a wound. 
 
 II. Division: 
 
 All wounds are to be included within one or the other of two 
 large classes. These are, 
 
 1. Those unaccompanied by solution of continuity • 
 
200 MEDICAL JURISPRUDENCE. 
 
 2. Those which are accompanied by solution of continuity. 
 
 First class of wounds : 
 
 Under this class are included all contusions, concussions, frac- 
 tures, dislocations and sprains. 
 
 A contusion is a bruise of the soft parts, without cutting or 
 laceration of the skin, caused by a blunt, hard, or firm and 
 heavy body. Watson on Horn., 21. There are various degrees 
 of this injury. There may be simply a rupture of the capillary 
 vessels, or a dilaceration, consisting in abrasion of the tissues, 
 or a complete attrition or disorganization of the soft parts. 
 
 Contusions may affect, more or less, all parts of the body. 
 They are rendered formidable by the commotion they may cause 
 in important organs, by rupture of tissue, by inflammation, sup- 
 puration, and gangrene, lb., 22. 
 
 A contused wound is generally what in common language is 
 termed a bruise, and in scientific, ecchymosis. The investigation 
 of this form or result of a wound, becomes of peculiar impor- 
 tance, connected, as it very frequently is, with many nice and 
 difficult questions of a medico-legal eharacter. 
 
 Ecchymosis, literally meaning, to pour out, consists of an in- 
 filtration, or effusion of blood, into the cellular tissue of any part 
 of the body. It may be of the superficial or deep-seated parts. 
 
 It is more frequently of the superficial parts, and, if very 
 slight, no external mark is presented. When the cellular tissue 
 under the skin is only affected, and a tumor slightly elevated is 
 formed, it is called ecchymosis by infiltration ; but when blood 
 is accumulated in a considerable mass, forming a soft, prominent 
 and elastic swelling, it is called ecchymosis by congestion. 
 
 The subject of ecchymosis will be best treated, by considering, 
 1. Its cause ; 2. Its seat; 3. Its form; 4. Its history; 5. Its diag- 
 nosis ; and, 6. Its production before and after death. 
 
 1 . Its cause. By far the most common, are blows, falls, or bring- 
 ing any soft part of the body suddenly and violently into contact 
 with any hard, unyielding substance. It may, however, occa ■ 
 sionally be referred to other causes. Narrow and oblique punc 
 tured wounds may occasion it; so, also, may certain diseased 
 states, such as scorbutic and hemorrhagic complaints. It may 
 
WOUNDS. 201 
 
 also, be caused by any great exertion of the body, continued foi 
 a length of time, or any violent movement, such as occurs in 
 leaping, lifting a heavy weight, vomiting, the stretching and 
 compression of the parts in child-birth, (Watson on Horn., 23 ;) 
 or any other species of effort, or movement, that is sufficiently 
 violent, or long continued, to produce a rupture of the capillary 
 vessels. Its presence is not, therefore, perfect evidence of the 
 infliction of injury. 
 
 2. Its seat : 
 
 The seat of the ecchymosis may be stated, in general terms, to 
 be the cellular membrane or tissue. It is not, however, confined 
 to this, but may involve, more or less, the whole substance of 
 the cutis. Guy's Principles of Forensic Medicine, 449. It may 
 be situated immediately under the epidermis, or the blood may be 
 infiltrated among the muscles, beneath the tendinous aponeu- 
 rosis ; it may be under the periosteum, between the viscera and 
 the membrane which covers them ; it may be found in the sub- 
 stance of the organs, between the peritoneum and the parieties 
 of the abdomen, or between the nerves and blood-vessels, being 
 effused into the cellular tissue which forms their sheath. In 
 some cases, the blood which is effused is small in quantity, and 
 the space occupied consequently small. In others, the quantity 
 is larger, and the space occupied considerably increased. Watson 
 on Horn., 23. 
 
 It is in general superficial, affecting only the layers of the skin ; 
 but in some instances, may be found deep-seated, the blood being 
 effused among the muscles and beneath the fascise. In the latter 
 case, it will be found much more difficult to determine the ex- 
 tent of it from the discoloration, which will be commonly slight. 
 Taylor's Med. Juris., 239 
 
 Sometimes the ecchymosis will not show itself immediately 
 over or around the seat of the injury, but at some distance from 
 it. Dr. Chowne mentions a case where a young man received a 
 severe bruise on the inner side of the ankle, the ecchymosis ap- 
 pearing in two days afterwards, around the outer ankle. There 
 is also a case mentioned of a compound fracture of the tibia, 
 about one- third down, produced by the wheel of a carriage pass 
 
202 MEDICAL JURISPRUDENCE. 
 
 » 
 
 ing over the leg, in which there was no ecchymosis around the 
 seat of the injury, but after some days, the skin of the knee and 
 lower part of the thigh became ecchymosed. Taylor's Med. 
 Juris., 239-40. 
 
 Where deep-seated, as under the tendinous aponeurosis of the 
 muscles, or among the muscles themselves, there is frequently 
 no external mark. Watson on Horn., 24. 
 
 3. Its form. The form of the bruise or ecchymosis will de- 
 pend on the shape of the weapon with which it has been inflicted ; 
 and this is a fact which may sometimes become of great impor- 
 tance. Guy's Principles of Forensic Medicine, 248, Taylor, 240. 
 
 In death caused by hanging, or by strangling with a cord, the 
 ecchymosed line around the neck will generally indicate its 
 cause with precision, as well as evidence the cause of death. 
 So, also, where the death has been caused by strangulation by 
 means of the hands, the ecchymosed spots caused by the appli- 
 cation of the fingers will generally render apparent the cause of 
 death. A very remarkable case is mentioned by Starkie, under 
 title, circumstantial evidence, vol. 1 of his work on evidence, 
 which goes to show the importance of attending to the form of 
 an ecchymosis. 
 
 In an attempt at murder, the person assaulted, in his own de- 
 fence struck the assassin violently in the face' with the key of the 
 house door, this being the only weapon he had near at hand. 
 The ecchymosis which followed the blow, corresponded precisely 
 in shape to the wards of the key, and it was chiefly through this 
 very singular and unexpected piece of evidence, that the assassin 
 was afterwards identified and brought to trial. 
 
 4. Its history. It becomes important to understand the changes 
 that take place in the ecchymosed spot, and the order of their 
 succession, with the view of arriving at the probable time at 
 which the injury was inflicted. When the superficial parts are 
 contused, especially the lax and yielding portions of the skin, 
 the color makes its appearance at once. When the effusion is 
 deeper seated, some days may elapse before any discoloration of 
 the skin takes plade ; and if it be under the tendinous aponeuro- 
 
WOUNDS- 203 
 
 sis of the muscles, or among the muscles themselves, there is 
 frequently no external mark whatever. 
 
 When the injury has been inflicted upon the superficial parts, 
 the color is not developed to its full extent at once, but continues 
 to deepen for five or six hours, and sometimes longer. After a 
 time, the serum becomes effused and inflammation supervenes, 
 by which the extent of the ecchymosis is increased. The follow- 
 ing are substantially the changes that occur. " In most cases the 
 ecchymosed part at first exhibits a red or bluish color, which 
 soon becomes livid, lead-colored, or black. This takes place 
 from the blood situated under the skin. But as the effused blood 
 ceases to circulate, it undergoes certain changes before it is ab 
 sorbed, which cause a variation in the color of the part. In a 
 few days the color lightens, acquires a violet tint, then becomes 
 greenish, yellowish and finally disappears. The time of the 
 change in color is marked by an extent of the spot, the centre of 
 it being always of a deeper color than the circumference. These 
 changes arise from the effused blood loosing its color, becoming 
 brownish, coagulated, undergoing daily absorption, as also being 
 diluted with the secretion from the cellular tissue, by which it 
 becomes more diffused. The age, constitution, habits of life of 
 the individual, the extent and situation of the ecchymosis, and 
 the cause by which it has been occasioned, have a remarkable 
 influence upon the time necessary for its complete resolution. It 
 has been found distinct when cut into, though probably much 
 lessened in size, several weeks after the infliction of the injury. 
 In the case of an old man it was distinct five weeks after. Wat- 
 son on Horn., 234 ; Guy, 448 ; Taylor, 240. When the cellular 
 membrane is dense, the ecchymosis is less rapidly formed, and 
 when formed the changes occur less rapidly, than when a loose 
 portion of it is effused." 
 
 The complete disappearance of the ecchymosis is owing to the 
 entire absorption of the effused blood. This disappearance, as 
 might reasonably be expected, commences at the circumference 
 or margin of the ecchymosis, and gradually extends towards the 
 centre. The central part of it often retains its deep blue color, 
 after the marginal parts have completely changed their ap- 
 
204 MEDICAL JURISPRUDENCE. 
 
 pearance. Guy's Principles of Forensic Medicine, 448 j Taylor') 
 Med. Juris., 240. 
 
 5. Its Diagnosis. Under this head is included the means and 
 methods of discriminating between real ecchyniosis, and cada- 
 verous ecchymosis or suggillation. The latter is so called from 
 sugillatio — a black mark, and is frequently found upon the dead 
 body, and occasionally upon the living. 
 
 In living persons, who are very aged, it is not unusual to find 
 upon the legs and feet livid patches, sometimes mottled, and at 
 others, possessing uniformity of color. They are owing to the 
 languor of the capillary circulation, and are found upon those 
 parts of the body the farthest removed from the centre of circu- 
 lation, and where the blood has to contend with the law of gravity 
 in ascending from the lower extremities. Taylor's Med. Juris., 
 242. The age of the individual, the place where found, the ab- 
 sence of all abrasion of the skin, the extent, enveloping often 
 the whole circumference of the leg, and other means of discrimi- 
 nation, rendered more apparent hereafter, will afford sufficient 
 data from which, in any such case, a true judgment can be 
 formed. 
 
 In those who have died from scurvy, typhus, and other ady- 
 namic diseases, similar discolorations are sometimes noticed. In 
 those severely affected with scurvy, a very slight pressure on any 
 part of the skin will produce a spot resembling ecchymosis, which 
 arises from a rupture of minute cutaneous vessels. The extra- 
 vasation, however, in such cases is the more generally wholly 
 confined to the superficial layers of the true skin. An examina- 
 tion of the gums, of the surface of the skin generally, and of the 
 mucous membranes, will, in such cases, enable any one properly 
 to discriminate and judge. Guy's Principles of Forensic Medir 
 cine, 449. 
 
 Discolored spots, under certain states of the system, sometimes 
 occur spontaneously, and often cover the body to a great extent. 
 When small they are termed petechise. When extensive, they 
 constitute the chief pathognomonic character of the disease 
 termed purpura. In distinguishing these, especially the latter, 
 a difficulty may sometimes exist, but the appearance of the sub 
 
WCUNDS. 203 
 
 ject, the general diffusion over the whole body, together with 
 their existence on the mucous membrane of the fauces and ali- 
 mentary canal, will, at least, indicate that their existence is not 
 owing to violence. Taylor's Med. Juris., 242-3. 
 
 To all these discolorations, as well as those presently to be no- 
 ticed as occurring after death, the term suggillation has been ap- 
 plied. Guy, 449; Taylor, 242-3. 
 
 The meaning of the term — a black mark, embraces equally a 
 real ecchymosis, as all other spots or discolorations, whether pro- 
 duced on the living or dead body. To remedy this, it has been 
 proposed to confine the term suggillation simply to those appear- 
 ances that are presented after death, and that make their first 
 appearance in the dead body. 
 
 These appearances are somewhat various, differing also as to 
 the times in which they occur. One of them may be said to be 
 a consequence of death, but is not fully developed until the body 
 has cooled. It is presented in the form of diffused livid, purple, 
 or mottled patches, over the chest, neck, sides, or abdomen, and 
 often covering the external or internal surfaces of the upper or 
 lower extremities. These patches are commonly well defined in 
 their extent by the whiteness of the surrounding skin. The 
 color is confined to the upper surface of the cutis, and never ex- 
 tends through it. These appearances will generally be present 
 in those who have died suddenly, or by a violent death ; as in 
 those who perish from apoplexy or asphyxia, and they are as- 
 cribed to the congestion which takes place in the capillary sys- 
 tem at the moment of death in subjects which are full of blood. 
 They indicate vigor in the circulating system at the time of death, 
 and suddenness of dissolution. There is little danger of confound- 
 ing them with real ecchymosis. Taylor' 's Med. Juris., 243 ; Guy's 
 Principles of Forensic Medicine, 450. 
 
 Another appearance presented is, when the discolorations, in- 
 stead of presenting in patches, are found distributed in stripes, 
 crossing and intersecting each other over the body, and bearing 
 son* -t resemblance to those caused by flagellation. They have 
 heiice been termed vibices. They occur on different parts of the 
 body, but the most frequently on the sides, upper part of the 
 
206 MEDICAL JURISPRUDENCE. 
 
 shoulders and" back. In color they vary from a scarlet to a da/k 
 red or livid hue. It has been supposed by some that their cause 
 is attributable to wrapping the body in a sheet or other covering 
 soon after death, and to the accumulation of the blood in those 
 parts of the skin which are exposed to the least degree of pres- 
 sure. The sound state of the cuticle and the superficial nature 
 of the discoloration, will generally be sufficient to enable any one 
 to discriminate between this, and the ecchymosis which is the 
 result of violence. • Taylor's Med. Juris., S43 -4 ; Guy's Principles 
 of Forensic Medicine, 450. 
 
 One other appearance still, is that observed in the dead body 
 and which is not to be found until some time after death. It is 
 supposed by some to be owing to incipient putrefaction. It is 
 usually confined to the skin covering the back, loins, buttocks, 
 and occiput, and is caused by the infiltration of blood into the 
 most depending parts of the body. The entire cutis becomes 
 injected, and the adipose tissue filled with sanguineous serum. 
 The color increases as putrefaction advances, passing from a dark 
 red to a green, and then to black. These are distinguishable in 
 several ways from the real ecchymosis. 
 
 1. They are found in the most 'depending parts of the body, 
 being principally, if not entirely, the result of gravitation. A 
 change in the position of the body will not unfrequently cause 
 these appearances to change, also, disappearing from the parts 
 that are elevated, and following those that are the most depending. 
 
 2.. In these there is simply congestion of blood in Ijhe capillary 
 tissue alone, not extending to the subcutaneous. The removal 
 of a layer of the skin, where these lividities are present, will 
 show that it is confined to this organ, and is not attended with 
 infiltration of blood into the cellular membrane. 
 
 3. They are of a uniform color, whereas in real ecchymosis 
 the central part is generally found to be of the deepest color. 
 
 4. In real ecchymosis, the blood, on cutting into it, will be 
 found to be thick, concrete blood ; but in these cadaverous lividi- 
 ties, thin, fluid blood. This remark was made by Zacchias. 
 Guy's Principles of Forensic Medicine, 449 ; Taylor's Med. Juris.. 
 245 ; 2 Beck's Med. Juris.j 14-15. 
 
WOUNDS. 207 
 
 In the great majority of cases, the medical jurist will fiiid no 
 difficulty in determining whether the appearance presented, be a 
 real ecchymosis or the result of causes operating towards the 
 close of life or after death. A case, however, is given by Mr. 
 Taylor, page 244, which shows that doubts and difficulties may 
 occur in some extraordinary cases. A man aged 33, died sud- 
 denly of disease of the heart. He had been laboring under ana- 
 sarca. The body was examined 18 hours after death, and the 
 skin was found covered in different parts with patches of ecchy- 
 mosis, some being small and others several inches in diameter, 
 and all closely resembling ecchymoses, which are the results of 
 violence. Around many of them was the wide border or ring 
 of straw color, with various shades of green, similar to those 
 witnessed in the disappearance of an ecchymosis upon the living 
 subject, and which has generally been considered as peculiar to 
 it. On cutting into these patches, the layers of the cutis as well 
 as the cellular tissue beneath, were throughout reddened by con- 
 gested blood. There could hardly be said to be extravasation of 
 blood, but small rounded semi-coagulated masses oozed out from 
 the cells on slight pressure. The border or ring of straw color, 
 was owing to the individual having labored under anasarca, the 
 effused serum having diluted the blood as it oozed out from the 
 cells. These patches, it was remarked were presented on the 
 most recumbent or depending parts. Notwithstanding their close 
 resemblance, there were here three indications that these were 
 cadaverous, and not real ecchymoses. 
 
 1. Their seats being the most recumbent or depending parts. 
 
 2. The skin was in a natural state and entirely unruffled. 
 
 3. The very slight extravasation of blood compared with the 
 extent of the ecchymosed surface. This case must clearly show 
 that there may be considerable difficulty, in some cases, in ar- 
 riving at clear conclusions upon this subject. 
 
 G. Its production before and after death. 
 
 The resemblance which contused wounds, inflicted after death, 
 bear to those inflicted previous to it, will depend upon their se- 
 verity, and the time that has elapsed after death before their in- 
 fliction. If sufficient time have elapsed to admit of vital r< -ac- 
 
208 MEDICAL JURISPRUDENCE. 
 
 tion, the swelling of the part will proclaim its infliction during 
 life, or a change of color, or other sign of inflammation, may 
 afford conclusions equally clear. Coagula of blood may afford a 
 remote presumption of bruises inflicted during life, but they are 
 not positively certain in their indications, as they may be found 
 in bruises inflicted soon after death. Fluidity of blood has been 
 cited by some as proving the contusion to have been inflicted 
 during life, but this cannot be relied upon, as blood ef- 
 fused into the brain and spinal canal is often fluid. Another 
 means of distinguishing, and to which considerable reliance can 
 be attached, is the extent of the effusion. In contused wounds 
 which are inflicted after death, there can be very little effusion, 
 unless some large vein be ruptured. Guy's Principles of Forensic 
 Medicine, 451 - 2 ; Taylor's Med. Juris., 243 -4 ; 2 Beck's Med. 
 Juris., 16-17; Watson on Horn., 24-5. 
 
 According to Dr. Christison, the best diagnostic mark of bruises 
 inflicted during life, and after death, is the discoloration of the 
 cutis, from the effusion of blood into its texture. If inflicted 
 during life, the ecchymosed portion of cutis is dark and dis- 
 colored by the infiltration of blood through its whole thickness, 
 the skin being increased in firmness and tenacity. 
 
 Where contused wounds are inflicted soon after death, while 
 the body still retains its warmth, and the muscles their contrac- 
 tility, they bear a very great resemblance to those inflicted dur- 
 ing life. Dr. Christison made some experiments upon the re- 
 cently dead, from which he arrives at the following conclusions. 
 " For some hours after death, blows will cause appearances 
 which, in point of color, do not differ from the effects of blows 
 inflicted recently before death. The discoloration, like lividity 
 or suggillation, generally arises from an effusion of the tbinest 
 possible layer of the fluid part of the blood on the outer surface 
 of the true skin, but sometimes also, from an effusion of thin 
 blood into a perceptible stratum of the true skin itself. Dark 
 fluid blood may even be effused into the subcutaneous cellular 
 tissue in the seat of the discolorations, so as to blacken or redden 
 the membranous partitions of the adipose cells, but this last is 
 never extensive." The general conclusion of the whole deduced 
 
WCCNDS. 209 
 
 by Dr. Beck is, " that severe blows inflicted after death, ivill exactly 
 imitate slight contusions inflicted during life." 2 Beck's Med. 
 Juris., 17. The time at which blows inflicted after death, will 
 so nearly resemble those inflicted during life, must be limited to 
 the lapse of two, or at most three hours after the extinction of 
 life. If the body be allowed to become cold, and the muscles to 
 acquire rigidity, contusions, although severe, will produce little 
 effect. 
 
 A question may here be properly raised, whether contused 
 wounds always produce the appearances ascribed to them ; and 
 whether, therefore, if these appearances are not to be found, the 
 conclusion must necessarily arise that no contusion has been in- 
 flicted. This is a very important question, as it has been often 
 asserted in courts of justice, that no severe blow could have been 
 inflicted on a deceased person, because there was no ecchymosis 
 to be found upon the part alleged to have been struck. The 
 general conclusion on this subject may be stated to be — that the 
 presence of ecchymosis may be considered as the presumptive 
 evidence of the infliction of violence ; but that its absence does 
 not negative this presumption. 
 
 The question above suggested arose on a trial before the jus- 
 ticiary court of Glasgow, in the year 1837. Taylor's Med. Juris., 
 246. A woman was found dead in her house, and her husband 
 was accused of having murdered her. There was no mark of 
 violence externally ; but on opening the abdomen, the liver was 
 found extensively lacerated, and there was no doubt that this 
 was the cause of death. A medical witness asserted, that as 
 there was no appearance of injury externally, the rupture could 
 not have been caused" by a fall or a blow. He attributed the 
 absence of the marks of ecchymosis to the rupture having been 
 occasioned by the forcible pressure of some heavy rounded 
 smooth body to the abdomen. The prisoner was acquitted on a 
 verdict of not proven. 
 
 Many instances have been collected, and may be found in Tay- 
 lor, Guy and Watson, in which blows and injuries sufficiently 
 severe to cause death, have been inflicted, and yet no mark, as 
 evidence of their infliction, could be found externally. In one 
 
 14 
 
210 MEDICAL JURISPRUDENCE. 
 
 case a man, aged about thirty, having stumbled and fell on his 
 back, a large iron pipe, for conveying Croton water, rolled on to 
 his body. He lived about a week, and on dissection, the liver 
 was found ruptured. There was no external ecchymosis found, 
 but after two or three days, a yellow suffusion appeared over the 
 abdomen, which gradually became livid. 
 
 Another was struck by a chain, which broke from violent ex- 
 tension, and knocked him down by a blow over the region of 
 the liver. He ultimately recovered. There was at no time any 
 marks of ecchymosis present. A boy was ran over by the wheel 
 of a cart which passed directly over his abdomen. He recovered, 
 but there was no ecchymosis or discoloration at any time. In 
 another case the wheel of a cart, loaded with brick, passed over 
 the chest of a boy ten years of age. He lived a few hours, and 
 there was no external marks of violence. Guy's Principles of 
 Forensic Medicine, 453 ; Taylor's Med. Juris., 245-6, 7. 
 
 A laboring man died some hours after fighting with another. 
 On inspection the peritoneum was extensively inflamed, owing 
 to an extravasation of the contents of the jejunum, which was 
 found ruptured to a considerable extent. There was no ecchy- 
 mosis or mark on the skin externally, and the medical inspectors 
 were inclined to affirm, contrary in this case to direct evidence, 
 that no blow could have been struck ; but others were appealed 
 to who at once admitted, that the laceration of the- intestine 
 might have been caused by a blow, even although there was no 
 appearance of violence externally. 
 
 A girl, aged nine years, received a blow upon the abdomen 
 from a stone. She immediately complained of great pain ; col- 
 lapse ensued, and she died in twenty-one hours. On inspection 
 there was no mark of injury visible externally. 
 
 A man received a kick from a horse on the abdomen. He 
 died in thirty hours, from peritonitis. The ilium was found 
 completely torn across in its lower third. Although the blow 
 was here struck by the hoof of a horse, a somewhat angular or 
 pointed body, yet there was not the slightest trace of ecchymesis 
 externally. 
 
 A case of some interest occurred in Scotland in the year 1836,, 
 
WOUNDS. 21 1 
 
 in which a woman named Finlay was indicted for the man- 
 slaughter of her husband. The deceased, during a quarrel with 
 his wife, met with a severe compound fracture of his leg, but 
 there was no ecchymosis whatever on any part of the limb. 
 Five medical witnesses swore that the fracture must have been 
 produced by a blow, and not by an accidental fall. On cross- 
 examination, one witness said that a blow adequate to cause sim- 
 ple fracture, would produce ecchymosis ; another, that ecchy- 
 mosis seldom occurred until some hours after such an accident. 
 Here the man lived several days and no ecchymosis appeared. 
 Mr. Syme stated that in an open wound, when the blood was 
 allowed to flow away, there would be no ecchymosis ; a statement 
 in general correct, although such might not be a contused wound 
 Other witnesses thought that ecchymosis ought to be produced 
 by blows inflicted on any part of the body, and judging from ex- 
 ternal appearances, they should have supposed that no blows 
 could have been inflicted on the deceased. Another said the 
 fracture must have resulted from a fall and not from a blow. 
 That had it resulted from a blow, he should have expected to 
 find ecchymosis, tumefaction, and ruffling of the skin in the 
 vicinity. That such violence as would have produced the frac- 
 ture, must have caused these appearances. The prisoner was 
 found guilty of a minor offence. It should have been borne in 
 mind in this case, that ecchymosis may be produced by a fall as 
 well as a blow ; and, therefore, that its absence could furnish no 
 proof whatever that the fracture had been caused by a fall. 
 
 A case is mentioned as occurring in Massachusetts in 1818, in 
 which a small stone was thrown so as to strike the side of the 
 head, causing death in ten minutes, and yet leaving no external 
 mark or bruise. The cranium was very thin, the ventricles filled 
 with coagulated blood, and the pia mater and vessels of the brain 
 gorged with blood. Verdict manslaughter. Guy, 455. 
 
 A girl was accidentally struck on the back by a log of timber ? 
 and died in a few minutes afterwards. On inspection the right 
 lobe of the liver was found torn through, and the stomach greatly 
 lacerated. There was, notwithstanding, no trace of ecchymosis, 
 or any mark of violence externally. 
 
212 MEDICAL JURISPRUDENCE. 
 
 Another was struck by the seat of a car, the wheel of which 
 was supposed to have passed over her. She was killed on the 
 spot ; but on examination there were no external indications of 
 violence whatever, although the heart was ruptured. 
 
 In another case, a man was run over by a wagon, and survived 
 thirty-six hours. All the ribs on the right side of the chest were 
 found broken ; the right pleura was filled with blood, the lung 
 collapsed, and other internal injuries ; and yet there were no ex- 
 ternal marks of bruise or ecchymosis, and the skin was un- 
 injured. 
 
 The fact that the skin is possessed of great elasticity, is assign- 
 ed as a reason why that may remain uninjured in these severe 
 cases of violence ; but how the vessels can escape rupture where 
 there is a bone beneath them, is difficult to explain. 
 
 These cases should certainly admonish the medical jurist to 
 be extremely cautious in pronouncing against the possibility of 
 an injury where the usual external indications of it are wanting. 
 They are all difficult of explanation, but some more so than 
 others. For the purpose of explaining the instances in which 
 death took place shortly after the injury, without the occurrence 
 of ecchymosis, it has been suggested, that the individual should 
 survive, for some hours, in order that ecchymosis should be ob- 
 served in the part injured. It is certainly true, that ecchymosis 
 is not always the immediate result of a bruise. It does not, at 
 times, appear for six or eight hours, or until the second day, and 
 in one instance, not until after the fourth day. Probably the 
 superficial or deep seat of the effusion may exert some influence 
 in reference to the time of its external manifestation. But as 
 severe blows on the recently dead body are productive of ecchy- 
 mosed appearances nearly resembling those upon the living, there 
 should be no good reason why a blow during life should not be 
 followed by the usual external indications developed either du- 
 ring life or immediately after its cessation. Taylvrh Med. Juris., 
 246. 
 
 It has also been suggested, that many of these blows were in 
 flicted upon the abdomen, and that, in order to have the appear- 
 ance of a bruise produced, it is necessary there should be com- 
 
WOUNDS. 213 
 
 paratively hard and unyielding parts beneath the skin. Guy's 
 Principles of Forensic Medici?ie, 452. 
 
 It will be obvious, however, that some of the cases mentioned, 
 especially that of the girl struck on the back by a log of timber, 
 are inconsistent with the entire correctness of this position. 
 
 A concussion or commotion is a derangement of the functions 
 of any part or organ of the body, arising from the shock occa- 
 sioned by sudden violence. It may, or may not, be accompanied 
 with derangement of structure. In the former case, it is much 
 more dangerous, particularly when it occurs in large and impor- 
 tant organs, and those which are more immediately necessary to 
 life. Watson on Horn., 25. 
 
 A fracture is a rupture of a bone, or of a cartilage, by exter- 
 nal violence, by a violent exertion, or a fall. Fractures are iden- 
 tified by a change of form, by unnatural immobility, and by a 
 crepitation of the fractured part. Their danger depends on 
 their situation, simplicity or complication, and on many modify- 
 ing circumstances, which have also an application to all other 
 forms of wounds. A fracture produced shortly after death, 
 would not be likely to present any very marked characters that 
 would distinguish it from one produced during life, but very 
 soon after followed by death. If sufficient time after its pro- 
 duction was allowed for the development of inflammatory action, 
 that would afford clear evidence that it was produced during life. 
 So, also, the occurrence of much bloody effusion would indicate 
 the presence of life. Guy's Principles of Forensic Medicine, 456. , 
 
 Another means of determining whether the fracture was pro- 
 duced prior or subsequent to death, is to examine the muscles 
 These are usually broken in the dead subject, at the same time 
 with the bone, and exhibit no effusion of blood, which would al- 
 most unavoidably occur if the injury preceded death. 
 
 All the medical witness can be expected to state, in reference 
 to a fracture, is the fact of its existence, and the kind of instru- 
 ment with which it was inflicted ; whether it was produced before 
 or after death, or whether it was not caused by the use of the 
 spade or mattock, during the process of exhumation, are points 
 
214 MEDICAL JURISPRUDENCE. 
 
 which, if -he can throw any light upon, he must derive it from 
 circumstances other than simply the inspection of the fracture. 
 
 A dislocation is a derangement of the position of the bony sur- 
 faces forming joints, which is the immediate result of a stroke, 
 fall, external violence, or muscular action, accompanied with 
 pain and alteration of form. Watson on Horn., 25. 
 
 These also may be simple or compound, but the latter are- 
 much the most dangerous. 
 
 A sprain is an affection of the joint, occasioned by a twist or 
 a sudden jerk, or violence ; characterized by a painful swelling: 
 and difficulty of movement, and generally attended with more or 
 less rupture of the ligaments of the joint. Watson on Homi r 
 25-6. 
 
 Second class of wounds : 
 
 These are accompanied by solution of continuity. They in- 
 clude all incised, lacerated, punctured sword, and gun shot 
 wounds. Of these, the incised are of much the most frequent 
 occurrence. 
 
 All wounds accompanied by solution of continuity, have two; 
 eifects or consequences following them. The first and immediate 
 one, is haemorrhage ; the other, and more remote, is inflamma- 
 tion. It is- chiefly by means of one or both of these, that the 
 medical jurist is expected to solve the problem, at times so neces- 
 sary and difficult of solution, whether the wound was inflicted 
 during life or after death. 
 
 , Hsemorrhage is assumed . as evidence of the existence of the 
 circulation, at the time of its commencement, and hence as 
 proving the fact of life when the violence was committed. 2 
 Beck's Med. Juris.,. 12. 
 
 This conclusion, however, should not be received without some 
 qualification. Blood often flows from incisions on the dead body, 
 ' on altering its position, but the quantity will not be very con- 
 siderable. If the large- vessels are found empty, and the blood 
 of a florid red color, it will tend to prove the wound was inflict- 
 ed during life. 
 
 Lacerated wounds 'are attended with but very little hsemor- 
 
V.OUNDS. 215 
 
 rhage. Even where an arm has been torn off, the haemorrhage 
 has been observed to be very trifling. 
 
 In regard to incised wounds, recently inflicted during life, the 
 following are their principal characteristics : 
 
 1 . The edges are everted, owing principally to the vital elas- 
 ticity of the skin. The cellular tissue around is also found deep- 
 ly reddened by effused blood. The hemorrhage will be abun- 
 dant, and mostly of the arterial character. 
 
 2. Between the lips of the wound, if it have not been inter- 
 fered with, there will be found coagula of blood. Blood that has 
 fallen upon surrounding bodies, will also be found coagulated. 
 
 3. If sufficient time have elapsed after the infliction of the 
 wound, say from eighteen to twenty-four hours, and life have 
 continued during that time, there will be found present the usual 
 signs of inflammation, viz., increased redness, swelling, and 
 effusion of coagulable lymph. Guy's Principles of Forensic Medi- 
 cine, 456 - 7 ; Taylor's Medical Jurisprudence, 237. 
 
 If incised wounds be inflicted upon the body some twelve or 
 more hours after death, their characteristics will be as follows : 
 
 1. The edges, instead of being everted, are in close proximi- 
 ty, and are soft, yielding, and destitute of elasticity. The cellu- 
 lar tissue around, is either not at all infiltrated with blood, or to 
 a very limited extent. There is usually little or no bloody effu- 
 sion, but whatever there is, is venous, proceeding from a divided 
 vein. 
 
 2. The blood is fluid. As it falls on surrounding bodies, it 
 forms no coagula. Neither are there any coagula between the 
 lips of the wound. 
 
 3. There are, of course, no signs of inflammatory action. Guy's 
 Principles of Forensic Medicine, 457 - 8. 
 
 The difficulty, here, as in ecchymosis, consists in discriminating 
 where the wound is inflicted soon after death, and while the 
 body is still warm. Mr. Taylor has given the results of several 
 experiments made by him upon limbs recently amputated. See 
 Taylor, 238. In one case, an incision, three inches in length, was 
 made in the calf of the leg, two minutes after its amputation. 
 The skin retracted considerably, causing a protrusion of the adi- 
 
216 MEDICAL JURISPRUDENCE. 
 
 pose substance beneath. But little blood escaped, owing, appa- 
 rently, to the sudden protrusion forwards of the cellular mem- 
 brane, mechanically preventing its exit. After the lapse of 
 twenty-four hours, the edges were found red, bloody and evert- 
 ed ; the skin not in the least degree tumefied, but merely a little 
 flaccid. On separating the edges, a small quantity of fluid blood 
 escaped, but no coagula were seen adhering to the muscles. At 
 the bottom of the wound, in close contact with the fasciae, was a 
 small quantity of coagulated blood ; but the coagula were so 
 loose, as readily to break down under the finger. 
 
 In another experiment, an incision of the same dimensions 
 was made on the other side of the leg, penetrating through the 
 peronei and into the flexor longus pollicis of the deep-seated 
 layer of muscles, ten minutes after its separation from the body. 
 In this case, scarcely any blood escaped, and the edges of the 
 wound became but slightly everted, the skin appearing to have 
 lost its elasticity. Twenty-four hours afterwards, the edges of 
 the incision were pale, and perfectly collapsed, presenting none 
 of the characters of a'wound inflicted during life. At the bot- 
 tom of the wound, and enclosed by the divided muscular fibres, 
 there were some coagula of blood, but fewer than in the other 
 experiments. A portion of liquid blood had escaped, owing to 
 the, leg having been moved. 
 
 Other experiments were made after a longer period of time 
 had elapsed, and the appearances were less distinctly marked. 
 If the incision was not made until two or three hours after the 
 removal of the limb, although -a small quantity of liquid blood 
 was effused, no coagula were found. , 
 
 "When the medical witness has an opportunity of examining 
 the body previous to its removal and being washed, the quantity 
 of blood lost by haemorrhage should be a special object of atten- 
 tion. If the wound be the cause of death, whether immediate 
 or after the lapse of some period of time, and that death arises 
 from exhaustion, the quantity of blood effused will be very great, 
 and the large vessels found comparatively empty ; whereas if the 
 wound be inflicted soon after death, and while the body is still 
 warm, the quantity will be small, unless the weapon happens to 
 
WOUNDS. . 217 
 
 cut a large vein, in which case the cause of the greater effusion 
 may be attributed to that circumstance. It is not always, how- 
 ever, that death from haemorrhage occurs in consequence of ex- 
 haustion. It may arise from the effused blood being confined, so 
 as mechanically to compress and impede the functions of some 
 of those organs which are immediately necessary to life. There 
 may be, for instance, an effusion of blood within the cranium, 
 compressing the brain, within the spinal canal, into the pericar- 
 dium or within the substance of the lungs ; all which may pro- 
 duce death without any great quantity of haemorrhage. But in 
 such cases it will be apparent from the locality of the heenior- 
 rhage. 
 
 A question in relation to the time of the infliction of a wound 
 arose in the case of Greenacre, tried in 1837, for the murder and 
 mutilation of a female. Taylor's Medical Jurisprudence, 238 - 9. 
 The head was found severed from the body, and the question was, 
 whether the severance took place during life or after death. The 
 medical evidence went to show that the head was severed from 
 the body while the female was alive, but probably after she had 
 been rendered insensible by a blow on the head, the marks of 
 which were visible. This evidence was founded on two circum- 
 stances. 
 
 1. The muscles of the neck were found retracted, and 
 
 2d. The head was completely drained of its blood. The last 
 furnished a strong inference ; for, although the severing of the 
 head from the body after death, will be attended with some ef- 
 fusion from the jugular veins, yet the quantity will not be suffi- 
 cient materially to affect the contents of the cerebral vessels. 
 
 In connection with the subject of haemorrhage, some attention 
 should be bestowed upon the means of identifying spots of blood 
 found on the body itself, on the soil, furniture or clothes, or on 
 the instrument with which death has been inflicted. 
 
 There is no direct chemical process by which blood can be 
 identified. This renders it necessary, in cases of doubt and dif- 
 ficulty, to resort to the physical character and appearances, and 
 also the action of chemical agents. 
 
 A small quantity of blood forms, on the surface of steel, a 
 
218 MEDICAL JURISPRUDENCE. 
 
 transparent red spot ; a greater quantity a deep reddish brown 
 crust. The crust scales off under a moderate heat, leaving a 
 clean surface beneath. On placing it within a tube, and subject- 
 ing it to a high v temperature, ammonia is given of, which will 
 be rendered evident by its re-action on test-paper. Guy's Prin- 
 ciples of Forensic Med., 458. 
 
 We are indebted principally to the French medical jurists, for 
 our knowledge of what light chemistry can throw over tl is sub- 
 ject. ( 
 
 In relation to steel instruments there are two kinds of spots 
 resembling those of blood. These are 
 
 1 . Spots of lemon juice. The agent here is the citric acid. 
 When the lemon juice is not wiped off the acid produces thin 
 spots of a reddish yellow color, the thicker being of a reddish 
 brown, nearly resembling those of blood. They separate, like 
 blood spots, on the application of a moderate heat. Subjected 
 to heat, a volatile matter is thrown off, having an acid re-action, 
 while that from blood has an alkaline. Both are soluble in dis- 
 tilled water, but the solution from the former is a light yellow ; 
 that from the latter, red. ' That from the former has an acid re- 
 action ; from the latter, neutral. Infusion of galls with the for- 
 mer yields a black precipitate ; with the latter, a red. 
 
 2. Spots of rust. These are sometimes mistaken for blood. 
 They resemble the lemon juice spots in color, but, unlike those, 
 or spots of blood, they will not scale off on the application of 
 heat. They resemble blood spots in giving off a sufficient quan- 
 tity of ammonia, to have an alkaline re-action on test-paper, when 
 subjected to heat in a glass tube. 
 
 The blood spot is dissolved by maceration in water, while the 
 rust spot is merely detached, and is capable of being completely 
 separated by nitration, so as to leave the water quite clear, and 
 unaffected by the tests of iron. Muriatic acid dissolves iron rust, 
 leaving the metal clean ; the solution affording evidence of the 
 existence of iron when subjected to the appropriate tests. The 
 same effect is produced by the same agent on the lemon juice 
 spot, but the blood spot is not removed, nor is the resulting so- 
 lution affected by the tests for iron. If the instrument, having 
 
WOUNDS. 219 
 
 bloody spots upon it, has been long exposed to the air, spots of 
 rust will be mixed with those of blood, and will be partially de- 
 tached by maceration in water. They can, in such case, be readily 
 separated by filtration. 
 
 Another difficulty may present itself in determining whether 
 appearances resembling spots of blood on clothes, are really ow- 
 ing to blood or to madder, or some other coloring matter. It has 
 been objected that a mixture of madder and albumen, possesses 
 all the characters assigned to blood. Mr. Taylor asserts that 
 mixtures of serum or albumen with cochineal, lac and madder, 
 can in no respect, except in color, be confounded with blood ; 
 that they can deceive no one who does not trust to the red color 
 alone. Taylor's Med. Juris., 271 -2. 
 
 The piece of linen or other stuff, on which the red spot is 
 found, must be cut out and macerated in distilled water. " If 
 the spot is of any thickness, the albumen or coloring matter, will 
 separate and sink to the bottom of the liquid, while the fibrin 
 adheres to the surface in the form of a white filamentary mass. 
 If attempts have been made to remove the stain, or if it has been 
 formed merely by contact with another stain, no fibrin will be 
 found attached to the cloth." Gvy's Med. Juris., 459. 
 
 The application of acids changes the color of madder to yellow, 
 and that of alkalies to violet. A drop of the acetic acid will 
 have this effect, but the blood spot will remain unaltered by it at 
 a low temperature, and acquires a deep brownish hue by boiling. 
 
 The coloring matter of blood in solution, remains unaltered on 
 the addition of ammonia, and the albuminous part of the blood 
 will be detected on boiling, or on the addition of a mineral acid. 
 On macerating stains of blood and red dyes in water, the former 
 are dissolved, while the latter remain unaffected. Guy's Principles 
 of Forensic Medicine, 460. Simple maceration in cold water is 
 the most effectual to remove a blood stain, but the process of re- 
 moval is sometimes slow. Taylor's Med. Juris., 273. 
 
 Iron moulds on linen have sometimes been mistaken for stains 
 of blood. The distinction is easily made. The coloring matter 
 of blood is discharged by water. That of iron is not. Muriatic 
 
220 MEDICAL JURISPRUDENCE. 
 
 acid dissolves out the iron, which may be discovered by its cha- 
 racteristics. Guy's Principles of Forensic Medicine, 460.- 
 
 It has been made a question, if it be possible to tell from 
 a blood stain, whether it be the blood of a man, or of some ani- 
 mal. As the difference in the microscopic character is not suf- 
 ficiently appreciable, except by the most experienced, and then 
 must fail, unless the spots had been entirely undisturbed ; it has 
 been proposed to adopt Barruel's aromatic test, and to attempt 
 distinguishing by the characteristic odor given off on adding to 
 the blood strong sulphuric acid. In the male, he finds the odor 
 of perspiration ; in the female the same, but in a less degree. In 
 the horse, that of horse dung ; and so also with sheep, the ox, 
 dog, &c. Taylor's Med. Juris., 275 ; 2 Beck's Med. Juris., 92-3. 
 
 It is now very generally conceded that this test, and these 
 means of distinguishing, are altogether too uncertain to be relied 
 upon in judicial proceedings. 
 
 The remote effect, or consequence, resulting from wounds of 
 the second class, is inflammation. This is rendered evident 
 principally by the presence in the part of pain, preternatural heat 
 and swelling. The fact of inflammation, resulting, as it does, 
 from living reaction, is of course evidence that the wound was 
 inflicted during life. 
 
 Lacerated wounds combine, to a considerable extent, the cha- 
 racters both of incised and contused wounds. They are accom- 
 panied with less haemorrhage than the incised, and with some of 
 the discoloration of the contused. They are more generally the 
 result of accident than design, and not unfrequently indicate, by 
 their appearance, the means by which they were produced. 
 
 Punctured wounds occupy an intermediate space between in- 
 cised and lacerated wounds. When inflicted with a sharp in- 
 strument, and attended by profuse hsemorrhage, they resemble 
 the former ; but when caused by a blunt instrument, and accom- 
 panied by slight effusion of blood, they are more like the latter 
 They are not unfrequently more dangerous than incised wounds, 
 because they penetrate deeper, and divide imperfectly the nervous 
 filaments . and aponeurotic parts, affording a less free egress to 
 matter effused from them. 
 
WOUNDS. 221 
 
 The considerations connected with sword and gun-shot wounds' 
 are reserved to the. fourth general topic, or that of medico-legal 
 questions. 
 
 III. Wounds as they affect the several parts and systems of the 
 body. 
 
 This may be made the subject of very extended remark, and, 
 even with a consistent degree of brevity, will claim considerable 
 consideration. 
 
 1 . Wounds of the head, injuries of the brain, spinal cord and 
 nervous system. These should be considered, because they are 
 of frequent occurrence ; and either cause death or produce ef- 
 fects dangerous to life ; and are often the subjects of medico- le- 
 gal examination. 
 
 Wounds of the head may either injure the integuments, frac- 
 ture the cranial bones, or penetrate into and injure the substance 
 of the brain. An injury to the integuments may be followed by 
 an erysipelatous inflammation, or by inflammation of the occi- 
 pito-froritalis tendon. The danger is less from incised wounds 
 than from punctured and contused, as punctures may injure the 
 tendon, and contusions disorganize the texture of the skin. A 
 contused wound, if accompanied with much laceration of the in- 
 teguments, is always dangerous on account of the tendency to 
 erysipelatous inflammation. 
 
 The same remark applies to wounds of the integumentary 
 parts as to all other parts of the head, viz : that all prognosis in 
 reference to them must be extremely uncertain. Those which 
 apparently inflict but a slight injury, may be attended with fatal 
 results, while those which seem much more severe, often turn 
 out perfectly harmless. 
 
 Simple fractures of the cranial bones, which are attended with 
 no injury to the membranes, afe not usually followed by any dan- 
 gerous consequences. A blow suflicient to cause a fracture,, may 
 also produce concussion or other injury of the brain. It is im- 
 portant to notice that the injured part of the bone may feel de- 
 pressed, from the fact that the outer table may be driven into the 
 diplce, while the inner one and the brain remain uninjured. The 
 
222 MEDICAL JURISPRUDENCE. 
 
 brain, in such a case, is less liable to suffer from concussion, as 
 the force of the blow is expended upon the fracture. 
 
 It is also important to notice, that the fracture is not always 
 found in that part of the skull on which the blow was inflicted. 
 The skull having the form of an arch, a blow upon one part of 
 it, is not unlikely to produce the fracture at the part directly 
 opposite. Hence, a blow on the vertex, will often occasion a 
 fracture at the base of the skull ; and that more particularly 
 when the force is applied at once to a large surface. 
 
 Fractures at the base, occurring before re-action of the occi- 
 put upon the atlas, occasioned by violence applied at the top of 
 the head, or in whatever other way produced, are more danger- 
 ous than fractures of any other part, for the reason that they are 
 very generally accompanied with a laceration of the brain at its 
 base, or an effusion of blood which compresses it at this vital 
 part, where many of the nerves take their rise. Watson on 
 Horn., 58. 
 
 In such cases, bleeding from the ears is often observed, which 
 is attributable to injury of the lateral sinuses. 
 
 Fractures of the skull are often found to be greatly dispro- 
 portioned to the amount of force used. The same degree of force 
 will cause different extents of fracture when applied to different 
 parts. This is caused principally by the varying thickness of 
 the skull. A blow on the temple, for example, would produce 
 much greater injury than one of equal force applied to other 
 parts of the cranium. So, also, the orbitar plate offers another 
 point easily injured; and the cribriform plate of the ethmoid 
 bone is fractured by a smaller amount of force than any other 
 parts. 
 
 The brain itself may receive injury from three prominent 
 causes. These are, concussion, compression, and inflammation. 
 
 1 . Concussion. This may arise from a severe blow or a violent 
 shock. When it is violent, the symptoms follow immediately, 
 death occurring without re-action. There are several instances 
 of death from this cause, where no lesion of the brain could be 
 discovered ; where there was even no fracture, no effusion, or 
 ■iny lesion to be found on dissection. This is more likely 
 
wounds. 223 
 
 to happen where death is the immediate result of the injury. 
 A shock is given to the "whole nervous organ, which, being un- 
 relieved, speedily lapses into annihilation of function." 
 
 " A prize fighter was taken off the ground insensible, and ap- 
 parently apoplectic, and died in eight hours. No lesion or extra- 
 vasation could be discovered on careful inspection of the brain." 
 
 Blows on the head with the fist may cause concussion, and are 
 not unfrequently made medico-legal subjects of inquiry. In such 
 cases, the person on whom the injury is inflicted, is generally 
 knocked down, and falls upon the ground with some degree of 
 violence. It may hence be doubtful whether the blow, or the 
 fall, caused the concussion. In such cases, if there is effused 
 blood within the cranium, an indication may be drawn from the 
 place where it is found. It will be found opposite to, and cor- 
 responding with, the external mark of injury, whether resulting 
 from the blow or fall. In such cases, however, the culpability 
 of the assailant is generally the same. 
 
 Where concussion is not the immediate cause of death, it may 
 ultimately produce it from an effusion of blood occurring from 
 the ruptured vessels, or from inflammatory effusion or softening 
 of the brain. In such cases, no immediate inconvenience may 
 arise from the injury; but after the lapse of some days, or even 
 weeks, symptoms of compression or inflammation of the brain 
 may supervene, which may result in death after intervals of 
 days, weeks, months, or even years. Hoffbauer mentions a case 
 where a death from concussion took place eleven years after the 
 receipt of the injury. In the case mentioned by Mr. Potts, the 
 woman who received the injury on the head remained well for 
 twelve days. She then fell ill, and died with symptoms of com- 
 pression of the brain. The ventricles were found to contain 
 bloody serum, and a small coagulum of blood. A girl fell from 
 a swing, striking her head violently against the ground. Sh<> 
 complained of headache for six weeks after; then came feverish 
 symptoms, followed by slight delirium and coma. She died in 
 two months after the fall. The ventricles were found distended 
 with serous fluid, but no other morbid appearances presented 
 In cases of chronic inflammation following concussion, the person 
 
224 MEDICAL JURISPRl-DEIKCE. 
 
 may suffer from pain in the head and vomiting. Gw/s Principles 
 of Forensic Medicine, 482-3 ; Taylor's Med. Juris., 304 ; Watscn 
 on Horn., 46-7. 
 
 The most prominent symptoms of concussion are immediate 
 stunning and insensibility, accompanied with headache, a small, 
 weak and irregular pulse ; as also coldness of the extremities 
 and surface of the body ; sometimes attended with delirium, at 
 others with syncope and convulsions. There appears to be a 
 depression of the vital powers by which the blood is circulated, 
 which occasions syncope and death. Simple concussion is dis- 
 tinguished from compression and inflammation, by the weakness 
 and irregularity of the pulse, vomiting and coldness, which ac- 
 companies the insensibility in the former ; while in compression, 
 there is a full, strong, and often irregidar pulse, natural heat of 
 the body, relaxation of the muscles, dilatation of the pupilfi, 
 stertorous breathing, and paralysis. Watson on Horn., 31 — 34 . 
 
 2. Compression. This may result from concussion, in either of 
 two ways : 
 
 1. By a portion of the bone becoming depressed into the 
 brain : or, 
 
 2. By an effusion of blood or serum into its substance. When 
 produced by the cause first mentioned, and death fohWs, there 
 is usually no difficulty, as' the cause will be clearly revealed on 
 post-mortem examination. When death follows compression, 
 resulting from the second cause, it is very possible to urge that 
 the effusion of blood or serum is due to some condition of the 
 system, or to some cause other than the injury. Guy, 483. 
 
 The conditions of the system favorable to effusion are, habits 
 of intoxication, a plethoric habit, an apoplectic make, advanced 
 .age, intense excitement arising out of a contest ; and more espe- 
 cially, a diseased state of the vessels of the brain. These will 
 come more especially to be considered, when we investigate the 
 question of the cause of death. 
 
 Compression from either of the causes enumerated, is attend- 
 ed with the same symptoms. These consist of insensibility, 
 coma, so deep that the sufferer cannot be aroused from it, palsy, 
 slow but otherwise natural pulse, stertorous breathing, dilated 
 
wounds. 225 
 
 pupils. These are sometimes followed by sudden death; bur 
 more commonly, death does not take place until after the lapse 
 of one, two, or several days. Watson on Horn., 58. 
 
 The effect of the concussion, by depressing the state of the 
 circulation, will produce, at first, a slow effusion of blood from 
 the ruptured vessels. When re-action takes place, the quantity 
 of effused blood becomes greater, lb., 52. 
 
 The points to be noted, in cases where death results from com- 
 pression caused by effusion, are, the age and habits of the de- 
 ceased, the condition of his system, whether plethoric or other- 
 wise, his make, his state of excitement at the time, the healthy 
 or diseased condition of the vessels of the brain, and the rela- 
 tion which the effusion bears to the external injury. In refe- 
 rence to the latter point, it may be remarked here, that the prin- 
 ciple formerly brought to view in the case of fractures, is again 
 disclosed in the case of injuries to the brain, viz., that the injury 
 is not always found under the spot where the blow was inflicted, 
 but often, by counter-stroke, on the surface of the brain directly 
 opposite. 
 
 3. Inflammation. Inflammation and its consequences are likely 
 to follow, when injuries to the brain are not immediately fatal. 
 They may follow slight injuries as well as severe ; and those, not 
 only of the organ itself, but also of its common integuments. 
 The time, after the injury, at which the inflammation occurs, is 
 exceedingly various. It sometimes sets in after one or two days ; 
 in others, after one or two weeks ; in others still, it proceeds for 
 several months, insidiously, without affording distinct indications 
 of its existence, until near the approach of a fatal termination. 
 In general, it does not supervene until one week after the acci- 
 dent, nor can the person injured be considered out of danger un- 
 til two or three weeks after the injury. Watson on Hem., 01 -2 ; 
 Guy's Principles of Forensic Medicine, 484. 
 
 A case is given in "Watson on Homicide, C3, which may illus- 
 trate the principle of the supervention of inflammation : 
 
 «T. Kerr, aged 22, was struck on the forehead with a hoe, caus- 
 ing a compound, comminuted and depressed fracture of the 
 
 15 
 
226 MEDICAL JURISPRUDENCE. 
 
 skull. On the day after receiving the injury, Kerr was brought 
 to the Royal Infirmary. He walked up stairs to his bed, and did 
 not seem very ill. Symptoms of inflammation came on, and he 
 died seven days after the injury. On dissection, there was in- 
 flammation of the membranes, and an abscess in the substance 
 of the brain, below the seat of the injury. 
 
 The symptoms indicating inflammation either of the brain 01 
 its membranes, are, fever, pain of head, flushing of face, delirium, 
 quick and sharp pulse ; and when the inflammation has advanced 
 to the effusion of lymph, or suppuration, these symptoms are 
 followed by rigor, convulsions, stupor, insensibility, coma and 
 death. Watson on Horn., 62. 
 
 It should be remarked, that ir juries of the head may at first 
 appear of very little consequence ; but, after a considerable in- 
 terval, dangerous symptoms may arise, and prove fatal. Guyh 
 Principles of Forensic Medicine, 484. 
 
 Injuries to the spinal cord are not of such frequent occurrence 
 as to become often the subjects of medico-legal investigation, as 
 this part is extremely well protected from external violence. 
 The medulla oblongata may be wounded, or compressed by 
 bloody effusion, or by fracture and dislocation of the vertebra, 
 and instant death caused in consequence of the suspension of 
 the circulation and respiration. The penetration of this part 
 with a very small instrument speedily occasions death. An effu- 
 sion of blood at the base of the cranium, may compress this part, 
 and thus quickly occasion death. 
 
 Injuries to the spinal cord will vary in their effects according 
 to the degree of violence used, and the part of the spine which 
 has been wounded. When deeply penetrated, or severely in- 
 jured, at its upper part, death takes place immediately. Such a 
 result may be anticipated, when the wound is above the third 
 cervical vertebrae. If the neck is bent forward, a fatal wound 
 may be very easily inflicted here, and yet leave but a trifling ex- 
 ternal mark of injury. 
 
 Injuries to the spinal cord may arise from falls or blows, the 
 most commonly inflicted on the head or lower part of the spina' 
 
wounds. 227 
 
 column. Injuries inflicted upon the middle or lower portion of 
 the spinal cord, are attended with a loss of power and sensation 
 in the parts below the seat of the injury, and also with a dis- 
 turbance of the functions of the viscera, which sooner or later 
 proves fatal. Injuries which produce neither fracture nor dislo- 
 cation, may occasion death by causing inflammation and soften- 
 ing of the spinal cord. Guy's Principles of Forensic Medicine, 
 484 ; Watson on Horn., 68 - 9 ; Taylor's Med. Juris., 313-14. 
 
 Wounds of the face. Injuries to the face may produce deformi- 
 ty, and thus result in a damage much greater than the injury 
 actually experienced. This is the most likely to occur when 
 the wound is deep-seated. The distribution of important nerves 
 over the face creates a source of danger to be apprehended from 
 wounds there, which does not exist in many other parts of the 
 body. There is also much danger resulting from the near prox- 
 imity of the principal features to the brain. In several instances, 
 trials for murder have taken place, in which the death has been 
 caused by a penetrating wound of the orbit, fracturing the orbi- 
 tar plate, and injuring that organ. It is not even absolutely 
 necessary that the orbitar plate should be fractured or perforated ; 
 but a severe injury there, unattended with fracture or perforation, 
 has caused a fatal inflammation of the brain. Guy's Principles 
 of Forensic Medicine, 484-5 ; Taylor's Med. Juris., 311. 
 
 Wounds of the throat and neck. may become subjects of medico- 
 legal enquiw. The infliction of these, is a mode of death select- 
 ed by many suicides. The murderer sometimes inflicts them, 
 in the hope that they may be attributed to suicide. Wounds on 
 the side of the neck are generally less dangerous than those on 
 the anterior part of the throat. The danger to be apprehended 
 is derived from two sources, viz., the position of the wound and 
 the parts that are injured by it. Wounds inflicted on the lower 
 part of the throat are less dangerous than those of the upper 
 part. A section of the carotid artery is almost invariably fatal, 
 and that almost instantaneously, from the excessive haemorrhage. 
 There are one or two rare cases on record, where immediate ana 
 continued pressure has succeeded in stopping the haemorrhage 
 
228 MEDICAL JURISPRUDENCE. 
 
 sufficient to save life. A division of the internal jugular vein 
 is about on the same footing as that of the carotid artery. 
 
 Wounds of the pharynx and oesophagus are dangerous for two 
 reasons ; one is, that the nourishment of the system must be 
 carried on through them, and deglutition, by the motion it ren- 
 ders necessary, is opposed to an adhesion of the parts ; the other 
 is, that other important parts are generally injured along with 
 them. A wound of the larynx is likely to have an injurious 
 effect on the voice, deranging or weakening it. The trachea may 
 be partially divided, without being attended with much danger. 
 There is always a difficulty in its healing, from the opposition re- 
 sulting from its unquiet state to any re-union of the parts. A 
 complete division of it is generally mortal. Guy's Prin. of Foren. 
 Med., 485 -6 ; 2 Beck's Med. Juris., 206, 7, 8. 
 
 Wounds of the chest or thorax may be either contused or incised. 
 The danger in case of the former is generally in a ratio to the 
 degree of violence used. Injuries of this kind may prove fatal 
 either, 1 . From syncopal asphyxia, or the depression of the con- 
 stitution resulting from the shock ; or, 2. From the inflammation 
 and fever occasioned by the violence. Injuries of this descrip- 
 tion are very generally accompanied by fractures of the ribs or 
 sternum ; or by a rupture of some of the viscera within the 
 cavity ; by a profuse haemorrhage ; or by subsequent inflamma- 
 tion of the organs. The danger resulting from fractur* of the 
 ribs, will depend very much upon whether they are splintered 
 by the fracture, and the points driven inwards, so that they are 
 not reducible. In such a case there is usually a fatal termination. 
 A greater degree of violence is required to fracture the upper 
 ribs than the lower, and hence more danger is to be apprehended 
 from fractures of the former than the latter. Fracture of the 
 sternum may be accompanied with such a degree of concussion 
 as to disturb the internal organs, or the bone may be depressed 
 as well as fractured ; in which case great danger is to be appre- 
 hended from injuries done to the viscera behind it. Otherwise 
 the fracture of this bone may not be considered as dangerous. 
 Taylor's Med. Juris., 314-15; Watson on Horn., 179; 2 Beck's 
 Med. Juris., 209. 
 
wounds. 229 
 
 The danger resulting from incised wounds will depend upon 
 the direction taken by the weapon or instrument inflicting them, 
 and the consequent injury done to the contained viscera. The 
 chances are, that the lungs or heart will be injured, and that the 
 rupture of some blood vessel may give rise to internal hemor- 
 rhage, which will be likely to have a fatal termination. 
 
 The lungs are subject to concussion termed wind concussion, 
 which is usually fatal. Incised wounds of the lungs are attended 
 with a degree of haemorrhage depending upon the size and im- 
 portance of the ruptured blood vessel. As the great mass of the 
 blood circulates through the pulmonary vessels for the purpose 
 of oxygenation, it will be readily perceived, that the rupture of 
 one of those vessels, especially if it be one of the larger trunks, 
 will cause the individual very speedily to sink. The quantity 
 of blood escaping from the wound, is here no criterion of the 
 extent of the injury. It may be also discharged by expectora- 
 tion, or it may accumulate in the cavity of the pleura, until it 
 excludes the respiratory process. One of the criteria by which 
 a wound of the lungs may be known, is the fro thin ess and florid 
 color of the blood which issues from the orifice or is expectorated. 
 The expectoration of it is also another indication. An injury to 
 the substance of the lung is not necessarily fatal. Portions of 
 lung have been entirely removed, and a recovery, nevertheless, 
 taken place ; and a bullet enclosed in a cyst has remained in the 
 substance of the lung for years. Guy's Principles of Forensic 
 Medicine, 487 ; Taylor's Med. Juris., 315 ; 2 Beck's Med. Juris., 
 209-10. 
 
 The heart is also liable to be injured by a penetrating wound 
 in the thorax. All wounds of this organ were formerly con- 
 sidered as necessarily mortal, and that too with very little delay. 
 A more widely extended knowledge, however, has settled the 
 point, that they are not necessarily immediately fatal. Some 
 even appear to be not necessarily mortal. The manner of occa- 
 sioning death is almost invariably by haemorrhage. The rapidity 
 and extent of this will depend very much upon the position and 
 circumstances attending the wound. "Wounds of the base are 
 less speedily fatal than those of the apex ; superficial, less so than 
 
230 MEDICAL JURISPRUDENCE. 
 
 those which penetrate the cavities. Wounds which are parallel 
 to the axis of the heart are less rapidly fatal than those which 
 are transverse to it. Wounds of the ventricles are less rapidly 
 fatal than those of the auricles. A weapon may pass so obliquely 
 through the parieties, that the flap may act like a valve ; or the 
 presence of the weapon in the wound, may mechanically obstruct 
 the effusion of blood ; and thus in each case, the fatal result will 
 be retarded. 
 
 All these circumstances render the time very uncertain at 
 which death occurs. In one case, a soldier had the apex of the 
 heart cut with a long and slender sword, and survived twelve • 
 hours ; the heart, at every stroke, losing a small quantity of 
 blood, till, at the expiration of that time, there was a sufficient 
 quantity entirely to fill the chest, and he died of suffocation. In 
 another case, the point of the sword cut the coronary artery, 
 which threw out its blood so slowly, that two hours elapsed be- 
 fore the pericardium filled with blood, when, after great anxiety, 
 he died. There have been instances of recovery from wounds 
 of the heart, but they are very rare, and generally under peculiar 
 circumstances. Taylor's Med. Juris., 315-16 ; Guy's Principles 
 of Forensic Medicine, 487-8 ; 2 Beck's Med. Juris., 210-11. 
 
 Wounds of the large arteries and veins around the heart are 
 necessarily mortal. Wounds of the thoracic duct are mortal 
 from the extravasation of its contents. Those of the cesophagus 
 would be likely to be so, as the passage of food would be pre- 
 vented, and the function of nutrition impeded or destroyed 
 
 The diaphragm may be wounded by a weapon penetrating 
 either the thorax or abdomen ; but it is seldom injured by any 
 weapon without an injury occurring also to sprue of the impor- 
 tant organs that are in contact with it. 
 
 A puncture of the diaphragm alone is not necessarily attended 
 with fatal consequences, although it may be fatal in its ultimate 
 results, as it is sometimes followed by hernia of , the stomach. 
 The most serious wounds of the diaphragm are those produced 
 by violent contusions. A severe blow or fall may rupture it, 
 and this will occur the most readily while the stomach and viscera 
 are distended. In such cases the muscular fibres are generally 
 
WOUNDS. 231 
 
 found ruptured. The death may occur immediately from a fata] 
 shock to the nervous system. It may also occur after a consider- 
 able interval, from a protrusion of the viscera of the abdomen 
 into the chest, thus disturbing the functions of the organs con- 
 tained in those cavities. . Guy's Principles of Forensic Medicine. 
 488 - 9 ; Taylor's Med. Juris., 318 - 19. 
 
 Wounds of the abdomen may arise either from contusion or in- 
 cision. Contused wounds of the abdomen are generally more 
 dangerous than those of the thorax, as the abdominal parieties 
 have less power to resist external shocks. Incised and punctured 
 wounds, without even penetrating the cavity, maj r prove fatal 
 by wounding the epigastric artery. Their danger, however, usu- 
 ally arises from touching the peritoneum, or injuring one or 
 more of the viscera contained in the abdomen. In the latter 
 case particularly, very difficult medico-legal questions may arise. 
 
 Wounds in the region of the abdomen may prove dangerous 
 in a variety of ways as, 
 
 1. By the shock made upon the nervous system. 
 
 2. By the haemorrhage which results from them. 
 
 3. By subsequently occurring inflammation. 
 
 4. By preventing the nutrition of the body, or other conse- 
 quences remote from the time of the injury. 
 
 Severe and even slight blows on the region of the stomach may 
 produce death immediately, without' any lesion of the internal 
 organs, or- subsequent inflammation. " A man walking through 
 Fleet-street, happened to quarrel with a woman, when another 
 came up and gave him a blow in the region of the stomach, which 
 caused almost instantaneous death. On dissection, no cause 
 could be found to account for his sudden death." Dr. Holland 
 maintains that in such a case, the fatal result is attributable to 
 the sudden propulsion of arterial blood into the left ventricle ; 
 this retrograde movement so overpowering the action of the heart 
 as to cause death. By others it has been generally ascribed to 
 the shock transmitted to the system, through a violent impres- 
 sion produced on the solar plexus. , 
 
 There are also other instances, where the internal organs, as 
 the stomach, intestines, gall bladder, or urinary organs are per- 
 
232 MEDICAL JURISPRUDENCE. 
 
 forated, and their contents become extravasated into the perito- 
 neal cavity. In such cases, such intense pain is immediately oc- 
 casioned, that, before inflammation begins, and without hsemor- 
 rhage, the powers of the nervous system become depressed, and 
 death occurs by the failure of the action of the heart. 
 
 There are also instances where blows, and other injuries of the 
 abdomen, have proved fatal by inducing inflammation, although 
 the internal organs are not injured. A death was caused by blows 
 inflicted on the abdomen with fists, and a kick on the right groin ; 
 and on dissection, the peritoneum was found much inflamed, and 
 covered with purulent effusion. 
 
 There are also other instances where, from a rupture of the 
 intestinal canal, or other viscera of the abdomen, an effusion of 
 foreign matter takes place into the peritoneal cavity, causing vio- 
 lent inflammation, and attended with so great a depression of the 
 nervous energy, that death very soon follows. In such cases 
 there is a feeble pulse, feeling of depression, exhausted look, 
 coldness of the surface and extremities, and collapsed appear- 
 ance, indicating great depression of the action of the heart 
 through the medium of the nervous system. It should be con- 
 stantly kept in view, that a rupture of some part of the bowels 
 may occur spontaneously, and that even without previous dis- 
 ease. 
 
 Penetrating wounds of the abdomen are not always fatal ; and 
 even wounds of the stomach are not necessarily so, many cases 
 of recovery being recorded, when the wound was extensive, and 
 the stomach, at the time, distended with food. Watson on Horn. 
 183, et seq ; Guy's Principles of Forensic Medicine, 489 ; Tay- 
 lor's Med. Juris., 319 -20 ; 2 Beck's Med. Juris., 213-14. 
 
 Wounds of the intestines, may prove injurious in many of the 
 ways already mentioned ; more generally, however, by hsemor- 
 rhage, effusion of contents, and inflammation. They are by no 
 means necessarily fatal, and in the absence of extravasation, 
 there is a fair chance of recovery, as coagulable lymph easily be- 
 comes effused and organized about the edges of the incision. 
 Wounds of the smaller intestines are more dangerous than those 
 of the large, as they are supplied with a greater number of 
 
wounds. 233 
 
 nerves, have more important functions confided to them, and 
 there is much more danger of extravasation of their contents, 
 being in a more fluid state. So also wounds of the duodenum 
 are more dangerous than those of the other small intestines. 
 Guy's Principles of Forensic Medicine, 490 ; 2 Beck's Med. 
 Juris.) 216. 
 
 Wounds of the liver may occur from rupture, or from pene- 
 trating instruments. The former may be occasioned by blows or 
 falls ; or it may happen, (as occurred to an individual who was 
 endeavoring to avoid a fall from his horse,) merely by a very 
 sudden action of the abdominal muscles. 
 
 The rupture generally appears on the convex surface, running 
 from before backwards with a small obliquity, the lacerated edges 
 slightly separated, and the surfaces presenting a granular appear- 
 ance. Ruptures are generally more certainly fatal than penetrat- 
 ing wounds. The latter, if extending to any depth, may prove 
 fatal by dividing some of the large vessels. In other cases, dan- 
 ger may arise from inflammation of the organ. Guy's Principles 
 of Forensic Medicine, 489 ; Taylor's Med. Juris., 320-21. 
 
 Wounds of the gall bladder are generally fatal, owing to the ex- 
 travasation of bile inducing peritonitis. 
 
 Wounds of the spleen are very similar to those of the liver. 
 When deep, they usually prove fatal from hemorrhage. When 
 superficial, they usually admit of recovery. Guy's Principles 
 of Forensic Medici7ie, 489 ; 2 Beck's Med. Juris., 218. 
 
 Wounds of the kidneys are the most likely to arise from blows 
 and stabs in the loins. The dangers to be apprehended from 
 penetrating wounds, are haemorrhage, extravasation of urine, 
 and inflammation. Wounds of these organs are not necessarily 
 fatal, and there are many chances of recovery, provided the ef- 
 fusion of urine into the peritoneal cavity can be prevented. 
 Guy's Prin. of For. Med., 490-2 ; 2 Beck's Med. Juris., 218. 
 
 Wounds of the bladder are the most likely to occur as the re- 
 sult of blows on the lower part of the abdomen. Rupture may 
 also be caused by an accidental fall. The part of it most subject 
 to rupture is the upper and posterior, where the organ is co- 
 vered by the peritoneum. The general effect is, that the urine 
 
234 MEDICAL JURISPRUDENCE. 
 
 becomes extravasated, and death takes place as the result of pe 
 ritoneal inflammation. The time at which the fatal termination 
 occurs, is usually from three to seven days, occasionally longer. 
 One fact to be specially noticed is, that a rupture may be caused 
 Dy a blow so severe in its consequences as to produce death, and 
 yet no mark of ecchymosis or injury to the skin be visible. This 
 furnishes a very plausible defence, and should certainly lead to a 
 more thorough examination of the part, to determine whether 
 some diseased condition may not have led to a spontaneous rup- 
 ture. The medical jurist must, however, be aware, that, owing 
 to the yielding and elastic nature of the parieties, ruptures of 
 the viscera of the abdomen from violence, may take place with- 
 out such ecchymosis or marks of injury. Spontaneous eruption 
 may be very reasonably expected to occur, where a paralysis de- 
 prives of the power to expel the urine, or where the bladder is 
 diseased, or some obstruction exists in the urethra. A blow will 
 seldom, if ever, produce rupture of the bladder, unless it be 
 distended with urine, which is at times its natural condition: The 
 pressure of the child's head during parturition, may occasion 
 rupture of the bladder. This, in England, has furnished the 
 occasion for a case of mal-practice. The danger may be avoided 
 by the use of the catheter. Ruptures of the bladder are com- 
 monly attended with intense pain, sickness, and prostration of 
 strength. The cavity of the pelvis is very frequently the reci- 
 pient of extravasated blood, or other fluids, that may escape in 
 consequence of wounds, or other injuries, to the abdominal 
 viscera. Taylor's Med. Juris., 322, et seq; Guy's Principles of 
 Forensic Medicine, 490. 
 
 Wounds of the genitals may be dangerous from the profuse 
 haemorrhage that sometimes follows. But for the danger arising 
 from this cause, the penis, and even the entire male genitals, 
 may be removed, without being followed by a fatal result. They 
 have in many instances been so, and yet a complete recovery 
 taken place. There have been instances where lunatics and 
 idiots have removed them, and in some cases others, as in the 
 case of Origen, from conscientious motives ; and yet have sur- 
 vived, although the haemorrhage may have been quite profuse 
 
wounds. 235 
 
 The entire removal of the testicles appears to be less dangerous 
 than a severe contusion or bruising them, which may prove fa- 
 tal by the shock communicated to the nervous system. Deep 
 wounds of the labia of the female are dangerous from haemor- 
 rhage. Taylor's Med. Juris., 224 ; 2 Beck's Med. Juris., 220. 
 
 Wounds of the extremities are not generally to be considered as 
 dangerous. When only the integuments, and the first layer of 
 muscular fibres are wounded, they will heal without difficulty. 
 Injuries inflicted on the tendons, are generally very slow in heal- 
 ing, and can often be only imperfectly healed. Compound frac- 
 tures are sometimes hazardous, and comminuted, extremely te- 
 dious in curing. All fractures are much more easily healed in 
 young than in old persons. 2 Beck's Med. Juris., 221 . Equal de - 
 grees of force will more readily produce fractures in the old than 
 in the young, and in the young rather than in the adult. There 
 are also certain diseases, such as syphilis, arthritis, cancer, 
 scurvy, and rachitis, that render the bones fragile, and much 
 more liable to fracture from the same degree of force. Success- 
 ful defences have sometimes been sustained upon this abnormal 
 condition of the bones. Some bones, such as the olecranon, os 
 calcis and patella, have at times been fractured by violent mus- 
 cular exertion alone, but this can seldom happen to the long 
 bones. Taylor's Med. Juris., 325. 
 
 IV. General medico-legal questions that may arise in the in- 
 vestigation of all the wounds, however or wherever inflicted, 
 including the legal principles applicable to this head. 
 
 Under this division arise a great many interesting subjects of 
 inquiry. These, as far as possible, should be presented in a 
 natural order. They are the following : 
 
 1. What was the weapon with which the wound was inflicted, 
 and what are the questions generally arising in the case of 
 sword and gun-shot wounds 1 
 
 2. Was the wound self-inflicted or accidental, or the act of 
 another 1 
 
 3. What circumstances can be gathered relative to the motive 
 or intent of the inflictor 1 
 
236 MEDICAL JURISPRUDENCE. 
 
 4. What acts indicate volition or locomotion after the infliction 
 of mortal wounds 1 
 
 5. How long has the wound been inflicted 1 
 
 6. Was the wound the direct cause of death 1 
 
 7. What are the circumstances that modify the medicolegal 
 character of wounds, and that vary the liability of the inflictor 1 
 
 8. What are the questions that arise in the case of maiming? 
 
 9. How should the medico-legal examination of wounds be 
 conducted 1 
 
 1 . What was the weapon with which the wound was inflicted, 
 and what are the questions generally arising in the case of sword 
 and gun-shot wounds 1 
 
 It may become important, for many reasons, to ascertain the 
 kind of weapon by w'hich the wound was inflicted. It may be 
 a means of identifying the murderer. It may serve to qualify, 
 in some measure, the nature of the action, rendering it murder- 
 ous or not, according to the weapon made use of. Murder, in 
 the State of New-York, may consist in killing another, either 
 
 1 . From a premeditated design to effect the particular death 
 effected, or any death : 
 
 2. When the death is perpetrated by any act imminently dan- 
 gerous to others, and evincing a depraved mind, regardless of 
 human life, although without any premeditated design to effect 
 the death of any particular individual : 
 
 3. When it is perpetrated without any design to effect death, 
 by a person engaged in the commission of any felony. 
 
 The character of an act imminently dangerous to others, and 
 evincing a depraved mind, regardless of human life, can be, to a 
 considerable extent, identified by a reference to the instrument 
 used, coupled, also, with the manner of using it. Hence, so far 
 as these are to be inferred from the nature of the wound, medi 
 cal testimony will go towards identifying the crime of which the 
 person committing it may have been guilty. 
 
 In the case of The People vs. Rector, for the murder of Shep- 
 ard, tried some years since in the city of Albany, the prisoner 
 was charged and found guilty, on one trial, of perpetrating that 
 crime, because he made use of the bar by which his door was 
 
wounds. 237 
 
 fastened, striking the deceased with it a blow or two en the 
 head, in such a manner, and under such circumstances, as that 
 the act was imminently dangerous, and evinced a depraved mind, 
 regardless of human life. It was claimed in defence, that the 
 injury which caused the death was not inflicted by the blow, but 
 arose from the fall of the deceased on the side-walk or curb- 
 stone. 
 
 The probable manner, force, and weapon employed, are to be 
 collected from the nature and extent of the wounds inflicted, 
 judging from the known effects ot certain weapons when applied 
 with different degrees of force. Watson on Horn., 252. 
 
 The remarks to be offered in the discussion of this question, 
 wfll be the best arranged under three heads, viz., those affecting 
 contused, incised and gunshot wounds. 
 
 1. Contused. The variety of means by which contused wounds 
 may be inflicted, the diversity of instruments that may be em- 
 ployed in their infliction, and the varying degrees of force that 
 may have been made use of, all create a greater difficulty in as- 
 certaining the manner of their infliction, and the weapon which 
 had been employed, than is found to exist in any other class of 
 injuries. It is not easy, it is often impossible, to say whether 
 such a wound has resulted from a weapon, or a blow of the fist, 
 or from the person injured having fallen against a hard body. 
 There are but few indications that can enable a witness to say, 
 that a wound on the head was produced by a weapon, and' not 
 by a fall. If the wound be inflicted on the top of the head, it is 
 probably produced by the use of a weapon. So also if there be 
 contused wounds on several parts of the head, with copious effu- 
 sion of blood beneath the skin. Taylor's Med. Juris., 249. 
 
 It is possible to infer,, to some extent, how the injury had been 
 inflicted, from the superficial or deep seated character of the 
 contusion. If a stone is struck smartly with a small hammer, 
 the blow is principally expended on the surface, while the inte- 
 rior remains uninjured. But if the same is struck a slow, heavy 
 blow, with a ponderous hammer, the force penetrates the interior, 
 and shivers its centre, producing little or no injury of the surface. 
 This principle applied to contusions on the human body justifies 
 
238 MEDICAL JURISPRUDENCE. 
 
 the general inference, that contusions of a superficial character 
 have been inflicted by the smart stroke of a comparatively light 
 body, while those which are deeper seated have been occasioned 
 by heavy blows from a more ponderous weapon. Watson on Horn., 
 253-4. It is much upon this principle, that we can explain the 
 fact heretofore mentioned, that there are many instances on re- 
 cord where death has resulted from a violent contusion, without 
 leaving any external mark of injury. 
 
 2. Incised, including punctured wounds. In this class, a close 
 attention to the nature of the wound will justify an inference as 
 to the probable weapon by which it was inflicted. Reference 
 must be had more particularly to its form, the appearance of its 
 edges, its situation, extent, and termination. Watson on Horn., 
 255. 
 
 Punctured wounds generally take the shape of the instrument 
 by which they are caused. This, however, is not always true, 
 as a cylindrical pointed weapon may produce elongated wounds, 
 having two edges, the direction of the wound being the same as 
 that of the muscular fibres of the part. The wound is more 
 usually round where there is much adipose matter. 
 
 In stabs or sword thrusts, the form and depth of the wound will 
 generally indicate the kind of weapon employed. These are ap- 
 parently smaller than the weapon, owing to the elasticity of the 
 skin. In those sword thrusts, or stabs, that have traversed the 
 body, it is important to notice that the entrance aperture is gene- 
 rally larger than that of the exit. The edges of the former are 
 sometimes found everted, owing to the rapid withdrawal of the 
 instrument. Taylor's Med. Juris., 248. 
 
 In incised wounds, the cleanness and regularity with which 
 the edges are cut, will furnish an inference in regard to the sharp- 
 ness of the instrument ; and in the case of a punctured or an 
 incised wound, it is important to ascertain the situation of the 
 edges, to see whether they are lacerated and irregular, or clean 
 cut, indicating that a sharp instrument has been employed. The 
 defence interposed not unfrequently is, that the deceased had 
 fallen on glass or some other substance that had caused the in 
 jury- 
 
wounds. 239 
 
 A case, strikingly illustrating this, is cited by Mr. Watscn, that 
 of Mrs. Pollock, page 256. On examining the body, and sepa- 
 rating the labia pudendi, a wound about an inch and a quarter 
 in length was found upon the inner side of the right nympha. 
 It was a clean, straight incision, and internally admitted the in- 
 troduction of the finger in four different directions to the depth 
 of about two and a half inches each. In each direction the 
 wound had nearly the same diameter, and an obtuse termination. 
 None of the large vessels had been wounded, nor the peritoneum 
 penetrated. The indications afforded by the cleanness of the 
 cut, the obtuse termination of the wounds, their small depth, and 
 the absence of any injury of the important neighboring parts, all 
 pointed to an instrument having a sharp edge and a round or 
 blunt point. The medical witnesses, therefore, had little doubt 
 but that this instrument was a razor, and in confirmation of their 
 conclusion, one was afterwards found, concealed in a piece of 
 cloth, having its. blade and handle covered with blood. One of 
 the defences here interposed was, that the deceased had fallen 
 upon a piece of broken earthen-ware and cut herself; but the 
 answer made was, that in such a case the wound would have 
 been a lacerated one ; of no great depth, not larger internally 
 than externally, in no part greater than the size of the wounding 
 body, and probably not having different directions internally. 
 
 In the case of Mrs. Calderhead, also stated by Mr. Watson, 
 page 258 - 9, the death was caused by the haemorrhage, which 
 proceeded from a wound upon the middle of the left labium pu- 
 dendi. It was a clean incision about three-quarters of an inch 
 in length, having a straight direction parallel with the margin 
 of the labium. The wound consisted of a bloody cavity, from 
 which the finger passed to a greater depth in three different di- 
 rections. The greatest depth was between two and three inches. 
 The divided vessels, and the internal surface of the wound, had 
 the appearance of having been very clean cut by a sharp instru- 
 ment. Near her was found some pieces of a broken wine glass, 
 and the question was whether the wound could have been occa 
 sioned by her falling upon these broken pieces of glass. For the 
 reasons assigned, it was judged by the medical witnesses t( U 
 
240 , MEDICAL JURISPRUDENCE. 
 
 scarcely possible, and very improbable, that the wound could 
 have been thus produced ; and from the straight, clean incision, 
 the length, extent and cleanness of the wound internally, and its 
 different directions, it was rendered very evident that the instru- 
 ment was a knife, and that the wound was produced by several 
 tirusts of it, each varying in the direction taken. 
 
 In another case, one man was struck by another and knocked 
 against a window. No weapon had been seen in the hand of the 
 prisoner, but there were three deep cuts on the face of the de- 
 ceased. The medical witness deposed that the wounds appeared 
 to have been inflicted by a knife or razor blade, and that no par- 
 ticles of glass had been found in the wounds, as would have been 
 likely to have been the case had they been inflicted by the broken 
 glass. Wounds made by glass are characterised by their great 
 irregularity and the unevenness of their edges. Taylor's Med. 
 Juris., 248. 
 
 3. Gun-shot wounds. Many questions may arise, and some of 
 a very difficult nature, in cases of gun-shot wounds. They are 
 of the contused kind, but differ from that class generally, in hav- 
 ing the vitality of the part struck destroyed, leading rapidly to 
 the process of sloughing. Taylor's Med. Juris., 328. 
 
 A gun-shot wound can, in general, be easily distinguished from 
 any other. The death resulting from it may proceed from the 
 haemorrhage or shock. Unless some large blood vessel happens 
 to be severed, or torn by the ball or shot, the haemorrhage is not 
 likely to be very extensive. Death is sometimes occasioned by 
 the shock given to the nervous system, as in the case of Daly, 
 (Taylor, 328,) who died in a few seconds, the bullet having tra- 
 versed the distended stomach at the cardiac end from behind 
 forwards. 
 
 One of the questions the most frequently arising, is, was the 
 wound inflicted before or after death 1 This is extremely diffi- 
 cult to answer. If the ball has struck and injured a large blood 
 vessel, the haemorrhage, and formation of coagula, may afford a 
 pretty clear indication that it was inflicted during life. A ball 
 penetrating a body after death, would cause no haemorrhage, un- 
 less it happened to wound a large vein. If the ball, in its rvi'rse, 
 
ros. 211 
 
 has injured no large vessel, the simple inspection of the wound 
 will hardly enable the medical witness to say whether the wound 
 was inflicted previous or subsequent to death. 
 
 Another question frequently arising is, was the ball fired near 
 the deceased, or from a distance 1 When the muzzle of the piece 
 is placed near the surface of the body of the deceased, the fol- 
 lowing are the characteristics of the wound, as given by Dever- 
 gie. Taylors Medical Jurisprudence, 329. 
 
 1. A superficial bluish color of the skin, arising from the con- 
 tusion caused by the explosion : 
 
 2. Particles of charcoal and ignited powder imbedded in the 
 skin : 
 
 3. Slight burning : 
 
 4. Coagulation of blood, mixed with the powder, on the lips 
 of the wound. 
 
 If the muzzle be in direct contact, the skin will be found torn 
 and lacerated, in addition to being burnt ; but if not, the wound 
 will exhibit a rounded appearance. This rounded appearance, 
 however, will not be presented, unless the ball strike the body at 
 right-angles, or nearly so. If it strike it obliquely, the orifice is 
 of an oval or valvular form ; and this may furnish something of 
 an indication relative to the position occupied by the assailing 
 party. 
 
 The parts of the body traversed by the ball, and the varying 
 degrees of resistance interposed, may afford some indication as 
 to the distance from which it was fired. As the force will be so 
 much modified by the strength of the charge, this, perhaps, 
 should be but little relied upon. If fired from a moderate dis- 
 tance, the entrance hole will be found well defined, round or 
 oval; the skin slightly depressed inwards, the edges being in- 
 verted, and presenting a faint bruised appearance. The exit 
 hole is considerably larger, sometimes three or four times, than 
 the entrance; more irregular, the edges being everted, and the 
 skin lacerated, but free from marks of blackness or burning. 
 When the ball has perforated flat bones, the same difference, but 
 less in degree, is observed between the size and appearance of 
 
 16 
 
212 MEDICAL JURISPRUDENCE. 
 
 the two openings. 2 Beck's Med. Juris., 76 ; Taylor's Med. Juris., 
 329. 
 
 The living skin is so elastic that the entrance aperture wilJ 
 generally have the appearance of being smaller than the ball. 
 So, also, if the dress be composed of an elastic material, the hole 
 made in it is smaller than that made by the ball in the integu- 
 ments. , 
 
 The appearances presented by a wound made by a rifle ball 
 will be different from those made by one from a common musket. 
 The former acquires a spiral motion from the spiral groove made 
 in the barrel, and hence makes a ragged hole, much larger than 
 itself. 2 Beck's Med. Juris., 78-9 ; Taylor's Med. Juris., 339. 
 
 Some indications can be sometimes drawn from the hole made 
 in the dress, as to the direction from which the ball was fired. 
 If from a moderate distance, the entrance aperture is round, and 
 the margin regularly defined ; but the exit, aperture is irregular 
 and torn. Taylor's Med. Juris., 330. 
 
 It sometimes becomes very material to determine, whether the 
 gun was fired near the deceased, or from a distance. A case in- 
 volving this question, occurred in Ireland, in 1834. The ques- 
 tion, whether, in a scuffle, a pistol had accidentally gone off, and oc- 
 casioned the death, or whether the person had deliberately fired at 
 him from some distance. The sons of the deceased swore thatthe 
 pistol was fired from some distance, the prisoner taking delibe- 
 rate aim. This was confirmed by the priest, who deposed that 
 such was the dying declaration of the deceased. But on a care- 
 ful examination of the body, which was disinterred for that pur- 
 pose, the surgeon was enabled to swear positively, that the pistol 
 must have been fired close to the body of the deceased, as there 
 distinctly appeared the marks of powder and burning on the wrist. 
 So conclusive was this evidence deemed, that the prisoner was 
 acquitted, and the parties who had appeared as witnesses against 
 him, were indicted and convicted of perjury. Taylor's Med. 
 Juris., 330. 
 
 So, in another case, a soldier placed as a sentry, was found 
 severely wounded, the calf of his leg having received a discharge 
 from a musket, and being greatly torn. He attributed it to a 
 
wounds. 243 
 
 shot from the enemy ; but on examination, the skin of the leg 
 was found completely blackened with charcoal, thus rendering it 
 perfectly clear that the wound had proceeded from the discharge 
 of his own musket, his object being to get a discharge from his 
 regiment. Taylor's Med. Juris., 331. 
 
 It is important to observe, that, under some circumstances, one 
 ball may produce several wounds on or in the body, owing to its 
 splitting and taking different directions. This has repeatedly 
 occurred, where the ball has encountered an angular surface, or 
 a projecting ridge of bones ; and sometimes, without encounter- 
 ing an angular surface. One instance is mentioned, in which the 
 ball, having struck the ridge of the tibia, divided itself into two 
 parts, which, after having traversed the calf of that leg, pene- 
 trated into that of the other ; thus inflicting no less than five 
 wounds — three of entrance and two of exit. So, also, a ball 
 which struck the parietal bone, divided into two portions, one 
 of which passed out through the integuments, while the other 
 penetrated into the substance of the brain. lb., 331 -2. 
 
 There are also some singular, and indeed very extraordinary, 
 instances on record, where the ball has been deflected from its 
 rectilinear course, and pursued an extremely circuitous route. 
 This is apt to occur when it strikes obliquely a curved surface, 
 and it seems unnecessary that it should come in contact with 
 bone, but may also take place on meeting with skin, muscles, 
 tendons and fasciae. Thus, where two openings in the scalp were 
 found nearly opposite each other, it was found that the ball had 
 not penetrated the bone, but had followed the curve of the cra- 
 nium to its place of exit. lb., 332 - 3. 
 
 A ball entering at the ankle made its exit at the knee. Another 
 entering at the back of the left shoulder, was found below the 
 right mastoid process. A ball which had entered near the thy- 
 roid cartilage, passed quite round the neck, and was found at 
 the spot at which it entered. Another instance is mentioned by 
 Dr. Hennen, where the ball struck the breast and lodged in the 
 scrotum, the man standing erect in the ranks. Taylor's Med 
 Juris., 333 ; 2 Beck's Med. Juris., 78. 
 
 In the case of The King vs. Morgan, which occurred in 1835, 
 
244 MEDICAL JURISPRUDENCE. 
 
 (Taylor, 333,) the question was raised, whether in case the gun 
 bursts, the ball will take the direction which it would otherwise 
 have taken, had it remained entire. It was held that the burst- 
 ing of a gun is posterior to the impulsive direction given to the 
 charge, and that therefore it will take the same direction it would 
 have taken if the gun had not burst. 
 
 It is generally a very material enquiry, to ascertain the direc- 
 tion from which the ball has been fired. This can be easily and 
 quite satisfactorily ascertained, if two fixed points can be found 
 where the ball has touched without being reflected. The follow- 
 ing case occurred, illustrating this. Several shots had been fired 
 into a church ; some balls entered at a window, and also struck 
 against a wall on the opposite side of the church. A line con- 
 necting these two, and extended out, would reach a window on 
 the opposite side of the street, from which the shots had been 
 fired. Taylor's Med. Juris., 333. 
 
 Another question which sometimes becomes important to settle, 
 regards the position of the party shot, at the time the charge 
 takes effect; whether he were* standing, falling, or lying down; 
 or whether he was advancing or retiring. This depends much 
 upon the circumstances of each case. In case of a person shot 
 standing, the gun being pointed from the shoulder, the course of 
 the ball will generally be transverse ; although, as we have al- 
 ready seen, it may become deflected. 
 
 A trial involving some of these questions, will be found re- 
 ported by Dr. Gordon Smith ; also, in 2 Beck, 76 - 7, and in 
 Taylor, 335-6. A man in company with a party of smugglers, 
 was shot in the night. The prisoner and Ms men were pursuing 
 them, and while so pursuing, he tripped, and in the fall, his gun 
 went off. The smugglers also were firing on the prisoner and 
 men in pursuit. The point to determine was, from which party 
 the fatal shot came, as the deceased was between his own party, 
 who were retreating and firing, and the prisoner and his party 
 who were pursuing. If, therefore, the ball entered in front, it 
 must have come from his own party ; if in the rear, from the 
 prisoner. One of the witnesses examined was a navy surgeon, 
 who found the wound in the upper part of the groin much small 
 
wounds. 245 
 
 er than that m the lower part of the buttock, the lattei being 
 twice or three times the size of the former, and quite ragged and 
 uneven. In the hinder opening were also found fragments of 
 bone, but none in the cavity of the pelvis. He was therefore of 
 opinion, that the ball had entered in front, and had come from 
 the smugglers. 
 
 Another case is reported in the English State Trials, of one 
 Richard Annesley, who asserted that his gun had accidentally 
 gone off in attempting to secure the deceased, who was a poach- 
 er. The evidence of the surgeon was, that the direction of the 
 wound was upwards, and that, in his opinion, therefore, the 
 fowling-piece had not been levelled from the shoulder. 2 Beck's 
 Med. Juris., 77; note. 
 
 "Where the charge consists of small shot instead of a ball, a 
 more certain evidence is furnished in regard to the distance from 
 which it was fired. This arises from the tendency of the shot 
 to scatter after leaving the gun barrel. When the discharge is 
 very near, the shot strike without spreading, and make a round 
 hole, but produce very extensive lacerations. In order to do 
 that, however, the distance cannot be greater than ten or twelve 
 inches from the surface of the body. When the distance ex- 
 ceeds twelve, and ranges between twelve and eighteen, the open- 
 ing is irregular, and borders much lacerated. When fired from 
 a distance of thirty-six inches, the central opening becomes en- 
 tirely lost, and the surface of the body more or less covered with 
 shot. Thus after the distance becomes so great that the central 
 opening is lost, the greater the spaces between the pellets of shot, 
 the greater must have been the distance from which the gun was 
 fired. This, it is true, will be modified by the goodness of the 
 gun, and the strength of the charge, as well as by the distance. 
 Taylor's Medical Jurisprudence, 336. 
 
 Another question connected with gun-shot wounds which has 
 arisen for investigation and settlement, is, whether a person firing 
 a gun or pistol in a dark night, can be identified by means of 
 the light produced by the discharge. Two or three cases have 
 occurred in which this question has arisen. In the case of Rex 
 vs. Haines, (see Taylor, 338,) same police officers were shot at by 
 
246 MEDICAL JURISPRUDENCE. 
 
 a highwayman during a dark night. One of the officers stated 
 that he was enabled, by the flash of the pistol, to see that the 
 robber rode a dark brown horse of such a remarkably shaped 
 head and shoulders, that he could identify him, and had since 
 done so at a stable in London ; and also that the person firing it 
 had on a dark brown great coat. In the case of the Queen vs. 
 White, which occurred in 1839, a gentleman was wounded in 
 the elbow by a shot fired at him. while riding home in a gig on a 
 dark night. He observed the flash of the gun, saw it was levelled 
 towards him, and was enabled by the light of the flash, to recog- 
 nize the features of the accused. He was quite sure he was not 
 mistaken in his identity. 
 
 Many experiments have been made with a view to the settle 
 ment of this question, the result of which seems to be, that on 
 a very dark night, and away from every source of fight, a per- 
 son who had fired the gun might be identified within a moderate 
 distance. But if the flash were very strong, the smoke very 
 dense, and the distance great, he could not be identified by such 
 means. Taylor's Med. Juris., 337-8. 
 
 2. The second general question that arises is, was the wound 
 self-inflicted, or accidental, or the act of another 1 The settle- 
 ment of this question must depend much upon the peculiar cir- 
 cumstances of each individual case. It may be important to at- 
 tend 
 
 1 . To the situation in which the body is found. 
 
 A body found in a room locked on the inside, the throat cut, 
 and the instrument of death near at hand, would not only justify, 
 but require the inference that the act was suicidal. So also it 
 would be about equally clear, if a body were found divested of 
 life by a similar wound, in a room accessible to others, the wea- 
 pon of death being removed, that it was neither suicidal nor ac- 
 cidental, but the act of another. Where there has been a secret 
 burial, or an attempt to wash away stains of blood, or to conceal 
 any of the evidences by which the nature of the transaction 
 would be likely to be revealed, the inference of suicide would be 
 negatived, and the fact of murder be rendered apparent. Any 
 cut or thing clearly evincing design, would go far towards mak- 
 
wounds. 247 
 
 ing out a case of intenticial homicide. Where a body is found 
 at the foot of a precipice, having upon it the marks of severe 
 contusions, the inference of accident or suicide- is very strong 
 Watson on Horn., 264 - 5. 
 
 2. The nature and situation of the wound or injury, may in- 
 dicate the manner in which this question should be settled . So far 
 as the nature of it is concerned, it may be assumed that contu- 
 sions are seldom self-iuflicted, but they may result either from 
 accident or homicide. They may, it is true, be produced by 
 one's throwing himself over a precipice or out of a window, but 
 in such cases the cause of death is very apparent. The marks 
 of injury found upon a body, at the foot of Salisbury crags, con- 
 sisted of a black eye, and slight cuts on the head, a large wound 
 on the sacrum, and a severe fracture of the left ancle joint. These 
 left little doubt, but that the death was due either to accident or 
 suicide. It is very important to examine the situation of a con- 
 tusion. It may be found on a part of the body which could not 
 well have been injured by an accidental fall, as on the inner side 
 of the arms or legs. Those very severe contusions or lacerations 
 that must necessarily have been produced by a ponderous wea- 
 pon, such as an axe or hammer, have, in all probability, been 
 inflicted by another for a murderous purpose. Watson on Horn., 
 269-70. 
 
 The anterior or lateral parts of the body, are the more gene- 
 rally wounded in case of suicide, as they are the most easily ac- 
 cessible. Where cutting instruments are employed, the throat 
 and chest are the parts the most commonly selected. Where fire 
 arms are made use of, the region of the heart, the mouth, the 
 orbit and the temples, are the parts frequently chosen. In more 
 general terms, the most exposed parts of the body are the most 
 likely to become the recipients of wounds which result from ac- 
 cident or suicide, while those which are inflicted in a concealed, 
 or rtot easily accessible part, afford presumptive evidence of mur- 
 der. It is a fact generally true, that all accidental wounds are 
 to be found in exposed parts of the body. There are, however, 
 several wounds of exposed parts that are of such a nature as al- 
 most to preclude the idea of their being accidental ; such, for in- 
 
248 MEDICAL JURISPRUDENCE. 
 
 stance, as deeply incised wounds of the throat, and gun-shot 
 wounds of the mouth and temples. Taylor's Med. Juris., 251-2. 
 
 It sometimes becomes necessary to determine whether the in- 
 dividual met his death by falling on the weapon, or by having it 
 t'mist into him. This question arose in the case of J. Scheffer, 
 who was found dead with a wound two fingers breadth below 
 the nipple, and between the second and third ribs. The defence 
 was, that he had met his death by rushing on the sword of the 
 accused. Taylor, 251 -2. 
 
 To this it was answered, that this was impossible, as the wound 
 was on the right side, and that it could not, therefore, have been 
 inflicted unless he had run sideways. The medical faculty of 
 Giessen, gave their opinion in favor of the defence, for the rea- 
 son, that the deceased being at the time drunk, and in a great 
 rage, probably assumed that kind of motion which the French 
 call passade, by which the wound could have been inflicted in 
 the manner it actually presented. 2 Beck's Med. Juris., 70. 
 
 3. The direction of the wound will sometimes afford an indi- 
 cation whether it be suicidal, accidental or homicidal. In suici- 
 cal wounds affecting the throat, the direction of the cut is the 
 most commonly observed to be from left to right, either trans- 
 versely or obliquely from above downwards. In suicidal stabs 
 and punctured wounds, the direction is commonly from right to 
 left, and from above downwards. This, however, is on the 
 supposition that the individual was right handed, which is not al 
 ways the fact. One good method that has been recommended is 
 to place the -weapon in the hand of the deceased, and then, by 
 moving the hand and arm, ascertain whether the wound could 
 possibly have been inflicted by him or not. Oblique wounds pas? 
 .sing from above downwards are very common both to homicide 
 and suicide. Taylor's Med. Juris., 255. 
 
 Those wounds which take an oblique course from below up 
 wards, are more commonly the result of homicide. The inStru 
 ment should be carefully compared with the wound. Its adapta- 
 tion to the edges of the incision should be ascertained. Its 
 sharpness should aho be compared with the cleanness and even- 
 ness of the cut, and its length with the depth of the incision o 
 
WOUNDS. 219 
 
 stab. The regularity of the wound, and the cleanness and even- 
 ness of the cut, have been considered by some as affording pre- 
 sumptive evidence of suicide, and by others, of homicide. Some 
 assert that an incised wound which is self inflicted, is likely to 
 be jagged and uneven, arising from the supposed inquietude and 
 want of resolution of the suicide. Again, others suppose that 
 such jaggedness and unevenness will be much more likely to oc- 
 cur in homicide, where there is undoubtedly resistance made to 
 the attempts of the murderer. Sir Everard Home, in the case 
 of Sellis, the servant of the Duke of Cumberland, says "I went 
 to his apartment, found the body lying on its side on the bed, 
 without his coat and neckcloth ; the throat cut so effectually, that 
 he could not have survived a minute or two. The length and 
 direction of the wound was such as left no doubt of its being 
 given by his own hand ; any struggle would have made it irregu- 
 lar. He had not even changed his position, his hands lay as 
 they do in a person who has fainted ; they had no marks of vio- 
 lence upon them, his coat hung upon a chair, out of the reach 
 of blood from the bed ; the sleeve, from the wrist to the shoul- 
 der, was sprinkled with blood quite dry, evidently from a wounded 
 artery P 2 Beck's Med. Juris., 82. 
 
 The direction of the wound, together with some other circum- 
 stances, became material in a case cited by Dr. Beck from Fodere. 
 See 2 Beck, 71 . A contest arose between a miller and a butcher. 
 The former was killed, but the latter pretended he had no inten- 
 tion of killing him, but had only threatened him with his knife ; 
 that the miller renewed the attack, and in attempting to pursue 
 him, made a false step and had fallen on the weapon. An ex- 
 amination disclosed the fact, that there was a single external 
 wound, which led downward to two wounds of the left ventricle 
 of the heart, separated from each other by an interval of two 
 lines. This showed very clearly that the accused had employed 
 the same method to destroy his victim, as that used by butchers 
 in Germany to kill cattle ; that is, after having driven the knife 
 into the heart, they withdraw it some distance, and re-plunge it, 
 so as to make a second internal wound. This peculiarity in the 
 direction of the wound, compared with the respective statures 
 
250 MEDICAL JURISFRUDEJSXK. 
 
 of the two parties, the miller being much the larger of the two, 
 proved that the blow had been inflicted obliquely from above 
 downwards, and must have been so inflicted while the miller was 
 sitting at his door, and not by a fall after getting on his feet, in 
 which case the wound must have taken an opposite direction. 
 
 Another rather remarkable instance is mentioned by Taylor, 
 page 253. The body of a farmer was found lying on the high 
 road, the throat severely cut, and the death having obviously 
 been caused by the great hsemorrhage that had taken place. At 
 some distance from the body a bloody knife was discovered, and 
 his pockets were found to have been rifled of their contents. 
 The wound of the throat, on being examined by a surgeon, proved 
 conclusively from its direction, that it could not have been self- 
 inflicted. It was not cut in the manner of suicides, by carrying 
 the cutting instrument from before backwards. 1 The knife had 
 been first passed in deeply under and below the ear, and then 
 brought out by a semi-circular sweep in front, all the great ves- 
 sels of the neck, together with the oesophagus and tracliEea,having 
 been divided from behind forwards. It was obviously done in 
 the same manner that the throats of sheep are cut when slaugh- 
 tered by a butcher. This circumstance not only negatived the 
 idea of self-murder, but served also to detect the murderer, who 
 was subsequently tried and executed, and proved, according to 
 the indication furnished, to have been a butcher. 
 
 A very singidar case, that of Augustus Dautun, occurred in 
 Paris in 1814. The body was found cut into four or five parts, 
 the head having contusions on it, and there being wounds in the 
 chest. All the different portions were carried to the Morgue, 
 and a model in plaster taken of the bust. By means of this 
 , plaster model the body was afterwards identified, a wart being 
 found on the upper Up, and the bones of the thigh proving that 
 the individual had been lame. 
 
 The principal wound was in the chest, which was found to 
 have penetrated to the heart. It was larger within than at the 
 surface, and a second wound was discovered in the aorta two 
 inches higher than the other. The. appearances very clearly 
 
WOUNDS. 251 
 
 justified the conclusion, that a second blow had been given with 
 'the dagger, before withdrawing it, merely altering its direction. 
 
 The murderer was found to have been his brother Charles 
 Dautun. The means of his identification, as related by Zerah 
 Colburn, were very curious, and sufficiently so, to merit insertion . 
 
 "In the teeth of the dead body, tightly compressed, was a 
 piece of human flesh, apparently torn out in the dying struggle. 
 After some time, Dautun, the brother, was gambling at the Palais 
 Royal, and becoming angry, threw a glass at the waiter. It was 
 shivered into pieces, and a fragment was carried into Dautun's 
 wrist, under the cuff of his coat. The spectators wished to 
 examine the injury, but he obstinately refused. At last, suspect- 
 ing something mysterious, they pushed up the sleeve by force, 
 and there beheld a scar recently healed, as if made by the tear- 
 ing out of flesh. The landlord had been at the Morgue, and 
 seen the plaster model. He therefore delivered him to the legal 
 authorities, as probably the murderer." 
 
 A companion in debauchery of Dautun was implicated and 
 tried as an accomplice; and on the trial, Depuytren was ask- 
 ed the important question, if any marks on the dead body could 
 indicate whether the murdered person had been attacked by one 
 or more persons. He replied, that he could say nothing except 
 as to probabilities, but that it appeared to him that a plurality 
 of persons had been engaged in the murder, and he assigned the 
 following ingenious reasons : 
 
 " When a man is struck, his first act is to present his hands 
 as a defence against the blow. In this case, there was not 
 the slightest mark of injury on them. The same person that 
 inflicted all these wounds could not, at the same time, have held 
 them. Again, the wounds on the head must have preceded 
 those on the chest. These were mortal, the thorax containing 
 four pounds of blood. While the hands were held, might not 
 the head have been interposed to prevent the wounds in the 
 chest." 2 Beck's Med. Juris., 88-9. 
 
 " In a case mentioned by Orfila, a body was found divided 
 into two parts by means of a cutting instrument pressed into 
 the fibro-cartilage, uniting the third and fourth lumbar vertebrae 
 
252 MEDICAL JURISPRUDENCE. 
 
 The articulating process of the vertebrae had been cut trans- 
 versely through, as butchers are accustomed to cut through the 
 spines of animals. M. Ouvrard was led to suspect that the man 
 who had committed the murder was a butcher ; and this turned 
 out to be the case." Guy's Principles of Forensic Medicine, 478. 
 
 It is stated generally, by Watson, that if a self-destroyer effects 
 his purpose by a cutting instrument, or incisions, he selects the 
 throat ; that if he stabs himself, he selects the chest or belly ; 
 and if he shoots himself, he generally does it through the head. 
 Watson on Horn., 276. 
 
 It is to be observed, that suicidal gun-shot wounds are almost 
 always directed to a vital part, either to the brain or to the' 
 heart. Another important thing to notice is, that they possess 
 the character of wounds inflicted near the body, such as the 
 blackened and burned skin, the wide and lacerated wound, the 
 discharged pistol near the hand, often blackened by its discharge, 
 and sometimes within its grasp. Taylor's Med. Juris., 334. 
 
 An interesting case illustrating this last remark, occurred in 
 France, in 1835. The body of the deceased was found sitting 
 in a chair by the side of the bed, his elbow resting on the bolster, 
 and his right hand laying over the right thigh, and grasping a 
 pistol which appeared to have been recently discharged. The 
 death was evidently caused by a severe gun-shot wound of the 
 head. The son slept in the same room with the deceased, and 
 he was accused of having murdered his parent, and then of 
 having placed the pistol in his hand-, to give the whole the ap- 
 pearance of suicide. There were some moral circumstances 
 against the son ; but the fact principally relied upon, was, that 
 when the hand, with the pistol within it, was carried to the posi- 
 tion in which the weapon must have been held by the deceased, 
 to have committed the fatal act himself, and the hand was after- 
 wards allowed to fall by its own weight, the pistol each time fell 
 from the hand to the floor. The medical witness, after some re- 
 flection, satisfactorily accounted for the hand retaining the pistol 
 after death, by the contractile state of the muscles continuing 
 under the form of cadaverous spasm. The fact that knives and 
 razors, as well as pistols, are not unfrequently found grasped in 
 
wounds. 253 
 
 in the hands of suicides, is accounted for on the same principle. 
 It is owing to the muscular spasm persisting after death, and 
 which is quite distinct from cadaverous rigidity. Taylor's Med. 
 Juris. , 261. 
 
 Suicidal gun-shot wounds will very seldom bt fired from be- 
 liind, so that if the entrance is at the posterior surface of the 
 body, the presumption is against suicide, and in favor of homi- 
 cide. A gun-shot wound in the mouth or temples, would not 
 generally be considered as accidental. 
 
 4. The number of the wounds is another circumstance, from 
 which, it is said by some, an inference can be drawn in reference 
 to their being of accidental, suicidal, or murderous infliction. 
 It may perhaps bcasserted, as a general rule, that the suicide in- 
 flicts but one wound, viz., that which destroys life; and with 
 those who are determined, and inflict it with a lethal instrument, 
 the rule is most likely to hold good. At the same time, it is per- 
 fectly clear, that the murderer can kill by one wound. So also 
 the suicide may inflict upon himself several wounds. The prin 
 ciple is, that the infliction of two mortal wounds, by the suicide, 
 is not a credible supposition ; because, by the infliction of one, 
 his mind would be so much impaired, and his strength diminish- 
 ed, that he would be unable to inflict another. If the first were 
 of a nature to stun him, and thus deprive him of sensation, or 
 if the trunk of a great artery were cut, or the heart or brain 
 traversed, this would probably be true. .But many wounds are 
 necessarily mortal, and yet permit many acts of volition to be 
 afterwards done by the person upon whom they are inflicted. 
 Taylor's Med. Juris., 257 ; 2 Beck's Med. Juris., 79-80 ; Guy's 
 Principles of Forensic Medicine, 478. 
 
 To illustrate this, the following case may be mentioned : A 
 gentleman of Rouen was found dead in his chamber ; in the 
 room were found two pistols, one near the body, and the other 
 on the bed, at some distance from it. It was ascertained that 
 the deceased had shot himself in two places. One wound had 
 completely traversed the left side of the chest, breaking a rib 
 before and behind, perforating the lung through its middle por- 
 tion, and passing near to the roots of the pulmonary veins. This 
 
254 MEDICAL JURISPRUDENCE. 
 
 was apparently inflicted while he was lying on the bed, and had 
 caused a very large quantity of blood to become extravasated in 
 the thorax. Notwithstanding the infliction of this mortal wound, 
 it appeared that he must have risen from his bed, and walked to 
 a closet to procure another pistol, with which he inflicted a sec- 
 ond wound, that must have proved instantly mortal, the ball 
 having entered at the frontal bone, and, after traversing the left 
 hemisphere of the brain, had become lodged against the os occi- 
 pitis. This was established to have been an act of deliberate 
 suicide. Guy's Principles of Forensic Medicine, 478. 
 
 It is, however, true, that the greater the number of wounds 
 inflicted, the more are multiplied the chances of demonstrating 
 that they must have been of homicidal infliction. A case occur- 
 red in New -York in 1839, under the following circumstances : 
 A woman was found dead, with many wounds upon her body. 
 The husband, who was suspected, asserted that she had destroy- 
 ed herself. On examination, there were found eleven stabs, 
 eight on and about the left side of the thorax, one of which had 
 penetrated the pericardium, and divided the trunk of the pul- 
 monary artery at its origin, while the others were on the back, 
 near the left scalpula. There was every reason to suppose thaf 
 the stabs in front and at the back were inflicted at the same 
 time ; and it was obviously quite impossible that the latter could 
 have been self-inflicted. Taylor's Med. Juris., 257-8. 
 
 When several wounds are self-inflicted, it is often only one that 
 is mortal, and has caused the death. The multiplicity of the 
 instruments that have been employed, causing several different 
 wounds, may not unfrequently lead to the conclusion that the 
 act was murderous. A' woman was found dead nearly twelve 
 months after she was first injured. Her body was identified. A 
 handkerchief was drawn tight round the neck, while a wound 
 from a pistol ball was traced through the left side of the chest, 
 passing out at the right orbit. Three other wounds were also 
 found, all made by a sharp instrument, and one of which had 
 entered the heart. The defence was, that the deceased had com- 
 mitted suicide, but the great variety of the means and instru- 
 ments employed to produce death, together with the fact that the 
 
wounds. 255 
 
 gun-shot wound in the head, the stab in the heart, and the act of 
 strangulation, were, each one of them, sufficient to account for 
 speedy death, left no doubt that it was an act of murder. Tay- 
 lor's Med. Juris. , 259. 
 
 It must not, however, be forgotten, that suicides, especially if 
 laboring at the time under insanity, often inflict upon themselves 
 many wounds., and sometimes those of a singular character. A 
 gentleman, for instance, was found lying in a state of insensibility 
 in his kitchen, with a cleaver by his side. Upwards of thirty 
 wounds were found to have been inflicted over the posterior por- 
 tion of the occipital bone. Many of these were superficial, and 
 they all had a horizontal direction from behind, forwards. A 
 portion of the skull, from the middle of the lambdoidal suture, 
 had been removed by one, and from this, a part of the brain 
 had escaped. The person afterwards recovered so far as to ad- 
 mit that he had inflicted the wounds on himself. He died at the 
 expiration of four days, and was a lunatic. Taylor's Med. Juris., 
 253. 
 
 The general remark has been made, that suicides, when foiled 
 iu a first attempt at self-destruction, continue to use the same 
 weapon, lb., 257. 
 
 This is probably generally true, but sometimes a severe in- 
 cision in the throat has been succeeded by shooting themselves, 
 or adopting other methods of self-destruction. 
 
 5. Some indications may possibly be gathered from the coun- 
 tenance of the deceased. That of suicides is usually haggard, 
 the eyes sunken, and this kind of physiognomy continues while 
 there is any vitality remaining. The victims of assassination, 
 on the contrary, have a greater degree of paleness and fear im- 
 printed on the countenance. 2 Beck's Med. Juris., 75 
 
 6. Circumstantial evidence. This embraces a wiae range of 
 enquiry, and may very well include several considerations al- 
 ready alluded to. Very much of it may also belong to the non- 
 professional witness. A brief allusion to a few circumstances, is 
 ill that can here be attempted. 
 
 Very few crimes of great er_ormity, and involving a resort to 
 violence in their perpetration, can be committed without leaving 
 
256 MEDICAL JURISPRUDENCE. 
 
 such traces in the circumstances, by which they are attended, as 
 to lead to the detection and conviction of the perpetrator. It is 
 rare indeed, that any amount of coolness and calculation, any 
 degree, of ingenuity, or any power of foresight, has ever been 
 sufficient to disentangle one from the meshes of that intermin- 
 able web of circumstances, which is interwoven around, and 
 into, the nature and character of every criminal act. It consti- 
 tutes one of the great guarantees which God has given, that tht 
 perpetrators of crime shall not go unpunished. 
 
 Sometimes the slightest circumstance has led- to the detection 
 of the criminal. In 1806, a Mr. Blight was mortally wounded 
 by a pistol-shot. No clue seemed to be afforded as to the person 
 who had discharged it, until Sir Astley Cooper, from an exam? 
 nation of the localities, was enabled to say, that the shot mus t 
 have been fired ly a left-handed man. There was only one pel 
 son of that description near the premises, a Mr. Patch, a par- 
 ticular friend of the deceased, and not in the least suspected. 
 Through this disclosure, he was afterwards tried and convicted 
 of the crime, and made a confession of his guilt. Taylor's Med. 
 Juris., 260. 
 
 The presence or absence of the weapon with which the wound 
 was inflicted, taken in connexion with the extent and mortal 
 character of the wound, must afford strong circumstantial evi- 
 dence of suicide or homicide. 
 
 In the case of Courvoisier, who was tried for the murder of 
 Lord William Russel, there were two facts relied upon to show 
 that it was not a case of suicide. One was, that a napkin was 
 placed over the face of the deceased, and the other, that the 
 instrument of death did, not lie near the body. Guy's Prin. 
 ofForen. Med., 480 ; Taylor's Med. Juris., 262. 
 
 The presence of a lethal instrument near the body is, by no 
 means, a proof that the case is one of suicide. A pistol has 
 been found near the deceased, of such a calibre that the ball 
 which had caused the death was of too large a size to enter it. 
 
 In the celebrated case of the Earl of Essex, which gave rise 
 to much contrariety of opinion, there were several points of 
 circumstantial eviderce, of which I shall notice only one : 
 
wounds 257 
 
 In July, 1683, he was found dead in the tower, with his throat 
 cut, and a razor lying near him. The throat was smoothly and 
 evenly cut from one side to the other, and entirely down to the 
 vertebral column. Notwithstanding this the razor w r as found to 
 be much notched on the edge. This fact those who favored the 
 view of suicide were asked to explain. They could do so no 
 other way than by supposing that the deceased had notched the 
 razor by drawing it backwards and forwards on the neck bone. 
 This he could hardly be deemed competent to Jo after all the 
 great vessels of the neck had been divided. Taylor's Med. Juris., 
 262 ; 2 Beck's Med. Juris., 82 - 3, 4. 
 
 The case of Jane Norkott which occurred during the reign of 
 Charles I., afforded a striking instance of a conviction upon cir- 
 cumstantial evidence. She was found dead in her bed with her 
 throat cut. There were here two circumstances going to show 
 that it was not a case of suicide as at first supposed. The one 
 was that the bloody knife was found sticking in the floor, a good 
 distance from the bed, but as it stuck the point was towards the 
 bed and the haft from it. The other was that on the left hand of 
 the deceased, was the bloody impression of a left hand. 2 Beck's 
 Med. Juris., 86-7; Guy's Principles of Forensic Medicine, 480. 
 It should here be remarked without dwelling upon it, that the 
 marks of blood afford much material for circumstantial evidence. 
 
 3. The third general question proposed for discussion was — 
 What circumstances can be gathered relative to the motive or 
 intent of the inflictor 1 
 
 It is well known that to constitute crime, the moral element 
 must enter, as a constituent part, into the action which it essen- 
 tially qualifies, It is this that creates the wide difference between 
 a mere injury, and a wrong. The first may be caused by the 
 kick of a horse, or the blow of a maniac. The last can only pro- 
 ceed from a rational creature, a free moral agent. The first is 
 ximited in its effects to the mere physical nature which it injures. 
 The last extends to, and embraces the moral nature, and is there 
 felt as a wrong done to that nature. Hence the law always re- 
 quires a felonious intent to be clearly shown, either directly or 
 inferentially, before conviction can be obtained for the commis- 
 
 17 
 
258 MEDICAL JURISPRUDENCE. 
 
 sion of a crime. Any circumstances, therefore, attending its 
 commission, which will throw any light upon the question of 
 intent, provided the fact of homicide be first established, should 
 be seized hold of and eagerly appropriated. In the general ques- 
 tions already discussed, especially the last one, many remarks, 
 and some cases will be found bearing directly upon this question. 
 These, it will be unnecessary to recapitulate. What then are 
 the facts and circumstances from which the intent of the party 
 can be gathered 1 
 
 1 . We must look at the nature, situation, direction, and extent 
 of the wound. When found inflicted in a concealed part, such 
 as a superficial observer would not be likely to notice, the in- 
 ference of intent is strong. The female organs of generation 
 have been selected as a part where a mortal wound could be in- 
 flicted, and the greatest chance of escape from its consequences 
 afforded. The inflictors of such wounds must have entertained 
 the impression either that they could escape entirely from the 
 want of observation, or that the blood, if observed and traced to 
 the organs, would be attributed to flooding, to which females are 
 frequently subject, or that, if the wound was actually discovered, 
 it might be accounted for by the female's having accidentally 
 injured herself by sitting down upon some sharp body. So con- 
 fident have they been of success that in some cases they have 
 been the first to go for medical aid for the deceased. Watson on 
 Horn., 272-3. 
 
 In the case of Pollock, which occurred in Edinburgh in 1826, 
 see Watson, 104, a wound about an inch and a quarter long, was 
 found, on separating the labia pudendi, upon the inner side of 
 the right nympha. It was a recent clean incision, admitting the 
 point of the finger which could be inserted in four several direc- 
 tions, where the cellular membrane had been divided in each of 
 these directions to the depth of two and a quarter inches. None 
 of the large vessels had been wounded and death had obviously 
 resulted from haemorrhage. In the case of the Duncans, also 
 reported in Watson, 105, the wound was a clean incision, three- 
 quarters of an inch in length, inflicted in the middle of the left 
 labium pudendi. The greatest depth was about three inches, 
 
wounds. 259 
 
 several large blood vessels being severed. In the case of Mc- 
 Teat, in 1830, reported by Watson, page 106, two wounds were 
 found, one on each side of the right nympha. They were found 
 to be clean cuts of a sharp instrument, about half an inch long, 
 and the deepest an inch and a half in depth. They were recent, 
 and the death had resulted from haemorrhage. These were all 
 clearly cases in which the nature, situation and extent of the 
 wound must clearly proclaim the intent of the party. They also 
 go to prove that where a highly vascular part is wounded by an 
 incision, death may take place in a very short time from the 
 haemorrhage, although no large blood vessel be divided. 
 
 The direction of the wound may also be an important circum- 
 stance to show the intent. This question arose in the case of 
 Campbell, who was tried in 1831, for shooting a man who came 
 to his house at night under suspicious circumstances. See Wat- 
 son, 24b. The defence was that the ground being rough and 
 slippery, the prisoner stumbled, and both barrels of the gun had 
 gone off by accident. This account of the matter was confirmed 
 by tracing the direction of the shot in the body of the deceased, 
 which was found to be slanting upwards. 
 
 2. We must also look at the nature of the weapon employed, 
 and the manner in which the death was occasioned. Although 
 every weapon, down to the fist, by the use of which death is 
 effected, is, in the eye of the law, a " lethal weapon," yet with a 
 view to collect the intent, it is obvious we are to have reference 
 to the character of the weapon, and its agency in producing im- 
 mediate death. A person must be held to intend the production 
 of such a result, as the means employed would justify any rational 
 being in infering must be produced by them. Hence the use 
 of fire-arms, a sword, an axe, or any other such kind of weapon, 
 in such a manner as evidences a design to take life, affords a very 
 clear inference that such was the original intention. 
 
 But where the fist only was used or a slight walking cane, or 
 some other slender weapon, and the wound has proved fatal, the 
 intent to produce such a result may well be doubted, unless it is 
 proven from other circumstances. A repetition of the blows, 
 however, may be evidence of the malicious intent, or it may be 
 
260 MEDICAL JURISPRUDENCE. 
 
 established from other circumstances. A single wound, or a 
 number of them, inflicted by repeated efforts, .would go to show 
 the existence of malicious intent, as also would be the infliction 
 of a wound in a cruel or atrocious manner ; as in the case of a 
 female related by Watson, page 194, who after becoming stupified 
 by drink and mal-treatment, had sharp pieces of stone and hay 
 thrust into the vagina and rectum by which she died in two or 
 three days. And also in the case of Brown, the father, who 
 held the deceased, while his son repeatedly struck him on the 
 head with a stick of which he died ; the father remarking 
 " there is no wounding by rule, so as to pay well and spare the 
 life." Watson, 239. 
 
 But if the injury seemed at first to be only of a trivial nature, 
 but afterwards, from some cause or other, proved to be fatal, the 
 malicious intent could hardly be inferred. Watson on Homicide, 
 244-5. 
 
 4. The fourth general subject of enquiry is, as to the acts 
 which indicate volition or locomotion, after the infl'ction of mor- 
 tal wounds. It sometimes becomes important to determine what 
 possible efforts can be made by an individual after the receipt of 
 a mortal wound. Wherever this question has arisen, it has been 
 generally in cases of injuries to the head, wounds of the heart, 
 large blood vessels, diaphragm and bladder. Important infer- 
 ences are sometimes sought to be drawn from the position in 
 which a body is found, considered relatively with the supposed 
 position of the murderer ; without adverting to the possibility, 
 or perhaps, probability, of the murdered person's having changed 
 his position after receiving the mortal wound. 
 
 As the object in this enquiry is to arrive at the maximum, or 
 utmost extent of effort, which is possible after the infliction of 
 the severest wounds, it may be well briefly to mention a few cases 
 which have occurred, in which this maximum seems the clearest 
 to have been shown. A man fell from a scaffold on the summit 
 of his head. He was at first stunned, but on reaching the hos- 
 pital dismounted, and walked up stairs with but little assistance. 
 He died in three days, remaining perfectly rational, and going 
 to the water closet the day before his death. On examination af- 
 
WOUNDS. 261 
 
 terwards, the skull was found split from the frontal bone back- 
 wards through the saggittal suture to the foramen magnum. In 
 both hemispheres there was a large quantity of eifused blood in a 
 semi-coagulated state, more than two ounces being found at the 
 base of the skull. Taylor's Med. Juris., 297-8. 
 
 A boy fired a pistol which burst, and the breach of it disap- 
 peared, but it was supposed to have entered the brain. The boy 
 remained sensible for two days, and even showed some signs of 
 amendment, but finally died 24 days after the accident. On ex- 
 amination the brain was found much disorganized, and the breach 
 of the pistol weighing nine drachms was found lying on the ten- 
 torium. Taylor, 298. 
 
 This question arose in a medico-legal case reported by Dr. 
 Wallace. A man was found dead in a stable, with a severe frac- 
 ture of the temporal bone, which had caused the rupture of the 
 middle meningeal artery. A companion was accused of his mur- 
 der, but alleged that the deceased had fallen from his horse the 
 day previous and met with the accident. It appeared that after 
 the fall, the deceased had gone into a public house and remained 
 there sometime drinking, afterwards returning to the stables. 
 The question was whether it was possible, after such an exten- 
 sive fracture with extravasation of blood, for a man to do what 
 the accused represented the deceased to have done. The medi- 
 cal witness denied its probability, but admitted that it was pos- 
 sible. The excitement of the drinking might in this case have 
 increased the quantity of blood extravasated, which was the im- 
 mediate cause of death. Taylor, 298. 
 
 Wounds of the heart have generally been considered as imme- 
 diately fatal. This has not been found to be invariably the fact 
 from experience. A man who had been stabbed in the right 
 ventricle ran eighteen yards after having received the wound. 
 He then fell and died in six hours. ' A punctured wound was 
 found extending into the right ventricle in an obliquely trans- 
 verse direction, dividing in its course the coronary artery. The 
 pericardium was nearly filled with blood, and about four pounds 
 were extravasated on the left side of the thorax. Watson, 98. 
 
 In a case reported in the Medical Gazette, XIV, 344, a boy 
 
262 MEDICAL JURISPRUDENCE. 
 
 survived five weeks, employing himself during that time in va- 
 rious occupations, in the substance of whose heart, after his 
 death, was found lodged a mass of wood. Taylor, 298. 
 
 This question has frequently arisen where some or all the great 
 blood vessels of the neck have been injured. In one case a wo- 
 man who had the right carotid artery and jugular vein, together 
 with the trachea and oesophagus completely divided, was able 
 afterwards and before death, to escape from the house where the 
 deed was perpetrated into a garden at some distance, where the 
 body was found lying. Taylor, 299. 
 
 In another, a man committed suicide while walking along Ox- " 
 ford-street, by cutting his throat with a razor. Immediately af- 
 ter inflicting the wound, he was observed to hold a handker- 
 chief to his neck and run forwards. He ran about four yards 
 from the spot where the wound was inflicted, and then fell dead 
 on the pavement, the razor firmly grasped in his hand. The ca- 
 rotid artery and several of its branches, with the jugular vein on 
 one side, together with the trachea, had been all cut through. 
 Taylor, mi. 
 
 The particulars of a very extraordinary case are given in Tay- 
 lor, 299-300, from which it appears that a woman, after being 
 knocked down by a blow on the temple, and while down having 
 her throat cut in such a horrid manner as to divide the trunk of 
 the carotid artery, and all the principal branches of the external 
 carotid, with the jugulars, was nevertheless able, after that, to 
 get up, leave the hovel in which the act was done, climb over a 
 gate outside, and find her way to a distance of twenty-three 
 yards, where the body was found. 
 
 It will readily occur to any one, that although the power of 
 locomotion may remain after the division of the trachea, yet that 
 all power of voice is entirely lost, and hence no calls for assist- 
 ance can be made, at however short a distance the murder may 
 be perpetrated. Taylor's Med. Juris., 301. 
 
 In a case of rupture of the diaphragm, a man, in an intoxi 
 cated state, who was mal-treated by anolher, returned home 
 walking two hours and died in 15 hours afterwards. On exami- 
 nation, a recent longitudinal rupture of the diaphragm was found 
 
wounds. 2G3 
 
 extending about two inches and an half, through which the 
 stomach had protruded. The question was when the rupture 
 had taken place, and whether it was possible for the man to have 
 walked for that space of time after its occurrence. The medical 
 witnesses thought it improbable, but, admitted the possibility of 
 it. No other cause could be assigned than the mal-treatment. 
 Taylor, 301. 
 
 There are also many cases where locomotion, to a considera- 
 ble extent, has been exercised after ruptures of the bladder, and 
 extravasation of urine. In one case a man, while intoxicated, 
 was made sober by a blow on the lower part of the abdomen. 
 Taylor, 301. 
 
 He felt cold immediately on receiving the blow, but walked 
 home the distance of a quarter of a mile, although suffering great 
 agony. He died four days after the accident. No ecchymosis 
 was found on any part of the abdomen, but the bladder was rup- 
 tured in its upper and posterior portion about an inch in length. 
 Taylor, 301. 
 
 In connection with this subject it should also be remarked, that 
 although the infliction of a mortal wound may admit of subse- 
 quent acts of volition and locomotion, yet that it will not admit 
 of struggling, and violent exertion, especially if accompanied 
 with extensive hsemorrhage. In view of this fact, a medical 
 witness may be called upon to determine whether a mortal wound, 
 found on the deceased, was inflicted for the purpose of murder, 
 or in self defence. This the following case will illustrate. 
 
 A woman was stabbed in the chest in an affray in Liverpool. 
 The prisoner, the deceased, and two other females were quarrel- 
 ling in the passage of the house. A struggle ensued between the 
 prisoner and the deceased, which lasted about ten minutes. The 
 defence was, that being attacked by several persons, he had stab- 
 bed the woman in self defence. The point to determine was, 
 when the blow was struck ; if, with premeditation, before the 
 struggle, it would be murder ; if during the struggle, it would 
 only amount to manslaughter. The medical evidence showed 
 that the blow could not have been struck before the struggle, be- 
 cause it was of a speedily mortal nature, and the deceased would 
 
264 MEDICAL JURISPRUDENCE. 
 
 not then have been able to struggle with the prisoner for ten mi- 
 nutes afterwards. In all medical probability, the deceased must 
 have received the blow towards the conclusion of the quarrel, and 
 it might, therefore, have been inflicted in self defence. The 
 verdict was manslaughter., Taylor, 302 - 3. 
 
 5. The fifth general question regards the length of time that 
 has elapsed since the wound was inflicted. The length of time 
 that has occurred between the infliction of the wound and the 
 time of the examination, is often a material subject of inquiry. 
 
 In the case of The Queen vs. Raynon, tried in 1841, the prison- 
 er was charged with maliciously cutting and wounding the prose- 
 cutrix. There was a cut on his thumb, which he attempted to 
 explain, by saying it was from an accident which occurred three 
 weeks before. The medical testimony went to show that it could 
 not have been done more than two or three days, which coincid- 
 ed in time with the murderous assault. This, and other circum- 
 stances, led to his conviction. Taylor, 293. 
 
 An incised wound, inflicted on the living body, has its suc- 
 cessive stages of progress to the time it becomes healed. The 
 first is the inflammatory stages when the edges of the wound 
 begin to swell, which usually takes place in eight or ten hours 
 from its infliction. Redness is exhibited and heat is developed, 
 which is followed by the secretion of lymph, this liquid being 
 poured out for about thirty-six or forty-eight hours. It is at first 
 semi-transparent, but afterwards becomes thicker, more tenacious, 
 and on the second or third day, white. It afterwards is pene- 
 trated with vessels, forms the connecting medium of the cicatrix, 
 and becomes confounded with the tissues. The color of the 
 cicatrix, in the first periods of its formation, is of a bright red ; 
 it afterwards grows paler, until it becomes whiter than the color 
 of the skin. 
 
 The second is the purulent stage. Usually, on the third day 
 the secretion acquires a purulent character. As early as the 
 fourth and fifth day, suppuration is fully established, and it lasts 
 some five, six, or eight days. 
 
 The third stage is where cicatrization follows the purulent 
 stage. Tins is commenced by a fibrous layer, which makes its 
 
wounds. 265 
 
 appearance between the edges, and is at first soft, and easily 
 broken down. This is complete about the twelfth or fifteenth 
 day, when the wound is simple, of little depth, and only affecting 
 parts endowed with great vitality. 
 
 The time occupied in these successive stages will depend con- 
 siderably, 
 
 1. Upon the situation of the wound. Wounds of the lower 
 extremities are longer in healing, than those on the upper part 
 of the body. 
 
 2. On its extent. Where many different structures are in- 
 volved, the wounds are longer in healing than when the skin and 
 muscles are alone affected. 
 
 3. On the age and health of the wounded party. The processes, 
 whether inflammatory, purulent, or of cicatrization, are slower 
 the more diseased and infirm is the individual. Taylor's Med. 
 Juris., 293 ; Watson on Horn., 19-20. 
 
 The form of the cicatrix varies with the wound. In incised 
 wounds, it is generally straight and regular. When newly form- 
 ed, it is red, vascular, injected with blood, and tender. At sub- 
 sequent periods, it becomes smooth, white, and less tender. 
 Where there is a loss of substance, or if it be a lacerated or con- 
 tused wound, the cicatrix exhibits an irregular appearance, and 
 the healing process is accomplished by granulation. The time 
 here required may be five, six, or eight weeks, according to cir- 
 cumstances. 
 
 The doctrine of cicatrization is important to be understood, 
 not alone in reference to ascertaining the time that has elapsed 
 since the infliction of a wound, but also as a means of identify- 
 ing both the living and the recently dead. They are among 
 those permanent marks and indications that usually remain for 
 a series of years, or during life. In reference to this, the enquiry 
 may be made in this connection, whether a cicatrix, once form- 
 ed, is ever removed, or so altered, as to have its character entire- 
 ly changed. 
 
 In answer to this, it may be stated, that the tissue of which a 
 cicatrix is formed, is different from that of the skin, being hard- 
 er, less vascular, and destitute of the rete-mucosum, which it 
 
2G6 MEDICAL JURISPRUDENCE. 
 
 never again acquires. It has a peculiar whiteness, more parti- 
 cularly remarkable on the cicatrized skin of a negro. In those 
 of lacerated and contused wounds, the form of the weapon is 
 sometimes indicated. The true cicatrix, when so produced in 
 the true skin, as to be easily perceptible, is looked upon as in- 
 delible, as undergoing by time no sensible alteration in form or 
 character. Taylor's Med. Juris. , 294. 
 
 During the healing process, there is a contraction of the skin, 
 which results in rendering the cicatrix of smaller size than the 
 original wound. The wound itself is apparently smaller than 
 the weapon, and the cicatrix still smaller than the wound. That 
 formed at the exit aperture of a ball is larger and more irregu- 
 lar than that formed at its entrance, lb., 294-5. 
 
 There may be said to be still a fourth stage in the progress of 
 wounds, viz., that of gangrene. This is the incipient stage of 
 mortification, is attended with diminution of feeling, and livid 
 discoloration. This never supervenes until at least fifty hours 
 have elapsed after the infliction of the wound, unless in the case 
 of very old persons, where it may occur earlier. It should also 
 be remembered that putrefaction commences sooner in a wound 
 than in any other part, but its effects must not be confounded 
 with gangrene. Appearances on other parts of the body will be 
 likely to afford indications by which it is easy to tell whether 
 putrefaction has commenced or not. Taylor's Med. Juris., 295. 
 
 A case occurred in which it became necessary to determine 
 whether contusions on the body were all produced only a few 
 hours before death, or for some time previous. The prisoner 
 alleged that he had struck the deceased, his wife, but once, and 
 that but a few hours before her death. The medical testimony 
 went to show, that there were some rings of color peculiar to a 
 disappearing ecchymosis, in some of the spots, while in others 
 there were not, proving that the deceased had received more 
 blows than one, and that some of these had been struck several 
 days before her death. This was corroborated by other evidence. 
 Taylor's Med. Juris., 295. 
 
 Although the history of ecchymosis has been formerly adverted 
 to, yet it may be well here to remark, that twenty-four or thirty- 
 
wounds. 267 
 
 six hours usually elapses before changes of color appear ; that 
 the livid circumference gradually passes into a green circle ; this, 
 in its turn, becoming gradually diffused into a wide straw yellow 
 band, completely encircling the ecchymosis ; that the dark livid 
 color slowly disappears from the circumference to the centre in 
 four, five, or six days, while the colored bands spread more 
 widely around ; that a central dark spot is perceptible after ten 
 days or a fortnight, and that, in the case of a very extensive 
 ecchymosis, some weeks usually elapse before all traces of it are 
 lost. Taylor's Med. Juris., 295. 
 
 6. The sixth question we propose to discuss is — Was the 
 wound the direct cause of death 1 The requirements of the law 
 render it necessary to answer this question. In order that a 
 person can be convicted of murder or manslaughter, it is neces- 
 sary that the individual should die of the injury inflicted. The 
 law can indulge in no speculation on the subject. It requires 
 that the death should be clearly traced to the injury, and un- 
 equivocally shown to have been caused by it. In a combat be- 
 tween two, one receives a wound which may, or may not, prove 
 mortal, and is left upon the field. Subsequently he is attacked 
 by ruffians, who strip and rob him and beat out his brains. No 
 indictment in such case would lie against the first assailant, be- 
 cause the deceased dies by the hand of others, and not of the 
 wound inflicted in the first combat. The following case, reported 
 in 2 Beck, 74, will serve as an illustration. In 1808, some dro- 
 vers had a quarrel at an inn in France. In the course of it, one 
 of the party was wounded with a knife on the face, hand and 
 upper part of the thorax, near the right clavicle. The injuries 
 were found on examination to be superficial and slight. The 
 wounded man having washed himself soon after, started for his 
 home. He was found dead the next morning bathed in blood. 
 The left lung and pulmonary artery were found cut. The medi- 
 cal witnesses swore that this last was the cause of death, and that 
 it must have been inflicted after the superficial wound upon the 
 thorax, which was not bloody, but surrounded by ecchymosis. 
 The fact was, that on his way home he was robbed and murdered. 
 
 If a person of a weakly habit 3 receives a wound of which he 
 
268 MEDICAL JURISPRUDENCE. 
 
 afterwards becomes cured ; but owing to the long confinement 
 he has been made to suffer, he is taken ill of a consumption, or 
 some other malady incident to such a state of weakness, and dies 
 of this consumption or malady ; no charge of homicide could be 
 sustained, as the death is directly attributable, not to the wound, 
 but to the consumption or other malady, which might, or might 
 not, have supervened, had no wound rendered the confinement 
 necessary. 
 
 There must also be a certainty as to tho cause of death. If 
 the injury sustained be one only, among many causes, that have 
 contributed to the fatal result, and the agency it has had in its 
 production not very clearly ascertained, no conviction can be 
 obtained. Thus in the case of William Duff and others, ( Watson, 
 202,) who broke into a house and so affrighted a poor woman in 
 child-bed, that she fell into a fever and died. The indictment 
 was held not sustainable. So also in a case somewhat similar, 
 where the prisoner broke into a house and so alarmed a woman 
 recently delivered, as to be injurious to her health, and cause th« 
 death of the infant at her breast. 
 
 Where, however, the death is traceable directly to the injury, 
 and has been clearly produced by it, no matter what may have 
 been the situation or circumstances of the deceased, the prisoner 
 is responsible. If the deceased were on his death-bed, and in 
 the last stage of a mortal disease, still if he were shot through the 
 head, or stabbed with a lethal weapon, in such a manner as to 
 produce death sooner than it would have resulted from the dis 
 ease, it is murder equally as if he had been in the vigor of health. 
 
 To avoid repetition the remainder of what might properly be- 
 long to this question will be discussed under the next, viz : 
 
 7. What are the circumstances that modify the medico-legal 
 character of wounds, and that vary the liability of the inflictor 1 
 This is a very important enquiry, as it will be found to involve 
 an investigation into the direct causes of death, as compared, in 
 several instances, with those which are indirect. 
 
 1. The first circumstance to be mentioned, is the interval of 
 time which elapses between the receipt of an injury, and the death 
 of the individual. In some countries the law fixes a definite 
 
WOCNDd. 2C9 
 
 period within which the individual must die of the injury, in 
 order that a conviction for murder or manslaughter can be ob- 
 tained. In Lombardy, for instance, the death must occur within 
 a year, in England within a year and a day, in France within 
 forty days, in Prussia within nine days. In Scotland there is no 
 limitation, nor is there at present in the state of New- York, al- 
 though the statute formerly prescribed six months as the requisite 
 period. Watson on Horn., 203. 
 
 In this state then, there is no obstacle in the way of connecting 
 the death with the injury, however distant they may be separated 
 from each other by lapse of time. In the majority of cases, 
 wounds destroy life within two or three months after their inflic- 
 tion, but many times the fatal catastrophe is long delayed. A 
 case is mentioned by Sir Astley Cooper of an individual, who 
 died from the effects of an injury to the head received about two 
 years previously, there having been during that whole period a 
 continuance of the symptoms of cerebral disturbance. Taylor's 
 Med. Juris., 283. 
 
 Another case is mentioned, where a man died in consequence 
 of a rupture of the liver, which occurred eight years before. 
 Another very extraordinary case is stated, where a ball remain- 
 ed lodged in the left lung, during a period of twenty-five years, 
 causing fits of suffocation and haemoptysis, under which the in- 
 dividual at last sunk. The important point, in such protracted 
 cases, is to connect the death with the infliction of the injury, 
 in such a manner, as to show that the one has resulted from the 
 other. If the wound be originally severe, or become so from its 
 extent and long continuance, and if it keep on in a regular pro- 
 gression from bad to worse, so that the person wounded continu- 
 ally languishes, and is consumed by it as by a disease, the case 
 •differs not in reason or in law from the infliction of such a 
 wound as would have produced death upon the spot. 
 
 The interval of time thus elapsing, may be important to the 
 prisoner,-in furnishing him with greater opportunities to urge 
 exculpatory circumstances in his favor. Thus, there may have 
 been improper conduct on the part of the injured party, or bad 
 medical treatment, or the accession of some other disease, either 
 
270 medical Jurisprudence. 
 
 of which, as we shall hereafter see, may form circumstances 
 modifying the medico-legal character of wounds. 
 
 2. Jlge, as a modifying circumstance. There is a difference in 
 the efl'ect produced by wounds on persons of different ages. 
 The least effect is generally produced on adults and persons of 
 middle age. A greater strength and vigor both of mind and 
 body, enable such to withstand the shock caused by severe inju- 
 ries better than others. They are also less affected by their sec- 
 ondary results. The very young, and the very old, have far less 
 vis vitee, and are therefore much more easily affected by injuries. 
 It is to be remarked, however, that fractures of the limbs are 
 less dangerous, and more speedily cured, in young subjects than 
 in adults. 
 
 3. Constitutional peculiarities, as a modifying circumstance. 
 These may be, 
 
 1. Malformation or transposition of parts. These, in relation 
 to important parts, are not of common occurrence. The possi- 
 bility of them, however, is clearly established. Bichat relates a 
 case as falling under his own observation, in which the stomach, 
 the spleen, the sigmoid flexure of the colon, the point of the 
 heart, the aorta, and the lung with two lobes, were all on the 
 right side. The liver, the ccecum, the base of the heart, the 
 vena cavse, the vena asygos, and the lung with three lobes, were 
 on the left side. All the organs placed beneath the middle line, 
 as the mediastinum, the mesentery, the duodenum, the pancreas, 
 the division of the trachsea, were reversed. The heart may be 
 found on the right side of the thorax, the spleen in the place of 
 the liver, the stomach descending into the umbilical region, and 
 the bladder rising into the abdomen. In all such cases, where 
 death results from an injury, and would not have so resulted had 
 there been no transposition, unless the malicious or felonious in- 
 tent is made out from other sources of evidence than what is 
 derivable from the infliction of the wounds, the charge of mur- 
 der cannot be sustained. The prisoner, so far as concerns any 
 inferuice deducible from the act itself, of inflicting the injury, 
 can only be held responsible for what would have been the re- 
 sult, had the parts had their usual, natural location Under this 
 
WOUNDS. 271 
 
 view, it will devolve upon the medical witness to state what is 
 the peculiar malformation or transposition in the given case ; 
 wherein it differs from the usual normal state ; what precise effect 
 is to be attributed to the injury in consequence of the deviation, 
 and what would have been the result nad no such malformation 
 or transposition existed. Could the prisoner be proved to have 
 known the fact of such malformation or transposition, it would 
 then go to prove the malicious or felonious intent. 
 
 2. There may be a preternatural thinness of the cranium, 
 unknown to the prisoner. Several cases of this kind are on re- 
 cord. A man caught a boy in the act of robbing an orchard, 
 and struck him a blow on the head with a stick. This caused a 
 fracture pf the skull, and the boy subsequently died. A mere 
 chastisement was intended, the stick being of so small a size, as 
 not to have caused injury, under ordinary circumstances. The 
 fatal result was owing to a preternatural thinness of the skull. 
 Guy, 462. 
 
 A case somewhat similar occurred in Massachusetts. Taylor, 
 287. A blow was inflicted from a small stone, on the side of 
 the head, of which the individual died in ten minutes. There 
 was no fracture of the bones, or external bruise visible. The 
 skull was found unusually thin, and the ventricles filled with 
 coagulated blood, and all the vessels in a congested state. The 
 same principle prevails here in regard to liability, as that just 
 mentioned. 
 
 3. There may be a preternatural phlogistic, or hsemorrhagic 
 diathesis. There are many cases of this kind upon record. The 
 slightest wound, or abrasion of the skin, will cause alarming dis- 
 charges. Even the scratch of the thumb nail, in the case men- 
 tioned by Metzger, produced death. 2 Beck's Med. Juris., 185. 
 
 Many authorities are cited by Dr. Beck, (see notes, 2 Beck, 185,) 
 which go to show, not only that this diathesis is liable to be he- 
 reditary, but that it is generally found to prevail in the male, and 
 not in the female, line. The same principle must also prevail 
 here in reference to liability in case of wounds or injuries, as 
 that already mentioned. 
 
 4. Previous injury, or disease, as a modifying circumstance 
 
272 MEDICAL JURISPRUDENCE. 
 
 Under this head, many cases may present themselves involving 
 no small amount of difficulty to the medical witness. It is really 
 one of the most important topics that comes up for discussion in 
 the whole range of Medical Jurisprudence. A person while la- 
 boring under the effects of an injury, or of some chronic disease, 
 may be killed by a very slight blow, or even a sudden fit of pas- 
 sion. The question then arises, as to the cause of death. Was 
 it the disease or the blow 1 And would the blow have been suffi- 
 cient without the disease 1 And did the blow accelerate the fatal 
 result, which would otherwise have been unavoidable 1 " 
 
 The law, as laid down by Lord Hale, is, that " it is sufficient 
 to prove that the death of the party was accelerated by the ma 
 licious act of the prisoner, although the former labored under a 
 mortal disease at the time of the accident." 
 
 The following principle, laid down by Starkie, will meet the 
 case, where a knowledge of the peculiar state and condition of 
 the deceased existed on the part of the prisoner : " It seems that 
 in general, notwithstanding any facts which tend to excuse or 
 alleviate the act of the prisoner, if it be proved that he was ac- 
 tuated by prepense and deliberate malice, and that the particu- 
 lar a icasion and circumstances upon which he relies, were sought ' 
 for, and taken advantage of, merely with a view to qualify ac- 
 tual malice, in pursuance of a preconceived scheme of destruc- 
 tion, the offence will amount to murder." 
 
 Several interesting cases will be found in the works upon 
 Medical Jurisprudence, illustrative of this point. A gentleman 
 was tried for the murder of his servant, killed by a blow on the 
 loins. It was shown that the kidney of the deceased contained 
 a calculus, the ragged points of which, by puncturing the blood 
 vessels, had occasioned a fatal haemorrhage. An acquittal fol- 
 lowed upon the capital charge. Guy, 463. 
 
 The wife of a play-actor stabbed her husband in New-Orleans, 
 in 1842, during a quarrel at the theatre. He died in about ten 
 minutes, as it was supposed, from the effect of the wounds, one 
 of which was on the right arm, and the other in the region of 
 the stomach. The medical evidence showed that there was a con- 
 siderable quantity of effused blood in the stomach, which was found 
 
wounds. 273 
 
 to proceed from the rupture of a large aneurism of the abdomi- 
 nal aorta, the parieties of which were so much thinned, that the 
 least excitement was sufficient to cause the accident. The prison- 
 er was acquitted. Guy, 468. 
 
 A husband, on returning home one night, found his wife in a 
 gin-shop, where she had been drinking and dancing. He struck 
 her twice, and carried her home on his shoulders. A short time 
 after, the husband described her as taking a fit, on account of 
 which, he laid her in bed, and some of the neighbors coming in, 
 found her to be dead. Sir Charles Bell found on the head, marks 
 of several bruises. The skull was uninjured, but an extravasa- 
 tion of blood was found at the base of the brain, and into the 
 ventricle. The anterior artery of the cerebrum was half torn 
 across, and from this the extravasation had taken place. 
 
 Were the blows the cause of this rupture 1 Mr. Bell thought 
 that such a shock was very likely to have caused it, because a 
 slighter injury would probably have produced it in consequence 
 »f her state of intoxication, and the struggle she had with her 
 husband, than would have been required in other circumstan- 
 ces. Watson, 214. 
 
 Cases of this kind, presenting peculiar difficulty, are those in 
 which the symptoms and effects both of the previous disease, 
 "and of the injury, are similar, so that it is difficult or impossible 
 to say which proved fatal. This class of cases may arise when 
 injuries have been inflicted on the head or chest, where there 
 already exists chronic disease of the brain and lungs. In such 
 cases, enquire, 
 
 1. Was the injury sufficient to cause serious mischief in a 
 healthy person, under ordinary circumstances 1 The answer to 
 this, question must depend upon an extensive knowledge of 
 physiological principles ; of the laws of life, and of the conse- 
 quences of their invasion. These we shall not discuss here. 
 There are cases, however, which have arisen under this inquiry, 
 in which no doubt could be entertained. A slight injury, for 
 instance, causes death by the rupture of an aneurism, or other- 
 wise diseased blood vessel, or by that of a hernia, or diseased 
 bowel. 
 
 16 
 
274 MEDICAL JURISPRUDENCE. 
 
 Two men, having been at enmity with each other, accidental 1 
 ly met in the street, when one of them, while passing on horse- 
 back, struck the other across the shoulders with a whip. The 
 man struck, immediately pursued the other, in a strong passion, 
 but had hardly advanced a dozen steps, when he fell, uttered a 
 few indistinct syllables, and died instantly. On examination, no 
 outward mark of injury could be seen. It was subsequently 
 found that an aneurism of the aorta had burst within the chest. 
 Watson, 215. 
 
 In 1744, Lydia Alien Was tried for the murder of her hus- 
 band, by having kicked him in the groin. He had an inguinal 
 rupture, and the injury proved fatal. Watson, 216. 
 
 Whether injuries inflicted on persons laboring, at the time, 
 under serious disease, might, or might not, cause death in a 
 healthy person, is often a very nice and difficult question. Where 
 the injury was of such a character as to have proved fatal in a 
 healthy person, not, at the time, afflicted with any weakness or 
 disease, the existence of a previous ailment would not mitigate 
 the nature, of the crime. Watson, 216-17. 
 
 2. Did the injury, or the previous disease, occasion the death 1 
 Tins is frequently a very difficult question, more especially when 
 the injury and the disease each produce the same symptoms and 
 appearances. The occurrence of a violent passion, or a state of 
 intoxication, may develope a previously latent disease, so as to 
 cause apoplexy with extravasation ; and at the time of such de- 
 velopment, an injury may be inflicted on the head. Some cases 
 illustrating this may be cited under the next enquiry. In such 
 cases, it may be impossible to say which was the cause of the 
 death. The disease and the injury may also act upon each other 
 sympathetically. 
 
 3. Did the alleged previous disease really pre-exist, or was it 
 the consequence of the injury 1 The greatest difficulty is likely 
 to arise here where the injury and the disease affect the same or- 
 gan, as the brain, lungs or alimentary canal. Fatal inflamma- 
 tory action may have been going on for a considerable time un- 
 observed previous to the injury, and when the effects of it be- 
 come suddenly developed, simultaneously with the infliction of 
 
wounds. 275 
 
 the injury, there is often much difficulty in deciding to which of 
 the two the result is attributable. The following case, reported 
 in, Watson, 218-19, will serve to illustrate. 
 
 David Kennoway was tried for parricide in 1825. The sister, 
 on Sunday evening, left him at home in a state of intoxication, 
 quarrelling and struggling with his father, an old man of seventy. 
 Shortly after the prisoner followed her down stairs and went away. 
 She immediately returned, having been absent about seven mi- 
 nutes, and found her father stretched dead upon the floor, with 
 a slight wound upon the nose, and a severer one upon the fore- 
 head. She had left him apparently in good health. On opening 
 the body there was found half a pint of red serosity in the ven- 
 tricles of the brain, but no fracture of the skull, no extravasa- 
 tion of blood beneath it, no laceration of the brain. There was 
 also an effusion of reddish serum in each pleural sac, but no 
 other morbid appearances, in the chest or elsewhere. 
 
 The countenance was very black, which was incompatible 
 with the supposition that the blows produced the result by caus- 
 ing a violent concussion of the brain ; as in cases of death from 
 concussion the countenance is pale. After determining that it 
 could not be the result of concussion, perhaps the next question 
 that would present itself would be, whether the effusion was a 
 vital one, or one of those pseudo-morbid appearances, which 
 occur after death, and are apt to simulate the results of disease. 
 The change was undoubtedly a vital one, no instance being known 
 in which the vessels poured out so large a quantity of serum af- 
 ter death. The next question that arises is, was it the result of 
 the injury and the struggle, or was it previously in existence, 
 without producing any symptoms of disordered health ? It could 
 not well have been the result of the injury and struggle, because 
 if so, it would have been blood and not serum. The serum 
 must be regarded as a sort of secretion or separation from the 
 blood, and could not therefore be the sudden production of an 
 injury. In connection with this, should also be taken into con- 
 sideration the fact, that there was the same sort of bloody serum 
 effused into the cavities of the pleura, which would seem to ne 
 
276 MEDICAL JURISPRUDENCE. 
 
 gative the conclusion that the effusion in the brain was the result 
 of violence. 
 
 It is rendered pretty clear from all the facts and reasonings 
 upon this subject, that the serum was effused previously to the 
 injury. The difficulty then is to account for its existence unac- 
 companied by any symptom of disease. Mr. Watson supposes 
 that the man had a latent hydrocephalic effusion, which proved 
 suddenly fatal by the shock of thp blow, or his, struggles, or his 
 violent passion. He cites some cases to prove this. Watson on 
 Horn., 219. 
 
 One was that of a young woman, who had complained, for 
 four days, of some headache and occasional vomiting, but was 
 able to go about. She was suddenly seized with ratling in the 
 throat, and died unexpectedly in the full possession of her senses. 
 On examination of the body, there was found in the ventricles 
 of the brain, three ounces of serosity and a watery vesicle. 
 Another case is mentioned by Dr. Abercrombie, very similar to 
 that of Kennoway, except that the effusion was external tp the 
 brain. Morgagni has also mentioned a case of fatal pneumonia, 
 where no less than eight ounces of serosity were found in the 
 ventricles of the brain after death, without any corresponding 
 symptoms during life, which must have been a case of true la- 
 tent hydrocephalus. < 
 
 " In the case of Kennoway, the surgeons attempted to get rid 
 of all these difficulties by ascribing the effusion to the blows, and 
 death to the effusion. But this is manifestly at variance with 
 sound pathology. Kennoway was convicted of culpable homi- 
 cide, and transported for life." 
 
 Several other cases are mentioned by Watson and others, but 
 the one above stated presents. features fully as important as any 
 other under this head, and may, therefore, serve as its illus- 
 tration. 
 
 5. Of subsequent injury or disease, as a modifying circum- 
 stance. This presents a class of cases, involving almost as much 
 difficulty, as the immediately preceding. We have already seen, 
 that the deceased must die of the injury inflicted, in ordgr to 
 sustain an indictment against the inflictor. This involves tht 
 
wounds. 277 
 
 necessity of being able to trace the cause of death clearly to the 
 injury. Sometimes a subsequent injury may be received to which 
 the death is properly attributable. One Williams, of Glasgow, 
 in 1833, received an injury which brought on a fever. He then 
 received some severe blows, which caused gangrene of the fin- 
 gers and arm, fever, delirium and death. Watson, 223. 
 
 The most difficult cases, however, are those in which the 
 wounds become modified by the supervention of diseases which 
 occur in their progress. These are the most commonly fever, 
 erysipelas, inflammation, gangrene, haemorrhage or tetanus. 
 The intervention of any one of these, after the receipt of a se- 
 vere wound, must render the case more or less doubtful and dan- 
 gerous. If traced clearly to the wound as their cause, the ae 
 cused will be held responsible, as they must then be regarded as 
 the consequences of his own wrongful act. 
 
 Janet McLar en received an injury upon the head in July, 1823. 
 The scalp was wounded, and the skull fractured and depressed, 
 but there were no symptoms of any brain affection. An inflam- 
 matory fever supervened ; and, several weeks after the injury of 
 the head, violent inflammation of the chest came on and she died 
 in two days after. Watson, 223. There were found three pounds 
 of serous effusion mixed with flakes of lymph in the chest. The 
 iight lung adhered to the walls of the chest, and formed an ab- 
 scess. There was also purulent matter in the substance of the 
 lung. It was thought that the diseased states of the head and 
 chest were each sufficient to have caused death, but that the lat- 
 ter appeared to be the immediate cause of it ; the inflammation 
 of the former being transferred to it. As both were traceable in 
 a very direct manner to the injury, there was no doubt but that 
 the wound was the cause of death. 
 
 The most difficult cases are those in which fever, erysipelas, 
 and tetanus, supervene upon the reception of a wound. It is not 
 easy to distinguish between fever which occurs as a consequence 
 of the injury, and that which arises from other causes. But in 
 case of an injury of the head, and the subsequent' occurrence of 
 fever, if lymph or pus is found effused on the membranes of the 
 brain, the fever has most probably been the consequence of the 
 
278 MEDICAL JURISPB.UDEtvXE". 
 
 injury, as this is frequently found in fever so caused. ' So also 
 wheu erysipelas is caused by a wound, it generally begins around 
 the wound itself. Reference should also be had to the prevalence 
 or non-prevalence of these diseases at the time. Watson, 224. 
 
 " Fever with coma in a case of injury of the head, inflamma- 
 tion of the lungs with a wound of the chest, spontaneous rupture 
 uf an intestine where a blow had been inflicted, are cases which 
 may be attended with much difficulty." Watson, 224. 
 
 An extremely difficult case for a decision is, where a slight 
 wound is followed by tetanus. This disease is the most likely to 
 supervene as a secondary consequence of lacerated or contused 
 wounds which affect nervous or tendinous structures. It gives 
 no warning of its approach, and may succeed very slight wounds. 
 It may occur spontaneously, and may come on in consequence ol 
 exposure to cold and wet. When it is the result of a wound, it 
 generally appears after about the third or fourth day. Taylor, 
 289. 
 
 Several cases have occurred and are reported, illustrating the 
 supervention of tetanus. One is the case of Mackenzie, tried for 
 the murder of Clark, in 1827, Watson, 208-9, in which a small, 
 ragged, lacerated wound was inflicted upon the nose, and also 
 some contused wounds upon the right elbow, and left hip joints. 
 The injury took place on the 8th of January. Although some- 
 what unwell, he was enabled to be about his business some days. 
 He died on the 19th. The report of the medical witnesses was, 
 " that Clark's death had been occasioned by tetanus, which had 
 supervened upon the injuries he had received on the 8th of Janua- 
 ry ; and that, though this was an occasional, yet it was not a 
 common or necessary consequence of wounds." The prisoner 
 was found guilty of assault, but absolved from the charge of 
 murder. 
 
 The case of Capt. Moir, tried in 1830, reported in Taylor, 290, 
 was also an important one. The deceased had been a poacher 
 upon the premises of the prisoner. He had furnished great pro- 
 vocation; and, on this occasion, the prisoner had rode back to 
 his house, which he had left shortly before, and, having pro- 
 cured his pistols, fired at the deceased, and wounded him severe- 
 
wounds. 279 
 
 ly in the arm. The muscles, vessels and nerves were extensive- 
 ly lacerated. The deceased lingered for some time ; tetanus su- 
 pervened, under which he died. The medical evidence adduced 
 on the trial, showed that death was caused by tetanus, brought 
 on by the gun-shot wound inflicted by the prisoner. The priso- 
 ner was found guilty and executed. The connexion in this case 
 was clearly traced between the disease and the injury inflicted. 
 In all such cases, very important inferences may be drawn from 
 the nature and character of the wound, and also from the instru- 
 ment with which it is inflicted. A slight wound, inflicted with a 
 trivial instrument, would go far to negative all malicious or felo- 
 nious intent ; whereas a severe wound, produced by a lethal 
 weapon, or under circumstances implying malice, would go 
 equally far to establish that intent which forms the gist of the 
 crime. 
 
 6. The sixth and last modifying circumstance I shall mention, 
 is misgovernment on the part of a wounded person, or his medi- 
 cal attendant — Malum Kegimen. The difficulty here frequently 
 consists in the inability to state how much of the fatal event is 
 to be ascribed to the injury, and how much to the individual's 
 own want of care, or to the inattention or improper treatment of 
 the physician. 
 
 Mr. Watson properly considers this subject under three heads, 
 the first of which is, 
 
 1. Was the want of assistance or attendance accidental, and 
 inevitable, or was it intentional 1 In the former case, the prisoner 
 is responsible ; in the latter not. The question involved in that 
 first mentioned, arose in the case of the Queen vs. T/wmas and 
 others, tried in 1841. Guy, 373. The deceased died from the 
 effects of severe injury to the head, no medical assistance having 
 been called. The judge said it was possible, that if he had had 
 medical advice he might not have died ; but whoever did a 
 wrongful act must take the whole consequences of it. That it 
 never could make any difference, whether the party injured had, 
 or had not, the means, or the mind, to apply for medical advice. 
 The prisoners were convicted. 
 
 "If, however, the neglect to call assistance is intentional ; if it 
 
28( MEDICAL JURISPRUDENCE. 
 
 proceed from carelessness ; or if a quack is employed, when a 
 regular practitioner might have been had, and the person dies, 
 the prisoner could not he considered responsible for the whole 
 damage. This would form a valid plea of exculpation, or, at 
 least, of mitigation of punishment." 
 
 2. Irregularities, or misgovernment, on the part of the patient. 
 These may be of various kinds : 
 
 1 . He may refuse to undergo the treatment prescribed : 
 
 2. He may be intemperate ; may expose himself to cold or 
 heat ; or give himself up to the indulgence of inordinate passions. 
 2 Beck, 195. 
 
 Of all these, intemperance is perhaps the most common. In 
 the case of Turner, reported in Watson, 228 - 9, a severe blow 
 was inflicted towards the back of the right side of the chest, and 
 several cuts on the head, by an earthen-ware dish, which fell 
 from the top of a screen, and broke into fragments. He was 
 seized, on the next evening, with great shivering, complaining 
 of pain in his side and breast. He refused to apply to a phy- 
 sician, and continued to drink whiskey. He died on the 18th, 
 three days after the injury. Externally, there were no marks 
 of severe injury. Internally, serous effusion was found between 
 the membranes of the brain, such as often exists in drunkards ; 
 about four ounces of sero-sanguineous fluid effused into the right 
 side of the chest ; the lungs adhering to the parieties at the lateral 
 and middle part of the right side, by firm old membranous ad- 
 hesions ; the lobes on the right side adhering to each other by 
 old appearing membranous adhesions ; the lower and middle 
 lobes much condensed, hepatised and fleshy ; the color red, and 
 air cells obliterated ; the liver enlarged, hardened, uniform ; the 
 kidneys enlarged, the right one encysted. The injury on the 
 right side of the chest appeared to be connected with the inflam- 
 mation of the lungs which proved fatal. 
 
 In another case, originally reported by Dr. Christison, see 
 Watson, 231, one prostitute, in a drunken revel, struck another 
 with a smoothing-iron, inflicting a denuding wound of the skull. 
 The wound never healed, and the woman constantly complained 
 of headache. . Eight weeks after the accident, she was attacked 
 
WOUNDS. 281 
 
 with erysipelas of the head and face, which ended fatally in ten 
 days. An indolent ulcer occupied the seat of the wound, from 
 the bottom of which, a small hole proceeded inwards, and per- 
 forated the bone. The woman, after the injury, kept up her old 
 habit of getting intoxicated, even dancing with great spirit, and 
 getting dead drunk at a ball, only a few days before the erysipelas 
 began. She continued to lead the very kind of life which was 
 calculated to induce serious consequences. The medical wit- 
 nesses testified, that the death could not with any certainty be 
 ascribed to the wound. The prisoner was convicted merely of 
 an assault. 
 
 In addition to the irregularities or misgovernment referred to, 
 it should also be mentioned, that the patient may conceal from 
 the medical attendant some fact or circumstance, the knowledge 
 of which may be important in the treatment of the case. Thus 
 in the case put by Watson, 232. A medical attendant is called 
 in a case where erysipelas has supervened in consequence of a 
 wound of the scalp. The fact of the wound is concealed, and 
 the case is treated as a spontaneous erysipelas. The person dies, 
 perhaps from the neglect of having that method of treatment 
 pursued, that would have been, had the physician known the 
 fact of the injury. 
 
 3. There may be misgovernment on the part of the medical 
 attendant, which may arise from ignorance, inattention, or mis- 
 management. This would form no exculpation if the wound was 
 necessarily mortal, but it might, if it were simply dangerous. 
 This ignorance, inattention, and mismanagement, may be mani- 
 fested in a variety of ways, not necessary to be mentioned. One 
 case will serve to illustrate this. 
 
 J. Bell was tried for the murder of John Kerr. He struck him 
 a severe blow on the forehead, with a hoe, on the 20th of July. 
 His death took place on the 28th. On the day after the injury, 
 Kerr did not seem very ill, and was able to walk to his bed, 
 having been admitted into the Royal Infirmary. On post-mortem 
 examination, there was found, about an inch above the right 
 orbit, and close to the mesial line, a circular, compound, com- 
 minuted, and depressed fracture of the middle part of the frontal 
 
282 MEDICAL JURISPRUDENCE. 
 
 bone, presenting the appearance of a shallow cup, of about half 
 an inch in depth. The pericranium was in a sloughy state. 
 The wound had suppurated. Internally there was purulent 
 matter between the broken cranium and dura mater. Some 
 spiculss of bone were found attached to the dura mater ; several 
 of which had penetrated through it into the brain. There was 
 also some purulent matter and lymph below the dura mater ; 
 and softening, with abscess, in the substance of the' brain, about 
 an inch deep at the seat of the injury. The medullary substance 
 of the" brain was inflamed, and had a yellow appearance to the 
 extent of about an inch and a half around the abscess. The de- 
 pressed portions of bone had not been removed. The death 
 obviously occurred from inflammation of the brain, and the in- 
 flammation itself, was caused by the irritating action of the de- 
 pressed portions of bone on the membranes and substance of the 
 brain. Those portions should have been elevated and removed. 
 This should have been done prior to any symptoms of inflamma- 
 tion or effusion having been developed. Watscm, 236 - 7. 
 
 Lord Hale attempts to distinguish between death as it results 
 from a wound rendered mortal by improper treatment, and death 
 as it results from the improper treatment, irrespective of the 
 wound. He thus lays down the rule. " It is sufficient to con- 
 stitute murder, that the party dies of the wound given by the 
 prisoner, although the wound was not originally mortal, but be- 
 came so in consequence of negligence or unskilful treatment ; 
 but it is otherwise, where death arises not from the wound, but 
 from unskilful applications or operations used for the purpose of 
 curing it. Guy, 472. 
 
 In the case of surgical operations, the principles that should 
 govern are ably set forth by Mr. Taylor. Taylor, 290-91. 
 " Should an operation be unnecessarily and unskilfully performed, 
 the responsibility of an agressor would, of course, cease, if the 
 death of a wounded party could be clearly ascribed to it. Thus, 
 if in carelessly bleeding a wounded person, the brachial artery 
 should be laid open, or if in performing amputation, a large 
 artery be imperfectly secured, so that the patient, in either case, 
 die from hemorrhage, the prisoner is not responsible, because it 
 
wounds. 283 
 
 would be punishing him for an event depending on the unskil- 
 fulness of the medical practitioner. But if the bleeding or am- 
 putation is performed with all proper care and skill, and yet, in 
 the one case, phlebitis, and in the other, tetanus, gangrene, or 
 fever should destroy life, the prisoner will be differently situated. 
 The practice of the law is strictly consistent with justice. If the 
 operation be absolutely required for the treatment of a wound, 
 if it be performed with ordinary skill, and still death ensue as a 
 direct or indirect consequence, the prisoner will be held respon- 
 sible for the result. It is presumed in these cases, that if the 
 patient were left to himself, he would, in all probability, die from 
 the effects of the wound. If, therefore, a surgeon, knowing that 
 an operation would give a chance of saving life on such an occa- 
 sion, did not perform it, it might be successfully contended in 
 the defence, that the deceased had died, not from the wounds, 
 but from the incompetency and neglect of his medical attendant ; 
 thence it follows, that if during this very necessary treatment, 
 unforeseen, though not unusual causes, cut short life, no excul- 
 pation should be admissable, if it went to attack the best directed 
 efforts made for the preservation of life." 
 
 8. What are the questions that arise in case of mayhem or 
 maiming 1 
 
 Mayhem -was always an offence at common law. It was there 
 denned to be a bodily hurt, whereby a man is rendered less able 
 in fighting to defend himself or annoy his adversary. Therefore 
 the cutting off, or disabling, or weakening a man's hand or finger, 
 or striking out his eye, or fore-tcoth, or depriving him of those 
 parts, the loss of which in all animals abates their courage, are 
 held to be mayhems. But the cutting off an ear, nose, or the 
 like, would not, at common law, be mayhem, because the effect 
 would be simply to disfigure, not to weaken. To render the act 
 indictable it must be done maliciously. United States' Criminal 
 Law, 509. 
 
 New-York, and most, of the other states, have statute enact- 
 ments upon this subject. In New- York it is enacted, that " every 
 person, who, from premeditated design, evinced by lying in wait 
 
284 MEDICAL JURISPRUDENCE. 
 
 for the purpose, or in any other manner, or with intention to 
 kill or commit felony ; shall, 
 
 1 . Cut out or disable the tongue ; or, 
 
 2. Put out an eye ; or, 
 
 3. Slit the lip, or slit or destroy the nose ; or, 
 
 4. Cut off or disable any limb, or member of another, on pur- 
 pose; upon conviction thereof, shall be imprisoned in a state 
 prison, for such term as the court shall prescribe, not less than 
 seven years. 2 R. S., 664, § 27. 
 
 The statutes of other states make some difference both in de- 
 fining the offence, and prescribing the punishment. Connecticut 
 punishes the putting out of the eye or eyes of a person, so as to 
 cause blindness, with imprisonment in the state prison for life ; 
 Delaware and North Carolina, the cutting oft" the genitals, with 
 death. 
 
 9. How should the medico legal examination of wounds be 
 conducted 1 
 
 A few practical suggestions are all that can here be offered 
 under this head of enquiry. It is important, if possible, to ex- 
 amine a wound that presents externally, before the body has 
 been removed from the position in which it was first found. 
 The relations sustained by the body, and the wounds, With 
 things external to them, can then, and then only, be properly 
 ascertained. 
 
 After examining with reference to these relations, the next 
 thing to be remarked is the kind of wound inflicted. Is it a 
 contused wound or a lacerated, gun-shot, incised, or punctured 
 wound 1 If either, what was the probable instrument by which 
 it was inflicted 1 Is the form and impress of the instrument de- 
 fined by the contusion, as is occasionally the fact 1 Can any- 
 thing be collected from the lacerated, incised, or punctured 
 wound, in reference to the instrument of its infliction 1 If it be 
 a sword or gun-shot wound, are the entrance and exit holes clear- 
 ly ascertainable 1 The existence of all foreign bodies should be 
 carefully noted, and they should be preserved. The depth of 
 the ball may serve to indicate the distance from which it was 
 fired. The wadding has identified the murderer. In one case, 
 
wounds. 285 
 
 half a ballad was found in it, and the other half in the pocket 
 of the accused. The bullets should be preserved, to compare 
 with fire-arms in the possession of the accused. 
 
 If the wound be incised or punctured, the quantity of hsemor- 
 rhage should be ascertained, with the view of determining wheth- 
 er it was inflicted during life. The bloodless state of the vessels 
 is best ascertained by a reference to the organs of the abdomen, 
 and also to the state of the brain. Watson, 381. 
 
 It should be observed whether there is a clot of blood over the 
 cut surface, and also whether any signs of living action are ob- 
 servable. Any appearance of inflammation, of suppuration, or 
 of gangrene, would be evidence of infliction during life. The 
 length, breadth and depth of the wound, should be carefully as- 
 certained. The external, or other parts of the wound, should 
 not be destroyed. As far as possible, they should be kept entire. 
 The custom observed in Paris is very admirable, and worthy of 
 imitation ; that is, to make a cast in plaster, of all wounds in 
 cases where bodies are found divested of life by wounding, and 
 preserve them in one particular place, called the Morgue, where 
 they may ever afterwards be seen, and, if necessary, appealed 
 to, for the purpose of discovering the murderer. 
 
 The external wound should be carefully compared with the 
 internal injury, whether it be of blood vessels, nerves, bone, or 
 viscera. Fractures require a careful examination, to determine 
 whether they were produced before or after death. The seat of 
 wounds should be described by actual measurement from known 
 points ; their figure and nature also carefully noted, and their 
 direction ascertained with exactness. The latter may serve to 
 show from what point the wound has been dealt. 
 
 The most approved mode of examining injuries is, if they be 
 not situated over great cavities, to expose the successive layers 
 of muscles in the manner of an ordinary dissection, observing 
 carefujly what injuries have been sustained by the parts succes- 
 sively exposed, before they are divided. Watson, 379. 
 
 All the great cavities should be examined, and every impor- 
 tant organ in each, however distinctly the cause of death may 
 seem to be indicated in one of them, lb., 375. 
 
286 MEDICAL JURISPRUDENCE. 
 
 After examining the position of the body, things external to 
 it should be noted ; all the objects in its vicinity, with a view to 
 discover on what it rested, or fell upon, or had been suspended 
 from ; all the marks of a struggle taking place near it ; signs ot 
 the presence of a second party about the time of death, or after 
 it ; weapons or other objects, the property of the deceased, or of 
 some other individual; all the remains of poisons, marks of 
 vomiting, &c, that may be found near. To a shrewd and cau- 
 tious observer, many indications of a character similar to the 
 preceding, will present themselves. 
 
 III. POISONS. 
 
 This very extensive division of the second class, will be found 
 to possess an importance second to none we have yet con- 
 sidered. That importance is increased, rather than diminished, 
 by the fact, that it may be secretly administered, in the solitude 
 and retiracy of the sick room, or amid the thousand occasions 
 that are offered in the transactions of social and domestic life ; 
 and that its successful discovery, and complete disclosure, is at- 
 tended with more or less of doubt and difficulty. Before bring- 
 ing to view the several individual poisons, the effects of which 
 are the most frequently made the subjects of investigation in 
 courts of law, it will be proper and necessary to present some 
 general considerations, which will be done in the following 
 order 
 
 1 . The definition : What is a poison ? 
 
 2. The law, and legal enactments in reference to its adminis- 
 tration : 
 
 3. The art of secret poisoning, or of preparing poisons in 
 such a manner that, in their effects, their poisonous quality shall 
 be concealed : 
 
 4. The various methods by which poisons may become intro- 
 duced into the system : 
 
 5. Their mode of action, when once introduced : 
 
 6. The various causes, or circumstances, which modifv theii 
 action, with some hints relative to their treatment 
 
poisons. 287 
 
 7. The general sources of evidence of the administration of 
 poisons : 
 
 8. The most approved methods of medico-legal examination 
 in case of poisoning : 
 
 9. The arrangement and classification of poison : 
 
 10. The consideration of the different classes, their orders or 
 groups, and the substances composing them, or the individual 
 poisons. 
 
 1. The definition : What is a poison 1 
 
 The great number and variety of substances that come under 
 the denomination of poisons, taken in connexion with the wide 
 diversity that characterizes their action upon the human system, 
 creates a difficulty in fixing upon any definition comprehensive 
 enough to include the whole, and yet sufficiently distinctive to 
 have an application to them, and to nothing else. There are sub- 
 stances which act mechanically, such as pins, needles, pounded 
 glass, but which are not poisons. So, also, the same substance 
 may, from some peculiarity of constitution, injuriously affect one 
 person and not another. Such is not a poison. A large draught 
 of «old water, taken into the stomach of a person heated by vio- 
 lent exercise, may prove suddenly destructive to fife, but cannot 
 be considered as a poison. So, also, hot water, taken into the 
 system, may prove destructive, but is not poisonous. In view 
 of all this, the definition given by Dr. Guy, 520, seems the most 
 unexceptionable, viz., that " a poison is any substance which, when 
 applied to the body externally, or in any way introduced into the 
 system, wit/tout acting mec/ianically, but by its own inherent quali- 
 ties, is capable of destroying life." 
 
 2. The law, and legal enactments, in reference to its adminis- 
 tration. -If one resorts to poison, as an instrument to accom- 
 plish the destruction of fife, it is equally murder, as if he had 
 employed any other agency to effect the same purpose. Even 
 where the person intended to be destroyed, does not take it, but 
 one not intended does, and death is the result, the crime of mur- 
 der is legally consummated, and morally too, as the intention was 
 to destroy life. 
 
 This principle was established in Saunders' case. See Plmoden 1 * 
 
288 MEDICAL JURISPRUDENCE. 
 
 Reports., 473. Saunders, intending to kill his wife, gave her a 
 poisoned apple, which she, in ignorance of its true character, 
 gave to his child, against whom he never meant any harm. The 
 child died, and Saunders was convicted of murder. The perpe- 
 tration of murder by means of poison was in England, anciently, 
 punished more severely than the accomplishment of death by 
 any other means. One was sentenced to be boiled to death. At 
 one time, the offence was adjudged high treason. But subser 
 quently, these distinctions in punishment were done away. 
 
 But the law not only punishes the use of poison which is suc- 
 cessful in destroying life, but also, the employment of it with 
 the intent to destroy it, although the attempt may fai-i. The 
 English statute (1 Vict, c, 85,) enacts, "that whosoever shall 
 administer to, or cause to be taken by, any person, any poison o.r 
 other destructive thing, with intent to commit murder, shall b», 
 guilty of felony, and being convicted thereof, shall suffer death:" 
 Guy, 519. 
 
 The Revised Statutes of New- York enact, that " if any person 
 shall be convicted of having administered, or of having caused 
 and procured to be administered, any poison to any other human 
 being, and which shall have been actually taken by such human 
 being, whereof death shall not ensue, he shall be punished by 
 imprisonment in a state prison for a term not less than ten 
 years." 2 R. S., 665. 
 
 So, also, it is made an offence to mingle poison with any food, 
 drink, or medicine, with intent to kill or injure any human be- 
 ing; and wilfully to poison any spring, well, or reservoir of 
 water ; and to administer or expose any poisonous substance, so 
 that it shall be taken by any horse, cattle, or sheep. 2 R. S., 
 666, 689. 
 
 " If any physician, while in a state of intoxication, shall, with- 
 out a design to effect death, administer any poison, drug or medi- 
 cine, or do any other act to another person, which shall produce 
 the death of such other, he shall be deemed guilty of man- 
 slaughter." 2 R. S., 662. 
 
 If, under the same, or similar circumstances, a physician, or 
 
poisons. 289 
 
 any other person, prescribes either of the above, and life is en- 
 dangered, it is declared a misdemeanor. 
 
 In nearly or quite all the states, wilful attempts to destroy life 
 by poison, although unsuccessful, are ranked among the higher 
 crimes. 
 
 3. The art of secret poisoning, or of preparing poisons in 
 such a manner, that, in their efliects, their poisonous quality 
 shall be concealed. 
 
 The history of this singular art will be found in 1 Beekman's 
 History of Inventions, 74, et seq. Although it has once occupied 
 a conspicuous place in history and Medical Jurisprudence, yet 
 the investigation of it, at the present day, belongs rather to the 
 curious than the useful. Under the term secret poisons, were 
 understood to be included all those which can be administered 
 imperceptibly, and which gradually terminate life like a linger- 
 ing disease. The art of preparing and administering these poi- 
 sons was known to the Greeks and Romans, particularly to the 
 latter. It was much practiced in Rome, about 200 years B C. 
 About 150 ladies of the first families were convicted and punish ■ 
 ed for preparing and distributing poison. The art, however, 
 was preserved ; arid we subsequently find the infamous Locusta, 
 condemned to suffer death, but pardoned in order that she might 
 be employed for state purposes. She afterwards prepared the 
 poison with which Nero dispatched Britanicus, the son of Ag- 
 rippina. The poisonous substances were derived from plants, 
 particularly aconite, hemlock and poppy ; or extracted from ani- 
 mals. The ancients seem not to have been acquainted with mi- 
 neral poisons. 
 
 This dangerous art appears to have been carried to the greatest 
 height in Italy, in the 17th century. The most infamous prac- 
 ticer of it was the celebrated Toffania, who first resided at Paler- 
 mo. She prepared the Aqua Tophania, which she distributed by 
 way of charity, to such wives as wished to have other husbands. 
 From four to six grains were sufficient to destroy a man, and it 
 was asserted that the dose could be so proportioned, as to operate 
 in a cei'tain time, such a number of days, weeks or months, for 
 instance, after it was administered. This, without a knowledge 
 
 19 
 
290 MEDICAL JURISPRUDENCE. 
 
 of the constitution, and manner of living of her victims, would 
 clearly have been impossible. She distributed her poison in 
 small glass vials, labelled Manna of St. Nicholas of Bari, and or- 
 namented with the image of the Saint. 
 
 She was at length seized and thrown into prison, where she 
 acknowledged that she had caused the death of over 600 persons. 
 She was afterwards strangled, and her body thrown, at night, 
 into the area of the convent, from which she had been taken. 
 This was to mitigate the arch bishop for invading the right of 
 sanctuary. 
 
 This singular preparation was colorless, transparent and taste- 
 less like water. Its poisonous quality was ascribed to arsenic, 
 and it was said to be a solution of arsenic in aqua cymbalaria, 
 the dose being from four to six grains. The symptoms as given 
 by Hahnemann, see Christison, 296, were "a gradual sinking 
 of the powers of life, without any violent symptom — a nameless 
 feeling of illness, failure of the strength, slight feverishness, want 
 of sleep, lividity of the countenance, and an aversion to food and 
 drink, and all the other enjoyments of life. Dropsy closes the 
 scene, along with black, miliary eruptions and convulsions, or 
 colliquative perspiration and purging." 
 
 In 1659, it was observed at Eome, that many young married 
 women were left widows, and that many husbands died when 
 they became disagreeable to their wives. It was at length dis- 
 covered that the mischief proceeded from a society of young 
 married women, whose president, a little old woman, pretended 
 to foretell future events, and who had often predicted, very 
 exactly, many deaths to persons who had cause to wish for them. 
 The old lady's name was Hieronyma Spara. She was a Sicilian, 
 and had acquired the art from Tofifania, at Palermo. She, her 
 assistant and three other women were hung. 
 
 This detestable art also excited great attention in France, about 
 the year 1670. The principal agent of destruction, through its 
 practice, was the Marchioness de Brinvillier, a young and beau- 
 tiful female, whose outward attractions concealed a heart of most 
 uncommon atrocity. 
 
 She became the intimate of one Godin de Sainte Croix, who, 
 
poisons. 291 
 
 while confined in the Bastile, learned of one Exili, an Italian, 
 the art of preparing secret poison. This art, after his liberation, 
 he communicated to the marchioness ; who, assuming the garb 
 of a nun, distributed food to the poor, and nursed and gave 
 medicines to the sick in the Hotel Dieu, for the sole purpose of 
 trying the strength of her different poisons. She was so success- 
 ful that it was said, in Paris, that no young physician, in intro- 
 ducing himself to practice, had ever so speedily filled a church 
 yard as Brinvillier. She caused her father and brother to be poi- 
 soned, and endeavored in the same way, but without success, to 
 destroy her sister. 
 
 Sainte Croix was, at length, found dead in his laboratory ; the 
 glass mask, which he always wore while preparing his poisons, 
 having accidentally dropped off, he became suffocated. In his 
 possession was found a small box, to which was affixed a written 
 request, that, after his death, it might be delivered to the Mar- 
 chioness Brinvillier ; or if she should not be living, that it should 
 be burnt. The authorities did neither, but opened it, and found 
 it to contain an abundance of poisons of every kind, with labels 
 on each, describing their effects, as proved by experiments made 
 on animals. The Marchioness endeavored to obtain possession 
 of the box, by bribing the officers of justice, but finally failing 
 in all her attempts, she left France. She was subsequently taken 
 by stratagem from a convent, whither she had fled for protection 
 and conveyed to Paris. She was there tried, convicted, beheaded 
 and afterwards burnt. 
 
 The execution of the Marchioness did not suppress the prac- 
 tice. Both in high and low life, there continued to occur occa- 
 sional instances of secret poisoning. These were so frequent that 
 in 1679, a court called the Chambre de poison, or Chamber Ar- 
 dente, was organized, charged with the special duty of watching, 
 searching after, and punishing poisoners. Two women, La Vi- 
 goreux and La Voisin, were detected by it in carrying on a great 
 traffic in poisons. Besides selling secret poison they distributed 
 philtres, thus hot only ridding women of bad husbands but also 
 recovering lost lovers. On the 22d of February, 1680, they 
 were burnt alive, after their hands had been bored through with 
 
292 MEDICAL JURISPRUDENCE. 
 
 a red hot iron and cut off. There were also several other exe- 
 cutions by the common hangman. 
 
 Difficulties have always existed in obtaining an accurate know- 
 ledge of the composition of secret poisons. Governments have 
 endeavored to conceal the recipes at the time of the criminal pro- 
 cedures. 
 
 In France they were burnt, together with the criminals. At 
 Rome, Pope Alexander VII., caused them to be shut up in the 
 Castle of St. Angelo. It is therefore, to some extent, a, matter 
 of conjecture, what were the component parts of there secret 
 poisons. In the casket of Sainte Croix were found sublimate, 
 opium, regulus of antimony, and vitriol. Besides these, a large 
 quantity of poison was found ready prepared, the principal in- 
 gredients of which, the physicians were unable to distinguish. 
 
 The poisons prepared, both by Toffania and Brinvillier, were 
 in all probability, arsenical mixtures, or arsenical neutral salts. 
 The symptoms, such as loss of appetite, faintness, gnawing pains 
 in the stomach, loss of strength without any visible cause, a 
 continual indisposition, followed by a wasting of the lungs', a 
 slow fever, &c. ; all appear to indicate the action of that d.in- 
 gerous poison. There may, however, have been different kinds 
 of poisonous preparations, as opium and cantharides have been, 
 by many, supposed to have been the principal ingredients. 
 
 There now exists little apprehension of secret poisoning, in the 
 sense in which that term has been understood. The great ex- 
 tension of medical and chemical knowledge, has tended both to 
 unveil the true nature and composition of the secret poison, and 
 also to destroy those sources of credulity in which it found so 
 strong a hold, to exercise a power and influence over the imagi- 
 nations of men. It has, therefore, ceased to be of much impor- 
 tance, except as a curious page in the history of man and of 
 Medical Jurisprudence. 
 
 4. The methods by which poisons may become introduced into 
 the system. 
 
 These methods are various, but require simply a brief enu- 
 meration. The most usual mode of finding their way into the 
 system, is by the mouth and oesophagus. Where large quanti- 
 
poisons. 293 
 
 ties are required to produce the proper effect, it may be doubt- 
 ful whether any other avenue maybe sufficient. Those of the 
 more active kind, and such as are easily volatilized, may be in 
 troduced through the nose, in the form of odors. The process 
 of inspiration may introduce them through the lungs. They 
 may also be injected into the rectum, in the form of injection. 
 They may be introduced directly into the circulating system, by 
 opening and inserting them into a blood vessel. It is also as- 
 serted by some, although it is denied by others, that in some in- 
 stances they may find their way through the skin by the process 
 of absorption. 2 Beck's, 240. 
 
 In whatever way they may be introduced, the next enquiry 
 is 
 
 5. As to their mode of action. 
 
 This is of two kinds local and remote. 
 
 Of the local mode of action, there are three varieties. 
 
 1. Corrosion. This is a chemical decomposition of the tissue to 
 which the poisonous substance is applied. A familiar instance 
 of this may be found in the concentrated mineral acids, which 
 corrode and disorganize the textures with which they come in 
 contact. The fixed alkalis have also a similar operation. 
 
 2. Irritation. This is a much less powerful effect than the pre- 
 ceding. Its immediate result, and the evidence of it, is inflam- 
 mation. This is not only the first, but is also the slightest eflect, 
 produced by this class of substances. There are many instances 
 of this variety. Alcohol reddens the stomach. The. mineral 
 acids in their diluted state, arsenic, nitre, cantharides, euphor- 
 bium, may all cause irritation, and consequent inflammation in 
 the stomach and intestines. From the first, or inflammatory 
 state, the part may pass into that of ulceration, and ultimately 
 of gangrene, its severest effects. By inflammation, ulceration 
 and gangrene, a breach may be made in the texture of the organ, 
 but this is different from corrosion. These two effects may be 
 produced in any tissue or organ of the body ; as the skin, mu- 
 cous membrane of the stomach and intestines, cellular tissue, se 
 rous membranes of the chest and abdomen, or in the muscular 
 fibre. Chrislison on Poisons, 3. 
 
294 MEDICAL JURISPRUDENCE. 
 
 3. Nervous impressions. These consist of peculiar impressions 
 made on the sentient extremities of the nerves, which are un- 
 accompanied by any visible change of structure. For instance, 
 monkshood, when chewed, causes numbness and tingling in the 
 lips and tongue ; opium, applied to the inner coat of the intes 
 tines of a rabbit during life, immediately paralyzed their muscu- 
 lar contractions, without, for some time, affecting the general sys- 
 tem. The prussic acid, applied to the hind leg of a frog, palsied 
 it in thirty-five minutes, while the other hind leg continued per- 
 fectly sensible and irritable. These facts go clearly to show, that 
 there may be local impressions of a purely nervous nature, with- 
 out any perceptible organic change. 
 
 Remote action defines the power which certain poisonous sub- 
 stances possess, of affecting an organ remote from that to which 
 they are applied. Thus cantharides irritates the organ with 
 which it is brought into contact, and also affects remotely the 
 urinary and generative organs. Morphine, applied to a wound, 
 or thrown into the stomach, exercises a direct influence upon the 
 brain. So, also, the strychnia tribe affect the spinal marrow. A 
 distinction is taken, by some, in relation to the manner of action ; 
 a few appearing to have a common, but most poisons a specific 
 action. Thus, ±he oxalic acid exerts a corrosive action upon the 
 lining membrane of the stomach and bowels, exciting inflamma- 
 tion around the parts destroyed. The same constitutional shock 
 attends the action of this acid, as accompanies all severe local in- 
 juries. Arsenic, taken into the stomach, irritates and inflames 
 its lining membrane, and also causes cramps in the extremities ; 
 these being the usual attendants in all acute inflammations of the 
 lining membrane of the stomach and bowels. When applied to 
 the skin, or inhaled into the lungs, it also excites inflammation 
 of the same lining membrane of the stomach, with which it does 
 not come in contact. This shows, that the production of in- 
 flammation of this membrane, is its specific action. 
 
 The remote action of poisons naturally leads to the inquiry, 
 as to the manner in which the poison is conveyed from one or- 
 gan to another. Two channels present themselves. These are 
 
poisons. 295 
 
 the bood vessels, and nerves. The conveyance by the first being 
 by absorption ; that of the second, by sympathy. 
 
 1. In regard to the blood vessels, and their action by absorp- 
 tion, several facts go plainly to show, that many poisons act 
 through the blood. 
 
 1. They disappear, during life, from the shut cavities into 
 which they have been introduced. They are absorbed. Four 
 ounces of a solution of oxalic acid were injected into the peri- 
 toneal sac of a cat, which was killed in fourteen minutes after ; 
 and yet, on opening it, although none of the poison had escaped 
 by the wound, scarcely a drachm was found remaining. Christi- 
 son on Poisons., 9. 
 
 2. Many poisons are found to act with rapidity, when they 
 are applied to a part which is attached to the body of arteries 
 and veins only. This has been proved in regard to opium, to 
 nux vomica^ hydrocyanic acid, and diluted oxalic acid. Many 
 poisons will not act, when they are applied to a part of which 
 the circulation has been arrested, although the connection, by 
 nerves, has been left with the body entire. The hydrocyanic 
 acid, when introduced into the hind leg of an animal, after the 
 abdominal aorta has been tied, will not act until the ligature is 
 removed, and then acts with rapidity, lb., 9-10. 
 
 3. It has been clearly ascertained that there is a difference in 
 the absorbing power of the different tissues. A poison introduced 
 into a wound, or injected into a vein, is absorbed with the great- 
 est degree of rapidity. The surface of serous membranes less 
 rapidly absorbs ; and that of the mucous membrane of the ali - 
 mentary canal, exercises the least of all absorbent power. 
 
 No doubt can, therefore, remain, but that poisons are absorb- 
 ed, and pass into the circulating system. But are they necessa- 
 rily detected in that system, or in parts of the body remote from 
 the place of their introduction 1 Some poisons have been dis- 
 covered in the blood, and soft parts of, the body. For instance, sal 
 ammonia has been detected in the serum of horses ; camphor in 
 the blood of the vena cavse ; copper in the liver, and lead in 
 the liver, spinal cord, and muscles. 
 
296 MEDICAL JURISPRUDENCE. 
 
 It is not often, however, that poisons can be detected in the 
 blood, although they may have entered it. 
 
 1 . The quantity of poison that enters it is so small, when comJ 
 pared with its entire mass, as to render it of difficult detection; 
 after being distributed through the whole body. 
 
 2. The poison may have passed off with the excretions, during 
 life, and thus have gone beyond the reach of analysis. Iodine, 
 for instance, passes off rapidly by the urine, and alcohol by the 
 breath. 
 
 3. Some poisons are, in a short period of time, removed from 
 the blood, and concentrated in particular organs. Where ani- 
 mals have been poisoned slowly, by small doses of the prepara- 
 tions of copper, no part of the body was found to contain any 
 of the poison, except the liver. So, also, sugar of lead, admin- 
 istered in the same way, could be discovered no where else, ex- 
 cept in the liver, muscles, and spinal cord. Christison on Per- 
 sons, 16. 
 
 4. The poison may be decomposed in the blood. Some ob- 
 viously act upon that fluid, which implies that corresponding 
 changes are effected in them. Nitric oxide gas gives the blood 
 a chocolate color, and deprives it of its power of coagulating. 
 Sulphuretted hydrogen and hydrocyanic acid effect obvious 
 changes in the blood. Other poisons, in all probability, are de-. 
 composed in the blood. Eight and an half grains of oxalic acid 
 were injected into the femoral vein of a dog, causing its death in 
 thirty seconds. Here it was impossible that the poison could 
 have passed off by the excretions, and yet not a particle could be 
 detected in the blood after death. It must, therefore, have been 
 decomposed by the blood. Many other poisons are destroyed in 
 the same way. 
 
 2. In regard to the nerves, and their action by sympathy. 
 Although all toxicologists seem fully agreed that poisons are 
 absorbed, and are conveyed to the different organs by means of 
 the circulation, yet there has ever failed to be an equal unanimity 
 of opinion, in reference to their transference, by sympathy, through 
 the medium of the nerves. The correct settlement of the ques- 
 tion is of some importance practically, because, if absorption is 
 
poisons. 297 
 
 the only medium of diffusion, the use of ligatures, and cupping 
 glasses, might always be resorted to with, at least, some prospect 
 of success, wherever circumstances and opportunities favored 
 the application. 
 
 The advocates of sympathy urge, that impressions, other than 
 those of the external senses, are conveyed, from one organ to 
 another, by means of the nerves ; that acute inflammation of the 
 stomach, for instance, proves fatal before death can result from 
 the suspension of digestion ; that severe wounds of the stomach 
 may cause death, even before inflammation can commence ; and 
 that rupture, from over distention, may produce almost instant 
 death, without any inflammation, or any material haemorrhage. 
 Christison on Poisons, 5, 6. 
 
 So also in the swallowing of corrosives, as the mineral acids, 
 the fatal result follows in a short space of time, and the symptoms 
 are imperceptible pulse, fainting and excessive weakness. These 
 are not only identical with those that accompany injury from 
 disease or violence, but are also such as show very clearly that 
 remote organs are affected. Again, dilution of the concentrated 
 mineral acids actuaEy facilitates their more rapid absorption, 
 but, at the same time, diminishes or entirely destroys," their re- 
 mote action. 
 
 But the argument the most generally urged is, that some poi- 
 sons produce so instantaneous an effect, as to preclude the pos- 
 sibility of their diffusion, through any other means, than a nervous 
 agency. The hydrocyanic or prussic acid, for instance, acts with 
 a celerity, which is compared by Magendie to the swiftness of a 
 cannon ball, or thunderbolt. From some experiments made 
 with the diluted acid, several dogs were brought under its in- 
 fluence in ten, eight, five and three seconds. One animal was 
 killed outright in four seconds. Christison, 7. Strychnia has 
 been known to commence acting in fifteen seconds. So also has 
 alcohol on animals. 
 
 The answer to this is, that from recent experiments, it has 
 been ascertained, that poisons are much more rapidly diffused, 
 through the medium of the circulation, than was formerly sup- 
 posed. From experiments made by Mr. Blake, see Guy, 525-6, 
 
298 MEDICAL JURISPRUDENCE. 
 
 it appears, that in the dog the time required for a poison to pass 
 from the jugular vein to the lungs, was from four to six seconds ; 
 from the same vein to the coronary arteries of the heart seven 
 secoDds ; from the same vein to the carotid artery, from five to 
 seven seconds ; and from the aorta to the capillaries, four seconds. 
 Introduced into the jugular vein, it was distributed through the 
 whole body in nine seconds. The time required for it to com- 
 plete its circulation through the system of the horse, was from 
 twelve to twenty seconds. 
 
 From these, and some other facts, Dr. Guy is of the opinion, 
 that absorption and diffusion through the blood vessels, is the 
 only method, by which, the poisons are transferred from one 
 organ, or one part of the system, to another. The physiologist 
 Muller was also of the belief, that all poisons entered the circula- 
 tion before producing their injurious effects. To account for the 
 rapid diffusion of the prussic acid, he supposed it possessed great 
 volatility, and power of expansion ; by which it was enabled to 
 diffuse itself through the blood more rapidly than that fluid cir- 
 culates ; to permeate the animal tissues very quickly, and in a 
 manner independent of its distribution by means of the blood ; 
 and thus to produce the peculiar material changes in the central 
 organ of the nervous system more quickly in proportion as it is 
 applied nearer to it. Guy, 527. 
 
 There are some facts, however, that are very diflicult of ex- 
 planation except upon the ground of diffusion by sympathy. 
 " If the nose of a rabbit be introduced into a receiver filled with 
 hydrocyanic acid vapor, the animal drops dead instantly." Ani- 
 mals have been seen to fall prostrate on being bit by a Viper, and 
 " others void their urine and excrements at the very instant, as 
 if their spincters had become paralytic at the moment of their 
 being bit." Guy, 527. The probability therefore is, that both 
 absorption and sympathy are among the instrumentalities, by 
 which, poisons are enabled to work out their injurious effects 
 upon different organs or parts of the human system remote from 
 the place of their introduction. When sympathy is the mode of 
 action, if death is the result, it must be ascribed to the shock 
 impressed on the general nervous system, from the contact of 
 
poisons. 299 
 
 the poison with the nerves of the living tissues. Taylor's Med. 
 Juris., 27. 
 
 6. The causes, or circumstances, which modify the action of 
 poisons. These are various, and may be briefly summed up in 
 the following. 
 
 1. The quantity administered. Here, as a general rule, the 
 larger the quantity, the more severe the effect produced. What 
 is very remarkable, the effect, in some cases, varies with the 
 difference in quantity. For instance,, arsenic, in small doses, 
 may cause inflammation of the stomach ; in a large one, it may 
 affect the action of the heart. Probably the most remarkable 
 poison of this description is the oxalic acid. That, according to 
 the dose given, may corrode the stomach, or act on the heart, or 
 spine, or brain. 
 
 2. The state of aggregation in which it is administered. The 
 general law is, that poisons act far more energetically, in a state 
 of solution, than in the solid state. In the former state, they are 
 more quickly diffused over a large surface, and are also better 
 fitted for entering the bibulous vessels. Poisons must be dis- 
 solved, previous to being absorbed. In some cases, the mode of 
 action is different when administered in the solid or liquid state. 
 Camphor in the former state, generally causes inflammation of 
 the stomach ; in the latter, delirium, or tetanus, and coma. 
 Some poisons act still more efficiently when reduced to a state 
 of vapor. Christison on Poisons, 21 . 
 
 3. Chemical combination. The effect of this varies with differ- 
 ent poisonous substances. Those which possess a purely chemi- 
 cal action, like the alkalis and mineral acids, lose a part, or all, 
 their active properties, when brought into combination with 
 other substances. The resulting substance possesses new proper- 
 ties, being more or less active according to its solubility. All 
 those poisonous substances, which possess a specific action, con- 
 tinue to exert it in their different combinations. The salts of 
 morphia, for instance, all possess the same specification whatever 
 be their combinations, the difference being only in degree. The 
 same is true of strychnia, arsenious, hydrocyanic, and oxalic 
 acids. 
 
300 MKDICAL JURISPRUDENCE. 
 
 4. Mixture. The effect of this varies considerably with differ- 
 ent poisons. So far as they are diluted by the mixture, their 
 activity should be lessened, both because the quantity is smaller, 
 and the time necessary for their absorption is prolonged. But 
 if the poison is an irritant of a powerful character, and acts 
 through the blood, a moderate dilution will enable i't to enter the 
 vessels more easily. This is particularly the case with the oxalic 
 acid. Concentrated, it is feebly irritant or corrosive. Diluted, 
 it speedily enters the blood and causes death. 
 
 There is another effect of mixture totally different, viz., that 
 which arises from the fact, that by means of it, a mechanical 
 impediment is thrown in the way of the poison's acting so directly 
 upon the animal membranes. This is aptly illustrated by sup- 
 posing arsenic to be taken at the same time that a meal of vic- 
 tuals is eaten. If the meal consists of solid food, the effects of 
 the poison would be very slowly manifested. If taken with 
 liquids, such as porridge, and still more if mixed with tea, beer 
 or water, those effects would be developed much more rapidly. 
 This furnishes a reason why many poisons, when taken with a 
 meal, are much longer in producing their usual effects than when 
 taken at any other time. They are also in general less dangerous, 
 because, as in the case of arsenic, a small portion only touching 
 the membrane of the stomach, may produce vomiting to such an 
 extent, as to throw up the entire contents of the stomach in-, 
 eluding the poison also. 
 
 An indication is here furnished in regard to remedies. Finely 
 powdered charcoal or magnesia, when taken in sufficient quan- ' 
 tities, may so envelop the poison as to prevent it from exerting 
 its hurtful effects. So also mucilaginous substances, freely ad- 
 ministered, may afford relief upon the same principle. Chrisii- 
 son, 22-3; Guy, 528-9. 
 
 5. Difference of Tissues and Organ. In the case of corrosive 
 and irritants, a difference of tissue can cause no essential varia, 
 tion in their action. It is in those poisons which are absorbed, and 
 act through the medium of the blood, that difference of tissue 
 works a variation. The point in which the difference consists, 
 
POISONS. 301 
 
 in reference u the speedy action of poisons, consists in the dif- 
 ferent absorbing powers of the tissues. 
 
 Poisons act the most speedily and energetically when injected 
 into a vein. No obstacle is then presented to their immediate 
 diffusion through the entire system, by means of the circulation. 
 They also act about as speedily and effectively on the mucous mem - 
 brane of the pulmonary air cells, and that whether introduced in 
 a fluid or gaseous form. 
 
 The serous membranes possess great activity of absorption. 
 Next to injection into a vein, or introduction into a wound, this 
 tissue affords the most readily the means of introducing and cir- 
 culating a poison through the system. Hence many poisons act 
 much more rapidly through the peritoneum, than they do through 
 the stomach. 
 
 The mucous membrane of the stomach and intestines, next to 
 the serous, affords the most rapidly absorbing surface. The 
 power of the cellular tissue to absorb, has never been very clearly 
 ascertained. 
 
 The cutaneous absorption of poisons is always slow. The cu- 
 ticle and intricate capillaries of the true skin, present many ob- 
 stacles in the way of a rapid absorption. Some have even de- 
 nied that poisons can be absorbed through the unbroken skin. It 
 is a fact, however, that most gaseous poisons, and some solid 
 ones, when volatilized, will act when simply placed in contact 
 with the skin. 
 
 In regard to nervous tissue, there are many active poisons, 
 being all of the narcotic class, that appear to act on the sentient ex- 
 tremities of the nerves, and indirectly, through the nerves, upon 
 the brain and spinal marrow. It is a curious fact, that not one 
 of these acts at all on the cut surface of the brain or nerves, or 
 upon any part of the course of the nerves. Christison, 24 - 5. 
 
 6. Habit. So far as this has any effect, it is generally to lessen 
 the action of poisons. The system, from having become habi- 
 tuated to their action, grows less and less affected by them. This 
 has a more special application to the narcotic class, where the 
 poison is specific, and acts by virtue of its own inherent pecu- 
 liar qualities. The two poisons, in regard to which the power 
 
302 MEDICAL JURISPRUDENCE. 
 
 of habit is the most frequently exercised, are opium and alcohol. 
 The opium eaters and the intemperate, sometimes astonish us by 
 the mighty power which habit comes to possess in them. This 
 is probably owing to the rapid decomposition of the poison in 
 some of the tissues. The stomach acquires an increased power 
 of decomposing the poison, in much the same manner, as it ac- 
 quires an increased facility in digesting some substances at first 
 indigestible. All those poisons, however, to which the system 
 can become habituated, produce in the end extremely injurious 
 effects upon it. 
 
 Many of the inorganic poisons, particularly the corrosives, re- 
 main little affected by the force of habit. Those that enter the 
 blood, are supposed to have their activity rather increased than 
 diminished by this force. ' The effects of cumulative poisons, or 
 those which are capable of gradually accumulating in the system, 
 and of ultimately producing their injurious effects, ought not 
 to be considered as acting under the dominion of habit. 
 
 7. Idiosyncrasy. By this term is understood that peculiarity of 
 constitution, which subjects the organism to be affected by the 
 action of agents, in a different manner, or in a different degree 
 from others. Both this and habit, enter as a disturbing force, 
 into the ordinary normal effects of poison, and the extent of the 
 variety they are enabled to produce, should be capable of being 
 fully appreciated by the medical jurist. Idiosyncrasy may operate 
 in three different ways. 
 
 1 . It may render less or more affected than others through the 
 action of the same agent. A few grains of mercury may sali- 
 vate one man, without in any perceptible degree, affecting an- 
 other. So also, it is perfectly well known, that alcohol, in the 
 same quantities, produces extremely different effects in degree, 
 in its action upon different systems. So also the same quantities 
 of arsenic will produce different effects upon different constitu- 
 tions, and that entirely irrespective of any diseased affec 
 tion. 
 
 2. It is possible for a substance, which ordinarily produces the 
 same effect upon individuals, to produce in one, having a pecu- 
 liar idiosyncrasy, a very different one. Thus Epsom salts have 
 
poison's 303 
 
 been known to act like opium, and opium to have a purgative 
 effect. Guy, 530. 
 
 3. Owing to this same peculiarity, some substances are actually 
 poisonous to some individuals, which, to the generality of man- 
 kind are not only harmless, but even nutritious. Different kinds 
 of fish act upon some in the manner of poisons, producing faint- 
 ing, sickness, pain of the stomach, and sometimes attended with 
 dangerous consequences. The same has also occurred in the 
 case of mushrooms. There are probably few articles of food, in 
 regard to which, such idiosyncrasies may not, in a few rare in- 
 stances, be met with. Christison on Poisons, 28. 
 
 8. Disease. This, like habit, tends in general to impair the ac- 
 tivity of poisons ; the system being rendered by it less suscepti- 
 ble of being influenced by them. The extent, as well as the de- 
 gree of influence, depends much upon the kind and nature of 
 the poison, and also upon the character and severity of the dis- 
 ease. The poisons chiefly influenced are from the organic king- 
 doms. They beloag principally to the narcotic class. Those 
 from the inorganic kingdom are much less affected. 
 
 So also much depends on the disease. In severe dysentery 
 and cholera, the susceptibility of the system to be influenced by 
 opium is very much diminished. One reason may be, that the 
 poison is then carried with great rapidity through the alimentary 
 canal. So also when the system is laboring under great weak- 
 ness, the power of absorption is much diminished ; and hence 
 the poison is not taken up with the usual quickness by the ab- 
 sorbent vessels. There are perhaps no diseases that impair, more 
 powerfully, the activity of poisons, than tetanus and the more 
 active forms of mania. In both these, the nervous system is in 
 a state of peculiar excitement, by means of which, the ordinary 
 action of the poison is, to a great extent, counteracted. 
 
 There are a few diseases which increase the susceptibility of 
 the system to the action of poisons. This occurs whenever the 
 poison and the disease both tend to bring on the same pathologi- 
 cal state of the system, or of any particular organ. Thus, in 
 cases where apoplexy has actually supervened or is threatened, 
 opium administered produces a much more powerful effect. So 
 
804 MEDICAL JURISPRUDENCE. 
 
 in case of inflammation of the alimentary canal, any irritating 
 substance may produce a dangerous impression. Christison,Bl. 
 
 It ought to be here remarked, that sleep has a strong effect in 
 delaying the action of poisons. All the organic functions are 
 then carried on more slowly, and there is, therefore, less suscep- 
 tibility in the system, to be influenced by the action of those 
 agents. Hence, when sleep either supervenes, or is produced 
 immediately upon the taking of a poison, the ordinary effects of 
 it may be expected to be delayed. Guy, 530. 
 
 As the duties of the medical jurist may be said to be accom- 
 plished when he has ascertained the fact of the existence of 
 a poison, and has rendered clear to others the evidence upon 
 which it rests, very little time can be occupied in remarks upon 
 the treatment in case of poisoning. 
 
 Antidotes are given with two views: One is, to alter the 
 chemical nature of the poison, and thus deprive it of its delete- 
 rious quality, before it comes within its sphere of action ; the 
 other is, to excite a contrary action in the system, and thus to 
 control its poisonous action after it has begun. 
 
 An instance of the first, is the neutralization of a mineral 
 acid, by the administration of an alkali. In regard to the sec- 
 ond, we have little knowledge of any substances that are capable 
 of acting as counter-poisons, or in any way to excite a contrary 
 action in the system, and thus to control the poisonous action 
 after it has begun. 
 
 The following are the antidotes, as enumerated by Christison, 
 in his work on poisons, 33 : When given in time, magnesia or 
 chalk is a complete antidote for the mineral acids, and oxalic 
 acid ; albumen for corrosive sublimate and verdigris ; bark for 
 tartar emetic ; common salt for lunar caustic ; sulphate of soda 
 or magnesia for sugar of lead ; muriate of baryta, chloride of 
 lime, or soda, for liver of sulphur ; vinegar or oil, for the fixed 
 alkalis ; and these substances act either by neutralizing the cor- 
 rosive power of the poison, or by forming with it an insoluble 
 compound. 
 
 Where a poison has not been taken into the stomach, but 
 some external application has been made of it, the object is, to 
 
poisons. 305 
 
 prevent its entering the blood, or to remove it from the local ves- 
 sels into which it has found entrance. One mode of doing this, 
 is to apply cupping-glasses to the part where the poison has been 
 introduced. This may prevent its further absorption, and suck 
 the blood out of the wound, washing the poison away with it. 
 
 Another method, is to check the circulation by the application 
 of a ligature. By the gradual tightening and loosening of it, the 
 poison may sometimes be so gradually introduced into the gene- 
 ral system, as to be productive of little or no injury. It has also 
 been proposed to withdraw as much as possible of the blood be- 
 low the ligature, for the purpose of extracting the poison ; or as 
 much of it as can readily be done, together with the blood. 
 Ckristison on Poisons, 34-5. 
 
 7. The general sources of evidence of the administration of 
 poisons. 
 
 Under this head is embraced a reference to those sources of 
 evidence, which may be appealed to in all suspected cases of 
 general poisoning, no regard being had to any particular poison 
 given. The object is, to render the general fact of poisoning 
 possible, probable, or certain ; or improbable, or impossible. 
 
 These sources of evidence are five in number, viz : 1 . The 
 symptoms developed ; 2. The appearances presented on a post- 
 mortem examination ; 3. Chemical analysis ; 4. Experiments on 
 animals; and, 5. Moral circumstances. Of these in their order, 
 
 1. The symptoms. These were formerly mwch relied on as evi- 
 dence of general poisoning. They are not now regarded as fur- 
 nishing anything more than a high probability. There are cer- 
 tain peculiar features of the symptoms that are to be regarded. 
 These have reference — 
 
 1 . To the suddenness of their occurrence. The symptoms devel- 
 oped by the more active poisons, whether irritants or narcotics, 
 are extremely sudden ; some are instantaneous, and most of 
 them occur within an hour after the poison has been taken. But 
 the most violent may be so administered in small doses, as to 
 cause the symptoms to be developed slowly. Even corrosive 
 sublimate may be so administered, as to cause at first only a 
 mild salivation. In criminal cases which arise for investigation 
 
306 MEDICAL JURISPRUDENCE. 
 
 in courts of justice, the more active poisons are commonly given, 
 and the dose administered is very large ; so that the fact general- 
 ly remains true, that the symptoms are sudden in their occur 
 rence. 
 
 2. The second feature to be noticed, is the regularity in their 
 increase. This feature cannot be universal. Where the poison- 
 ing is by repeated small doses, there will be remissions and ex- 
 acerbations, the same as in natural diseases. Some poisons ad- 
 mit of exacerbations and remissions, even when given in one 
 large dose, while others produce violent symptoms in frequent 
 paroxysms. Of these latter, the strychnia tribe afford instances. 
 In poisoning with arsenic, after the first five or six hours, there 
 is often a remission, and a subsequent return with increased vio- 
 lence. Christison^ 42. 
 
 It is, nevertheless, generally true, that the symptoms of poi 
 soning are steady in their progress. 
 
 3. The third feature is uniformity in their nature. This, al- 
 though stated as a general characteristic, is nevertheless true in 
 the case of but comparatively few poisons. Many poisons cause 
 very different symptoms at the close, from what they do at the 
 beginning. The first symptoms of arsenic, may be inflamma- 
 tion of the alimentary canal ; afterwards, palsy or epilepsy. 
 Nux vomica may excite, at first, violent tetanus; afterwards, 
 inflammation of the stomach and bowels. Even the fact of 
 change is sometimes cited as evidence of poisoning. Although, 
 therefore, the presence of this feature generally adds little, if 
 any weight, to the evidence in favor of death by poison ; yet its 
 absence may sometimes afford even positive proof in favor of 
 natural death. Changes may occur in the symptoms, during 
 their progress, that may be incompatible with the known effects 
 of poison, and capable of being accounted for only on the sup- 
 position of natural disease. Chrislison, 46. 
 
 4. The fourth feature is, that the symptoms begin soon after a 
 meal. Although poisons, as mushrooms, may remain for a long 
 time in the alimentary canal before their effects commence, yet 
 the more common poisons, such as arsenic, corrosive sublimate, 
 the mineral acids, oxalic acid, nux vomica, and some others, be- 
 
poisons. 307 
 
 gin to develope their symptoms soon after they have been taken. 
 It must, however, be borne in mind, that poisons may be intro- 
 duced into the system through other avenues than the oesopha- 
 gus and stomach. So, also, there are causes that may delay, for 
 some time, the action of poisons. One of these is certain diseases, 
 as already mentioned j another is sleep, occurring immediately 
 or soon after taking the poison. This should always be taken 
 into consideration, in connexion with the time intervening be- 
 tween the taking of a meal and the commencement of the symp- 
 toms. 
 
 5. The fifth, and last feature noticeable, is the appearance of 
 the symptoms during a state of perfect health. This, although 
 generally, is by no means universally, true. It has no applica- 
 tion in case of slow poisoning. Poisons may also be administer- 
 ed to a person at the time diseased. The symptoms developed 
 by the poison may be analogous to those produced by the disease, 
 which would render the case extremely embarrassing. Christi- 
 son, 44-5. 
 
 We have brought under review, briefly, the principal features 
 .')f the symptoms which characterize general poisoning. It now 
 remains to examine how far they are distinctive, or can be dis- 
 tinguished from those of natural disease. 
 
 1 . As to suddenness of occurrence. This is also a peculiarity 
 of many diseases. The plague, inflammation of the stomach, in- 
 flammation of the intestines, cholera, may, for the most part do, 
 all develope their symptoms suddenly ; generally running on 
 speedily to a fatal termination. Diseases of the heart, and apo- 
 plexy, may also prove suddenly fatal, without previous warning. 
 This feature, therefore, except what can be collected from par- 
 ticular poisons, cannot be regarded as distinctive. 
 
 2. The regularity of increase is also to be noticed in many 
 diseases. Apoplexy, cholera, most acute diseases, when they 
 prove rapidly fatal, are marked by a regularity in the increase 
 of their sypmtoms. 
 
 3. In their uniformity they are hardly less distinctive. . Many 
 diseases are characterized by the same uniformity. 
 
 i. The symptoms beginning soon after a meal. This also occmy 
 
308 MEDICAL JURISPRUDENCE. 
 
 in some diseases. Apoplexy is likely to take place after a hearty 
 meal. So also is cholera, occurring from some causes. Disten- 
 tion of stomach, rupture of its coats, are likely to happen soon 
 after an ingestion of food and drinks. As the diseases, however, 
 that have this characteristic, are comparatively few in number, 
 and of unfrequent occurrence, this feature is justly regarded as 
 entitled to considerable weight. 
 
 It is not alone as positive evidence, that this feature is entitled 
 to consideration. Its negative force is often greater than its posi- 
 tive ; that is, where the symptoms are such as usually character- 
 ize the most active poisons, but their occurrence is so long after 
 taking any food, drink, or medicine, as to exclude all reasonable 
 probability that they could have been produced by the action of 
 any poison which was taken with any such food, drink or medi- 
 cine. 
 
 This was particularly exemplified in the case of the crown 
 Piince of Sweden, which occurred in 1810. While reviewing his 
 troops, he was observed suddenly to waver on his horse, and soon 
 afterwards fell. He was immediately found insensible, and ex- 
 pired in half an hour. A rumor was circulated that he was 
 poisoned. It appeared in proof, that he had taken nothing after 
 he had breakfasted, which was about four hours previous to his 
 falling from his horse. No other poison than an active narcotic 
 could have caused the symptoms developed in the case, and such 
 could only have produced them when given in a large dose. No 
 poison of this character, could have had its eifects suspended for 
 four hours, and then have proved so suddenly fatal. It was un- 
 doubtedly an attack of apoplexy, of which he had already had 
 some warnings, and of which some marks were found about the 
 head after death. Christison en Poisons, 47-8. 
 
 The practice is sometimes resorted to, of substituting poison- 
 ous mixtures, for medicinal drafts or powder. In the case of 
 Sir Theodosius Boughton, who was poisoned in 1781, by his 
 brother-in-law, Donnellan, the most important evidence against 
 the prisoner was the fact, that alarming symptoms came on in 
 two minutes after the deceased had swallowed what was sup- 
 
poisons. 309 
 
 posed to be a simple medical draught. Laurel water was sub- 
 stituted for the medicine. 
 
 5. The symptoms first appearing while the body is in a state of 
 perfect health. Although almost all acute diseases commence 
 during health, yet those of the inflammatory kind, seldom begin 
 without some adequate ■and obvious natural cause. 
 
 From a careful review of every thing relating to symptoms, it 
 is obvious, that the medical jurist cannot be justified in placing 
 any very great reliance upon them alone in any case of suspected 
 poisoning. They should by no means be neglected, as they may 
 furnish the first hints of the cause of mischief. They may fur- 
 nish evidence of probability, but not of certainty. They may 
 demonstrate the impossibility of the poisoning. They may also 
 furnish a necessary link, in the chain of proof, to determine 
 whether the poison was the cause of death. In illustration of 
 the last remark, Dr. Christison cites the case of Charles Munn 
 tried in 1824, for procuring abortion and of murder by poisoning 
 The evidence went to show, that arsenic had been given, under 
 the effects of which, the deceased labored for twelve days. After 
 that, she recovered, and in two weeks was free of every symp- 
 tom, except weakness and pains in the hands and feet. She soon 
 afterwards became affected with headache and sleeplessness, and 
 died in nineteen days under symptoms of obscure general fever, 
 but without any local inflammation. The medical witnesses in 
 that case decided, that, admitting the first symptoms to be owing 
 to arsenic, the death could not be ascribed to it with any degree 
 of certainty. 
 
 2. The second source of evidence consists in the appearances 
 which present themselves on a post-mortem examination. These 
 also were formerly much relied upon, but with little reason. 
 There are but very few poisons that leave any distinctive marks 
 upon the organization. Dr. Christison thus briefly states his 
 conclusions in reference to this source of evidence. " The ap- 
 pearances after death, which are really morbid, and which may 
 be produced by poisons, are in one great class, the signs of in- 
 flammation of the alimentary canal in its progressive stages, in 
 another class, the signs of congestion within the head, and in a 
 
310 MEDICAL JURISPRUDENCE. 
 
 third, a combination of the effects of the two preceding classes ( 
 that neither set of appearances is invariably caused by the poi- 
 sons which usually cause them ; that congestion within the head 
 is really seldom produced by those which are currently imagined 
 to produce it ; and that most of the appearances of both kinds 
 are exactly similar to those left by many natural diseases." It 
 is of little use here to dwell further on this source of evidence. 
 It will be found, when we arrive at the mineral acids, that the 
 corrosives, and some of the simply irritant poisons, leave distincl 
 traces in the body, although sometimes not so easily distin 
 guishable from those left by some natural diseases. 
 
 It was formerly supposed that unusual blackness pr lividity ol 
 skin afforded a general indication of death by poisoning. A 
 more enlarged experience has given to this a decided negative, 
 and has also affirmed as true, that there is no difference in kind; 
 between the lividity that succeeds death by poison, and that 
 which follows death from disease. 
 
 Nor does early putrefaction, as was once supposed, follow death 
 by poisoning. It is not generally caused by poisons, and in some 
 cases, as in that of arsenic, the putrefactive process is delayed by 
 the action of the poison. 
 
 It should be remarked, that post-mortem appearances may 
 sometimes furnish negative evidence that may be valuable. 
 Where, for instance, it is alleged that corrosives have been ad- 
 ministered, the absence < of all corrosion would serve to disprove 
 the charge. So also the entire absence of all inflammation, in a 
 case of alleged poison by irritants, would render doubtful or en- 
 tirely disprove, the truth of the allegation. 
 
 If a poison is introduced into the body after death, with a view 
 to inculpate an innocent person, the post-mortem appearances 
 may become important. The absence of the peculiar appear- 
 ances produced by the poison would, in such cases, frustrate the 
 malicious purpose. 
 
 3. Evidence from chemical analysis. To this source of proof is 
 justly attached a high degree of importance. Although its fail- 
 ure, for reasons which will presently be rendered apparent, can- 
 not be received as evidence that no poison has been administered, 
 
POISONS. 31] 
 
 yet its clear detection of the poison, must always satisfy the af- 
 firmative enquiry. In order, however, to rest upon this evi- 
 dence, the poison should be found either in the stomach, intes- 
 tines or gullet ; or in the matter vomited ; or in articles of food, 
 drink, or medicine, of which the sufferer has partaken; or in 
 articles found in the possession of the prisoner, and unaccounted 
 fur. 
 
 The main enquiry should always be in relation to the cause of 
 death. Although other apparent causes may develope them- 
 selves, yet this should not supercede the investigation of any 
 suspicious substance, exhibiting the appearance of a poison. An 
 interesting case is given by Dr. Christison, 55-6, quoted from 
 Dr. Willdberg, of Rostock, of a girl, who actually expired, while 
 her father was chastising her severely for stealing. Her death 
 was supposed to have been the result of the beating, but, on the 
 examination, although there were found the marks of many 
 stripes on the arms, shoulders and back, with extravasated blood 
 under them, yet they did not appear, by any means, sufficient to 
 account for death. On opening the stomach it was found very 
 much inflamed, and lined with a white powder which chemical 
 analysis proved to be arsenic. The girl had taken arsenic 
 through fear of her father's displeasure after being detected, had 
 vomited during the flogging, and died in slight convulsions. 
 
 If, on the closest examination, no poison can be detected, it 
 does not therefore folliw that none has been administered. For, 
 
 1 . It may have been discharged by vomiting and purging. In 
 the case of Thorn, tried in 1821, although the deceased had 
 clearly died of poisoning by arsenic, yet none could be detected 
 in the stomach or its contents. He had lived seven days, and 
 all the time had labored under frequent vomiting. In another 
 case, arsenic could not be found in the matter vomited twenty- 
 four hours after it had been swallowed. In another case, a grocer 
 died eight hours after swallowing an ounce of arsenic, and yet 
 chemical analysis could detect none whatever in his body. It is 
 nevertheless true, that poisonous substances not easily soluble, 
 and which have been taken in a state of minute^division, do ad- 
 here to the villous coat of the stomach with such strong tenacity 
 
312 MEDICAL JURISPRUDENCE. 
 
 as not to be easily dislodged by vomiting. Many instances of 
 this have occurred in the case of arsenic. Christison, 56-7. 
 
 The length of time a poison, which has excited vomitirsg, may 
 remain in the stomach, will depend on its solubility; the fre- 
 quency of the vomiting ; the remedies taken ; and other similar 
 circumstances. 
 
 2. The poison may have been absorbed, and may thus have 
 disappeared. This is more especially the case where poisons are 
 taken in a liquid form, particularly laudanum. It has taken 
 place where solid opium has been taken. In a case of laudanum, 
 which occurred in 1823, none could be detected, although the 
 circumstances left no doubt but that it had been swallowed seven 
 or eight hours before death. The readiness and celerity with 
 which the absorption would take place, must depend much upon 
 whether the poison was in a liquid form ; or, if it was not, 
 whether it was easily soluble. Some mistakes have been made 
 in arriving at hasty conclusions that no poison has been taken, 
 because none could be found in the stomach, which have occur- 
 red in consequence of overlooking its disappearance through the 
 means of absorption. 
 
 3. Poisons may be decomposed, and hence not be found in the 
 stomach or its contents. Many poisons are destroyed by the pro- 
 cess of digestion. Some of the mineral poisons are also decom- 
 posed in the stomach. Among these are corrosive sublimate, 
 lunar caustic, and hydrochlorate of tin. Their decomposition is 
 owing to a chemical, not a vital process. 
 
 Other poisons become changed by entering into combination 
 with other substances, without themselves undergoing decompo- 
 sition. The decay of the body, prior to examination, may also 
 have caused the disappearance of the poison. Where any con- 
 siderable portion of time has elapsed between dissolution and 
 the examination, " some poisons, such as oxalic acid, might be 
 dissolved and then exude ; others, such as the vegetable narco- 
 tics, will undergo putrefaction ; and others still, such as prussic 
 acid, are partly volatilized, partly decomposed, so as to be undis- 
 tinguishable in the course of a few days only." 
 
 The results of experimental enquiries conducted by Orflla and 
 
poisons. 313 
 
 I esueur were, that after a time the acids become neutralised by 
 the ammonia disengaged during the decay of animal matter ; that 
 by the action of the animal matter the salts of mercury, anti- 
 mony, copper, tin, gold, silver, and likewise the salts of the 
 vegetable alkaloids, undergo chemical decomposition, in conse- 
 quence of which the bases become less soluble in water, or alto- 
 gether insoluble ; that acids may be detected after several years 
 interment, not always, however, in the free state ; that the bases 
 of the decomposed metallic salts may also be found after inter- 
 ment for several years ; that arsenic, opium and cantharides un- 
 dergo little change after a long interval of time, and are scarcely 
 more difficult to discover in decayed, than in recent animal mix- 
 tures, but that hydrocyanic acid disappears very soon, so as to 
 be undistinguishable in the course of a few days-. Chrislison on 
 Poisons, 61. 
 
 The discovery of poison, by means of the chemical tests, af- 
 fords undoubtedly the clearest and most satisfactory evidence 
 that can be obtained. Some have even gone so far as to insist 
 that no case of poisoning should be considered as proven, unless the 
 roison had been discovered by these tests. A case, however, is 
 related by Dr. Christison, 62-3, in which although the tests 
 f died to discover any, yet no doubt could really exist but that 
 poison had been administered. A man, known to have some 
 design on another, persuaded him to breakfast with him at a 
 tavern. They had beef-steaks, fried potatoes, eels, claret and 
 rum. Soon after commencing, the guest complained of feeling 
 unwell, and began to vomit violently. This continued, with ex- 
 cruciating pain in the abdomen, long before a physician was pro- 
 cured. The physician, at first, imputed the whole to cholera, 
 but on returning in the evening and finding him dead, said he 
 had been poisoned. The body presented much external lividity, 
 contraction of the fingers, great inflammation of the stomach 
 and intestines, the appearance resembling that of gangrene. 
 Some fluid was found in the stomach, but on analyzing it, no ar- 
 senic or other poison could be detected. 
 
 The attention was turned particularly to arsenic, as the priso- 
 ner was proved to have bought that poison, and to have made 
 
314 MEDICAL JURISPRUDENCE. 
 
 a solution of some white powder in bis kitchen not long before 
 the occurrence of this event. The deceased also presented symp- 
 toms of stupor, and other signs of derangement of the nervous 
 system, remarked in rapid cases of poisoning with arsenic. Un- 
 der all these circumstances, " the kind and character of the symp- 
 toms, their commencement during a meal, the rapidity of death, 
 the signs of violent inflammation in the stomach after so short 
 an illness, and the facility with which the absence of poison in 
 the contents of the stomach may be accounted for, more espe- 
 cially if it be supposed that the poison was administered in solu- 
 tion," leave little doubt but that arsenic had been administered, 
 most probably in solution, although none could be detected in 
 the stomach or its contents. 
 
 4. Experiments on Animals. 
 The results obtained from this source of evidence are not often 
 introduced in courts of justice. Several objections have been 
 made to their introduction. It is objected 
 
 1. That what is> poison to man is not always such to the lower 
 animals. From the experiments of Orfila, it would seem, that 
 the cat and dog are two animals generally affected by poisons in 
 nearly the same way as man. And although poisons act on them, 
 yet they do not act to the same extent, nor do all of them in the 
 same manner. In general they act on them less violently than 
 on man, but alcohol acts more powerfully. Opium, and some 
 other poisons, produce different symptoms in man from what 
 they do in animals. Most of the active poisons, however, pro- 
 duce nearly the same effects on all animals. 
 
 2. It is objected that it is difficult or impossible, to administer 
 poison to animals in such a state of concentration, as to prevent 
 it from being discharged by vomiting. To obviate this objection, 
 it is directed to make a small opening into the gullet of the ani- 
 mal, having previously detached it from its surrounding con- 
 nexions. All the liquid part is then introduced by a funnel 
 thrust into the opening, and the solid portions made into little 
 pellets are squeezed down. The gullet is then to be tied under 
 the aperture. All this can onlv be done successfully by a prac 
 ticed operator. 
 
poisons. 315 
 
 3. When the experiment is to be made of the vomited matter 
 or contents of the stomach, it is objected that the poison may 
 have been, either in part or wholly, vomited before hand or ab- 
 sorbed, or transmitted into the intestines, or decomposed by the 
 process of digestion. Or that it may be so much diluted as to 
 have no effect The validity or force to be attached to these ob- 
 jections will, of course, depend upon the circumstances of each 
 particular case. 
 
 4. It is objected that animal fluids, secreted during disease, 
 may occasionally act as poisons. Animal fluids are no doubt 
 poisonous when putrid. The introduction of such fluids into an 
 external wound, causes spreading inflammation of the cellular 
 tissue. As to the effect of disease in rendering the contents of 
 the stomach actually poisonous, there is one known fact going to 
 prove it, which certainly demonstrates its possibility. Mor- 
 gagni states, that in the case of a child that died of the tertian 
 ague, an aruginous bile was found in the stomach, of so delete- 
 rious a character, that a little of it given with bread to a cock 
 caused convulsions and death in a few minutes, and that a scal- 
 pel stained with it, and thrust into the flesh of two pigeons, killed 
 them in the same manner. 
 
 On the whole, this will not be a source of evidence upon 
 which can be placed a very great degree of reliance. It may be 
 useful as a means of testing a suspected substance, and of de- 
 termining whether it possessed poisonous qualities or not. So also 
 it may be resorted to as a means of experimenting on different 
 poisons, but usually, in medico-legal cases. When a sufficient 
 quantity of suspected substance is found to subject to this test, 
 it is also sufficient to subject to other and better tests. 
 5. Moral circumstances. 
 
 With these the skilled witness, as such, has nothing to do. 
 There are, nevertheless, not unfrequently things connected with 
 them, that do require his examination and testimony. All that 
 can be necessary, therefore, is to state briefly the circumstances 
 and the occasions where medical aid may be required. 
 
 1 . The first circumstance relates to suspicious conduct on the 
 part of the prisoner before the event ; such as dabling with poi- 
 
316 MEDICAL JURISPRUDENCE. 
 
 sons, conversing about them, and showing a knowledge of their 
 properties. The medical witness may here be called upon to 
 state the extent and accuracy of the knowledge, which the 
 prisoner manifests by his acts and conversation. 
 
 2. Another circumstance relates to the purchase or possession 
 of poison, at or about the time of the alleged crime, and the 
 pretence under which it was procured, and whether the pretence 
 turns out to be true or false. 
 
 3. The circumstances attending the administration of poison 
 either in food, drink, medicine or otherwise. The great object, 
 in case of any suspected administration, is to ascertain the fact 
 and the intent. Two cases may be found in Dr. Christison, 75, 
 which will serve to illustrate. The one occurred where the poi- 
 son, arsenic, was contained in a bowl of porridge. A past of 
 the meal, from which the pomdge was made, was preserved. 
 Another portion was obtained from the family stores. The for- 
 mer was shown by chemical analysis to contain arsenic, which 
 the latter did not. There were also other circurastaiAces going to 
 show, that the poison must hare been mixed with flie me*d in 
 the morning, before any strange*- entered the houo», The ac- 
 cused was convicted. 
 
 The other case is cited from Barrael, and in that "he arsenic 
 was found mixed with a large mass of flour, of wli 5 <ih only a 
 small portion had been used in making bread. Thi? was pre- 
 sumed to be accidental, the very large portion of flour in which 
 the mixture occurred, negativing the presumption a'' criminal 
 intent. The wheat was, in all probability, intended for <!eed ; 
 and was sent by mistake to the mill, the arsenic having been 
 mixed with it to destroy insects. 
 
 Where corrosive poisons have been used, the examination of 
 the clothes has sometimes led to the conviction of the murderer 
 This has, at least, once occurred, in the case of poisoning with 
 nitric acid. Guy, 537. 
 
 4. The intent of the person who is proved to have adminis 
 tered the poison. This will depend for its proof much upon tb<j 
 quantity given, and the circumstances under which it was ad 
 ministered 
 
poisons. 317 
 
 In the trial of Hodgson, in 1824, for attempting to poison his 
 wife, it was proved, that he had substituted corrosive sublimate 
 for calomel and opium in pills, which, had been prescribed by her 
 physician. Also that a laudanum draught contained corrosive 
 sublimate. These he attributed to mistakes and the first also to 
 intoxication. In the latter case, he also alleged that he had 
 mistaken for the water bottle, an injection of corrosive subli- 
 mate, which he had previously prepared for a sailor. The chemi- 
 cal analysis of the draught and the injection disproved the truth 
 of this, by showing that the former contained fourteen grains to 
 the ounce and the latter only five. 
 
 5. The simultaneous illness of other members of the family, 
 besides the person chiefly affected. "Where several persons have 
 partaken of the same dish, and have been seized at the same 
 time, with the same kind of symptoms, it affords strong evi- 
 dence of general poisoning. The symptoms, however, must be 
 characteristic of the action of some particular poison, in order 
 to be justly attributable to it ; otherwise the cause of the diffi- 
 culty may be in the food itself. Where all who have eaten of a 
 particular dish have suffered, and all who have not, have es- 
 caped, the moral evidence of poisoning is possessed of great 
 strength. So also the several persons affected, may suffer in pro- 
 portion to the quantity taken, by each, of a particular dish. 
 
 Thus, in the case of Lanargan, tried for the murder of O'Fla- 
 herty, it was proved that the daughter of the deceased, and two 
 servants, were affected at the same time, and with the same 
 symptoms as himself; that they had partaken of the same dish 
 with Mm ; that the severity of their several complaints was in 
 proportion to the quantity each had taken ; and that others of 
 the family, who did not eat it, were not affected. Christison on 
 Poisons, 85. 
 
 A very instructive case is recorded by Morgagni, of a clergy- 
 man who was traveling in company with another gentleman and 
 two ladies. They had all dined together at an inn, and were 
 about to resume their journey, when the clergyman was sudden- 
 ly taken ill, with violent pain in the stomach and bowels ; and 
 soon after, with vomiting and purging. Of the rest of the com- 
 
318 MEDICAL JURISPRUDENCE. 
 
 pany that had dined together, one of the ladies was similarly af- 
 fected, but in a less degree ; and likewise the other gentleman, 
 though in a still less degree ; but the other lady was not at all 
 affected. It was found that this lady was the only one of the 
 party, who had not tasted a dish of soup at the commencement 
 of dinner. But the gentleman who had suffered least, had eaten 
 the largest share of it, while the clergyman had taken less than 
 either. But it was there the custom to use scraped cheese with 
 soup, and it was ascertained that each had added cheese exactly 
 in proportion to the extent of their illness. There was no diffi- 
 culty, therefore, in deciding, that the poison was contained in 
 the cheese ; and after the recovery of the whole party, the land- 
 lord admitted that he had served up to his guests cheese that 
 had been seasoned with arsenic to kill rats. Christison on Pin- 
 sons, 85-6. 
 
 6. Another item of moral evidence consists in suspicious con- 
 duct on the part of the prisoner during the illness of the person 
 poisoned. He may prevent medical advice being procured, or 
 the relatives being sent for. He may attempt to destroy food or 
 drink, or vomited matter, which may have contained the poison. 
 
 7. Suspicious conduct after the person's death, as hastening 
 the funeral, preventing inspection of the body, giving a false ac- 
 count of the previous illness, and other things of a like charac- 
 ter. 
 
 8. The personal circumstances and state of mind of the de- 
 ceased ; his death-bed declarations, and other particulars. 
 
 9. The fact that a motive or inducement exists on the part of 
 the prisoner, such as his having had difficulties with the deceas- 
 ed, or a hatred of him, succeeding to property on his death, or 
 being relieved of a burden by it, and other particulars of that 
 character. 
 
 8. The most approved methods of medico-legal examination 
 in case of poisoning. 
 
 Where a suspicion is created that a case of poisoning has oc- 
 curred, several important points are to be attended to : 
 
 1. In reference to the symptoms. When did they commence ? 
 In what state or condition of the system 1 How long after a meal, 
 
POISONS. 31 £ 
 
 or the taking of food or medicine 1 What was the nature of the 
 symptoms 1 What the order of their occurrence 1 Have they 
 been uniformly progressive, or attended with exacerbations 1 
 
 2. In reference to the matter vomited, or passed by stool. 
 What is its character, its quantity, its color 1 Was there any 
 sense of acridity or burning in the throat or mouth, previous or 
 subsequent to the vomiting 1 
 
 3. In reference to the dishes used at the previous meal. In 
 what manner were they prepared 1 What was the nature of all 
 the different articles of food used at the meal 1 If several per- 
 sons have partaken of it, what articles have been taken by those 
 who have suffered, and by those who have escaped, and in what 
 quantities 1 Had the same articles of food been previously ta- 
 ken, without any bad effects, by the parties attacked ? If more 
 than one person partook of the meal, how many, and were they 
 all affected, and how 1 
 
 4. In case of the death of the patient, what was the exact time 
 at which it occurred, and how long had he survived after the 
 first appearance of the symptoms 1 What was the attitude and 
 position of the body, the state of the dress, the surrounding ob- 
 jects 1 What bottles, paper packets, weapons, or spilled liquids 
 are lying about 1 And if any, collect and preserve them. 
 
 5. In reference to a post-mortem examination. What are the 
 external appearances of the body 1 Is the surface livid or pal- 
 lid 1 What is the state of the countenance 1 Are there any 
 marks of blood or violence on the person 1 Any discomposure 
 of the dress 1 What is the temperature in the legs, arms, abdo- 
 men, mouth, or axillae'? Is there any rigidity, or cadaverous 
 spasm, in the body 1 
 
 6. In reference to the inspection of the body Observe the 
 state of the abdominal viscera. Are there any signs of inflam- 
 mation in the stomach and intestines, and where are its seats '? 
 Are there any marks of ulceration, effusion of blood, corrosion, 
 or perforation 1 Collect the contents of the stomach in a clean 
 vessel ; also those of the duodenum. What is the state of the 
 large intestines, especially the rectum 1 What the state of the 
 
320 MEDICAL JURISPRUDENCE. 
 
 larynx, iauces, and oesophagus 1 What that of the thoracic vis- 
 cera, and of the brain 1 
 
 7. In reference to preserving the identity of substances that 
 are to be submitted to chemical analysis. The main question to 
 be settled is, are they the same substances 1 Have they always 
 been in the possession of the person ^ho first took possession of 
 them 1 Has he preserved them under lock and key 1 If trans- 
 ported from one place to another, have they been carefully seal- 
 ed, so as to preclude the possibility of their having been tamper- 
 ed with I 
 
 9. The arrangement and classification of poisons. 
 
 As poisons are obtained from the three kingdoms, the mineral, 
 animal, and vegetable, they were formerly divided into threr 
 classes, to correspond with them. The principle of their classi 
 fication, now generally adopted, is founded on their mode of ac 
 tion, as indicated by the symptoms they induce in man. Wo 
 shall accordingly arrange them under three classes : 
 
 1 . Irritants : 
 
 2. Narcotics : 
 
 3. Narcotico-irritants, or acrids. 
 
 Under the first, are included all those substances which cor- 
 rode, or irritate and inflame the surfaces to which they are ap- 
 plied ; creating, at the same time, that constitutional disturbance 
 which characterizes a very high degree of inflammatory action. 
 
 Under the second, are included all those that attack the ner- 
 vous centres, developing, as their usually attendant symptoms, 
 delirium, stupor, coma, and convulsions. 
 
 Under the third, are included those that combine, in different 
 proportions and degrees, the symptoms that characterize the ac- 
 tion of the two first classes. 
 
 10. The consideration of the different classes ; their orders or 
 groups ; and the substances composing them, or the individual 
 poisons. 
 
 1 . The irritant class of poisons : 
 
 This class properly embraces two kinds of substances, viz : 
 1. Those which have a purely local irritating action upon the 
 part or surface to which they are applied : and, 
 
poisons. 32] 
 
 2. Those whicli also act remotely, but whose most prominent 
 feature of action is the inflammation they excite wherever they 
 are applied. 
 
 The symptoms developed through the action of the irritant 
 class of poisons have a general similarity to each other, varying 
 in degree, and sometimes some little in kind, according to the 
 particular poison given. When taken internally, they cause vio- 
 lent irritation and inflammation of one or more divisions of the 
 alimentary canal. Their action upon the mouth Will depend 
 upon their corrosive power and easy solubility. When both 
 these concur, they cause a prickling or burning of the tongue, 
 and a redness, swelling, and ulceration, both of the tongue, and 
 of the palate, and lining membrane of the cheeks. Christison on 
 Poisons ■, 100. 
 
 The throat and gullet are the next to suffer from soluble cor- 
 rosives. In them are experienced burning pains, and difficulty 
 in swallowing. When the poison is not a corrosive, and not 
 easily soluble, the throat and mouth may not be affected until 
 after the poison has exerted its action upon the stomach. 
 
 The organ which the most invariably suffers from the action 
 of irritant poisons, is the stomach. The first symptom usually 
 developed is sickness, accompanied frequently with vomiting, 
 tenderness on pressure, tension of the abdomen, especially of the 
 upper part, and occasionally swelling. In the case of corrosive 
 irritants, severe pain is experienced at the same time with sick- 
 ness. The pain is acute, and generally burning, sometimes lan- 
 cinating or pricking. 
 
 If vomiting is produced, the contents of the stomach are first 
 thrown up ; and afterwards, a tough mucous, the product of in- 
 flammatory action^ often streaked with blood and mingled with 
 bile, is ejected. Frequently, clots of pure blood are vomited up. 
 The stomach may be affected without the intestines suffering. 
 When the poison is of so severe a character as to act upon the 
 intestines, the pain experienced in 'them is often a sense of burn- 
 ing, but not unfrequently a prickling or tearing pain, and some- 
 times a twisting and intermitting pain, like that of cholic. There 
 is seldom swelling, frequently tension, and tenderness of the ab 
 
 21 
 
322 MEDICAL jurisprudence:. 
 
 domen. The pain of the intestines is generally attended with 
 purging, rarely with constipation, and frequently with tenesmus. 
 The matter discharged consists, first, of the alimentary and fecu- 
 lent contents, and next of an abundant mucous fluid, often 
 streaked with considerable quantities of blood. All these are 
 attended with great disturbance of the circulation, the pulse be- 
 coming quick and feeble ; great prostration of strength, coldness, 
 and clammy moisture of the skin, lb., 101-2. 
 
 The morbid appearances caused by corrosives, are usually well 
 marked and clearly exhibited. Sometimes they are confined to 
 small spots, at others extending over larger surfaces. When cor- 
 rosion is produced, it is followed by inflammation and its conse- 
 quences. The action extends beyond the corroded part, where 
 we find the evidences of inflammatory action, sometimes in the 
 form of increased vascularity, and at others, with deep redness. 
 The coats are thickened, and are often dark, as if gangrenous, 
 the blood having become extravasated into the mucous mem- 
 brane and beneath the sub-mucous tissue. They are sometimes 
 softened, but at others hard and shrivelled. The mucous mem- 
 brane is occasionally found ulcerated, and sometimes, but more 
 rarely, gangrenous. These various appearances may present in 
 the stomach, the fauces, the oesophagus, and the duodenum. In 
 the remainder of the small intestines are found evidences of 
 acute inflammation, ulceration, and softening of the mucous 
 membrane. Ulcers may also be found in the large intestines. ' 
 Guy's Principles of Forensic Medicine, 544. 
 
 These symptoms, as well as morbid appearances, must not be 
 considered as alone indicating the action of irritant poisons. 
 There are many diseases, and certain conditions of body, which 
 render discrimination extremely difficult. It is necessary brief- 
 ly to allude to some of these, and to point out the means of dis- 
 criminating between them and the action of irritant poisons. 
 
 1. Simple cholera. This very much resembles irritant poison- 
 ing. One point of distinction is, that the vomiting caused by 
 irritant poisoning is very generally bloody, while that of cholera 
 is rarely if ever so. The season of its appearance may also pre- 
 sent a point o'f distinction. Th% cholera is mostly confined to 
 
poisons. 323 
 
 summer and autumn. Poisoning may occur at all seasons. Both 
 in cholera and irritant poisoning, there is a sense of acridity in 
 the throat, which accompanies vomiting ; but there is this stri- 
 king difference between them, that in poisoning, this sense pre- 
 cedes the vomiting, while in cholera it succeeds it. Again, 
 cholera seldom proves fatal under three or four days, while irri- 
 tant poisoning generally does in two days or less. The appear- 
 ances after death, and the application of the chemical tests, will 
 generally decide. Guy's Principles of Forensic Medicine, 544-5. 
 2. Asiatic cholera or malignant cholera. Between this disease, 
 and irritant poisoning, there are many points of resemblance. 
 They are distinguished, 
 
 1 . By the nature of the discharges, those of irritant poisoning 
 being often bloody ; those of cholera more resembling rice-water, 
 with flakes of lymph : 
 
 2. By the blue color of the skin, and the peculiar expression 
 of the countenance, which indicates cholera : 
 
 3. The sense of acridity in the throat, in the case of cholera, 
 succeeds the vomiting ; while in poisoning, that same sense pre- 
 cedes it: 
 
 4. The purging follows the vomiting, in case of cholera, much 
 more rapidly than it does in case of irritant poisoning. 
 
 3. Inflammation of the stomach. If this be of the chronic kind, 
 the slowness of its course will serve sufficiently, to distinguish it. 
 There is much doubt whether acute inflammation ever exists as 
 a natural disease; at least, its occurrence is certainly extremely 
 rare. 
 
 There are two points by which it may be distinguished : 
 
 1 . It is not accompanied by diarrhoea : 
 
 2. The sensation of burning in the throat, if present, exists 
 only as the consequence of continued vomiting. 
 
 4. Inflammation of the intestines. This, in the acute form, is 
 much more common than that of the stomach. Its seat is the 
 peritoneal coat, and the mucous coat is rarely if ever involved. 
 It is distinguished — 
 
 1. By an obstinate constipation : and, 
 
 2. In most cases, by an absence of vomiting. 
 
324 MEDICAL JURISPRUDENCE. 
 
 5. Drinking cold water or cold liquids. This lias caiised death 
 in various ways. Sometimes it has given a sudden shock to the 
 nervous system ; at others, it has given rise to acute gastritis ; 
 at others still, to cholera ; and in other cases, it produces symp- 
 toms resembling those caused by the narcotico-acrid poisons. If 
 a person heated by violent exercise, has drank a large quantity . 
 of cold water, and soon after expires, the cause of death cannot 
 be very doubtful. The post-mortem appearances, added to the 
 fact, that the chemical tests can detect nothing poisonous, will 
 generally be sufficient to clear up any doubt that may remain. 
 
 6. Distention of the stomach. Death has sometimes occurred 
 from mere distention of the stomach, without rupture of vessels. 
 A man in good health, for instance, while greedily devouring his 
 dinner, became suddenly blue and bloated in the face ; a clammy 
 sweat broke out over his body ; and he died almost immediately. 
 On dissection, his stomach was found enormously distended with 
 food ; the vessels of the brain extremely gorged, the brain itself 
 appearing too large to be contained within the cranium. There 
 is little danger of confounding this with irritant poisoning. 
 The points of discrimination are — 
 
 1 . In all such cases the stomach will be found greatly dis 
 tended : 
 
 2. There will be no marks of severe inflammation of the mu 
 cus membrane. 
 
 7. Rufture of the stomach. This is no common' occurrence. 
 A case is mentioned by Dr. Christison, 104, of a woman who, 
 having eaten to satiety, was soon after seized with a sense of 
 weight in the stomach, nausea, and fruitless efforts to vomit. 
 She complained that she felt her stomach tearing open, afterwards 
 ceased to make efforts to vomit, became insensible, and during 
 the night expired. The fore part of the stomach exhibited a la- 
 ceration five inches in length, and a quantity of half digested food 
 had escaped into the abdomen. Rupture has also been caused 
 by an accumulation of gases arising from depraved digestion. 
 In some rare cases a partial rupture, or laceration of the inner 
 coat only of the stomach, is observed. A youth of fourteen, after 
 eating and drinking heartily at a Christmas feast, was attacked 
 
poisons. 325 
 
 with violent and frequent vomiting. The next morning he was 
 unable to swallow ; said he felt as if the blood in his heart was 
 boiling ; his pulse became irregular, and pressure on the heart 
 or stomach gave Mm excessive pain. The day following he 
 vomited two pound3 of blood at successive intervals, and soon 
 after expired. The inner coat of the stomach was torn in seve- 
 ral places, and that of the duodenum was lacerated almost com- 
 pletely round. Christison, 106. In all such cases, should the 
 symptoms prove equivocal, the appearances after death could 
 not easily mislead the practitioner. 
 
 8. Rupture of other viscera of the abdomen. These may be the 
 duodenum, biliary ducts, uterus and its appendages. These may 
 be followed by vomiting, and occasionally by purging, excessive 
 pain and extreme tenderness of the abdomen, cold skin, feeble 
 pulse, and symptoms of collapse, with death within twenty-four 
 hours. Little difficulty will occur in distinguishing all such 
 cases by the appearances presented on a post-mortem* examina- 
 tion. 
 
 It also becomes necessary to examine the morbid appearances 
 caused by irritant poisons, compared with those of certain natu- 
 ral diseases. 
 
 The morbid appearances caused by the powerful irritants are, 
 in the stomach, vascularity, bloody extravasation in the villous 
 coat and into the cavity of the organ, the secretion of a tough 
 mucus, the deposition of coagulable lymph, ulceration, occasional 
 perforation, preternatural softness of the villous coat, and some- 
 times hardening and shriveling of it. In the intestines, vascular- 
 ity, extravasation and ulceration. 
 
 The corrosives produce much more extensive ravages. They 
 sometimes divest the stomach of its entire mucous membrane. 
 Large patches of its whole coats may be wanting and extensive 
 perforation caused. 
 
 1. As to redness of the stomach and intestines from natural 
 causes, or the results of disease, and its distinction from that 
 caused by poisons. Redness of the mucous membrane of the ali- 
 mentary canal is not an uncommon appearance on a post-mortem 
 examination. This pseudo morbid redness is of various kinds, 
 
326 MEDICAL JURISPRUDENCE. 
 
 and cannot be easily, if at all, distinguished from the parallel 
 varieties caused by inflammation. These appearances are formed 
 three, five or eight hours after death, and are found chiefly iri 
 the most depending turns of the intestines, and in the most de 
 pending parts of each turn, or of the stomach. After their form- 
 ation they may even be made to shift their places, and to appear 
 where the membrane was previously healthy, by altering the 
 position of the intestine. This kind of redness has its seat in the 
 veins of the part, and it is the more intense in proportion as the 
 death has been sudden and the circulation active. 
 
 But redness when not found on the most depending parts is 
 not necessarily the result of inflammatory action. It is sometimes 
 found in large tracts both in the stomach and intestines without 
 any symptom whatever of inflammation. These have been at- 
 tributed to the contraction which takes place in the arteries after 
 death, by means of which the blood is forced into the veins. In 
 order to pronoupce that the redness is the result of inflammatory 
 action it is important to observe — 
 
 1 . Whether it occurs in the most depending parts, or whethei 
 it is limited to those parts : 
 
 2. Whether the reddened membrane is covered with a thick 
 tenacious, and adhering mucus : 
 
 3. Whether the mucous membrane is opaque, and so much so 
 that when dissected off,- and stretched over the finger, the fingej 
 is not visible : 
 
 4. Whether the cellular tissue, connecting that membrane with 
 the subjacent muscular coat, is brittle ; so that the former may 
 be easily scratched off' with the nail. 
 
 The membrane may also be stained with a reddish, brownish, 
 yellowish, or greenish tint, from having been in contact with the 
 liver, spleen, or colon, if it contain faeces. This can hardly be 
 mistaken for the result of inflammatory action. 
 
 The discoloration may also arise from the presence of colored 
 fluids among the contents. The discoloration produced by a 
 strong infusion of the corn poppy, once came very near being 
 attributed to the action of an irritant poison. 
 
 It should be remarked that where an abundance of tough mu- 
 
poisons. 327 
 
 cus is found secreted in the stomach, it indicates irritation of 
 that organ. So also effusion of lymph is evidence either, of natu- 
 ral inflammation, or of that produced by poisons. Where reticu- 
 lated lymph is found adhering to the villous coat, and is accom- 
 panied with corresponding reticulated redness of that coat, it 
 affords very clear evidence of inflammatory action. Christison on 
 Poisons, 126. 
 
 2.. Gangrene and lividity. Gangrene of the mucous membrane 
 is of very rare occurrence. Acute inflammation, by causing an 
 infiltration of blood into its texture, has given it a dark appear- 
 ipce, which, by some, has probably been confounded with gan- 
 grene. This lividity has presented itself in various shapes, occa- 
 sionally appearing in points, stride, ramifications, and patches ; 
 sometimes the vessels being entirely filled with black blood ; at 
 others presenting points resembling petuchise ; and in other cases, 
 still, the membrane itself is thickened with black coagulated 
 blood. The latter appearance would be likely to present in case 
 of poisoning with the mineral acids. These appearances in the 
 stomach in a marked form, are almost always due to the action 
 of violent irritants, and are seldom or never the result of disease. 
 Guy, 548 - 9. 
 
 3. Softening. This may occur to the mucous membrane in 
 consequence of the action of poisons. It more especially charac- 
 terises the action of corrosive poisons, and is sometimes the effect 
 of inflammation without corrosion. The softening of this mem- 
 brane may be produced from other causes arising both before 
 and after death. The distinction between the two is arrived at 
 by attending — 
 
 1. To the symptoms, and their history. The softening, from 
 disease, is not preceded by any characteristic symptoms ; that 
 from irritant poisoning, by those usually attending the action of 
 irritant, particularly corrosive poisons : 
 
 2. The softening, caused by corrosion, is attended by those 
 changes of color, and appearances of violent inflammation, pro- 
 duced by the action of corrosive poisons. If caused by irritants, 
 which are not corrosives, there will also be found to be present 
 marks of acute inflammation. Guy, 549. 
 
328 MEDICAL JURISPRUDENCE. 
 
 4. Ulceration. This may occur in the stomach, either as the 
 result of natural disease, or from the action of irritant poisons. 
 When it arises from poison, there is a more intense degree of 
 inflammation, than that which occurs when it is the result of 
 disease. The ulcer is also sometimes found discolored by the 
 particular poison whose action has produced it, as in the case of 
 nitric acid and iodine ; or, if arsenic has been used, covered with 
 a white powder, or with a substance resulting from the decom- ' 
 position of the poison. These, taken in connexion with the vio- 
 lence of the inflammation, and also with the symptoms that are 
 developed, will usually be sufficient to indicate the cause of the 
 ulceration. 
 
 5. Perforation. This may arise from various causes, as, 
 
 1 . From corrosion. An attentive observer will find it difficult 
 to confound a perforation, caused by the direct action of a corro- 
 sive».poison, with one arising from natural causes. In the first 
 place, the margin of the corroded aperture will not unfrequently 
 be found of a peculiar color. If yellow, the corrosion is due to 
 nitric acid, if brown to sulphuric or the alkalis, and if orange to 
 iodine. In the second place, it may be safely calculated, that if 
 the poison is in sufficient quantity and strength to destroy life 
 before vital reaction takes place around the perforation, some of 
 it will be found in' the stomach. If vital reaction have taken 
 place, although no poison may be found in the stomach, as it 
 may all have been ejected, yet the indications of the reaction will 
 at once distinguish it from a gelatinised aperture : 
 
 2. From ulceration. This is extremely rare. The surround- 
 ing membrane is found more highly inflamed than in case of 
 idiopathic inflammation. The condition of the remainder of the 
 alimentary canal, as also a resort to the previous symptoms, may 
 serve to distinguish : 
 
 3. From softening during life, or after death, from natural 
 causes, or from causes other than the action of irritant poisons. 
 There is a spontaneous perforation that sometimes take place, 
 without proper inflammatory action, but from simple gelatinising 
 of the coats of the stomach. It is very apt to be, and has been, 
 mistaken for the effect of corrosive poison. 
 
poisons. 329 
 
 Its occurrence, previous to death, is the most frequent in young 
 females, commencing after slight symptoms of indisposition. It 
 generally takes place soon after a meal, and is followed by acute 
 pain in the abdomen. There is little vomiting, no purging, and 
 the patient dies in a state of collapse, in from eighteen to thirty- 
 six hours. The aperture varies in size, has smooth edges, and 
 is usually situated near the lesser curvature of the stomach. 
 The margin is often blackened, the aperture funnel shaped, the 
 mucous coat the most removed, the peritoneal the least. Guy's 
 Principles of Forensic Medicine, 550. 
 
 In the perforation after death, the seat of the opening is gene- 
 rally the posterior surface of the stomach, but depending some- 
 what upon the position of the body. It varies much in size, from 
 that of a shilling piece, to one-half the entire stomach. It is of 
 various shape, and its edges are fringed, softened, and smeared 
 with a dark pulpy mass. Sometimes there is more than one 
 aperture. The opening exhibits no appearance of inflammation. 
 
 The cause of this singular phenomenon has been the subject of 
 much controversy. The French Pathologists supposed it arose 
 from a morbid process, constituting a peculiar disease, and which, 
 from its imparting to the fluids a solvent power, might extend 
 after death. 
 
 Dr. Hunter ascribed it entirely to the solvent power of the 
 gastric juice after death. As the process of softening has been 
 actually traced extending in the dead body, and other proofs 
 have also been adduced, it is now very generally attributed to 
 the action of the gastric juice. Christison, 128, &c. ; Guy, 550. 
 By referring to the remarks just made under the head of perfo- 
 ration from corrosion, and noting the absence of inflammatory 
 action in these cases of spontaneous perforation, it will not be 
 difficult to discriminate this from a case of irritant poisoning. 
 
 The intestines also, as well as the stomach, may be perforated 
 by the same erosive or solvent process. They are never perfo- 
 rated by chemical corrosion from within, for either the poison is 
 expelled from the stomach by vomiting, or the pylorus contracts, 
 and prevents the passage of every poison that is sufficiently con- 
 centrated to corrode. They may, however, be corroded from with 
 
330 MEDICAL JURISPRUDENCE. 
 
 out, in consequence of the poison escaping through a hole in the 
 stomach. Christison, 136 ; Guy, 551. 
 
 The irritant class of poisons is divisible into five orders, viz : 
 The acids, alkalies, metallic compounds, the vegetable and animal 
 irritants, and the irritant gases. 
 
 The acids that are resorted to for the purpose of self destruc- 
 tion or homicide are, with one exception, from the mineral king- 
 dom. It is stated that out of 543 cases of death by poison re- 
 turned by the Coroner's Court of England, in the years 1837-8, 
 thirty-six, or one fifteenth, were by the mineral acids, and thirty- 
 two of these were from sulphuric acid. Guy, 553. 
 
 Poisoning by the mineral acids, is not so likely to occur as a 
 homicidal act, as by many other poisons. Still there are several 
 cases on record, some of which are enumerated by Dr. Christi- 
 son, where they have been resorted to for the purpose of homi- 
 cide. In their administration to adults, they have been either 
 given as medicine, or poured down the throat while asleep — in- 
 toxicated. Not long since, a new method of poisoning with the mi- 
 neral acids was discovered, and that was by throwing them on 
 the person. So frequently was this perpetrated, that a special 
 act was called for and passed by the Parliament of England, pro- 
 hibiting it under a severe penalty. 
 
 The mineral acids have three common properties. 
 
 1. They redden vegetable blue ; 2. They color articles of dress, 
 and 3d. They corrode the substances to which they are ap- 
 plied. 
 
 The following is a brief statement of the symptoms which 
 characterize the action of the mineral acids. They produce in 
 the mouth, throat and gullet a burning pain, which occurs im- 
 mediately on swallowing the acid ; next, excessive pain in the 
 stomach, retching, eructations of gases, vomiting, the matter 
 vomited being brownish or blackish, containing blood, coagulated 
 mucus, or portions of the mucous membrane of the stomach. 
 
 There is great difficulty of swallowing, and of deglutition ; 
 intense thirst, bowels confined, tenesmus, urine scanty or en- 
 tirely suppressed. Pulse small and frequent, respiration often 
 laborious, the countenance anxious. The larynx often injured, 
 
poisons. 331 
 
 the voice hoarse. The lips are shriveled and changed in color, 
 the color varying with the acid, being first white and afterwards 
 brown with the sulphuric, and yellow with the nitric. The in- 
 side of the mouth is white, shriveled and corroded. The tongue 
 sometimes white and polished, at others changed in color, like 
 the other parts. The marks of the acid are generally found on 
 the cheeks, neck, fingers and clothes. Death takes place com- 
 monly with symptoms of collapse, but sometimes life is termi- 
 nated in convulsions. 
 
 Death sometimes takes place in the course of two hours, at 
 others at the end of days, weeks or months ; the symptoms modi- 
 fying in proportion as the time was longer or shorter. A dry 
 skin and frequent pulse are present, indicating a feverish state. 
 Not unfrequently flakes of tough mucus are vomited. There are 
 pains and spasms of the limbs. Digestion is impaired, all the 
 bodily functions languish, the emaciation becomes extreme and 
 death finally supervenes-. Guy's Principles of Forensic Medi- 
 cine, 556 - 7. 
 
 There are also cases of imperfect recovery, characterized by a 
 greater mildness of the primary symptoms, and by the patient 
 always being liable to attacks of pain in the stomach, vomiting 
 and disorder of the digestive function. 
 
 When the mineral acids are inhaled in the form of gas or va- 
 por, they act chiefly by irritating or inflaming the mucous mem- 
 brane of the air passages and lungs. 
 
 The evidence of having taken nitric or sulphuric acid may be 
 thus summed up. 
 
 1 . Immediately after swallowing a liquid, a sense of burning 
 is experienced in the throat, gullet, and stomach. 
 
 2. Vomiting ensues, the vomited matter often mixed with 
 blood. 
 
 3. The mouth becomes white or yellow, and stripped of its 
 lining membrane. 
 
 4. The cheeks, neck, or neighboring parts, show vesications, 
 or white, and subsequently yellow or brown, excoriated spots. 
 
 <i. The clothes show red spots, and wherever they occur are 
 in i disentegrated state. 
 
332 MEDICAL JURISPRUDENCE. 
 
 The morbid appearances are the following. 
 
 The body externally appears healthy. The lips, neck and fin- 
 gers have brownish spots, resembling old parchment or a burn ; 
 sometimes they have small verications. The mucous membrane 
 of the mouth is considerably disorganized. It is generally har- 
 dened, being whitish, or yellowish with sulphuric acid. The 
 pharynx is often found red, and even swelled. The gullet is 
 sometimes lined with a dense yellow membrane, resembling the 
 inner coat, but of morbid formation. The epiglottis is con- 
 tracted, sometimes swollen ; the larynx is inflamed. 
 
 Marked differences are observable in the stomach. It is usu- 
 ally distended with gas, and filled with a glutinous secretion, 
 which is yellowish, brownish or blackish. This extends into the 
 oesophagus and commencement of the small intestines. Its mu- 
 cous membrane exhibits a high state of inflammation, its vessels 
 being minutely injected with black blood. There is a softening 
 of the rugee, or separation of the mucous coat, ulceration, and 
 frequently perforation. The pyloric orifice is generally found 
 contracted. When the stomach is perforated, the holes are cir- 
 cular, the coats thin at the margin, colored, disintegrated, and 
 surrounded by vascularity and black extravasation. 
 
 The inner coat of the duodenum often presents appearances 
 closely resembling those of the stomach ; but, at times, the inner 
 coat of the small intestines is not affected at all. 
 
 The outer surface of the abdominal viscera is commonly either 
 very vascular or livid, exhibiting effusion of fibrin and adhesions 
 among the different turns of intestine. Peritoneal inflammation 
 is not ' usually caused by any other metallic poison except the 
 acids. 
 
 Inflammation sometimes extends into the chest, and the tho- 
 racic surface of the diaphragm is occasionally found coated with 
 lymph. The blood in the large vessels is often found firmly 
 coagulated. The bladder is commonly empty. 
 
 Where the patient lingers for a long period of time, and death 
 results after the chronic variety of poisoning, there is extreme 
 emaciation. The stomach and intestines are found excessively 
 contracted. The stomach exhibits spots of apparently regene- 
 
poisons 333 
 
 rated villous tissue, -which is smoother and redder than the na- 
 tural membrane. 
 
 To determine whether a mineral acid, found in the dead body, 
 has been the cause of death, or introduced there afterwards, it 
 will be found, when examined, that wherever the parts are 
 touched by the acid, the mucous coat is yellowish and brittle, 
 while the muscular and peritoneal are white, as if blanched and 
 the blood in the vessels charred. The injury will also be con- 
 fined to the parts actually touched, and is surrounded by an 
 abrupt line of demarcation, showing no sign of inflammatory 
 redness._ Sulphuric and nitric acid produce nearly the same ef- 
 fects, except that in the case of nitric, the whole tunics are yel- 
 low, and the disorganization is greater. Christison on Poisons, 
 169. 
 
 In relation to the treatment in cases of poisoning with the mi- 
 neral acids, it should be remarked that as they are local irritants, 
 their poisonous effects may be prevented by neutralising them. 
 But the antidote must be quickly applied or the injury is reme- 
 diless. Chalk or magnesia, if accessible, should be administered 
 without delay. If nothing better is at hand, the plaster of the 
 apartment beaten into a thin paste with water, may be made use 
 of. Milk and mucilaginous and oily drinks should be freely used, 
 and in large quantities, both previously and subsequently to the 
 administration of the antidote ; and should be continued for 
 many days. The subsequent treatment is that of inflammation, 
 and need not be detailed here. 
 
 The three principal mineral acids are the sulphuric, the nitric 
 and the muriatic. After the general remarks already made, little 
 need be said upon each one of these acids. 
 
 The action of the sulphuric acid is distinguished from that of 
 the other mineral acids, by the dark brown appearance of the 
 stain which is formed by it. Taken internally, it produces a 
 great degree of disorganization, perforation of the stomach be- 
 ing very frequent, leaving the color of the mucous membrane, a 
 dark brown or black, as if charred. 
 
 The smallest quantity of sulphuric acid known to be destruc- 
 tive to life in the adult, was one drachm, which proved fatal in 
 
334 MEDICAL JURISPRUDENCE. 
 
 seven days. The shortest period in which it has proved fatal is 
 two hours. 
 
 This acid is clearly carried to different parts of the body by 
 the circulation. In a pregnant female poisoned by it, it was de- 
 tected in the peritoneum, pleura, heart, bladder, liquor aninii 
 and foetus. Guy's Prin. of For. Med., 562-3. 
 
 The nitric acid causes a less degree of corrosion than the sul- 
 phuric, perforation of the stomach being a rarer occurrence. Its 
 action is distinguished from that of the sulphuric by the orange 
 or brownish yellow color of the stains. When the mucous mem- 
 brane is touched by it, it becomes yellow in parts, or green from 
 the action of the acid on the bile. 
 
 Yellow stains are not distinctive of the action of nitric acid. 
 They may also be produced by iodine or by bile. They may be 
 thus distinguished. When touched with a weak solution of caus- 
 tic potash, stains from nitric acid become orange yellow, and 
 the stain is indelible. When touched with the alkali, those caused 
 by iodine immediately disappear, while those caused by bile un- 
 dergo no change. Guy, 566. 
 
 The smallest quantity of nitric acid which has destroyed life 
 is two drachms, and the shortest period within which the poison 
 has been known to prove fatal in the adult, is one hour and 
 three quarters ; and in the infant in a few minutes. Guy, 567. 
 
 The muriatic acid is seldom made use of for the purpose of 
 poisoning. The smallest quantity which has destroyed life was 
 one ounce, and the shortest period, within which it has proved 
 fatal, was five hours and a half. Guy, 571 . 
 
 The oxalic acid oxacid of sugar, is a substance of great interest, 
 and has recently, in England, been frequently employed as a poi- 
 son. In its crystalline state it bears a very great resemblance to 
 Epsom salts, for which it has been very often mistaken, and thus 
 given rise to melancholy and fatal results. There are several 
 points of difference between them. 
 
 1. The acid has an extremely sour taste, while the salts are 
 bitter. 
 
 2. The acid in solution has a strong acid re-action the salts 
 are neutral. 
 
poisons. 335 
 
 3. The acid is entirely dissipated by heat ; the salts and zinc 
 are fixed by it. 
 
 4. Liquor potasspp. produces no change in a solution of oxalic 
 acid, while it precipitates the white oxides of the salts and zinc. 
 
 5. The acid discharges the color of ink, while the salts pro- 
 duce no change in it. Guy, 572. 
 
 Several experiments have been made of the action of this acid 
 upon animals ; from which, it has been ascertained, that it acts 
 dhTerently, as its quantity is greater or less - y and also as it is ad- 
 ministered in a concentrated or considerably diluted state. This 
 is reckoned one of the most rapid and unerring of all the com- 
 mon poisons, and acts with violence to whatever texture of the 
 body it is applied. A large dose, and concentrated solution, 
 causes the appearance of symptoms immediately on swallowing 
 the poison. The most prominent of these are, a sour taste, burn- 
 ing sensation in the stomach, and occasionally in the throat; a 
 vomiting, sometimes of bloody matter, but generally of a green- 
 ish brown, or black grumous matter. After some hours, if the 
 patient survive, there is purging of a similar matter, sometimes 
 tinged with blood. Other symptoms are those of collapse, pale 
 and anxious countenance, small and frequent pulse, cold and 
 clammy skin, hurried respiration ; to which are sometimes super- 
 added, convulsions. There are also, after some hours, soreness 
 of mouth, inflammation and swelling of the tongue, constriction 
 of the throat, painful deglutition, intense thirst, restlessness, dif- 
 ficulty of breathing, cough, extreme debility, cramps and numb- 
 ness of the legs and arms, acute pain in the head and back, de- 
 lirium and convulsions. Guy's Principles of Forensic Medicine, 
 574. 
 
 The symptoms are rot always uniform. Pain and vomiting 
 have been absent, and an eruption has, in one instance, appear- 
 ed on the skin. When the acid is considerably diluted, it ceases 
 to corrode, and even hardly irritates. It then acts indirectly on 
 the brain, spine, and heart. When the dose is large, it produces 
 palsy of the heart. A smaller dose causes an animal to perish, 
 after several fits of violent tetanus, affecting the respiratory 
 muscles of the chest, fixing it spasmodically and causing suffoca- 
 
336 MEDICAL JURISPRUDENCE. 
 
 tion. A still smaller dose causes death under symptoms of pure 
 narcotism. Christison on Poisons, 201. 
 
 From tlie fact that leeches applied to the epigastrium, in a case 
 of poisoning by oxalic acid, speedily die, it has been inferred 
 that the blood is altered in its quality, through the action of the 
 poison. 
 
 The post-mortem appearances are — 
 
 1 . The body natural, the countenance pale and composed : 
 
 2. Mucous membrane of the mouth and fauces white, shrivel- 
 ed, and easily detached : 
 
 3. Lining membrane of the oesophagus more or less detached : 
 
 4. Mucous membrane of the stomach is, at times, pale, and 
 free from rugae; at others,.the membrane is highly inflamed, and 
 the rugse strongly marked : 
 
 5. The stomach contains a thick fluid, commonly dark, like 
 coffee grounds, containing a good deal of blood ; its vessels are 
 minutely injected with black blood; its mucous membrane is 
 easily stripped off, and sometimes is found extensively detached ; 
 perforation may sometimes be found, but it is of rare occur- 
 rence : 
 
 6. The small intestines have, in some cases, presented the 
 same appearances as the stomach : 
 
 7. The peritoneum has been -found inflamed, and in one case, 
 the right pleura also : 
 
 8. The lungs are sometimes greatly congested ; and, in one in 
 stance, there existed traces of inflammation of the brain. 
 
 The smallest quantity of oxalic acid which has destroyed life, 
 is half an ounce ; but a recovery has been had where two or 
 three times that quantity was administered. But a much less 
 quantity than that has produced severe symptoms. The shortest 
 period at which death has taken place, is ten minutes, the dose 
 being one ounce. In the case where half an ounce was taken, 
 the death occurred at the end of twenty-three days. Guy's Prin- 
 ciples of Forensic Medicine, 575. 
 
 Br. Christison remarks, page 207 - 8 : " If a person, immedi- 
 ately after swallowing a solution of a crystalline salt, which tasted 
 purely and strongly acid, is attacked with burning in the throat, 
 
poisons. 337 
 
 then with burning in the stomach, vomiting, particularly of 
 bloody matter, imperceptible pulse, and excessive languor, and 
 dies in half an hour, or still more, in twenty, fifteen, or ten 
 minutes, I do not know any fallacy which can interfere with the 
 conclusion, that oxalic acid was the cause of death. No parallel 
 disease begins so abruptly and terminates so soon ; and no other 
 crystalline poison has the same effects." 
 
 In regard to treatment, it is obvious that the rapidity of ope- 
 ration is such, that unless remedies are speedily administered, 
 they can be of no utility. The proper antidotes are chalk and 
 magnesia. If these cannot be immediately obtained, the plaster 
 of the apartment may be resorted to. Lime-water and oil have 
 been used with advantage. Emetics may be made use of, unless 
 the vomiting is already free. Sulphate of zinc is recommended 
 as an emetic. The alkalis should not be used, as they form, with 
 the acid, salts which are themselves poisonous. Ghiy, 75 ; Chris- 
 tison, 206 -7. 
 
 The Alkalies, and their Salts : 
 
 These are, potash and its carbonate ; soda and its carbonate ; 
 ammonia and its carbonate ; the two first being the fixed, and 
 the last being the volatile alkalies. 
 
 The action of the fixed alkalies is purely irritant, and strictly 
 local. When concentrated, they chemically decompose, soften- 
 ing the animal tissues, and reducing them to a pulpy mass. 
 When diluted, they inflame without corroding the textures. 
 Poisoning with the fixed alkalies is rare, seldom occurring ex- 
 cept as the result of accident. The usual symptoms developed 
 by them are, " an acrid burning taste in the mouth, which ac- 
 companies the act of swallowing, and extends rapidly to the 
 throat and gullet. This is followed by acute pain in the pit of 
 the stomach, and great tenderness on pressure ; frequent and 
 violent vomiting of tenacious mucus, often containing blood, and 
 tinging vegetable blues green ; violent colic pains, and purging 
 of stringy mucus, mixed with blood. There is constriction of 
 the throat, with difficult deglutition, and sometimes hoarseness 
 of the voice and cough. In the more acute cases, death takes 
 place with symptoms of collapse^ excessive weakness, cold sweats., 
 
 22 
 
338 MEDICAL JURISPRUDENCE. 
 
 hiccough, tremors, and convulsions. In the chronic cases, there 
 is constant vomiting of food, difficulty in swallowing, bloody 
 stools, tenesmus, rapid emaciation, and death from starvation. 
 In still more chronic cases, death is due to long continued stric- 
 ture of the oesophagus." Guy, 578 - 9. 
 
 The post-mortem appearances have generally been found to 
 differ with the nature of the case. Usually, the mucous mem- 
 brane of the throat and gullet is softened and corroded, with in- 
 flammation, in varying degrees of intensity, in the oesophagus, 
 stomach and intestines ; patches of ulceration, and dark spots 
 caused by the extravasation of blood beneath the membrane. 
 The inflammation is sometimes found extending to the larynx. 
 In chronic cases, large portions of mucous membrane are found 
 removed, with the contraction of the gullet and stomach. Guy, 
 579. 
 
 In regard to treatment, the first object is to neutralize the poi- 
 son. This may be accomplished by giving the acetic acid, vine- 
 gar, diluted ; also lemon juice, or citric acid, diluted, may be 
 administered. Almond or olive oil may also be given, together 
 with acidulated demulcent drinks. 
 
 The smallest quantity which has .proved fatal is half an ounce, 
 and the shortest time within which it has proved fatal, is twelve 
 hours. Guy, 579. 
 
 The nitrate of potash, nitre, saltpetre, is a dangerous poison, 
 when taken in considerable quantity, and has been not unfre- 
 quently taken by mistake for sulphate of soda, which it very 
 much resembles in appearance. Several cases have occurred, in 
 one of which, the symptoms were nausea, vomiting and purging ; 
 the muscles of the face being convulsed ; the pulse weak, respi- 
 ration laborious, extremities cold, but a sense of burning and 
 severe pain in the stomach. In another case, which also termi- 
 nated fatally, the symptoms were those of violent cholera. In 
 another, there was pain in the stomach, and swelling of the 
 whole body. In another, reported by Dr. Falconer, there occur- 
 red immediately violent pain in the epigastrium, in half an hour 
 vomiting, and in three hours, about a quart of blood was dis- 
 charged from the stomach. The person recovered, but was af 
 
poisons. 339 
 
 terwards subject to attacks of pain in the stomach. The use of 
 speech, and power of voluntary motion, have been known to be 
 lost ; insensibility to supervene, and finally an attack of tetanic 
 spasms. Costill on Poisons ; 43-4-5. 
 
 The appearances after death are those which characterize vio- 
 lent inflammation of the stomach and intestines; the contents 
 tinged with blood ; the peritoneal coat of a dark red color, mot- 
 tled with black spots. 
 
 To this poison there is no particular antidote. There should 
 be a copious exhibition of demulcents, and if vomiting be ab- 
 sent, of emetics. 
 
 Jlmmonia and its salts : 
 
 Ammonia is called the volatile alkali, as it is a gaseous body 
 when pure. The alkaline poisons included under the above 
 general term, exert a double action on the system. They not 
 only act as powerful irritants, but produce besides, through the 
 medium of the blood, a disorder of some part of the nervous 
 system. This nervous affection consists probably of irritation 
 upon the spinal column, as it very closely resembles tetanus. 
 Christison, 223. 
 
 The effects are generally simply irritant, the seat of the irri- 
 tation varying with the mode of administration. When swallow- 
 ed, the stomach and intestines suffer ; when inhaled, inflamma- 
 tion seizes upon the lining membrane of the nostrils and air- 
 passages. A case is mentioned, of a medical man, liable to epi- 
 lepsy, being found in a fit by his servant, who endeavored to 
 rouse him by holding to his nose a handkerchief dipped in am- 
 monia. Two drachms were in this way consumed. A burning 
 pain from the mouth downward to the stomach was experienced, 
 great difficulty of swallowing, difficult breathing, severe cough 
 and expectoration, a mucous discharge from the nostrils, and 
 excoriation of the tongue. He died in the course of the third 
 day. 
 
 In this case, the following morbid appearances were presented : 
 The nostrils blocked up with albuminous membrane ; the whole 
 mucous membrane of the larynx, trachea, bronchi, and some of 
 the bronchia] ramifications, mottled with patches of lymph ; the 
 
340 MEDICAL JURISPRUDENCE. 
 
 gullet and stomach exhibiting here and there red streaks ; and 
 a black eschar on the tongue, and another on the lower lip. 
 Chi-istison, 225. 
 
 Remedies. The vegetable acids, such as vinegar, lemon juice, 
 or citric acid. The oils, also, such as castor, olive, or linseed, 
 may be used ■with advantage. Costill, 42-3. 
 
 There are some other poisons included under this group and 
 general division, but their small importance in a medico-legal 
 point of view, must justify our passing over them here without 
 comment. We accordingly pass to another division of poisons, 
 viz: 
 
 The Metallic Compounds ; at the head of which stands 
 
 ARSENIC. 
 
 Of all the substances within the entire range of toxicology, 
 this is the most important to be understood by the medical jurist. 
 It is a substance extremely common, so cheap that it may be 
 purchased by almost every body ; may be bought under a plau- 
 sible pretext ; may be mixed without suspicion, with many ar- 
 ticles used as food ; possesses scarcely any taste, and is, when ad- 
 ministered, a deadly poison. All these circumstances go to fa- 
 vor the employment of this, as the most common means, of 
 effecting murder in a secret manner. 
 
 As a compensation for all this, it happens to be very fortunate, 
 that there is perhaps no other poison, the presence of which can 
 be detected in such minute quantities, and with so great a de- 
 gree of certainty. 
 
 There are many different preparations of arsenic, such as fly- 
 powder, the arsenious acid, or white arsenic, the arseniate of cop- 
 per, or mineral green, the various sulphurets, &c. But the only 
 preparation necessary for the medical jurist to be well acquaint 
 ed with, is the arsenious acid, or white arsenic, or as it is more 
 commonly called, arsenic. This is met with in two forms, the 
 one, the more usual, that of a fine snow-white powder ; the other, 
 in solid masses, generally opaque, sometimes translucent. 
 
 This preparation is an oxide, arising from the combination 
 
poisons. 341 
 
 of the metal with oxygen. The metal itself is entirely inert, 
 possessing no poisonous quality. 
 
 The two properties of arsenic which are the most important 
 to be inquired into, are its solubility and its taste. Its degree of 
 solubility is important to be settled, as on that depends very 
 much the fact, whether, when swallowed in the solid state, we 
 may expect to find it in such a state, or dissolved among the 
 fluid contents of the stomach Water dissolves it, but its power 
 of doing so has been variously estimated by different experimen- 
 talists. Hahnemann states, that, at the temperature of the blood, 
 a thousand parts of water dissolve ten parts of the arsenious 
 a,cid, having the aid of ten minutes agitation. The presence of 
 organic principles in the water, renders the poison less soluble. 
 In consequence of its insolubility, while among the organic mix- 
 tures of the stomach, it is the most generally found solid, but it 
 is sometimes found among the fluid contents. Christison, 23 - 5 ; 
 Guy, 484. 
 
 As to its taste, it was once asserted that it had an acrid taste, 
 but in reality it has little or no taste at all. If anything, it has a 
 faint sweetish taste. It makes very little impression, as it is 
 often swallowed unknowingly with articles of food. 
 
 Some other qualities are, that in solution, it has a very slight 
 acid reaction ; when dissolved in boiling water, and slowly evapo- 
 rated, it deposits well formed, octahedral crystals; and when 
 taken combined with alkalies, it forms soluble arsenites. Guy, 
 584. 
 
 The chemical tests by which arsenic may be detected, whether 
 it exist in the solid form, or in solution, or in organic liquids, or 
 in the fluids and solids of the human body, are all matters of in- 
 terest to the medical jurist Their application, however, will 
 hardly be undertaken by any one who is not a professed chemist, 
 or, who has not learned the practical methods by which it is 
 made. I cannot dwell upon them extensively in this place. They 
 may be found particularly detailed in Christison, Guy, Beck and 
 Taylor. A bare reference to some of them is all that can be here 
 undertaken. 
 
 The simplest test for oxide of arsenic in its solid state, is to 
 
342 MEDICAL JURISPRUDENCE. 
 
 reduce it to the metallic state. The instrument, generally made 
 use of for this purpose, is a glass tube, the material for its reduc- 
 tion being freshly ignited charcoal. The best method of apply- 
 ing the heat is Avith the spirit lamp. Soon a well denned crust 
 will be formed, having the character of the fly-powder. This 
 will detect the arsenic in exceedingly small quantities. A crust 
 weighing a twentieth of a grain, when properly formed, exhibits 
 the physical properties of arsenic to the naked eye with as great 
 distinctness as any quantity however large. 
 
 There are some other tests, such, for instance, as its alliaceous 
 or garlicky odor. This is evolved by tlje sublimation of metallic 
 arsenic only, and not by the oxide. The objection to this is that 
 it does not always detect arsenic when present, and that the same 
 odor affords no infallible proof that it is present. Zinc powder, 
 phosphorus, phosphoric acid, and the phosphates, give out a 
 similar odor. 
 
 Solid arsenic produces a silvery alloy, when the oxide is mixed 
 with carbonaceous matter, and heated between two copper plates. 
 This is now little used, as it requires something more than a 
 grain to make application of the test, which quantity may be 
 subjected to other tests with more satisfactory results. 
 
 The oxide may also be converted into the arsenite of copper, 
 by keeping it, for a few hours, in a solution of the ammoniacal 
 sulphate jf copper. The mode of applying the ammoniacal sul- 
 phate, as well as the ammoniacal nitrate of silver, is to press the 
 oxide in powder, by means of a glass rod, into common writing 
 paper ; to touch the spot with a drop of solution of sulphate of 
 copper, or nitrate of silver ; to place the paper, so prepared, over 
 a phial of ammonia, and to expel the ammoniacal gas through 
 the paper, by plunging the phial into hot water. Christison, 245. 
 By these means, the green and yellow colors speedily appear, 
 which characterise the action of the copper and silver tests or 
 arsenic in solution. 
 
 The arsenic may be sometimes found in a state of solution, 
 when it may be subjected to the reduction process, to exhibit 
 metallic arsanic, or to the liquid tests. The general principle, 
 upon which the first is accomplished, is " to throw down the 
 
poisons. 343 
 
 whole arsenic in the form of sulphuret, by means of sulphuretted 
 hydrogen; to convert the sulphuret, by the process of reduction, 
 1o the metallic state ; and to oxidate the metal thus procured." 
 Christisoii) 246. 
 
 The liquid tests are resorted to for the purpose of causing, in 
 the solution, peculiar precipitates. The re-agents, generally em- 
 ployed for this purpose, are the sulphuretted hydrogen, the am- 
 moniacal nitrate of silver, and the ammoniacal sulphate of copper. 
 The indications of each should concur, and when they do so, the 
 proof they furnish is clear and satisfactory. It is not deemed 
 necessary, or advisable, to go into the consideration of either of 
 these liquid tests. 
 
 Marsh's, or the hydrogen test, evolves hydrogen, in the nascent 
 state, from the action of diluted sulphuric acid on zinc, and by 
 means of it, decomposes arsenic and its soluble compounds. In 
 the application of it, the metallic arsenic combines with the hy- 
 drogen, forming arsenuretted hydrogen gas, which possesses the 
 properties of burning with a bluish white flame and thick white 
 tmoke, and also of impressing a dark stain upon a cold plate of 
 glass, which is held in the flame, which arises from a deposit of 
 arsenic upon it. In the centre of this stain is the pure metallic 
 arsenic. On the outside of this, is an opaque black ring exhibit- 
 ing, at the extreme edge, a clear hair brown color. Outside of 
 this is a thin, wide film, of a milk white appearance, which is the 
 arsenious acid reproduced by combustion. The objection has 
 been urged that antimony produces nearly the same stain as 
 arsenic, but a difference has been observed in the following re- 
 spects, viz., the antimonial stain lacks the bright metallic lustre, 
 which distinguishes that of arsenic, and also it appears smoky 
 black, by means of transmitted light, while that of arsenic is of a 
 hair brown color. If the arsenical and antimonial deposites are 
 received en a sheet of bright copper or brass, the former have an 
 iron gray lustre, and clear metallic polish, while the latter present 
 the same rings of black hydruret of antimony, alternating with 
 rings of oxide, which are observed on glass. Taylor, 131-2. 
 
 Another test, denominated Reinsch's, is for the detection of 
 arsenic in liquids. A few drops of muriatic acid are added to 
 
344 MEDICAL JURISPRUDENCE. 
 
 the suspected solution, and a slip of bright copper placed in it. 
 The liquor is then brought to a boiling point, when, if arsenic 
 be present, the copper acquires an iron gray coating from the 
 deposit of that metal. This may scale off, if the arsenic be pre- 
 sent in large quantity. From the slip of copper washed, dried, 
 and gradually heated, arsenious acid will be sublimed in minute 
 octohedral chrystals. When the quantity of arsenic is small, the 
 copper will exhibit a faint violet or blue coat, and the deposit is 
 materially affected by the quantity of water present. To this it 
 is objected, that other metals may be deposited on copper, under 
 similar circumstances. To the objection it is replied, that from 
 the arsenical deposit octohedral chrystals of arsenious acid may 
 be procured, by slowly heating the slip of copper in a reduction 
 tube. Taylor's Med. Juris., 134. 
 
 It not unfrequently becomes important to test the existence of 
 arsenic in liquids containing organic matter. Tor this purpose, 
 a slip of bright copper may be placed in a portion of the liquid 
 boiled, and acidulated with pure muriatic acid. If arsenic is 
 present, this will soon acquire a gray metallic coating. This 
 should be dried and heated in a reduction tube, for the purpose 
 />f obtaining octohedral chrystals of arsenious acid. Taylor, 135. 
 Before any step is taken in testing organic fluids, a transparent 
 solution should be obtained. In subjecting these fluids to the 
 test, it is important, first, to destroy the animal matter, to con- 
 centrate the poison, and subsequently, to reduce it. In order to 
 accomplish the first, the nitrate of potash, the nitric acid, and the 
 sulphuric acid may be employed. 
 
 Arsenic, when really present in the stomach at death, dees not 
 readily disappear afterwards. Many instances have occurred, 
 in which it has been detected in the dead body long after death. 
 In one case, it was found fourteen months after interment ; in 
 another, at the end of three years ; and in another still, after 
 seven years interment. In such cases, it will generally be found 
 attached to the coats of the stomach, in the form of a sesquisul- 
 phuret of arsenic, formed by the union of the arsenious acid, 
 with the sulphuretted hydrogen generated in the process of pu- 
 
poisons. 345 
 
 ticfaction. It may be collected, dried, and reduced with black 
 flux. Guy's Principles of Forensic Medicine, 596. 
 
 In relation to the action of arsenic upon the living system, 
 several important points of enquiry present themselves. These 
 are, 
 
 1. The quantity required to produce fatal effects : 
 
 2. The time within which its effects begin to be developed : 
 
 3. The course and character of the symptoms, including the 
 periods of time, within which, it proves fatal : 
 
 4. The treatment : 
 
 5. The post-mortem appearances. 
 
 1 As to the quantity. This, of course, will be found to vary 
 with the strength and power of the constitution to be subdued. 
 In a child four years old, four and a half grains in solution de- 
 stroyed life in six hours. Fifteen grains destroyed the life of a 
 young man of twenty-two years of age in four and a half days. 
 In the case mentioned by Alberti, six grains destroyed the life 
 of a man. Hahnemann says, that, " in circumstances favorable 
 to its action, four grains may cause death within twenty-four 
 hours, and that even one or two grains may prove fatal in a few 
 days. Small quantities have often given rise to very alarming 
 symptoms. So larger quantities, as much as one ounce, have 
 beeD taken, and yet the patient, under the use of sulphate of 
 zinc and magnesia, has recovered. Christison, 275 - 6 ; Guy, 600. 
 
 2. The time within which its effects begin to be developed. 
 This is various, depending much upon circumstances. When 
 taken in solution, the effects begin to be manifested much sooner 
 than when administered in the solid state. In a case in which 
 arseniate of potass was taken, the symptoms began violently in 
 fifteen minutes ; where the oxide was mixed in coffee, the effects 
 were manifested immediately on taking the second cup. In anoth- 
 er case, the symptoms began in eight minutes. The assertion, 
 therefore, made by some, that arsenic never begins to operate 
 under half an hour, is a mistake. It may however be admitted, 
 and laid down as a general rule, that this poison, under ordinary 
 circumstances, does not begin to. operate within half an hour 
 <!rom the time it was taken. It is also equally as true, that its 
 
3-16 MEDICAL JURISPRUDENCE. 
 
 operation is seldom delayed beyond an hour. There have been, 
 however, instances in which a much longer period of time has 
 intervened, between the taking it and its effects. In one case, 
 the arsenic taken at eight in the evening, did not begin to mani- 
 fest itself until eleven, the person having slept during the inter- 
 mediate time In another case, the symptoms did not begin to 
 appear under three hours. In another, scarcely any symptoms 
 appeared for five hours. In another, very extraordinary case, a 
 white draught was administered at ten in the evening, to a girl, 
 who went immediately to bed. No well marked symptom ap- 
 peared until six the next morning, from which time her illness 
 went on uninterruptedly. In all these cases, a state of sleep in- 
 tervened, between the taking of the poison and the production 
 of its effects. It is therefore not improbable, that the greater 
 comparative inactivity of the system during sleep, may operate 
 to retard the action of the poison. When taken upon an empty 
 stomach, the symptoms will be developed sooner than w r hen ta- 
 ken upon one filled with food. The rule above laid down, may 
 be taken subject to be varied by the following disturbing influ- 
 ences, viz : the taking it in a state of solution, or on an empty 
 stomach, or the intervention of a state of sleep between its ad- 
 ministration and effects. Christison <m Poisons, 279-80. 
 
 3. The course and character of the symptoms, including the 
 period of time within which it proves fatal. 
 
 Arsenic, although included in the irritant or acrid class of 
 poisons, is, in strictness, a narcotico-acrid, as it possesses both an 
 irritant and narcotic power. So far as it produces inflammation 
 in the alimentary canal or elsewhere, it is purely irritant ; but so 
 far as it creates disorder of parts or organs remote from the seat 
 of its application, it is narcotic, although the symptoms it occa- 
 sions are somewhat different from proper narcotism. 
 
 The medium through which arsenic acts, is not yet clearly 
 settled. It seems never to have been detected in the blood, yet 
 it is generally believed to enter, it and act through it. It is a 
 fact, that it acts with almost equal energy, whatever be the or- 
 gan or texture to which it is applied. It acts when taken into 
 the stomach, when laid on to a fresh wound, when applied to the 
 
poisons. 347 
 
 conjunctiva of the eye, when injected into the rectum, when 
 brought into contact with the mucous membrane of the vngina, 
 and even, under some circumstances, when applied to the sur- 
 face of ulcers. Christison on Poisons, 271 -2. 
 
 It appears to act the most efficiently, when injected into a 
 vein, or applied to a fresh wound, or introduced into the perito- 
 neal sac. The symptom which is the most uniformly produced, 
 is that of inflammation of the stomach. This occurs, whatever 
 be the texture of the body with which the arsenic is brought in 
 contact, unless death has ensued too quickly to admit the devel- 
 opment of inflammatory action. When externally applied, it 
 has caused a higher degree of inflammation of that organ, than 
 when it has been swallowed. 
 
 The symptoms of poisoning with arsenic are most convenient- 
 ly arranged under three heads : In the first, there is violent in 
 flammation of the alimentary canal, occasionally embracing othei 
 mucous membranes, accompanied with excessive general de- 
 pression. In the second, there is little irritation, sometimes 
 trivial vomiting, or slight pain in the stomach, excessive prostra- 
 tion of strength, and frequent fainting. In the third, the signs of 
 inflammation in the alimentary canal at first appear, and these, 
 about the third or fourth day, are either succeeded or accompa- 
 nied by symptoms of irritation in the other mucous passages, 
 and also by palsy or epilepsy, or other indications of derange- 
 ment of the nervous system, lb., 277-8. 
 
 The first class of cases is the most frequent. The duration of 
 a case in this class generally exceeds twenty-four hours, but sel- 
 dom more than three days. The first symptom of a decisive 
 character, is sickness and faintness. The region of the stomach, 
 at the same time, feels painful ; the pain being of a burning kind, 
 and aggravated by pressure; vomiting and retching ensue. 
 There is a sense of dryness, heat, and tightness, in the throat. 
 The matter vomited is greenish or yellowish, and sometimes 
 streaked with blood. 
 
 Diarrhoea is occasionally present. The pain at the pit of the 
 stomach becomes excruciating, and is compared to a fire burn- 
 ing within. The abdomen becomes tense and tender, sometimes 
 
348 MEDICAL JURISPRUDENCE. 
 
 swollen, and sometimes even drawn in at the navel. In some 
 cases, a burning pain extends along the entire course of the ali- 
 mentary canal. 
 
 There are occasionally signs of irritation of the lungs and air- 
 passages, shortness of breath, a sense of tightness across the bot- 
 tom of the chest, and pain darting through its upper part. 
 The urinary passages are sometimes affected; there is painful 
 micturition, pain in the region of the bladder, and swelling of 
 the penis. If a female, pain in the vagina, and excoriation of 
 the labia. 
 
 The symptoms of irritation of the alimentary canal, are, not 
 unfrequently, succeeded by convulsive motions, commencing on 
 the trunk, and extending over the whole body. These consist 
 generally of tremors and twitches. There are also distressing 
 cramps of the legs and arms, which are peculiarly severe and 
 frequent. 
 
 The local derangement affects, more or less severely, the gene- 
 ral system. The pulse becomes small, feeble, and rapid, and in 
 time, almost imperceptible. There is great coldness, clammy 
 sweats, and sometimes lividity of the feet and hands. The coun- 
 tenance appears collapsed, and is expressive of great torture, and 
 extreme anxiety ; the eyes red and sparkling ; the conjunctiva in- 
 jected ; the tongue and mouth parched ; delirium sometimes pre- 
 sent, and stupor not unfrequent. Death is sometimes preceded 
 by convulsions, lb., 282. 
 
 There sometimes occurs a total intermission of all the distress- 
 ing symptoms, which is accompanied with dozing stupor. This 
 may occur more than once. 
 
 These are the symptoms the most generally attending the first 
 variety, which embraces the cases the most commonly occurring 
 of poisoning with arsenic. They may not all be present, and 
 they may be developed in different degrees of violence ; but it 
 may be laid down, as a general, rule, that the symptoms of poi- 
 soning with arsenic are very uniform. 
 
 2. The second class of cases includes those in which there are 
 little if any signs of inflammation, death commonly ensuing in 
 
poisons. 349 
 
 five or six hours, too early for inflammatory action to be develop- 
 ed. The action here is probably on some remote organ. 
 
 Three conditions are necessary to the occurrence of this va- 
 riety, viz : 
 
 1. That the dose should be large : 
 
 2. That it should be administered in little masses : or, 
 
 3. In a state of solution. The principle seems to be, that a 
 large quantity of the poison is suddenly taken into the system, 
 and that, by that means, its remote action may commence before 
 its local inflammation is fully developed. 
 
 Several cases illustrating this variety are given by Dr. Christi- 
 son, 286-7-8. In the case of a young man, who made use of 
 an arsenical solution to cure the ague, he was attacked after ta- 
 king it with vomiting, and gave utterance to loud cries ; after- 
 wards talked incoherently ; then fell into a profound sleep ; and 
 finally perished in convulsions in five hours. In another, who 
 swallowed an ounce of powdered arsenic, the chief symptoms 
 were two or three fits of vomiting, and afterwards slight pain 
 and heat in the stomach. He died in eight hours, and the stomach 
 and intestines were found quite healthy. A girl, fourteen years 
 of age, took about ninety grains, and died in five hours, having 
 vomited once or twice. She complained of some little pain in 
 the belly, and was affected, towards the close, with great faint- 
 ness and weakness. The stomach and intestines were healthy. 
 Another person expired in five hours, and no vomiting occurred 
 at all, although emetics were given. In another case, death took 
 place in eight or nine hours ; the symptoms being at first slight 
 vomiting, afterwards little else than fa'intness, sickness, a sullen 
 expression, and general appearance considerably resembling in- 
 toxication. 
 
 In a case where a large quantity of arsenic was taken in frag- 
 ments, death occurred in a few hours. There was no other 
 symptom present than great feebleness and frequent tendency to 
 fainting. The stomach and intestines were not affected during 
 life, nor was any morbid appearance discoverable after death. 
 
 The most uniform symptom characterizing this variety, is ex- 
 treme faintness, attended occasionally with some degree of stu 
 
350 MEDICAL JURISPRUDENCE. 
 
 por, or rather oppression, and often with slight convulsions. 
 Pain in the epigastrium is generally present, but it is slight and 
 unaccompanied with other signs of inflammation. 
 
 This variety is not of frequent occurrence, and appears not to 
 be generally understood. It may pass, by almost insensible grada- 
 tions, into the first variety. Christison on Poisons, 289. 
 
 3. The third variety of symptoms occurs when either a small 
 quantity has been taken, or where, a considerable quantity hav • 
 ing been swallowed, a portion of it has been vomited up. It 
 brings more clearly into view its action on the nervous system. 
 
 There are generally two trains of symptoms which character- 
 ize this variety, the one of which usually follows the other. The 
 first is composed principally of signs of inflammation in the ali- 
 mentary canal, and may therefore be termed the inflammatory 
 stage. The second is composed of symptoms referable to ner- 
 vous irritation. These symptoms are considerably various. 
 Sometimes it is imperfect palsy of the arms or legs, and occasion- 
 ally consists of coma. There have also been observed epileptic 
 fits and tetanus, and also an aifection resembling hysteria or 
 mania. 
 
 The nervous symptoms generally succeed the inflammatory ; 
 rarely, they may be found co-existing at the same time. There 
 has been observed in some cases a singular combination of de- 
 lirium, convulsions, tetanus and coma, such as is frequently met 
 with in paroxysms of hysteria. "Sometimes the convulsions 
 caused by arsenic assume the form of pure tetanus." Christison 
 on Poisons , 292. 
 
 Another affection of the nervous system occurring in an 
 advanced stage, is partial palsy. In cases of recovery, an incom- 
 plete paralysis of one or more of the extremities, resembling the 
 lead palsy, is very frequently observed. 
 
 A case is stated of a female who took a small quantity of ar- 
 senic by mistake. The inflammatory stage was easily subdued. 
 On the fourth day she was attacked with cramps, tenderness and 
 weakness of the feet, legs and arms, increasing gradually till the 
 whole extremities were almost entirely palsied. In this case, the 
 
poisons. 351 
 
 power of motion returned first in the hands, then in the arms 
 and eventually in the whole body. Christison, 293. 
 
 In another case, the paralytic affection consisted in the loss of 
 sensation and power of motion in the hands, and loss of motion 
 in the feet, attended with contraction of the knee joints. Local 
 palsy appears to be a very frequent secondary effect of arsenic. 
 In some cases, it is completely incurable. 
 
 Our attention has now been entirely directed to the effects of 
 arsenic, when introduced into the system, through the medium 
 of the stomach. It remains to examine those effects when intro- 
 duced through other channels. 
 
 It may be applied externally to blistered surfaces, eruptions, ul- 
 cers, wounds, or other parts deprived of the cuticle, and causes 
 both local inflammation and constitutional symptoms. Several 
 cases have occurred illustrating this fact. A girl having psoriasis 
 of the scalp, rubbed it with a liniment of butter and arsenic. 
 She was soon after seized with acute pain and swelling of the 
 whole head, fainting fits, restlessness, fever, delirium, and died 
 in six days. Christison on Poisons, 297. 
 
 The application of arsenical paste to an ulcer of the breast, 
 caused strongly marked constitutional symptoms. Although the 
 quantity was small, and the application only for a single night to 
 a surface of half an inch in diameter, yet the next day there was 
 violent cholic and frequent vomiting ; the countenance became 
 collapsed, and death occurred in two days. 
 
 There is much uncertainty attending the action of arsenic, 
 when applied to ulcerated surfaces. One reason probably is to 
 be sought in the quantity applied. It has been suggested, and 
 with some reason, that a large quantity applied to sores, is less 
 likely to produce fatal effects than a small, as the large quantity 
 quickly destroys the part and prevents absorption, while the 
 small, if properly applied, will cause little local injury, and readily 
 enter the absorbent system. Again it is said, that it may be 
 applied to ulcers, wounded surfaces, or the abraded skin, without 
 any great degree of danger, provided the part be not recently 
 wounded so as to pour out blood. The dangf r arises from its 
 coming in contact with an open mouthed blood vessel. If a fresh 
 
352 MEDICAL JURISPRUDENCE. 
 
 surface be made to an ulcer, by paring away the granulations 
 previous to the application of the arsenic, danger may be appre- 
 hended from its application. Christison, 298 - 9. There is con- 
 siderable variety of symptoms in cases of external application. 
 The inflammation is not unfrequently local, extending around 
 the eruption or ulcer. Sometimes it extends to, and embraces 
 the alimentary canal ; and very frequently there is an affection 
 of the nervous system. Sometimes it occasions partial palsy of 
 the muscles adjoining the seat of its application, without other- 
 wise injuring the nervous system, or disordering the stomach, or 
 causing inflammation. Christison on Poisons, 299. 
 
 It has been occasionally, although very seldom, introduced by 
 injection. Several instances have occurred of its having caused 
 death by being introduced into the vagina. In one case of thi t 
 kind, the woman was attacked with acute pain in the stomach 
 and incessant vomiting. She then became delirious, and died in 
 twenty-one hours. 
 
 Poisoning with arsenic may also take place through the bron- 
 chial membrane, or membrane of the air passages, although it is 
 of rare occurrence. As formerly remarked, whatever be its ap- 
 plication, it almost uniformly produces signs of irritation, and 
 consequent inflammation, of the stomach. 
 
 The principal points to be observed in relation to symptoms 
 are, 
 
 1. The time of their commencement — how soon after a meal, 
 how many there were at the meal, and of what dishes they par- 
 took — whether sleep intervened or not, between the meal and 
 commencement of symptoms : 
 
 2. The character of the symptoms that first appear. Ifirrita 
 tion and inflammation, what portions of the mucous membrane 
 of the alimentary canal are affected, what is the state and con- 
 dition of the stomach, what of the intestines, what the indications 
 of constitutional derangement : 
 
 3. The succession of the symptoms. In what manner they 
 succeed each other : 
 
 4. To note whether any symptoms occur which indicate dis- 
 order of the nervous system ; what they are, when they are ob- 
 
poisons. 3G3 
 
 served, what other symptoms they accompany or succeed, and 
 what is their particular character and course of succession. 
 
 4. The treatment. The first object should be to remove the 
 arsenic from the stomach. If removed before any part of it be- 
 comes dissolved and has entered the blood, or otherwise been 
 taken into the system, no serious bad effect may be expected 
 from it. As it sometimes serves itself the purpose of an emetic, 
 it wjll occasionally cause its own expulsion, together with the 
 other contents of the stomach. This will be more likely to take 
 place, where it has been taken in large quantities, upon a full 
 stomach. To promote vomiting, sulphate of zinc may be admini- 
 stered. The use of the stomach pump has been also recom- 
 mended. When the sulphate of zinc is not at hand, a substitute 
 may be found in mustard powdered, in the proportion of one or 
 two teaspoonsfull to a glass of water, administered at intervals. 
 Taylor, 124. Powder of charcoal has been recommended as an 
 antidote, but the manner of its operation is probably by envelop- 
 ing the particles of arsenic, and thus preventing their injurious 
 action until they can be expelled. Magnesia may perhaps ope- 
 rate in the same way. A mixture of milk, lime water, and albu- 
 men, has been much recommended. There appears not yet to 
 be discovered any specific antidote to the action of arsenic ;. any 
 substance that, by uniting with it while in the stomach, will neu- 
 tralize, and thus render it innocuous. That which comes nearest 
 to an antidote, seems to be the hydrated peroxide of iron, given 
 in doses of a tablespoonful to an adult, and a dessert spoonful to 
 a child, every five minutes, mixed with water. If this should 
 not be at hand, the precipitated carbonate, or the rubigo ferri in 
 very fine powder, may be given, every five or ten minutes, until 
 some relief is afforded. The efficacy of the hydrated peroxide is 
 not, however, universally admitted ; but it may, perhaps, be 
 stated as the antidote now the most relied upon. When the 
 poison has been expelled or neutralized, the object should be to 
 subdue the inflammation of the alimentary canal, and to sustain 
 the system by mild treatment. Costill, 52-3. 
 
 5. The post-mortem appearances. These will differ, with the 
 different varieties. In the second variety of symptoms, where 
 
 23 
 
354 MEDICAL JURISPRUDENCE. 
 
 death takes place in a few hours, there are frequently no morbid 
 appearances left in the system. Death occurs too soon to permit 
 inflammatory action to develope itself.. It must not, however, 
 be supposed, that in all cases in which death takes place within 
 a short period, no morbid appearances will be found. In many 
 such cases they have been found. Christison on Poisons, 309-10. 
 The diseased appearances are the most likely to exhibit them- 
 selves, in those cases, where the death has been delayed until the 
 second day, or longer. These appearances are the following : 
 
 1 . Redness of the throat and gullet. This is by no means 
 common, severe inflammatory action seldom embracing both, or 
 either : 
 
 2. Redness of the inner coat of the stomach. This is a very 
 constant attendant as the effect of arsenic. There is nothing pe- 
 culiar in the redness, nothing to distinguish it from other inflam- 
 matory redness, or even from the pseudo-morbid varieties of 
 redness. This inflammatory redness seldom extends to the peri- 
 tonseal coat of the stomach. There is sometimes a turgescence 
 of the external veins sufficient to make the stomach look livid : 
 
 3. Blackness of the villous coat. This, when it occurs, pro- 
 ceeds from effusion of altered blood into its texture. When the 
 irritation has been violent, the color is a brownish black, or gray- 
 ish black ; the inner membrane is elevated into firm knots, or 
 ridges, by the effusion, and the black spots are surrounded by 
 vascularity, or other signs of reaction : 
 
 4. There is an unnatural softness of the villous coat of the 
 stomach. Sometimes also it is brittle, so as to be easily separable 
 by the nail : 
 
 5. At times the villous, and even other coats of the stomach, 
 are actually removed in scattered spots and patches : 
 
 6. On the stomach's inner surface, are often found various 
 secretions. The most common is a mucous secretion, which is 
 frequently thin and glairy, but sometimes abundant and solid, as 
 if coagulated. A sanguinolent fluid is sometimes found in the 
 cavity of the stomach, and a bloody effusion is considerably relied 
 on to prove the administration of arsenic, or some other active 
 irritant : 
 
poisons. 355 
 
 7. The presence of the arsenic itself among the contents of the 
 stomach. Some portion will be likely to remain after long con- 
 tinued vomiting. It may occasionally be found dissolved among 
 the contents of the stomach, but more commonly is detected 
 there in the solid form, either in loose particles, or enveloped in 
 coagulated mucus, or in little clots of blood, or wrapped up in 
 the more solid parts of the contents. It may be often found ad- 
 hering to the coats of the stomach, either scattered in the form 
 of fine dust, or collected in little knots. The particles are covered 
 by mucous, surrounded by redness of the membrane ; or by 
 effused blood, or imbedded in little ulcers. It sometimes ex- 
 hibits a yellow surface, from its conversion into the sulphuret. 
 
 It must not, however, be supposed, that every white powder, 
 found lining the inside of the stomach, is arsenic. Not only may 
 other white powders find entrance, but white pulvurulent scales 
 resembling powdered arsenic, but composed of animal matter, 
 are occasionally formed on the mucous coat of the stomach and 
 intestines : 
 
 8. When the stomach has been much inflamed, the redness 
 may extend to the mucous membrane of the intestines. Traces 
 of inflammatory action are seldom found in the small intestines, 
 or lower down than the extremity of the duodenum, not often 
 affecting the colon. But the rectum is at times found much in- 
 flamed : 
 
 9. In the cavity of the chest, are sometimes found redness of 
 the pleura, redness and congestion of the lungs, redness of the 
 inner surface of the heart, and redness of the fining membrane 
 of the windpipe : 
 
 10. The organs of generation are found occasionally affected — 
 the penis and labia being distended and black : 
 
 11. The conjunctiva of the eyes frequently presents vasculari- 
 ty, and spots of extravasation : 
 
 12. It was once affirmed that bodies, poisoned by arsenic, 
 passed more rapidly into decay than other bodies ; but this is 
 now very clearly settled to be so far from being true, that it 
 actually, in many cases, has been found to possess antiseptic 
 properties. The circumstances under which it proves to be a 
 
356 MEDICAL JURISPRUDENCE. 
 
 good preservative of animal textures appear to be, when there is 
 a direct application to them in sufficient quantity. Hence its 
 antiseptic qualities will generally be found exerting themselves 
 upon the stomach, and, perhaps, also on the intestines, leaving 
 the rest of the body to decay in the usual manner. Owing in 
 part to this quality, and to the fact that it is not easily decom- 
 posed and resolved into new compounds, it has often been de- 
 tected in the stomach, or some parts of the system, long after 
 interment. In one case, it was detected thirteen months, in an- 
 other fourteen, and in another still, seven years after interment. 
 In a case recently occurring, mentioned in a London paper, it 
 was proved that two children had been poisoned with arsenic, 
 from examination of their bodies after eight years interment 
 Mr. Herepath, in giving his testimony on the trial, said, " I wish 
 it to be circulated throughout the country that years have no 
 eifect in removing traces of arsenic. The roots of trees, as large 
 as my little finger, had passed through the head and skeleton, 
 and followed the bones in all directions. I found arsenic in the 
 bones, in the black mould under the head, and a great quantity 
 in the black mould under the ribs. I have never found arsenic 
 in the body which was in a natural state. I mention this to cor- 
 rect the ridiculous notions which have gone abroad, owing to 
 some sayings which have been attributed to the French chemists. 
 Raspail is reported to have said, that he could produce arsenic 
 from the legs of chairs ; and Orfila that he could do so from the 
 common soil. I have made experiments on hundreds of bodies 
 of human beings and brutes, but have never discovered arsenic 
 unless it had been administered mechanically or for criminal 
 purposes." 
 
 In regard to the force of the evidence derived from post-mortem 
 appearances alone, Dr. Christison sums up by saying, that " mere 
 redness, conjoined or not, with softness of the mucous membrane, 
 may justify suspicion only. But if there should be found in the 
 body of a person who has died of a few days illness, redness, 
 black warty extravasation, and circumscribed ulcers of the villous 
 coat of the stomach, effusion of blood or bloody clots among the 
 contents of that organ redness of the intestines, more especially 
 
poisons. 357 
 
 redness and ulceration of the colon and rectum, and redness of 
 the pharynx, or of this along with the gullet ; the proof of poi- 
 soning with some irritant will amount to a strong presumption." 
 332. 
 
 MERCURY. 
 Mercurial preparations offer very interesting subjects of en- 
 quiry, but are less frequently resorted to for the purpose of de- 
 stroying life than arsenic. Still some of them are occasionally 
 made use of for that purpose, and hence become subjects of 
 medico-legal investigation. All the remarks on the subject of 
 Mercury may be included under the following heads • 
 
 1 . Its preparations : 
 
 2. Its tests : 
 
 3. The symptoms it develops : 
 
 4. The post-mortem appearances it produces : 
 
 5. Its treatment. 
 
 1. Its preparations. Although there are several different pre- 
 parations of mercury, yet two of them are of vastly more impor- 
 tance than the others, viz., the bichloride, or corrosive sublimate, 
 and the protochloride, or calomel. Of these two, the first is al- 
 together the most important to be investigated in a medico-legal 
 poinlf of view, as it is this preparation which is the most pro- 
 ductive of fatal results. Calomel is seldom given with the direct 
 design to destroy life. 
 
 2. Its tests. These are somewhat different, as they have ap- 
 plication to the corrosive sublimate, the most active of mercurial 
 poisons, in a solid state, in solution, or in organic liquids. A 
 small quantity, in the solid form, is first heat on platinum foil, 
 \intil it becomes completely volatilised. A few drops of liquor 
 potassse changes it to a yellow color ; hydro-sulphuret of ammo- 
 ria, to a black ; and a solution of iodide of potassium, to a bright 
 scarlet. It is also recommended to mix one part of the poison, 
 with three or four parts of calcined carbonate of soda, to place 
 the mixture in a reduction tube, and to apply the heat of a spirit 
 lamp, having previously dried the upper part of the tube. The 
 result will be the formation of a ring of globules on the cool sides 
 of the tube. Guy's Principles of Forensic Medicine^ 610. 
 
358 MEDICAL JURISPRUDENCE. 
 
 When in solution, there are several tests that may be made 
 use of. Such as, 1. Potash ; 2. Pfotochloride of tin ; 3. Sulphu- 
 retted hydrogen gas ; 4. Precipitation by metals ; and 5. The 
 galvanic test. It is hardly necessary to dwell on these tests. 
 There are various ways of applying the last mentioned. It may 
 be done by twisting a slip of zinc round a slip of bright copper, 
 and introducing them into the solution. Mercury is deposited 
 upon both. Taylor's Med. Juris., 147. 
 
 In organic liquids, it cannot always be found in a state of solu- 
 tion. It is decomposed and precipitated by many organic prin- 
 ciples, such as albumen, fibrin, mucous membrane, as well as by 
 gluten, tannin, and other vegetable substances. There are seve- 
 ral tests by which its presence can be satisfactorily made known, 
 but the galvanic is that which seems to be the most effectual, as 
 it is capable of detecting the presence of mercury in exceedingly 
 small quantities. For the purpose of applying this, cut a slip of 
 fine gold foil, of about an inch in length and an eighth of an inch 
 in width, just large enough to enter into a small reduction tube. 
 Twist around this, in a spiral form, a narrow slip of finely lami- 
 nated zinc ; then acidulate the suspected liquid with a few drops 
 of diluted muriatic acid, and suspend the gold and zinc by a 
 thread in the midst of it. If mercury is present, and in propor- 
 tion to its quantity, the gold will be coated of a gray color, either 
 immediately, or in the course of a few hours. If at the end of 
 five or six hours, the gold remains undimmed, the fair inference 
 is, that no mercury, or none of the slightest consequence, is pre- 
 sent. The bright, yellow color of the gold renders it easy to see 
 whether there is any deposition upon it or not, as if there is, that 
 color will be tarnished. Taylor's Med. Juris., 149. 
 
 Ail that can properly be required of the medical jurist, in 
 applying these, or any tests, is to detect the presence of mercury 
 in the system. How it came there, whether administered as a 
 medicine, or given as a poison, must depend on other circum- 
 stances. To solve such questions, recourse must be had to the 
 testimony of the physician, to the character of the symptoms, 
 and the morbid appearances after death. 
 
poisons. 359 
 
 3. The symptoms it developes during life. 
 
 These are extremely diversified, more so than those of any 
 other poison. It acts on a number of important organs. In 
 large doses, it corrodes- the stomach, paralyses the heart, arid re- 
 sults in a rapid death. It is an active poison to whatever part 
 or tissue of the body it is applied. In tins respect, it resembles 
 arsenic. It also resembles it in another respect, and that is, its 
 singular power of inflaming the stomach and intestines, whatever 
 be the method of its introduction into the system. It may act, 
 therefore, by corrosion, when introduced into the stomach, or, 
 if introduced into the system through a wound, or any other 
 less direct means than swallowing, it may cause irritation both 
 of the stomach and rectum ; also inflammation of the lungs, de- 
 pressed action, and perhaps inflammation of the heart, oppres- 
 sion of the functions of the brain, and inflammation of the sali- 
 vary glands. 
 
 Whether mercury has been detected in the solids and fluids 
 of the body, has been asserted by some and denied by others. 
 There are now so many facts bearing upon this subject, that it 
 would seem to be fairly settled in the affirmative. 
 
 In the case of a gilder, where there was an eruption of little 
 boils, each was found to contain a globule of quicksilver. In 
 another, fluid mercury was passed by the urine. 
 
 Metallic mercury has been discovered in the bodies of persons 
 who have undergone a long mercurial course recently before 
 death. A skull, found in a church-yard, contained running 
 quicksilver in the texture of its bones. In another body, mer- 
 curial globules were found lying on the os hyoides, laryngeal car- 
 tilages, frontal bone, sternum, and tibia. On scraping the perios- 
 teum of several of the bones of a man who had labored under 
 syphilis, minute globules were seen issuing from the osseous sub- 
 stance. Mercury has also been obtained by boiling the bones 
 of those who had been long under a mercurial course. 
 
 The results of actual chemical analysis have been somewhat 
 contradictory. Zeller has detected it, after death, in the blood 
 and bile ; Cantu has obtained it from the urine ; Buckner has 
 
300 MEDICAL JURISPRUDENCE. 
 
 found it in the blood, saliva, and urine ; and Schubarth has also 
 extracted it from the blood. Christison on Poisons, 3G6. 
 
 It would appear from these facts to be well established, that 
 mercury, under some circumstances, is found to be present both 
 in the solids and fluids of the body, which, during life, has been 
 subjected to its action. 
 
 There are three varieties of symptoms which result from poi- 
 soning with the different preparations of mercury : 
 
 1 . In the first, the leading symptoms, and those to which all 
 the others have a direct reference, are a violent irritation of the 
 alimentary canal. The effects which result from this irritation 
 are very similar to the symptoms caused by poisoning with ar- 
 senic. There is vomiting, pain in the pit of the. stomach, often 
 extending over the whole abdomen, and profuse diarrhoea. But 
 there are several points that serve effectually to distinguish be- 
 tween the two : 
 
 1. In the taking of corrosive sublimate, the symptoms begin 
 much sooner than those caused by arsenic ; the irritation in the 
 throat occurs immediately on swallowing; its effects in the 
 stomach commence also immediately or very soon afterwards : 
 
 2. The taste is sufficient to distinguish ; it is nauseous, metal- 
 lic, and styptic, while that of arsenic is sweetish : 
 
 3. The greater solubility of mercury, and its stronger chemi- 
 cal operation on the animal textures, enable the corrosive subli- 
 mate to act very much more powerfully on the throat than arse- 
 nic, creating a tightness and burning there, which often continue 
 throughout the whole duration' of the poisoning : 
 
 4. It generally produces a different effect upon the counte- 
 nance, and instead of rendering it pale and ghastly, gives it a 
 flushed, and even swollen appearance : 
 
 5. As it is the more powerful irritant of the two, it gives rise, 
 much more frequently than arsenic, to discharges of blood by 
 vomiting and purging : 
 
 6. It causes irritation of the urinary passages more fre- 
 quently than arsenic. This consists in frequent and painful 
 micturition ; but at times, the secretion of urine is suppressed : 
 
 7. It is more apt, than arsenic, to cause nervous affections 
 
poisoiij. 361 
 
 during the first or inflammatory stage ; there is more of a dozing 
 tendency, more tremors and twitches of the extremities, and so 
 great a degree of stupor, that it sometimes approaches to abso- 
 lute coma : 
 
 8. Its effects upon the system are much more curable than 
 those of arsenic : 
 
 9. Deviations from the ordinary course and combination of 
 the symptoms, are rarer met with in the case of corrosive sub- 
 limate, than in those of arsenic. Christison on Poisons, 372. 
 
 Taking all these things into consideration, it is no difficult mat- 
 ter to distinguish cases of poisoning with corrosive sublimate, 
 from those of poisoning with arsenic. 
 
 The matter vomited, or discharged by purging, is a stringy 
 mucous, or bilious matter, which often contains blood. The en- 
 tire abdomen becomes distended, and extremely painful; the 
 pulse is full, quick and frequent, when the countenance is flush- 
 ed and swollen ; but in occasional cases, where the latter is pale 
 and collapsed, it is small, frequent and intermittent. There are 
 sometimes intervals of greater ease, when drowsiness is general- 
 ly present; the tongue is white and shrivelled, the skin cold and 
 clammy, and the respiration difficult. When death occurs, it 
 usually takes place either during a fainting fit, or in the midst 
 of strong convulsions, or during a state of protracted insensibili- 
 ty. The ordinary duration of life in fatal cases, is from twenty- 
 four to thirty-six hours. It has sometimes continued three days. 
 The shortest duration on record is two hours and a half. Christi- 
 son, 374. 
 
 This variety of poisoning with mercury takes place only in 
 those cases in which considerable doses of its soluble salts have 
 been taken, particularly corrosive sublimate. 
 
 2. In the second variety of poisoning with mercury, the symp- 
 toms begin much like those already mentioned, irritation in the 
 alimentary canal being among the first witnessed. To these, 
 however, succeed the symptoms of what is called mercurial ere- 
 thysm, the leading affection of which is inflammation of the 
 organs in and adjoining the mouth, more especially of the sali- 
 vary glands. These symptoms are seldom developed sooner than 
 
362 MEDICAL JUKISPB.UDENCE. 
 
 the beginning of the second day, and more usually, they do not 
 commence until its close. 
 
 The various questions connected with mercurial erethysm, or 
 ptyalism, will be discussed under the third variety. 
 
 The following case, found in Christison, 376, will illustrate this 
 second variety of symptoms : A stout young girl, soon after sup- 
 per, swallowed a drachm of corrosive sublimate, dissolved in 
 beer. In a few minutes after, she was found on her knees in 
 great torture. She had a sense of burning in the stomach, ex- 
 tending towards the throat and mouth, soon followed by violent 
 vomiting of a matter at first mucous, afterwards bilious and 
 bloody; also by purging a brownish, fetid fluid. There was 
 suppression of urine, and much tenderness of the urethra and 
 bladder. The pulse was small, contracted, and frequent ; the 
 countenance anxious ; and the stupor considerable, interrupted 
 frequently by fits of increased pain. All these symptoms were 
 developed in four hours. Subsequently, the pain in the stomach 
 became much easier, but that in the throat much worse. In the 
 course of the second day. the teeth became loose, the gums ten- 
 der, and the saliva more abundant than natural. Profuse 
 ptyalism and great fetor of the breath ensued, and she expired 
 towards the close of the fourth day. 
 
 This variety is caused by the same preparations of mercury 
 that produce the first. 
 
 3. In the third variety, come to be considered all the forms of 
 what is called mercurial erethysm, embracing all the secondary 
 and chronic effects of mercury. Here arise several questions 
 of importance, which the medical jurist may be called upon to 
 settle : 
 
 1 . By what preparations, how large a dose, and within what 
 time, is mercurial erethysm produced 1 
 
 Any mercurial preparation may give rise to the secondary 
 effects of mercury. It most frequently results from its milder 
 compounds, such as calomel, which are either given medicinally, 
 or applied continuously to the bodies of workmen who are ex- 
 posed by their trade or occupation to its fumes. It is most gene- 
 rally the result of repeated small doses, but may be produced by 
 
poisons. • 363 
 
 a single dose. When it proceeds from a single dose, it usually 
 commences between the beginning of the second and the end of 
 the third day. It is to be observed, that there is a vast difference 
 between different constitutions, in regard to susceptibility to the 
 action of mercury. Children are generally less susceptible than 
 adults, and robust than delicate persons. Where the nervous 
 system is affected, smaller doses produce more marked effects. 
 Guy, 614. 
 
 In cases of extreme sensibility to the action of mercury, sali- 
 vation has resulted from one or two small doses even of the 
 mildest preparations. Fifteen grains of blue pill, taken in three 
 doses, one every night, have excited fatal salivation. Even two 
 grains of calomel have caused ptyalism, extensive ulceration of 
 the throat, exfoliation of the lower jaw, and death. ' Christison 
 on Poisons , 379. 
 
 On the other hand, it is equally true, that some constitutions 
 resist the action of mercury, so as hardly to appear capable of 
 salivation at all. 
 
 It is rare that mercurial salivation commences within twenty- 
 four hours. In one case, it commenced in four hours j in anoth- 
 er, in three, which is the shortest period on record. Guy, 616. 
 
 Fully as important a question to be settled, is the length of 
 time that may elapse after the administration of mercury has 
 been abandoned, before its effects on the salivary glands and 
 mouth commence. Mercury is a cumulative poison when given 
 in small doses. It may silently accumulate in the body for some 
 time before its symptoms break forth. One case is given, where 
 the interval was three months. Other instances are reported, 
 where the interval was several months. Christison on Poisons, 
 383. 
 
 2. What are the symptoms that characterize mercurial ere- 
 thysm'? 
 
 Its usual commencement is with a brassy taste, and tenderness 
 of the mouth, accompanied or succeeded with swelling, redness, 
 and subsequent ulceration of the gums, and peculiar fetor of the 
 breath. An augmentation is also observed in the flow of the 
 saliva, which is commonly accompanied with fullness around the 
 
364 MEDICAL JURISPRUDENCE. 
 
 lower jaw. The symptoms vary considerably in their severity. 
 In the milder forms, there is only the brassy taste, tenderness of 
 the mouth, redness of the gums, and fetor. In those which are 
 severe, the salivation is profuse; the face, neck and tongue 
 swollen; the inside of the mouth ulcerated or gangrenous. 
 There may also be more or less constitutional disorder, frequent 
 pulse, hot skin, and other symptoms of fever. 
 
 3. What is the duration of mercurial ptyalism ? 
 
 This is extremely variable. The ordinary time may be stated 
 to be two or three weeks. But from that it may extend to al- 
 most any possible duration. In one case, it continued invete- 
 rately for a whole year ; in another, it continued for six years. 
 These, however, are extraordinary instances. 
 
 4. Is there danger of confounding mercurial salivation with 
 any other affection 1 
 
 Mercurial preparations are not the only substances that excite 
 a preternatural flow of saliva. Preparations of gold, of copper, 
 of antimony ; also of croton oil and foxglove, have been known 
 to produce this effect. The salivation itself may also form an 
 idiopathic disease, and may be both profuse and obstinate. Seve- 
 ral cases of this kind are related by Dr. Chrislisan, 380-81 
 It may even be produced by the influence of the imagination 
 It is generally easy to distinguish the real effects of mercury 
 from the affections resembling them, if the examination be made 
 in the first stage. The real effects are preceded by the coppery 
 taste and fetor of the breath, and are accompanied by redness, 
 sponginess, and ulceration of the gums. These are wanting in 
 the affections alluded to. In the more advanced stages, there is 
 much more difficulty in discriminating. Guy, 615 ; Christison on 
 Poisons, 382. 
 
 5. Is mercurial erethysm ever intermittent 1. Can it cease and 
 recur, without the renewed use of the mercurial preparation 1 
 This enquiry actually arose in the case of Miss Butterfield, tried 
 in 1775. Taylor, 141. The charge was, the administering corro- 
 sive sublimate. The defence, that the salivation might have 
 been simply the renewal of a previous ptyalism, which had been 
 brought on by a common mercurial course, and had ceased two 
 
foisoNs. 3C 5 
 
 months before the second salivation began. There was a differ- 
 ence of opinion among the witnesses; but one testified that in- 
 termission was very common in the London Lock Hospital, and 
 that in one case, the interval was three months. The prisoner 
 was acquitted. 
 
 The instances of well settled intermissions must, however, be 
 rare, and are rather among the number of possibilities than pro- 
 babilities. Dr. Reese, in his Notes on Cooper, mentions, as a pe- 
 culiarity of mercurial action, that when salivation has been ar- 
 rested after an interval of weeks, or even months, it may be re- 
 newed by the slightest doses of mercury. One interval is men- 
 tioned of several weeks ; another, of four months ; and another 
 still, of six months. 
 
 6. In what manner does mercurial salivation prove fatal 1 ? 
 It may prove so — 
 
 1 . From extensive spreading gangrene of the throat, mouth, 
 face and neck. When this is the cause of death, it begins in the 
 mouth or throat and spreads from that till it reaches the face : 
 
 2. Death may take place from exhaustion, from discharges of 
 saliva, without material injury to the mouth or adjoining organs : 
 
 3. It may be owing to exhaustion from laryngeal phthisis, and 
 may take place suddenly, from suffocation. 
 
 There is still another class of ailments, flowing from the second- 
 ary effects of mercury, the consideration of which should consti- 
 tute an important branch of medical police. This embraces the 
 shaking palsy, or mercurial tremors, which so generally affect 
 miners, gilders, and others whose trade exposes them to the ope- 
 ration of this poison. The shaking palsy, caused by mercury, 
 generally begins by an unsteadiness of the arms, next a quiver- 
 ing, finally, tremors, becoming more and more severe, till they 
 resemble convulsions, and render walking, speaking, or even 
 chewing, a matter of much difficulty. If the exposure is con- 
 tinued, there occurs loss of memory, sleeplessness, delirium and 
 death. Attending the trembling, are, a brown tint of the body, 
 dry skin, flatus, and slow pulse. The tremors are generally not 
 difficult of cure, although requiring considerable time. 
 
 In whatever wav mercury is introduced into the system, it 
 
366 MEDICAL JURISPRTJDHSCE. 
 
 always acts as a poison. The most common and dangerous way, 
 is its introduction into the stomach. There it irritates, inflames, 
 and usually corrodes the alimentary canal, or causes mercurial 
 erethysm. It does not generally occasion dangerous symptoms 
 when applied to a wound or ulcer ; although when applied in a 
 diluted state, to sores, it has been known to cause bad effects, if 
 too long persevered in. The system may be brought under the 
 poisonous action of mercury by introducing its preparations into 
 the lungs. The most effectual method of doing this, is the in- 
 halation of its preparations in the form of vapor. 
 
 Corrosive sublimate, incautiously sublimed, has caused very 
 serious effects. Even the long continued inhalation of vapors, 
 arising from metallic mercury, has been productive of bad con- 
 sequences. An event, illustrating this, occurred in 1810, when 
 several bags, containing quicksilver, were burst and the mercury, 
 spilled on two English vessels, which were on their voyage home 
 from Cadiz. The result was that the whole crews of both vessels 
 were salivated, some severely, two died, and many were danger- 
 ously ill. The rats, mice, cockroaches, cats, dogs, goats and 
 sheep were all destroyed. Christison on Poisons, 391 . 
 
 The soluble preparations of mercury will excite mercurial 
 action when placed in contact with the skin. Even the mere 
 carrying of mercurial preparations, for a length of time, near the 
 skin, although not in direct contact with it, may communicate 
 the poison to the system. The following case, very curious in 
 its details, will illustrate this. A man became affected with a 
 violent salivation evidently mercurial, but which, during his life, 
 could be traced to no real cause. It proved fatal, and after his 
 death, a little leathern bag, containing a few drachms of mercury, 
 was found hanging at his breast. It was then discovered that he 
 had been in the practice of carrying this bag for six years, as a 
 protection against itch and vermin, and had several times re- 
 newed the mercury during that period. 
 
 Mercury, in the metallic state, is inert and harmless. The 
 sulphurets of mercury are also harmless. The bichloride, or 
 corrosive sublimate, is the most poisonous. The red precipitate 
 and turbith mineral, as well as the white precipitate, act as irr». 
 
poisons. 367 
 
 tants. The protochloride or calomel, is also an irritant, but is 
 the most manageable of all the preparations of mercury for pro- 
 ducing ptyalism. In large doses, it has produced death by its 
 irritant operation. 
 
 In reference to the strength of the evidence derivable from the 
 symptoms, it should be remarked, that in a case of sudden death 
 from poisoning with corrosive sublimate, the symptoms alone 
 would furnish but slight proof, but in such case the poison would 
 generally be found in the stomach. To justify the conclusion 
 that some preparation of mercury has been taken, there should 
 be a concurrence of the following circumstances : 
 
 1. A strong, acrid, styptic, metallic taste on swallowing the 
 suspected substance : 
 
 2. The almost immediate occurrence of a sense of heat, prick- 
 ing, or tightness, in the throat : 
 
 3. The common characteristic signs of poisoning with the irri- 
 tants, making their appearance in the usual time, and attended 
 with the discharge of blood upwards and downwards : 
 
 4. The accompanying or following these signs with a true 
 mercurial salivation. 
 
 4. The post-mortem appearances it produces. 
 
 These appearances have a general resemblance to those caused 
 by other irritant poisons, their peculiarities arising mostly from 
 the greater solubility of this poison, and its stronger irritant ac- 
 tion. To these is owing the fact, that the mouth and throat are 
 much more frequently found affected than in cases of poisoning 
 with arsenic. There is, in case of poisoning with corrosive sub- 
 limate, a peculiar shriveled appearance of the tongue, and a great 
 enlargement of the papillae at its root. The alimentary canal is 
 more generally disordered, and that disordered condition reaches 
 a greater height before death. The throat, stomach, gullet, rec- 
 tum, and even the colon, are very generally found affected, so 
 much so, that the coats of the stomach and intestines are fre- 
 quently destroyed. The kinds of destruction the most common 
 are corrosion and ulceration, the first of which results from 
 chemical decomposition, and the last from organic action under 
 the influence of the poison. The first is seldom witnessed on 
 
368 MEDICAL JURISPRUDENCK. 
 
 account of its liability to be ejected in vomiting and its solubility 
 and facility of decomposition in the contents of the stomach, and 
 is never found unless the corrosive sublimate be given in large- 
 quantity, and in a dose that is very concentrated. In cases 
 which have ended fatally in eleven and twenty-four hours, the 
 corrosion was black, and is described as. being " like the charring 
 of leather with a red hot coal, and the rest of the stomach scarlet 
 red or deep rose-red." Christison on Poisons, 403. 
 
 When the poisoning takes place slowly, the disorganised mat- 
 ter sloughs away, leaving an ulcerated cavity. If examined be- 
 fore the slough is thrown off, the disorganised tissue yields mer- 
 cury by chemical analysis. If the disorganised part has sloughed 
 off, and been discharged, the ulcer left will be distinguished by 
 signs of surrounding reaction. 
 
 The corrosive sublimate is not so likely to be found in the 
 stomach as arsenic. Its solubility is much greater, and hence it 
 adheres with far less obstinacy to the villous coat of the stomach, 
 and is more liable to be discharged by vomiting. It may also be 
 decomposed by its contact with the mucous membrane, or with 
 the matters contained in the stomach, or with the antidotes taken. 
 Iron, zinc, and other metals, are the most effectual agents in pro- 
 moting such decomposition. Whenever it takes place from the 
 operation of any cause, there can generally be found a deposition 
 of mercury in a state of minute division on the lining membrane, 
 as a thin slate colored covering, which may serve to identify the 
 poison. Christison, 405 ; Guy, 621. 
 
 When mercurial salivation has taken place during life, the 
 mucous membrane of the mouth will be found inflamed or 
 sloughing. 
 
 In cases of poisoning with corrosive sublimate, the urinary 
 organs, particularly the kidneys, are often found in an inflamed 
 state, and the bladder much more contracted than natural. 
 
 The evidence derived from this source can never amount to 
 anything more than a strong presumption or probability. " If 
 the gullet, stomach and colon be all inflamed and ulcerated, and 
 these injuries have taken place during a short illness, the pre- 
 sumption in favor of some form of irritant poisoning will be 
 
poisons. 3C9 
 
 strong. And the presumption of poisoning with corrosive sub- 
 limate will be strong, if the usual marks of salivation are also 
 found in the mouth and throat." Christison, 407-8. 
 
 5. Treatment. 
 
 If vomiting be not already present, it should be induced by the 
 exhibition of emetics. Taylor's Med. Juris., 144. But if the poi- 
 son cannot by these, or ? ny other means, be expelled, there are 
 antidotes that may be administered generally with great success 
 The most important of these is albumen in the form of white of 
 eggs, beat up with water. This has the effect of destroying the 
 corrosive properties of the bichloride of mercury, by convertiua: 
 it into the protochloride of mercury and albumen. It is said tht*. 
 white of one egg is required to render four grains of the prison 
 innocuous. 
 
 Another remedy is gluten. This may be used as a substitute 
 for albumen, when that is not readily attainable. The gluten 
 contained in wheat may be successfully employed. Wheat flour, 
 mixed with water or milk, should be administered. 
 
 When neither albumen nor gluten is at hand, milk may be ad- 
 ministered. Also iron filings are recommended, the iron acting 
 by reducing the corrosive sublimate to the metallic state. 
 
 There are several other metallic compounds, besides arsenic 
 and mercury, that are included in the class of irritant poisons. 
 Thus copper, lead, antimony, zinc, tin, silver, iron, bismuth, and 
 chrome are all, when taken internally, more or less active poisons. 
 It is, however, so extremely seldom that the medical jurist is 
 called upon to give any results of the knowledge he may have 
 acquired in reference to these substances, with the exception of 
 the two first mentioned, that it seems hardly proper to expend 
 much time upon them. In regard to the exceptions mentioned, 
 the occasions must be very unfrequent when he may be called 
 upon to give any information. Still in reference to them a few 
 words may properly be said. 
 
 COPPER. 
 
 The salts of copper are seldom resorted to by any one for the 
 purpose of poisoning others. Their deep color, and strong disT 
 
 24 
 
370 MEDICAL JURISPRUDENCE. 
 
 agreeable taste, render it difficult to administer them secretly. 
 The same reasons prevent them from being often taken accident- 
 ally. They are occasionally used by the suicide. The use of 
 copper utensils in cookery may also lead to the accidental admix- 
 ture of these salts with food. 
 
 All that it is deemed important to say, in regard to this metal, 
 may be embraced under — 
 
 1 . Its compounds or salts : 
 
 2. Its tests : 
 
 3. Tje symptoms it developes : 
 
 4. The post-mortem appearances it causes : 
 
 5. Its treatment : 
 
 6. Its use for culinary, and other domestic purposes. 
 
 1 . Its compounds. The pure metallic copper is not poisonous, 
 being in this respect similar to mercury and arsenic. Many per- 
 sons have swallowed copper coins, and retained them for weeks 
 without any symptoms of poisoning. All its salts are poisonous. 
 Of these there are several, but with the exception of two, they 
 are seldom met with: These two are the sulphate, well known 
 as blue vitriol, and the subacetate, known as verdigris. The 
 first is found in the form of large crystals of a deep blue color, 
 and having an acrid, astringent, and metallic taste, and is known 
 in common language as blue stone, blue vitriol, or blue copperas. 
 The other is a common pigment, met with in the form of a light 
 powder, of a greenish blue color ; of a peculiarly disagreeable 
 smell, which approaches to that of vinegar. This last is the salt 
 which the most frequently produces deleterious effects. 
 
 2. Its tests. Without going into an enquiry in relation to all 
 the tests of copper, I shall merely invite attention to two, calcu- 
 lated to discover its presence in organic mixtures. These are 
 both stated by Mr. Taylor, 170-71. They proceed upon the 
 principle, that a portion of the poison is held in solution. Be- 
 fore applying any test, the color of the liquid is to be particular- 
 ly notieed. If it contain any salt of copper, it will exhibit a 
 decidedly green color. 
 
 The first test is very simple, and consists in thrusting into the 
 liquid, a zine and platina needle. If any salt of copper be pre- 
 
poisons. 371 
 
 sent,*in a few hours it will be coated over with the metal. To 
 have this test succeed, the needle must be bright, and not rusty. 
 The smaller the quantity of copper in the liquid, the longer will 
 the needle be required to remain, because the slower -will be the 
 formation of the coat. This will succeed, notwithstanding a 
 large quantity of organic matter may be present ; and a small 
 quantity of the salt of copper may be discovered in tea, coffee, 
 porter or gruel, provided we acidulate the liquid slightly with 
 diluted sulphuric acid, before the introduction of the needle. 
 
 The other test is applied by first filtering the liquid, and pla- 
 cing a portion of it in a clean platina capsule or crucible, and 
 then adding to it a few drops of diluted sulphuric acid. A slip 
 of zinc foil is then introduced, and wherever the platina is touch- 
 ed, by the zinc, metallic copper is deposited. After coating the 
 platina capsule, the surplus liquid may be poured off, and the 
 capsule well washed out. The metallic copper may then be dis- 
 solved out by a few drops of nitric acid with a small quantity 
 of water. By these means, a pure solution of nitrate of copper 
 is obtained, giving the usual reactions with ammonia ; and, when 
 the surplus acid is neutralized, with ferrocyanate of potash and 
 polished iron. In this way, copper, if in moderate quantity, may 
 1 ie separated from milt, gruel, porter, or the most complex or- 
 ganic liquids. 
 
 3. The symptoms it developes : 
 
 These are, in general, much the same as those caused by ar- 
 senic, and the most poisonous preparations of mercury. One 
 peculiarity is, that sometimes throughout the whole course of 
 the symptoms, there is a strong coppery taste in the mouth, and 
 a singular aversion to the smell of copper. In the cases related 
 by Orfila, the first symptom was a violent headache, next occur- 
 red vomiting and cutting pains in the bowels, and afterwards 
 cramps in the legs and pains in the thighs. Another occasional 
 symptom is jaundice. In cases ending fatally, convulsions and 
 insensibility generally precede death, indicating some injury to 
 the brain. 
 
 There are two varieties in the character of symptoms caused 
 by copper. One arises from its local action on the alimentary 
 
372 MEDICAL JURISPRUDENCE. 
 
 canal j the other, from its operation on distant organs. Christir 
 .son on Poisons, 432. 
 
 In a case in which half an ounce of verdigris, suspended in 
 water, was. taken, there was an accession of cholic pains in fif- 
 teen minutes, accompanied by profuse vomiting and purging. 
 Eight hours afterwards, the vomiting was diminished, but there 
 was frequent eructation of a matter containing verdigris, some 
 salivation, a small pulse, and blueness about the eyes. In six- 
 teen hours, jaundice appeared. He recovered about the fourth 
 day. 
 
 In a case where two ounces were taken, death occurred on 
 the third day, under incessant vomiting and diarrhoea, attended, 
 towards the close, with convulsions, and then with palsy of the 
 limbs. Christison, 435. 
 
 Other cases clearly show the action of this poison on the brain. 
 In some rather extraordinary cases, narcotic symptoms form the , 
 commencement, and irritant symptoms the termination, of the 
 poisoning. When vomiting occurs, the matters vomited have a 
 bluish or green color. 
 
 4. The pcst-mortem appearances it causes : 
 
 Where death takes place very soon after swallowing the poison, 
 it is probable no diseased appearances will be perceptible ; when 
 death occurs after a longer period, signs of inflammation are 
 present. In one case reported, the skin was yellow, the intes- 
 tines of an unusual green color, inflamed, and here and there 
 gangrenous. The stomach was green, its inner coat inflamed, 
 and near the pylorus, a spot where the villous coat was thick, 
 hard, and covered with' firmly adhering verdigris. The lungs 
 were also inflamed, and the blood firmly coagulated. 
 
 5. Its treatment : 
 
 The most effectual antidote is albumen There should be a 
 free administration of the white of egg, followed by mucilagi- 
 nous'drinks. Vomiting frequently occurs from the action of the 
 poison. It should be promoted as much as possible, by the ad- 
 ministration of warm water, milk, or any mucilaginous drink ; 
 and the stomach pump may be used. Sugar has been recom- 
 mended as an antidote, but it acts very feebly at the ordinary 
 
poisons. 373 
 
 temperature of the human body. Iron filings, suspended in 
 mucilage, have also been recommended. 
 
 6. Its use for culinary and other domestic purposes : 
 It becomes a very interesting subject of enquiry, and one with 
 which the medical jurist should be conversant, how far vessels 
 made of copper may be safely made use of for cooking and other 
 domestic purposes. The substance of the results arrived at on 
 this subject is thus briefly summed up by Dr. Guy, 630 : 
 
 " Distilled water kept in contact with clean copper, is not im- 
 pregnated with it. Solutions of several saline matters, as com- 
 mon salt, alum, nitre, and epsom salts, when heated in copper 
 vessels, are found to contain the poison. Acids, and fatty and 
 oily matters, especially when rancid, act still more strongly 
 on copper vessels. One general principle applies to all these 
 substances, which is, that provided the vessels be clean, they 
 may be boiled in them with comparative safety, but cannot be 
 allowed to stand in them without danger. The contact of air 
 with the moistened copper, leads to the formation of the hy- 
 drated carbonate, which is dissolved by any acid that the sub- 
 stance may happen to contain. As, however, saline, acid, or 
 oily matters act strongly on copper vessels, it would be well to 
 avoid using such vessels in preparing articles of food containing 
 any of these matters. Milk, tea, coffee, beer, and many of the 
 more common articles of diet, have been boiled in copper vessels 
 without becoming impregnated with the poison. Sulphate of 
 copper has been used to promote the fermentation of dough, to 
 decolorize sugar, and to give a green color to pickles. So also 
 has the arsenite of copper been used to color sweetmeats." 
 
 LEAD. 
 
 It is very rare indeed that the salts of lead have been made 
 use of for the purpose of intentional poisoning. It is rather in 
 its connections with medical police, that it becomes an interest- 
 ing subject of inquiry. It is used so much in the arts, and its 
 effects, as a slow poison, are so frequently presented, that the 
 medical jurist must feel under the necessity of making himself 
 
374 MEDICAL JURISPRUDENCE. 
 
 acquainted with it. AH the remarks to be submitted in relation 
 to this substance, may be embraced in considering — 
 
 1 . Its compounds or preparations : 
 
 2. Its tests : 
 
 3. The symptoms it developes : 
 
 4. The post-mortem appearances it causes : 
 
 5. Its treatment : 
 
 6. Its use for cuhhary and other domestic purposes. 
 1 . Its compounds or preparations : 
 
 The metal itself possesses no poisonous properties. As it in 
 readily acted on by acids, it cannot be taken into the stomach 
 without hazard, as it may become poisonous by combining with 
 its contents. The compounds of lead, which are of the most 
 frequent use in the arts, are litharge, red lead, white lead, sugar 
 of lead, and Goulard's extract. The three first are much used 
 by house painters and glaziers, and the two last, extensively em- 
 ployed in surgery. The two, however, which the medical jurist 
 is the most interested in becoming acquainted with, are white 
 lead, (which is the carbonate of the metal,) and sugar of lead, 
 (which is the acetate.) The first is exhibited in the form of a 
 heavy snow-white powder, or in white, chalk-like masses ; and 
 the second, in the form either of a white, heavy powder, or of 
 aggregate masses of long, four-sided prismatic crystals. The 
 first is insoluble in water, but soluble with effervescence in nitric 
 acid. The second is very soluble in water, has a slight odor of 
 vinegar, and a sweetish astringent taste. 
 
 3. Its tests. White lead may be known by its being blackened 
 by sulphuretted hydrogen; by its being soluble with efferves- 
 cence in nitric acid, while it remains insoluble in water, unless 
 it contain free carbonic acid ; and by its becoming permanently 
 yellow when heated to redness, in consequence of the expulsion 
 of its carbonic acid, and its conversion into protoxide. 
 
 Sugar of lead, in a fluid state, may be detected, by the follow- 
 ing reagents, viz : Sulphuretted hydrogen, chromate of potass, hy- 
 driodate of potass, and metallic zinc. The first mentioned causes 
 a black precipitate, which is the v - sulphuret of lead. This acts 
 upon the metal, whether it be in a fluid or solid state. The sec 
 
poisons. 61b 
 
 ond causes a fine gamboge-yellow precipitate, the cliromate of 
 lead. The third causes also a lively gamboge-yellow precipitate, 
 which is the iodide of lead. The third, in case the solution of 
 lead is not too diluted, if held for some time in it, displaces the 
 lead, taking its place in the solution, the lead being deposited in 
 the form of a crystalline arborescence. Christison on Poisons, 
 473-4. 
 
 It must not, however, be taken for granted, that lead, when 
 in combination with animal and vegetable matters, can be de- 
 tected by the application of each one of these tests. 
 
 The salts of lead may be decomposed by vegetable or animal 
 matters, or those matters may alter the action of the re-agents. 
 Many vegetable infusions possess, more or less, the power of de- 
 composing; so also do almost all animal fluids. Where the de- 
 composition is not effected, the color of the precipitate is materi- 
 ally altered. The sulphuretted hydrogen should be excepted 
 from these remarks, as that may be so applied as to detect lead 
 in all possible states of mixture. Christison, 475. 
 
 Accordingly, to detect the salts of lead in organic liquids, the 
 method prescribed is to "add to the suspected liquid a little 
 nitric acid, to boil, and then filter it ; to transmit sulphuretted 
 hydrogen gas through the filtered liquid. If a salt of lead be 
 present, a black precipitate will be formed. If no precipitate 
 falls when the liquid is treated in this manner, collect the solid 
 matters remairing on the filter, incinerate, dissolve the ash in 
 nitric acid, dihte and filter the resulting liquid, and transmit 
 the sulphurettet hydrogen gas as before." Guy, 633. 
 
 If a black precipitate is thus obtained, it may be proved to 
 contain lead, eitier 
 
 1 . By placing 'he dried precipitate on a fragment of charcoal, 
 and reducing themetal by the blow-pipe : or, 
 
 2. By exposing the sulphuret to a red heat in a tube open at 
 both ends, to bun off the sulphur, treating it with strong nitric 
 acid, and diluting the resulting solution with distilled water; 
 then filter the solution, evaporate to dryness, and gently heat in 
 order to expel the excess of nitric acid. Dissolve the residue in 
 
376 
 
 MEDICAL JURISPRUDENCE. 
 
 distilled water, and it will give the characteristic reactions (if 
 lead. Ghiy, 633 ; Christiscn, 504. 
 
 3. The symptoms it developes : 
 
 It has been a matter of considerable controversy, whether lead 
 is to be found in the fluids and solids of men and animals who 
 have died of it, or have labored under its effects. The result 
 seems to be, that some have been able to detect it, while others 
 have failed to do so. The positive evidence of those who have 
 detected it, would seem to establish the fact, that it is Occasion- 
 ally found in animal fluids arid solids. Chrislison oi Poisons, 
 507-8-9. J 
 
 Although all the preparations of lead are poisonous, except 
 perhaps the sulphuret, yet it seems probable that irri/ant poison- 
 ing can only be produced by those compounds which/are soluble, 
 such as the acetate, sub-acetate, and nitrate. 
 
 The preparations of lead produce in man three kinds of symp- 
 toms : One indicates inflammation of the alimentary canal j 
 another, spasm of its muscles ; and a third, injury of the ner- 
 vous system, apoplexy or palsy. Each of these ipy exist inde- 
 pendent of the other. 
 
 The acetate of lead, in large doses, either give? rise to symp- 
 toms of simple irritation, or to those of inflammation, united 
 with the spasmodic cholic of lead. The differait preparations 
 of lead are weak irritant poisons, and require to pe given in large 
 doses to produce any symptoms immediately dangerous. The 
 most interesting cases of poisoning by lead, arejthose which are 
 induced slowly, by the long continued use of Its preparations, 
 which have been gradually introduced into the system, in minute 
 quantities. Hence results the painters' coli$ or colica picto- 
 num, and lead palsy. 
 
 The former may be divided into two stages,bf which the first 
 consists in an affection of the alimentary can 1, and its leading 
 feature is a severe colic. The uneasiness, a; first confined to 
 the stomach, soon stretches through the wholeabdomen ; cramps 
 commence in the pit of the stomach, which soon extend to the 
 rest of the abdomen. The pain is sometimes constant, some- 
 times subject to intermissions. It is general/ relieved by pres- 
 
poisons. 377 
 
 sure. The abdomen is hard, the abdominal muscles contracted, 
 and the navel is often drawn in so as almost to touch the spine. 
 A great degree of costiveness generally prevails, there being 
 either no discharge, or one consisting of scanty knotty fseces. 
 The effect on the urine is to diminish it, but the saliva is increas- 
 ed in quantity, and observed to possess a bluish color. Christi- 
 son, 513-14. 
 
 The limbs are generally racked with cutting pains, either from 
 the beginning, or after a- few hours or days. The countenance 
 appears dull, anxious and gloomy ; the skin becomes bedewed 
 with a cold perspiration ; the breathing quick and catching ; the 
 pulse sometimes accelerated, but more generally retarded. 
 
 This first stage may terminate in three ways. The first is in 
 a recovery, the same as from an ordinary colic ; and if it be the 
 first attack, it is likely, under judicious management, to termi- 
 nate in this manner. 
 
 A second termination occurs in violent and neglected cases, in 
 which the colic in a few days becomes attended with giddiness, 
 great debility, and torpor. The torpor sometimes deepens into 
 coma, attended with convulsions, from which very few recover. 
 
 A third termination takes place in the departure of the colic, 
 leaving the patient in a state of extreme debility, which amounts 
 to a partial palsy, more or less complete. The palsy affects 
 cu."efiy the upper extremities, and is attended with excessive 
 mv. cular emaciation. It is of a very peculiar character. The 
 loss if power, as well as of substance, prevails to the greatest ex- 
 tent in the muscles which supply the thumb and fingers, the ex- 
 tensers suffering much more than the flexors. The paralysis is 
 hardly ever complete, the hands are constantly bent,. except 
 when the arms hang straight down by the side. Whenever the 
 patient moves, they dangle loose. He is unable to extend them, 
 or to raise one without the aid of the other. He has racking 
 pains in the limbs and arms, and feeble digestion. From this 
 state, restoration is possible, but a fresh and fatal attack is likely 
 to supervene from a fresh exposure. 
 
 The habitual application of lead to the body, whether by in- 
 haling its fumes ; by the continuous contact of its compounds 
 
378 MEDICAL JURISPRUDENCE. 
 
 with the skin ; by the using them for a long time as medicines, 
 or applying them as unguents and lotions ; and the introduction 
 of them for a length of time with food, may all sooner or later 
 produce the colica pictonum. Christiscn on Prisons, 516. 
 Those who are the most subject to it are — 
 
 1. Miners of lead. They are less liable since the employment 
 of proper precautions for removing the danger : 
 
 2. Manufacturers of litharge, red lead, and white lead : 
 
 3. House painters, on account of the preparations of lead con 
 tained in the paints made use of by them : 
 
 4. Plumbers, sheet lead manufacturers^ and lead pipe makers 
 
 5. Glass blowers, glaziers and potters, who use the oxide oi 
 lead in their respective manufactures. These last are not gene- 
 rally subject to it. 
 
 The disease can generally, if not always, be avoided by a resort 
 to prudential measures, among which is the enforcement of clean- 
 liness. The substitution of moist for dry grinding of lead, has 
 had the effect greatly to diminish the amount of the disease. 
 
 There is one symptom which is said to be characteristic of the 
 action of lead on the system, and one that is rarely absent Avhere 
 marked symptoms of lead poisoning are present, and that is a 
 blue line on the gums around the margin of the teeth. Guy's Prin- 
 ciples of Forensic Medicine, 634. 
 
 4. The post-mortem appearances it causes. In one case of 
 acute poisoning by a compound of lead the following were the 
 morbid appearances : 
 
 The lower end of the gullet, the whole stomach and duodenum, 
 a part of the jejunum, and the ascending and transverse colon, 
 were greatly inflamed. The villous coat of the stomach appeared 
 as if it had been macerated. The stomach contained six ounces 
 of a reddish brown fluid, which had a sweetish, styptic, metallic 
 taste, exhaled the odor of vinegar while evaporating, and yielded 
 globules of lead when the dry residue was subjected to the pro- 
 cess of reduction. Christison, 521. 
 
 In colica pictonum there are no appearances of inflammation 
 presented. Its peculiarity consists in an unusual constriction of 
 the large intestines. The mucous coat is generally found healthy, 
 
poisons. 379 
 
 the disease probably affecting the muscular coat only. Some- 
 times no morbid appearance is presented. In lead palsy the 
 affected muscles are found pale and flaccid, and when the disease 
 has been of long continuance they resemble white fibrous tissue. 
 Guy, 635. 
 
 5. Its treatment. The antidotes to the compounds of lead are 
 the soluble alkaline or e&rthy sulphates. The sulphates of soda 
 or magnesia should be freely administered, dissolved in water. 
 Vomiting should be excited by the sulphate of zinc, and warm 
 water should be given. Also milk and white of eggs. The phos- 
 phate of soda is also an antidote. 
 
 6. Its use for culinary and other domestic purposes. Lead has 
 been extensively used in the construction of pipes and cisterns 
 for conveying and holding water. Ill effects have sometimes re- 
 sulted from its use. It becomes, therefore, important to ascer- 
 tain what kind of action air and water exert upon the metal. 
 Air tarnishes lead from its oxidation, and also from the formation 
 of a thin crust of carbonate of lead. In relation to water it seems 
 settled that distilled water, deprived of all its gases by boiling, 
 and excluded from the air, has no action on lead. When distil- 
 led, or very soft water, is placed in contact with lead, the air 
 having also free access, a white powder collects around the metal, 
 which continues to increase, until white, pearly scales are formed, 
 which either float or fall to the bottom of the vessel. Guy, 635. 
 Various saline substances held in solution in the water prevent 
 the formation of this powder, the carbonate of lead. All the 
 neutral salts possess this power, more especially the sulphate of 
 lime. The general result is stated to be — that neutral salts in 
 various, and very generally, in minute proportions, retard or 
 prevent the corrosive action of water on lead ; allowing the car- 
 bonate to deposit itself slowly, and to adhere with such firmness 
 to the lead, as not to be afterwards removable by moderate agi- 
 tation ; adding subsequently to this crust other insoluble salts of 
 lead, the acids of which are derived from the neutral salts in so- 
 lution, and thus at length forming a permanent, and impermeable 
 skreen, through which the action of the water cannot any longer 
 be carried on. Christison on Poisons, 483. 
 
380 MEDICAL JURISPRUDENCE. 
 
 It will thus be seen, that the danger arising from bringing 
 water into contact with lead increases according to the purity of 
 the water, and to render the use of lead safe, it is necessary to 
 mix a quantity of saline matter with the purer kinds of water. 
 Some kinds of river water contain a sufficiency of saline matter 
 to render the use of lead safe, while some degree of danger always 
 attends its employment to collect or preserve rain or snow water, 
 or even spring water of unusual purity. The danger is much 
 increased by covering the cisterns with leaden lids, as the pure 
 water then rises by a natural process of distillation, and collects 
 on the lid. Rain or snow water for culinary use, should not be 
 collected on leaden roofs, nor preserved nor conveyed in lead. 
 
 Whenever, by the contact of some other metal with the lead, 
 or of the solder employed upon it, a galvanic action is excited, 
 it will neutralize all the preservative effects of saline matter. So 
 also the same counteracting power will be exerted by carbonic 
 acid if present in the water. The use of lead at all, in connection 
 with water, must always be attended with more or less danger. 
 Guy, 636. 
 
 Lead may be dissolved by vegetable acids and fatty substances, 
 and hence acescent fruits, or liquors, or fatty matter, should not 
 be kept in vessels made of that metal, or glazed with its oxide.- 
 By these means, sour milk, cider, wine, and rum have come to 
 possess poisonous properties. Guy's Principles of Forensic Medi- 
 cine, 636. 
 
 In regard to antimony, there are two of its salts that are poi- 
 sonous, viz., tartar emetic and butter of antimony. The first is 
 found in the form of a white powder, or of yellowish white efflo- 
 rescent crystals. The second is a corrosive liquid, of a light yel- 
 low, or dark red color ; yielding with sulphuretted hydrogen, 
 the orange red precipitate of the salts of antimony. 
 
 The tartar emetic in solution is distinguishable from all other 
 metals, by the effect of sulphuretted hydrogen, or hydro-sulphuret 
 of ammonia, which throws down an orange red precipitate. All 
 vegetable substances containing tannin, decompose the salts of 
 antimony. 
 
 Antimony is absorbed, and may be found in the secretions, in 
 
' poisons. 381 
 
 the blood, and in the solid viscera of the body. A large dose of 
 tartar emetic produces nausea, vomiting, pain and tenderness of 
 the epigastrium, extending to the whole abdomen, constriction 
 of the throat, and severe cramps of the extremities. 
 
 The morbid appearances after death are those of inflammation, 
 in various degrees, in the mucous membrane of the stomach, and 
 duodenum. 
 
 The best antidote is a decoction of cinchona bark ; and when 
 this is not readily obtainable, the powder, or what is more effect- 
 ual still, the tincture. Also any thing containing tannin, such as 
 tea, or decoction of oak bark may be used as an antidote. Chty's 
 Principles of Forensic Medicine, 640. 
 
 Vegetable Irritants : 
 
 This embraces a numerous class of substances, such as aloes, 
 colocynth, gamboge, jalap, scammony, castor oil seeds, croton oil, 
 &c, which are used in small doses as medicines, but which, in 
 large doses, either alone or in combination, may prove fatal. 
 They are seldom resorted to for criminal purposes, and are, 
 therefore, very seldom the subjects of strict medico-legal enquiry. 
 Their mode of action, the symptoms developed by them, and the 
 morbid appearances remaining, are nearly the same in all. 
 
 The poisonous property in some plants resides in a pecular 
 resin ; in others in a peculiar fecula or extractive matter ; in 
 others in an oil ; in others in an alkaloid ; and in others in a 
 neutral crystalline matter. Some of these principles appear to 
 act through the medium of the blood. Others produce an in- 
 flammation of the subcutaneous cellular tissue, and also of the 
 stomach and intestines, without entering the blood. Christison 
 on Poisons, 536 - 7. 
 
 The symptoms are chiefly those which indicate inflammation 
 of the villous coat of the stomach and intestines. They generady 
 excite vomiting when taken in large doses. There is also not 
 unfrequently a diarrhoea, both being attended by twisting pain 
 of the belly, at first remittent, but becoming more constant as 
 the inflammation becomes more strongly marked. There is 
 often tension, fulness, and tenderness, of the belly. There is 
 generally excessive weakness ; sometimes, although not frequent- 
 
382 MEDICAL JURISPRUDENCE. 
 
 ly, giddiness, and a tendency to delirium. Tenesmus and stran- 
 gury are often present, and the patient sometimes falls into a 
 state of collapse. 
 
 The morbid appearances are a redness of the stomach, more 
 or less deep, ulceration of its villous coat, redness of the intes- 
 tines, especially of the rectum and colon, which often exhibit an 
 inflamed appearance when the small intestines are not visibly 
 affected. 
 
 The treatment consists in the free use of diluents, in the ad- 
 ministration of emetics when vomiting is absent, in local or gene- 
 ral blood-letting when the inflammatory symptoms run high, and 
 in stimulants or narcotics if collapse or nervous symptoms are 
 present. Guy's Principles of Forensic Medicine, 644. 
 
 There is no necessity of dwelling upon the particular poisons 
 embraced in this class. There is one, however, the administra- 
 tion of which has several times been made a matter of judicial 
 investigation. That is the lobelia or Indian tobacco, which is a 
 violent acrid irritant, and has occasioned several deaths by its 
 improper administration. In the case of the Commonwealth vs. 
 Thompson, 6 Mass. Rep., 134, the defendant was indicted for the 
 murder of Ezra Lovett, by administering lobelia. The deceased 
 was simply confined by a cold when he sent for the defendant, 
 who professed to cure diseases upon a new principle, and had 
 several different substances, one of wnich he called his coffee, 
 another well-my- gristle, and another ram-cats. He commenced 
 by giving the powders of lobelia, which he kept up for several 
 days, until they ceased to operate. He still continued to admin- 
 ister them, until the patient lost his reason, and became con- 
 vulsed, so that it required two men to hold him. Two more 
 powders were forced down, soon after which he expired. 
 
 There was no doubt but that the administration of the drug 
 caused the death of the deceased, but the defendant was acquitted 
 on the ground that no malice was shown, his intention being to 
 cure the patient. 
 
 A case also occurred in New -York, in 1837, in which lobelia 
 was administered both by mouth and injection ; besides, the 
 power of steam was applied, and large quantities of " composi- 
 
poisons. 383 
 
 tion tea" given. The result of this course was, that inflamma- 
 tion of the stomach, bowels and brain was induced ; delirium, 
 with great prostration, took place, and the patient finally sank, 
 exhausted. The defendant was found guilty, and sentenced to 
 fine and imprisonment. 
 
 Animal Irritants : 
 
 The most prominent on the list of animal irritants is cantkari- 
 des. This has seldom, if ever, been used for the purpose of com 
 miting murder. It has been resorted to as a means of procuring 
 abortion, and given for the purpose of exciting aphrodisaic pro- 
 pensities. The form in which it is administered is either in the 
 state of powder or tincture. 
 
 It may frequently be detected in the stomach by its gliste- 
 ning green color. Another method of detecting it is, to dis- 
 solve it in ether, evaporate it to the thickness of an extract, and 
 apply it to the skin. If a blister is the result, it affords convinc- 
 ing evidence of its being cantharides. 
 
 The symptoms it produces are those of a violent irritant poi- 
 son. It causes a burning sensation in the throat ; pain and great 
 difficulty in swallowing ; dryness of the fauces, accompanied by 
 severe thirst ; a burning pain at the pit of the stomach, increased 
 by pressure, and extending at length over the whole abdomen ; 
 nausea, and discharges of bloody mucus from the stomach, mixed 
 frequently with shining green particles ; pain in the loins, tenes- 
 mus, strangury, bloody urine, priapisma and swelling, and inflam- 
 mation of the genital organs. The patient becomes restless, the 
 breathing laborious, the pulse quick and hard. Sometimes head- 
 ache, delirium and convulsions are superadded. Another occa- 
 sional symptom is salivation. Taylor, 191 ; Guy, 647-8. 
 
 In the form of tincture, it has been resorted to for the purpose 
 of removing sexual inability on the part of the male, and even 
 for barrenness in the female. For these purposes, from one to 
 two or three drachms daily have been given, and even to the ex- 
 tent of one ounce within the twenty-four hours, is said to have 
 been taken for several days in succession, and yet to have pro- 
 duced no evil consequences. Guy's Prin. of Form. Med., 649. 
 
 As to the q iantity"required to Produce a fatal result, the 
 
381 MEDICAL JURISPRUDENCE. 
 
 smallest quantity of the tincture is one ounce ; but, it seems well 
 settled, that no rule can be laid down as to the quantity that may 
 prove injurious, some being but little affected by large do^es, 
 while others are extremely susceptible to the smallest quantity. 
 It will operate as a poison when applied externally to a wound or 
 ulcer. 
 
 The post-mortem appearances show an inflammatory state of 
 the whole alimentary canal, from the mouth downwards, as well 
 as of the ureters, kidneys and internal organs of generation. The 
 mouth and tongue have been found deprived of their mucous 
 membrane. The brain has been found in a congested state. The 
 powder has been sometimes found in the stomach for a long pe- 
 riod after death ; in one case, after an interment of nine months . 
 
 In regard to treatment, there is no antidote to this poisor . 
 Vomiting should be excited and encouraged by emetics and wanii 
 liquids. Diluents should be used freely, with oily or demulcent 
 injections into the rectum and bladder, and leeches or bleeding, 
 if the inflammatory symptoms run high. Guy, 648. 
 
 There are some kinds of fish belonging to the irritant poisons. 
 A few are always poisonous, while others are only occasionally 
 so, and others still only affect certain persons. The most com- 
 mon example of the poisonous fish is the common muscle ; which, 
 after an interval of one or two hours, causes an eruption on the 
 skin, attended with intense heat and itching, dyspnoea, extreme 
 weakness, and, in fatal cases, very frequently delirium, convul- 
 sions and coma. 
 
 The treatment consists in the free use of emetics, cathartics, 
 and diluents. Guy, 649. The halibut, crab, lobster, mackerel, 
 &c, have been occasionally known to cause violent attacks of 
 cholera-morbus, or symptoms of acrid, irritant poisons. 
 
 Very severe and dangerous symptoms, nearly allied to those 
 of irritant poisoning, have been caused by eating decayed animal 
 matter. Those articles which have the most frequently acted as 
 poisons are sausages, bacon, cheese, and goose-grease. Guy, 650. 
 The symptoms rarely come on until after the lapse of three or 
 four hours. They are sometimes accompanied by narcotic symp- 
 toms. The poisonous quality of the food developes itself only in 
 
poisons. 385 
 
 ihe first stage of putrefaction, and disappears when that process 
 is far advanced. " The milk of cattle fed in particular pastures, 
 containing poisonous plants, is said to acquire poisonous proper 
 ties, just as the honey of bees, which feed on certain poisonous 
 flowers, produces delirium and symptoms of narcotic poisoning/' 
 Guy, 651. 
 
 There are also certain gases that belong to the irritant class of 
 poisons. The most prominent of these are the nitrous acid gas, 
 chlorine, and ammonia. The first mentioned, when in a concen 
 trated state, destroys life by exciting violent inflammation in the 
 lungs. A chronic form of the disease is sometimes produced bi 
 its daily inhalation, when mixed with common air, in those who 
 work at brass finishing and water gilding. 
 
 The second class embraces the 
 
 NARCOTIC POISONS. 
 
 » 
 
 Narcotic poisons are all those substances which chiefly or sole- 
 ly produce symptoms of disorder of the nervous system. By 
 entering the blood vessels, they act on the brain or spine, or both. 
 It has been alleged by some, that they produce on the inner coats 
 of the blood vessels a peculiar impression, which is conveyed to 
 the center of the nervous system along the nerves. 
 
 The usual symptoms characterizing the action of the narcotic 
 poisons are, giddiness, headache, obscurity or depravation of 
 sight, stupor or perfect insensibility, palsy of the voluntary mus- 
 cles, or convulsions of various kinds, and at last, complete coma. 
 Christison, 607 ; Guy, 654. 
 
 The morbid appearances left in the body are generally insig- 
 nificant. The vessels of the brain are sometimes gorged with 
 blood, the ventricles and membranes containing serosity. Ex- 
 travasation of blood has been an occasional, although very rare, 
 occurrence. 
 
 There are several diseases, the symptoms of which are very 
 liable to be confounded with the action of narcotic poisons. 
 Among these, that which is perhaps the most common is, 
 
 Jlpoplexy. 
 
 This disease, with the exception of the nervous or simple kind, 
 
 35 
 
386 MEDICAL JURISPRUDENCE. 
 
 arises from congestion or effusion of blood within the cranium. 
 The symptoms common to it, and to some of the narcotic poi- 
 sons, are a more or less complete abolition of sense, and the 
 power of motion, combined frequently with convulsions. 
 The means of distinguishing are the following : 
 
 1 . Apoplexy is sometimes, although not always, preceded by 
 warning symptoms, such as giddiness, headache, ringing in the 
 ears, depraved vision, or partial palsy. The action of narcotics 
 is never preceded by any precursory symptom. 
 
 2. Apoplexy attacks men more frequently than women, and 
 generally old persons, or persons over thirty years of age, while 
 narcotic poisoning is fully as much or more likely to occur in the 
 case of young than old persons. 
 
 3. Apoplexy is much the most likely to occur among fat 
 people, not that there is perhaps any close connection between 
 the two, but the same circumstances, viz., great strength, vigo- 
 rous constitution, and good digestive powers, predispose both to 
 corpulency and apoplexy. 
 
 4. Where a meal is the exciting cause, the symptoms of apoplexy 
 generally begin immediately after, or not unfrequently,* during its 
 continuance. This is rarely the case when the common narco- 
 tics have been administered as poisons. An interval of ten, fif- 
 teen, twenty, or even thirty minutes, in the case of opium, al- 
 ways occurs. So, also, if the symptoms are delayed beyond one, 
 or at furthest two hours, after anything has been taken, it is 
 hardly possible they can be owing to opium ; or if beyond four, 
 to any narcotic poison. 
 
 5. The symptoms of apoplexy generally begin abruptly, some- 
 times commencing at once with deep sopor. Those produced by 
 the narcotic poisons advance gradually, except in the instances 
 of the hydrocyanic acid and the narcotic gases. 
 
 6. Apoplexy sinks the patient into so profound a sopor, that 
 it is rarely possible to rouse him to a state of consciousness. In 
 poisoning with the common narcotics, the patient may be roused 
 trom the deepest lethargy. A loud voice, or forcible striking, 
 or the injection of water into his ear, is generally sufficient for 
 that purpose. 
 
poisons. 387 
 
 7. In apoplexy, convulsions are common ; in poisoning with 
 opium, very rare. So, also, the countenance is much more com- 
 monly bloated in apoplexy, than in the case of narcotic poison- 
 ing. The pupil of the eye is dilated in apoplexy, and generally 
 contracted in the case of poisoning with opium. 
 
 8. The eighth point of difference regards the duration of the 
 symptoms. Few cases of narcotic poisoning last beyond twelve 
 hours, the most common time in which they prove fatal being 
 six or eight hours. Apoplexy often lasts a whole day, or longer ; 
 or apoplexy sometimes proves rapidly fatal, destroying life im- 
 mediately, or in a few minutes, much sooner than any of the 
 narcotic poisons, except the hydrocyanic acid and the narcotic 
 gases. The shortest period of time in which opium has been 
 ever known to destroy life, is three hours. 
 
 There is also considerable difficulty in distinguishing the post- 
 mortem appearances caused by apoplexy, and those produced by 
 the narcotic poisons. There are several different kinds of apo- 
 plexy. Of these kinds, simple, or what has frequently been called 
 nervous apoplexy, occasions death without leaving any sign in the 
 dead body. Its occurrence, however, is very rare, and more espe- 
 cially in those who are in the enjoyment of perfect health. It 
 seldom, if ever, occasions death in less than five hours. 
 
 Another kind is congestive, which may leave in the dead body 
 no other sign than congestion of vessels within the head. This 
 is also regarded by many as the common effect of narcotic poi- 
 sons. There is nothing here, therefore, that can be termed dis- 
 tinctive ; but it has been remarked, that this kind of apoplexy 
 seldom if ever destroys life, except after an interval of nearly a 
 day at least after its first attack ; so that this feature might serve 
 to distinguish. 
 
 Serous apoplexy may produce serous effusion on the external 
 surface, or, in the ventricles of the brain. Such effusion is fre- 
 quently the termination of some inflammatory disease of the 
 brain, but does also occur in connexion with pure apoplexy. 
 When it is preceded by decided apoplectic symptoms, the disease 
 is always of several days duration. 
 
 Apoplexy from extravasation leaves its traces m extravasation 
 
388 MEDICAL JURISPRUDENCE. 
 
 of blood within the head. This is the most common kind of 
 apoplexy, and is that which narcotic poison rarely imitates. An 
 apoplectic cell, or cavity containing blood in ihe brain, should 
 not always be set down as the cause of death. A recovery may 
 take place, and the cell nevertheless remain full. It is only when 
 the blood contained in the cell is recent, or when it is surround- 
 ed by the signs of recent inflammation, that it may be assumed 
 with certainty to have been the occasion of death. Christison on 
 Poisons, 617. 
 
 Another disease liable to be confounded with narcotic poison- ' 
 ing, is Epilepsy. 
 
 In this there occurs an abolition of sense, accompanied by 
 convulsions. The symptoms developed by the hydrocyanic acid, 
 and some of the narcotic gases, bear the nearest resemblance to 
 this disease. Some of the narcotico-acrid poisons also bear, in 
 their effects, a resemblance to the same disease. These are bella- 
 donna, stramonium, hemlock, camphor, &c. 
 
 The circumstances principally relied upon to distinguish be- 
 tween an epileptic fit and narcotic poisoning, are the following : 
 
 1 . The epileptic fit is sometimes, but not always, preceded by 
 certain warnings, such as stupor, a sense of coldness, or creep- 
 ing, or of a gentle breeze proceeding from a particular part of 
 the body towards the head. Christison on Poisons, 618. 
 
 2. The symptoms of epilepsy begin violently and abruptly ; 
 those of the narcotic poisons, with the exception of the hydro- 
 cyanic acid, the narcotic gases, and a few rare alkaloids, always 
 begin gradually. 
 
 3. In epilepsy, the patient cannot, in general, be roused by 
 external stimuli. In cases of narcotic poisoning, this is almost 
 always practicable. 
 
 4. In death from epilepsy, the paroxysm generally lasts long, 
 sometimes more than a day ; and, unless there have been several 
 previous fits, it may be said never to prove fatal in less than 
 several hours. The lapse of time, therefore, shows effectually, 
 that the death cannot proceed from hydrocyanic acid or the nar- 
 cotic gases, and renders it extremely improbable that it is the 
 result of opium. 
 
poisons. 389 
 
 5. Epilepsy never proves fatal in the first paroxysm. The 
 poison whose symptoms the most resemble epilepsy, is the hy- 
 drocyanic acid, and that can be generally detected by its smell. 
 
 In relation to morbid appearances, there seems to be none pe- 
 culiar to epilepsy. The brain, in epileptics, is often found ex- 
 tensively diseased. Tumors may be found in it, excrescences, 
 concretions, or abscesses. The fit may also be produced by ir- 
 ritation in distant organs, as worms in the intestines of children, 
 teething, &c. In some cases, no decided morbid appearance can 
 be found in the body. It is only to cases of epilepsy that prove 
 fatal during the fit, that the attention need to be directed ; and 
 few, if any, such cases ever occur without leaving some distinct 
 trace in the organization. 
 
 There are other diseases that fasten on the brain, such as men- 
 ingitis, or inflammation of its inner membranes ; inflammation, 
 and hypertrophy of the brain itself. But there is little necessity 
 of dwelling upon these. The first is gradual in its progress, 
 well marked, and less rapid than the common cases of narcotic 
 poisoning ; and the tracos remaining in the dead body, such as 
 effusion of serum, lymph, or pus, will render very obvious the 
 cause of death. There is one form of it, in which the symp- 
 toms may lead to some doubt and difficulty, but this is of un- 
 frequent occurrence, and an examination after death will gene- 
 rally disclose the fact whether it be due to such a cause or not. 
 
 In common inflammation of the brain, the course is much 
 slower than that of narcotic poisoning, as it seldom proves fata] 
 in less than several days. But to this there are some exceptions 
 where it proves instantly fatal. 
 
 There are some diseases of the spinal cord which may resem- 
 ble narcotic poisoning, but they are exceedingly rare ; and, if 
 nothing else, the traces they leave in the dead body are generally 
 a sufficient indication. 
 
 To any one who thoroughly examines the subject, it must be 
 apparent, that where all the circumstances are taken into con- 
 sideration, there can be little difficulty in distinguishing between 
 these several diseases, and a case of narcotic poisoning. 
 
 The substances that come under the head of narcotic poisons 
 
390 MEDICAL JURISPRUDENCE. 
 
 are derived almost entirely from the vegetable kingdom. The 
 poisonous property they possess, is owing to a peculiar principle 
 which is probably of an alkaline nature, and which slightly dif- 
 fers in each. The principle is an energetic one, and in it is con- 
 centrated all the leading properties of the drug from which it is 
 procured. w 
 
 Chemical analysis, so much relied upon to disclose the truth in 
 cases of irritant poisoning, is a very inadequate source of evi- 
 dence in those of narcotic. The reasons are, that the chemical 
 properties of most of the narcotics are not very characteristic ; 
 and besides, they are not well developed unless with a larger 
 quantity of the poison than will usually be met with in medico- 
 legal investigations. Christison on Poisons, 630. 
 
 OPIUM. 
 
 This substance not only stands at the head of the narcotic 
 class, but appears to be more frequently resorted to than any 
 other poison. It is the' most frequently made use of for the pur- 
 pose of suicide ; occasionally, although seldom, for that of mur- 
 der. It has been often the source of fatal accidents, and has 
 been employed to induce stupor previous to the commission of 
 robbery. It presents, on many accounts, an interesting subject 
 for investigation, and one with which the medical jurist should 
 become intimately acquainted. 
 
 Opium is the inspissated juice of the poppy. Its color is red- 
 dish brown ; its odor strong and peculiar ; its taste bitter and 
 acrid. On account of the latter quality, it cannot easily be ad- 
 ministered secretly, and hence the sense of taste is usually dead- 
 ened by strong spirits before it is administered for the purpose 
 of robbery, theft, or rape. It consists of a number of distinct 
 principles, combined with the meconic acid, with resin, and ex- 
 tractive matters. It is acted on readily by the common solvents. 
 Water and alcohol both dissolve its principles at low tempera- 
 tures. The mineral and vegetable acids also readily dissolve it. 
 
 There are many preparations of opium, the principal of which 
 are its tincture, laudanum, containing one grain in every nineteen 
 drops ; wine of opium, containing one- fifth less than the tincture 
 
poisons. 391 
 
 black drop, containing four times as much as the tincture ; and 
 paregoric, containing opium, camphor, benzoic acid, and oil <f 
 aniseed dissolved in alcohol, having only one grain of opium in 
 every half ounce. There are also some other preparations, which 
 it is unnecessary to notice. 
 
 There are a number of principles contained in opium, by far 
 the most important of which are morphia and meconic acid. 
 Through the properties of these, the opium may be recognized, 
 should its own peculiar properties furnish insufficient evidence 
 
 The quantity of morphia contained in opium varies from two 
 per cent in the Bengal variety, to nine per cent in some of the 
 varieties obtained, from the East Indies. The Turkey opium 
 contains five to ten per cent. This may account, in some de- 
 gree, for the great difference in the effects that are occasionally 
 produced by particular doses ; as its poisonous properties ai e 
 due to the presence of morphia, existing as a soluble salt and 
 combined with the meconic acid. 
 
 The chemical tests for opium are much less satisfactory than 
 those for the irritant poisons. They would even fail altogether 
 in the majority of cases. Few or no traces of opium can be 
 found in the stomachs of those poisoned by it. Guy, 664-5. 
 
 The opium itself is only detected by its smell, and other physi- 
 cal properties, and also by administering it to animals, and wit- 
 nessing its effects. The smell is peculiar, and many times dis- 
 closes the presence of the poison. Taylor's Medical Jurispru- 
 dence, 204. 
 
 From some experiments, by which it appears that the intes- 
 tines of a dog have been paralyzed by applying opium to their 
 mucous coat, and the hind legs of a frog palsied by injecting 
 opium between the skin and the muscles, it is inferred that 
 opium has the power of stupifying or suspending the irritability 
 of the parts to which it is immediately applied. Christison cm 
 Poisons, 645. 
 
 It probably acts constitutionally by entering the blood vessels, 
 and it is by many supposed, that after entering them, it pro- 
 duces on their inner coat an impression which is conveyed along 
 the nerves. It is found to be most of all energetic when intro- 
 
392 MEDICAL JUKISPEUDENCE. 
 
 duced directly into the blood. The next method of introduc- 
 tion, by which it acts the most energetically, is when it is applied 
 to the surface of a wound ; and the next, when it is introdued 
 into the stomach. These facts would seem to prove that the 
 poison must enter the blood before it acts. 
 
 In whatever way introduced, this poison, unlike many others, 
 produces different effects on animals from what it does on man, 
 and even different effects on different tribes of animals. M. 
 Charret announces, as the result of his experiments, that opium 
 produces on animals three leading effects. That one is on the 
 brain, causing a congestion of the blood vessels, inducing a state 
 of sopor ; another is on the general nervous center, acting as an 
 irritant, and exciting convulsions ; a third is on the muscular 
 system, as a direct sedative. While it is poisonous to all ani- 
 mals, including quadrupeds, birds, fishes, reptiles, and even the 
 mollusca, it does not produce in each the above leading effects. 
 In the class mammalia, with the exception of man, it induced no 
 cerebral congestion, but it acts as an irritant, producing convul- 
 sions. In birds, it produces more cerebral congestion, but still 
 its more prominent action is as an irritant and a sedative. 
 
 Its effect on man, in a small dose, is at first stimulating. The 
 head feels a sense of fulness, although usually in a slight degree, 
 and the action of the heart and arteries is increased. Its action, 
 in small doses, is, however, by no means uniform in all cases. 
 The stimulus, to some people, is very agreeable, and may be 
 kept up for a considerable time by repeating small doses fre- 
 quently. Hence the opium-eater, who generally possesses the 
 kind of constitution in which opium developes its effects by ren- 
 dering more brilliant his imagination, exalting his passions, and 
 incieasing his muscular force. Christison, 649. In some consti- 
 tutions, small doses are followed by narcotic symptoms, without 
 any previous stage of excitement. 
 
 When taken in large quantities, so as to prove dangerous, 
 there is generally no previous stimulus, the first effects being 
 giddiness and stupor. The latter increases and deepens until the 
 patient becomes motionless and insensible to external impres- 
 sions. Every appearance indicates the most profound repose, 
 
poisons. 393 
 
 the eyes being shut, and the pupils contracted, the bodj' lying 
 still and the breathing very slow. The features, after a time, be- 
 come ghastly, the pulse feeble and imperceptible, and the mus- 
 cles much relaxed. Death, in such case, soon intervenes, unless 
 assistance is speedily obtained. In case it is, and a recovery 
 takes place, a prolonged sleep usually succeeds the sopor, which 
 is followed by nausea, vomiting, giddiness, and loathing of food. 
 Christison on Poisons, 650. 
 
 One important enquiry regards the time elapsing between the 
 taking of the poison and the commencement of the symptoms 
 This is very various. It will depend much on the quantity 
 taken, and more still, on the form in which it is taken. When 
 swallowed in tincture, and on an empty stomach, it will, if the 
 quantity be considerable, begin to act in a few minutes. A man 
 having taken an ounce and a half of laudanum, was found com- 
 pletely soporose in half an hour. In another case, after two 
 drachms of solid opium were taken, the sopor fairly commenced 
 in fifteen minutes. When taken in a solid form, however, it 
 does not usually begin to operate under half an hour, or even an 
 hour, from the time it was swallowed. There is good reason to 
 suppose that the time would be considerably extended if, when 
 the opium was taken, the person was under the excitement of 
 intoxication from the drinking of ardent spirits. In one case of 
 this kind, five hours intervened before any material degree of 
 stupor was observable. Christison on Poisons , 651. 
 
 The sopor which characterizes the action of opium differs from 
 pure coma, in that the patient is generally capable of being 
 roused ; but, if roused, he will soon return to his lethargic state 
 unless the exciting power is constantly kept up. If no relief is 
 obtained, it becomes more and more difficult to rouse and restore 
 consciousness, until a state of coma may supervene. 
 
 Convulsions are not frequent, but are occasionally present 
 Sometimes, they alternate with stupor ; at others, they constitute 
 the most prominent symptom ; at times, assuming the form of per- 
 manent spasm, which may affect the whole muscles of the body. 
 
 Another occasional symptom is delirium, which is of rare oc- 
 currence, and may exist either with or without convulsions, 
 
394 MEDICAL JURISPRUDENCE. 
 
 The pulse varies. It is occasionally nearly natural. In the 
 first stage, it is sometimes full and accelerated. Frequently, it 
 is slower, and rather full than feeble. When convulsions occur, 
 it is hurried ; and becomes slower as the patient approaches to 
 coma. 
 
 The respiration is slow, sometimes even stertorous, but this is 
 not common. More frequently, it is gentle, so much so, that, at 
 times, it can hardly be perceived. 
 
 The pupils are sluggish in their contractions, often insensible, 
 contracted, and occasionally to an extreme degree. 
 
 The countenance generally has a placid expression, resembling 
 that of sleep. Occasionally, it exhibits anxiety mingled with 
 stupor. It is commonly pale, but sometimes appears flushed. 
 
 In regard to the secretions, perspiration is generally promoted, 
 but the excretion of urine and faeces is more commonly suspend- 
 ed. But, although generally there is a constipation of the bowels, 
 yet, in some rare cases, a diarrhoea has been induced. 
 
 It may become material, in reference to distinguishing it from 
 natural disease, as apoplexy or epilepsy, to ascertain the ordinary 
 duration of a fatal case of poisoning. This is usually from seve, n 
 to twelve hours. A recovery generally takes place in those who 
 outlive twelve hours. But cases have proved fatal in fifteen and" 
 seventeen hours, and one even in nearly twenty-four hours. 
 There are, also, many cases that prove fatal in less than seven 
 hours ; some in six, some in five, in four, and one even in three, 
 which appears to be the shortest authenticated one on record. 
 
 In relation to the quantity required to prove fatal, there is 
 great diversity. It varies much with circumstances. The small- 
 est quantity that has proved fatal in an adult is four and a half 
 grains. On the other hand, some enormous quantities have been 
 taken, and yet a recovery been had. In one case, no less than 
 eight ounces of solid opium were taken, and yet the person re- 
 covered. Comparatively small doses of opium operate fatally 
 upon some, owing to a peculiarity of constitution. The power 
 of habit possesses a very considerable influence in delaying its 
 action upon the system accustomed to it. 
 
 The morbid appearances caused by opium are, in general*, 
 
poisons. 395 
 
 neither constant nor well marked. In a case that might be called 
 an extreme one, all the sinuses and vessels of the brain were 
 gorged with fluid blood, and. a quantity of serosity was found in 
 the ventricles and base of the skull. The pharynx was red ; the 
 lungs distended and gorged with fluid blood ; the cavities of the 
 heart contained the same fluid blood ; the villous coat of the 
 stomach and intestines exhibited some degree of redness. 
 This is an extreme case ; but the appearance the most generally 
 met with is, turgescence in the vessels of the brain, and watery 
 effusion into the ventricles and on the surface of the brain. 
 Neither of these, however, are by any means universal. Extra- 
 vasation of blood is a possible, although a very rare effect of 
 opium ; and, perhaps, never occurs unless the poison happen to 
 develope a disposition to apoplexy. In the bodies of those who 
 have been poisoned with opium, lividity of skin is always more 
 or less present, and sometimes it is excessive. Occasionally, a 
 portion of the poison may be found in the stomach; but this is very 
 rare. If taken in tincture, or any liquid form, it will be likely to 
 be absorbed, or if not wholly so, it may be so in part, and partly 
 decomposed by the process of digestion, and this whether it be 
 taken in a liquid or solid form. 
 
 Treatment. Here the first and greatest object is to endeavor 
 to remove the poison from the stomach. This may be accom- 
 plished in one of three ways. 1. By emetics. 2. By the stomach- 
 pump. 3. By injection of emetics into the veins. Sulphate of 
 zinc is the emetic recommended. The dose to be repeated after 
 a short interval, in case the first fails to operate. In using the 
 stomach-pump, care must be taken not to injure the stomach by 
 too forcible suction. The injection of tartar-emetic, or a solu- 
 tion of antimony, into the rectum has succeeded in exciting 
 vomiting. So, also, as a last resort, an emetic has been injected 
 into the veins, and tartar-emetic has been generally found to an- 
 swer the best for such a purpose. 
 
 During the whole of the treatment every effort should be made 
 to keep the patient roused. This should be done by causing 
 him to walk rapidly between two assistants ; by blows on the 
 
396 MEDICAL JURISPRUDENCE. 
 
 hands and feet with a wet towel j and by dashing cold water in 
 the face and on the head. 
 
 Artificial respiration has sometimes been resorted to with suc- 
 cess. The principle of resorting to this is, that the ultimate 
 cause of death from opium is the suspension of respiration ; and 
 that if it could for some time be maintained artificially, the poison 
 in the blood would be at length decomposed, and consciousness 
 gradually restored. So also galvanism has been resorted to in 
 extreme cases. 
 
 Several substances have been proposed as antidotes to opium. 
 On a rigid examination by Orfila, no one was found entitled to 
 rank as such except a decoction of galls, and this but imperfectly. 
 The conclusion he arrived at was, that this might with propriety 
 be used as an imperfect antidote until the poison can be evacu- 
 ated from the stomach. 
 
 THE HYDROCYANIC OR PRUSSIC ACID. 
 
 There are several considerations that tend to gather around 
 this substance a great amount of interest. Among these are in- 
 cluded the sources from which it is obtained, the minuteness of 
 the quantity required for a fatal operation, and the amazing ce- 
 lerity with which it extinguishes life. In regard to the two lat- 
 ter, it is probably unequalled by any other poison. It comes, 
 therefore, strongly recommended to the suicide and murderer, 
 and is liable to be taken by accident. 
 
 This acid may be found under the form of a pure acid, or in a 
 state of dilution with water. When exhibited under the first 
 form, it is limpid and colorless ; has an acrid, pungent taste, and 
 a peculiar odor, which resembles that of the bitter almond. It 
 is in the state of dilution, and as kept in the apothecaries' shops, 
 that it is commonly used as a poison. This has nearly the same 
 appearance, smell, and taste, as the strong acid. It is volatile, 
 and looses its activity by exposure. Guy, 671. 
 
 The diluted acid found in the shops is possessed of different 
 degrees of strength. Even the same preparation can be made to 
 vary very considerably from any other, by means of evaporation 
 and decomposition. 
 
poisons. 397 
 
 The sources from which it is obtained are principally the bit- 
 ter almond, the cherry laurel, the peach blossom, the cluster 
 cherry, and the mountain ash. Christison on Poisons, 689. 
 
 The tests, by means of which its presence may be detected, are, 
 1 . Its peculiar odor. Under favorable circumstances, its smell 
 is perceptible when no chemical agent is delicate enough to de- 
 tect it. In the celebrated case of Sir Theodosius Boughton this 
 was the only test resorted to. To be much relied upon, it should 
 be identified by more than one person : 
 
 2. The sulphate of copper added to the acid rendered slightly 
 alkaline by potash, throws down a greenish precipitate, which, 
 on adding hydrochloric acid, becomes nearly white : 
 
 3. A salt of the protoxide of iron, such as common green vit- 
 riol, is added to the fluid first rendered alkaline by caustic potash, 
 when a greenish brown precipitate is thrown down, which, on 
 the addition of dilute muriatic or sulphuric acid, becomes of a 
 deep prussian blue color. 
 
 The nitrate of silver is also a fourth test. 
 
 To detect it in a mixed fluid, Orfila recommends that the fluid 
 be treated with animal charcoal without heat. A slip of bibulous 
 paper, moistened with pure potash, is then to be immersed in 
 the suspected fluid for a few minutes, and then touched with a 
 solution of sulphate of iron, upon which the usual blue color will 
 be produced en the paper. Christison on Poisons, 693. 
 
 This substance is poisonous in all its chemical combinations ; 
 affects all animals indiscriminately, from the highest to the very 
 lowest in the scale of creation ; and destroys all nearly in the 
 same manner. Its most energetic action is through the serous 
 membranes ; its next most energetic is upon the stomach. It 
 also acts on the cellular tissue. With all its energy and power 
 of producing effects, it exerts no action when it is applied to the 
 trunks or cut extremities of nerves, or to a fissure made in the 
 brain or spinal marrow. The previous division of the nerves 
 prevents not its action, but when the vessels of any part are tied 
 before the application of the poison, its action is prevented. 
 Both its odor and chemical analysis often detect it in the blcod 
 
398 MEDICAL JURISPRUDENCE. 
 
 after death, and hence it is supposed to act through the medium 
 of the blood vessels. 
 
 This acid acts on the brain, and on the spine also. This is 
 clearly made out by its producing both coma and tetanus. To 
 prove its independent action on the spine, the following experi- 
 ment was made : The spinal cord in a dog was divided at the 
 top of the loins, so that no movement took place when the hind 
 legs were pricked. Hydrocyanic acid being then introduced into 
 a wound in the left hind leg, symptoms of poisoning commenced in 
 one minute, and the hind legs were affected with convulsions as 
 well as the fore legs. Christison on Poisons, 698. 
 
 It is no easy thing to arrive at the smallest fatal dose of hydro- 
 cyanic acid. It will vary much with circumstances, such as the 
 strength of the individual, and the fulness or emptiness of the 
 stomach at the time. As nearly as can be ascertained, a trifle 
 less than a grain of the pure acid is sufficient to destroy the life 
 of an adult. Christison, 706-7 ; Guy, 677. 
 
 The time at which the symptoms first begin to show them- 
 selves, is an enquiry of considerable importance. This, of 
 course, will depend much upon the quantity taken. In a case 
 reported by Hufeland, a man swallowed about forty grains of 
 the pure acid, and he was observed immediately to stagger a few 
 steps, and then to sink down without a groan, apparently life- 
 less. 
 
 In the case of a physician who, by way of experiment, swal- 
 lowed a dose which was evidently but little short of a fatal one, 
 there was time to leave the shop and return, and to utter some 
 expressions of fear, before the fatal symptoms commenced. 
 
 From experiments made by Magendie and others on animals, 
 it would seem that if any considerable quantity be administered, 
 the death is almost immediate. A single drop put into the throat 
 of a dog, caused two or three deep, hurried respirations, and in- 
 stantly he dropped down dead. When dropped under the eye- 
 lid, it caused death almost as instantaneously ; and when inject 
 ed into the jugular vein, he dropped down dead at the very in- 
 stant, as if struck with a cannon-ball, or with lightning. Christi- 
 son on Poisons, 694. 
 
poisons. 399 
 
 It has in one or two cases, become an important medico-legal 
 question, what amount of voluntary effort can be made, in the 
 interval occurring between the taking of the poison and the full 
 commencement of its operation, so as to suspend consciousness. 
 This question arose in the following case : 
 
 An apothecary's maid servant, who was pregnant by Freeman, 
 her master's apprentice, the defendant, was found dead in bed, 
 poisoned by the hydrocyanic acid. The body was found lying at 
 full length on the bed, with the head turned a little on one side, 
 the arms crossed over the trunk, and the bed-clothes pulled 
 smoothly up to the chin. Under the clothes, on the right side, 
 'ay a phial corked, wrapped in paper, and containing three and 
 an half drachms of the poison. The leather and string which 
 had fastened the cork, were found in the chamber -vessel. It 
 seemed probable that four and a half drachms had been swallow- 
 ed ; and the question was, whether this was a case of suicide or 
 homicide ; whether the girl could, after swallowing this quantity 
 of the poison, have corked the bottle, wrapped it up, and adjust- 
 ed the bed-clothes. Several experiments were made on animals, 
 with a view to settle this question. Several medical witnesses 
 were sworn, all of whom, with one exception, testified that the 
 supposed acts of volition, although within the bounds of possi- 
 bility, were in the highest degree improbable. Christison, 704-5. 
 
 The only reliable means of settling the question properly, is, 
 to collect cases where acts of volition have been performed after 
 the taking of the poison. Of these, there are a few instances. 
 An apothecary's assistant in Germany, took four ounces of the 
 hydrocyanic acid of the Bavarian-pharmacopeia, which contains 
 about four per cent of the acid. He was found dead in his bed, 
 with an empty two-ounce phial on each side of the bed. The 
 mattress, used in Germany as a covering, was pulled up as high 
 as the breast, the right arm extended beneath it, and the left arm 
 bent at the elbow. 
 
 In another case, an apothecary's apprentice left the shop to 
 descend into the cellar for some carbonate of potash. He had 
 been gone but a few minutes, when he was heard to cry, in a 
 voice of alarm, " Hartshorn ! Hartshorn " On instantly rush- 
 
400 MEDICAL JURISPRUDENCE. 
 
 ing down stairs, he was found reclining on the lower step, and 
 grasping the rail, and had scarcely time to mutter " Prussic acid," 
 when he expired, not more than five minutes after leaving the 
 shop. He had taken a drachm of the Bavarian acid; had en- 
 deavored to get at the ammonia, but had not sufficient strength 
 to uncover the bottle. 
 
 In a third case, a man was found dead on the seat of a water- 
 closet, and had the bottle from which the poison was taken, 
 corked in his pocket. Guy, 678 - 9. 
 
 These cases certainly go to show that some degree of volun- 
 tary effort can be made after taking a fatal dose of the prussic 
 acid, and hence to justify the verdict of acquittal which was 
 rendered in the case before mentioned. 
 
 The symptoms developed in both man and animals, vary with 
 the quantity taken. In the case of an individual, who was ex- 
 perimenting to determine the effect of small doses on himself, 
 and who took from twenty to eighty-six drops of the diluted 
 acid, he says he was attacked for a few minutes with nausea, 
 salivation, hurried pulse, weight and pain in the head, succeeded 
 by a feeling of anxiety, which lasted about six hours. 
 
 Given medicinally, it frequently produces salivation with ul- 
 ceration of the mouth. If given in doses too small to prove 
 fatal to animals, it soon produces giddiness, weakness, and sali- 
 vation ; then tetanic convulsions, and gradually increasing in- 
 sensibility. After some time, the insensibility goes off rapidly, 
 and is succeeded by a few attacks of convulsions, and transient 
 giddiness, the whole duration sometimes not exceeding half an 
 hour, but sometimes a whole day, or even longer. Any con- 
 siderable increase of the dose, causes the animal to die either 
 convulsed or comatose. Guy, 675. 
 
 In illustration of the effect of a large dose on man, the follow- 
 ing case may be taken : A man apprehended for theft, swallow 
 ed an ounce of alcoholized acid, containing about forty grains 
 of the pure acid. He immediately staggered a few steps, and 
 then sank down without a groan, apparently lifeless. His pulse 
 was gone, and the breathing, for some time, imperceptible. After 
 a short interval, he made so forcible an expiration, that the ri^s 
 
POISONS. 401 
 
 seemed drawn almost to the spine. The legs and arms then be- 
 came cold ; the eyes prominent, glistening, and quite insensible ; 
 and after one or two more convulsive expirations, he died five 
 minutes after swallowing the poison. Chrislison on Poisons, 701. 
 
 The hydrocyanic acid does not belong to the class of cumula- 
 tive poisons. In regard to the duration of the poisoning, it is 
 probable that very large doses occasion death in a few seconds, 
 and at all events in a lew minutes. In one case, death occurred 
 from taking a large dose of alcoholic solution of the acid, in two 
 minutes. In two cases, already alluded to, death occurred in 
 five minutes. It is said, that if the individual survive forty 
 minutes, he will generally recover. It has however been found 
 the fact, that in several cases, life has continued for forty-five 
 minutes, and yet death been the result. The action is the most 
 immediate, and the life the soonest extinguished, when the acid 
 is inhaled into the lungs in the form of vapor. Of several ani- 
 mals breathing air saturated with its vapor, a bird died in one 
 second ; a rabbit in one, a cat in two, one dog in five, and anoth- 
 er in ten seconds. Dangerous accidents have ensued from its 
 vapor having been incautiously snuffed up the nostrils. Christi- 
 son on Poisons, 695-707. 
 
 In regard to the post-mortem appearances, the first thing to 
 be noticed is, that the eyes retain a peculiar glistening and staring 
 appearance long after death, resembling, somewhat, their appear- 
 ance in life. It is not, however, uniformly observed. Besides, 
 it is not peculiar, death from carbonic acid having the same effect. 
 The countenance is pale and composed ; the spine and neck 
 stiff ; the belly drawn in ; the back livid. The blood has been 
 generally found extremely fluid, and altered in its nature, having 
 a glimmering bluish appearance, as if it had been mixed with 
 Prussian blue. The substance of the brain is natural, but its 
 vessels' were gorged with blood, and effusion of serum into the 
 ventricles. The lungs are turgid. There is generally a tumes- 
 cence of the venous system, and an emptiness of the arterial, 
 throughout the whole body. The villous coat of the stomach has- 
 been found red ; the intestines reddish ; and the liver gorged with 
 blood. From the body generally, the blood, and more especially 
 
402 MEDICAL JURISPRUDENCE. 
 
 the cavities, exhaled the odor of the hydrocyanic acid. This 
 has been relied upon strongly as a test, but it will not be found 
 to be constant. If the patient long survive after taking the poi 
 son, it will exhale so freely from the lungs as to have nearly or 
 quite all escaped. There have been instances where it has been 
 recognized in the stomach, and not in the other parts of the body ; 
 and, also, in other parts of the body, and not in the stomach. 
 The exposure of the body ibr some time after death to a shower, 
 or to a current of air, or even in a large airy room, will generally 
 be sufficient to cause the odor to exhale. The presence of the 
 odor in the blood is more satisfactory than in the stomach, intes- 
 tines or brain. Christison, 709-10 ; Guy, 677. 
 
 In regard to treatment, it is unnecessary to say much. No 
 specific antidote has ever been discovered. Unless the relief 
 comes speedily, it will be useless. The course commonly resorted 
 to is to employ powerful and diffusible stimulants. Of these, 
 ammonia is considered the best. It may be applied immediately 
 to the nostrils ; so, also, it has been injected into the jugular vein 
 of a horse with good results. Another remedy is chlorine. Cold 
 affusion has been applied to the spine of the back, with great 
 success So, also, frictions of the chest and stimulating liniments. 
 On the whole, Dr. Christison concludes that the proper treatment 
 consists in the use of the cold affusion, and the inhalation of 
 diluted ammonia or chlorine. Christison, 715; Guy, 679. 
 
 The bitter almond, as also its essential oil, are both poisonous, 
 owing to hydrocyanic acid contained in them. The symptoms, 
 post-mortem appearances, and treatment, are all substantially the 
 same as those of the hydrocyanic acid. 
 
 The essential oil and the water distilled from the leaves of the 
 cherry laurel are poisonous from the prussic acid contained in 
 them. The celebrated case of Sir Theodosius Boughton was from 
 supposed poisoning with the cherry laurel water. 
 
 So, also, the common peach, the cluster-cherry, and the mountain 
 ash, derive poisonous properties from the hydrocyanic acid they 
 contain. 
 
 Narcotic Gases. The principal of these are the carbonic acid, 
 sulphuretted hydrogen, and carburetted hydrogen. These only 
 
poisons. 403 
 
 produce their characteristic effects when received into the lungs 
 in a diluted state, as their effect, when pure, is to asphyxiate, by 
 creating such a violent spasm of the glottis as to exclude the at- 
 mospheric air from the lungs. 
 
 The carbonic acid gas is derived from the combustion of fuel, 
 the calcining of chalk or limestone, the fermenting of vegetables, 
 animal respiration, from plants during the night, and it is fre- 
 quently found in mines, caverns, pits and wells. 
 
 When this gas is diluted with atmospheric air and respired, it 
 produces a sensation of weight in the head, principally in the 
 fore and back part of it ; of tightness in the temples, giddiness, 
 ringing in the ears, imperfect vision, drowsiness, loss of power, 
 hurried respiration, nausea and vomiting. These are followed by 
 complete insensibility, slow pulse, and stertorous breathing, 
 foaming at the mouth, pale and livid skin, occasionally convul- 
 sions and tetanic spasms, at other times a deep sleep, which gra- 
 dually terminates in death. Guy, 684. 
 
 The post-mortem appearances are not constant. The body is 
 generally swollen, and marked with livid spots ; the countenance 
 pale and composed, but sometimes livid and bloated ; the limbs 
 frequently rigid; the tongue sometimes protruded; the eyes 
 bright and prominent ; cadaverous rigidity is slow in appearing, 
 and putrefaction is retarded. The large veins and right cavities 
 of the heart are filled with..black blood ; the lungs congested ; the 
 vessels of the brain distended ; both its membranes and substance 
 injected ; serum in the ventricles, and at the base of the brain ; 
 and sometimes effusion of blood on the surface, and into the ven- 
 tricles. Guy's Principles of Forensic Medicine, 684-5. 
 
 The treatment consists in restoring pure air to the lungs ; in 
 using cold affusion ; applying ammonia and stimulant em- 
 brocations to the chest ; and, in extreme cases, resorting to arti- 
 ficial respiration, galvanism, and the inhalation of oxygen gas. 
 
 The sulphuretted hydrogen is the most deleterious of all the 
 gases. It is an extremely active poison, and may cause death by 
 being injected into a blood vessel, by its introduction into any 
 cavity of the body, and even, when applied to the skin, it exerts 
 a powerful influence. 
 
404 MEDICAL JURISPRUDENCE. 
 
 When breathed in a moderately diluted state, it produces gid- 
 diness, a sense of tightness across the temples, oppression at the 
 pit of the stomach, nausea, weakness, loss of sense and motion, 
 occasionally tetanus, delirium, convulsions, cold skin, an irre- 
 gular and frequent pulse, and laborious respiration. Guy's Prin. 
 of Form. Med., 693. 
 
 The post-mortem appearances are, fluidity and blackness of 
 the blood ; dark tint of all the internal vascular organs ; des- 
 truction of the contractility of the muscles ; redness of the 
 bronchial tubes ; engorgement of the lungs ; all the viscera ex- 
 haling an odor resembling that of decayed fish, and a strong ten- 
 dency to early putrefaction. Christison on Poisons, 739. 
 
 The treatment consists in restoration to pure air, the use of 
 stimulants and of chlorine gas. Guy, 693. 
 
 The carburetted hydrogen, the chief constituent of the coal gas 
 produces vomiting, convulsions, tetanic spasms, stertorous res- 
 piration, and injection of the countenance, foam at the mouth, 
 and dilated pupil. 
 
 The morbid appearances are, pallor of the integuments and 
 internal tissues, generally ; florid discoloration of the neck and 
 back ; light florid color of the muscles ; absence of indications of 
 venous congestion ; fluidity of the blood ; infiltration of the 
 lungs ; injection of the small intestines ; rapid rigidity. Guy's 
 Prin. of Form. Med., 694. 
 
 CLASS III. NAKCOTICO-ACKIDS. 
 
 The poisons included under this class possess a double action, 
 one local and irritating, the other remote, and acting on the 
 nervous system. They are all derived from the vegetable king- 
 dom. They generally prove fatal by operating on the nervous 
 system, although some produce very violent local symptoms, but 
 seldom sufficiently severe to occasion death. When they pro- 
 duce narcotism it is generally of a comatose nature, and often 
 attended with delirium. 
 
 It is seldom indeed that any one of these produces its irritant 
 and narcotic effects at the same time. In small doses they are 
 often irritants, the dose not being large enough to act narcotically. 
 In large doses they are narcotics, and while that is their mode 
 
poisons. 405 
 
 of action, the body is generally insensible to the local irritation. 
 The narcotic symptoms, and those of irritation, more commonly 
 exist successively, preceding or succeeding each other, and very 
 rarely both exist simultaneously. Christison on Poisons, 758. 
 
 Most or all of them act remotely by entering the blood vessels. 
 Some produce obvious effects where they are applied, like monks- 
 hood which produces numbness and tingling of the part with 
 which it is placed in contact. They act remotely on the brain 
 and spine and sometimes the heart. 
 
 The symptoms the most common to the entire class are dryness 
 of the throat, vomiting and purging, giddiness, delirium, convul- 
 sions, palsy and stupor. Delirium may be termed a character- 
 istic symptom, and is commonly of the violent kind, and fre- 
 quently attended with incoherence. 
 
 Few traces of them are left in the dead body. There may be 
 inflammation in the stomach and intestines, when the irritating 
 effects have been developed, and fullness or congestion in the 
 brain, as a trace of the narcotic action. But neither of these are 
 constant, well marked, or decisive. 
 
 The poisons in this class are very numerous. The great ma- 
 jority of them are possessed of little interest to the mere medical 
 jorist. They have been divided by Orfila into six groups, of 
 which the v 
 
 1 . Includes those whose principal symptom is delirium, such 
 as atropa, datura, stramonium, &c. : 
 
 2. Those whose principal symptom is tetanus, as nux vomica, 
 strychnine, &c. : 
 
 3. Those which excite convulsions, and cause impaired sen- 
 sibility and sleep, as coculus indicus, camphor, upas antiar : 
 
 4. Poisonous mushrooms : 
 
 5. Poisonous grain : 
 
 6. Alcohol, ether and empyreumatic oils. 
 
 A brief reference to some of these is all we can do. 
 
 Jilropa Belladonna — deadly night shade, is poisonous in its root, 
 leaves, and berries. The poisonous property is due to an alka- 
 loid, called atropia. It is not an active poison, and does not pro- 
 duce its symptoms until after the lapse of one or two hours. 
 
.[06 MEDICAL JURISPRUDENCE. 
 
 They are dryness of the throat, dilated pupil, and delirium suc- 
 ceeded by coma. In addition to these, slight convulsions, tetanic 
 spasms, loss of sight and speechlessness, are sometimes to be met 
 with. 
 
 The treatment consists in removing the poison from the stomach 
 as promptly as possible, and afterwards using stimulants. Guy's 
 Principles of Forensic Medicine, 696. 
 
 Datura Stramonium — thorn apple. This plant prevails very 
 extensively in the United States, and several cases of poisoning 
 with it have occurred. The fruits and seeds are both poisonous. 
 The symptoms are dryness of the throat, giddiness, dilated pupils, 
 flushed face, glancing of the eyes, incoherence, a state resembling 
 that of intoxication. A wild, happy, talking delirium generally 
 prevails. Sometimes paralysis of the limbs, convulsions and cold 
 sweats are prssent. Vomiting should be procured or promoted 
 as soon as possible. Dissection has disclosed the blood fluid, the 
 brain considerably congested, the stomach, intestines, and other 
 organs natural. Guy, 696-7. 
 
 JVicotiana Tabacum — tobacco. This has proved destructive to 
 life when used as a clyster. The symptoms are nausea, giddi- 
 ness, vomiting, purging, great faintness, weak and irregular pulse. 
 It acts on the circulation, as well as on the nervous system. 
 
 Conium Maculatum — hemlock, produces as symptoms, vertigo, 
 dimness of sight, delirium, stupor, pain in the abdomen, vomit- 
 ing, diarrhoea. There are but few traces left of the action of 
 the poison. 
 
 Aconitum JVapellus — monkshood, is every part poisonous, but 
 that in most common use is the extract of the leaves. It is a 
 very active poison, producing as its symptoms, a burning heat in 
 the mouth, throat, gullet and stomach. There is a sensation of 
 swelling in the face, and of tingling over the whole body. Along 
 with this are restlessness, dimness of sight, and stupor, followed 
 by vomiting, purging, swelling and tenderness of the stomach, 
 cramps, convulsive twitchings, delirium and tetanic spasms. 
 
 The traces left in the body are of severe inflammation in the 
 gullet, stomach and intestines. Guy, 697-8. 
 
 Colchicum is also poisonous in all its parts, causing acute pain, 
 
poisons. 407 
 
 followed by retching, vomiting, and tenesmus, feeble pulse, great 
 anxiety, and after some time, incessant vomiting of coffee-colored 
 matter, suppression of urine, excessive debility, feeble respiration, 
 and, shortly before death, profuse, dark, watery purging. 
 
 Digitalis — fox-glove is frequently used in medicine, and is 
 important as being one of the cumulative poisons. It acts both 
 on the brain and alimentary canal. When given in large doses, 
 it produces nausea, headache, giddiness, dryness of the mouth 
 and throat, slight salivation, great debility, vomiting, purging 
 and colic pains, a small, frequent and irregular pulse, followed 
 by dimness of vision, a feeling of distension in the eyeballs, con- 
 vulsions, delirium and. coma. Guy^s Principles of Forensic Medi- 
 cine, 698. 
 
 When small medicinal doses are repeated a sufficient number 
 of times, their accumulated results are nearly the same with 
 those above stated. 
 
 The second group of narcotico-acrids, according to Oriila's ar- 
 rangement, includes but five poisonous substances; but those 
 act in a very peculiar manner. They act violently on the ner- 
 vous system, and also possess local irritant properties. A small 
 dose will produce a fatal effect. Their action is exerted through 
 the medium of the blood vessels, but it is expended principally 
 upon the spinal cord. They produce violent spasms, like teta- 
 nus, and cause death during a fit, probably by suspending respi- 
 ration. Their action more resembles that of the hydrocyanic 
 acid, than any other poison, but they do not in the least impair 
 the sensibility of the nervous system. Christison, 796. 
 
 Their energy resides in peculiar alkaloids. They seldom leave 
 any considerable traces in the dead body. There may be slight 
 venous congestion, and sometimes signs of inflammation in the 
 alimentary canal. To this group belong the tribe of 
 
 Strychnia, which is endowed with a greater amount of destruc- 
 tive energy than any other poison except the hydrocyanic acid. 
 A wild boar was killed with a third of a grain, in ten minutes, 
 injected in the form of alcoholic solution into the chest. It acts 
 powerfully in whatever way it is introduced into the system ; 
 but more energetically, when injected into a vein. The first 
 
408 MEDICAL JURISPRUDENCE. 
 
 symptoms are agitation and trembling. These run into a gene- 
 ral spasm, in which the head is bent back, the spine stiffened, 
 the limbs extended and rigid, and the respiration for some time 
 interrupted by the fixing of the chest. A calm then succeeds, 
 the senses remaining entire and acute. Another paroxysm then 
 sets in, which may be succeeded by another, and another still, 
 until death occurs through suffocation. 
 
 This poison is to be found in the 
 
 JVux vomica, which is exhibited in the form of a light-brown 
 kernel, of a flattened round shape, with radiating fibres exter- 
 nally, and with a fine downy covering. The nux vomica is fre- 
 quently found in the stomachs of those poisoned with it. In 
 order to detect it, the contents of the stomach must be boiled in 
 water acidulated with sulphuric acid. The liquid, after filtration, 
 is neutralized with carbonate of lime, and then evaporated to 
 dryness. The dry mass is then acted on by successive portions 
 of alcohol, and evaporated to the consistence of a thin syrup. 
 The product has an intensely bitter taste, precipitates with am- 
 monia, becomes deep orange-red with nitric acid, and will some- 
 times deposit crystals of strychnia on standing two or three 
 days, lb., 799. 
 
 It has an intensely bitter taste, but notwithstanding that, has 
 occasionally been used as an instrument of murder. It has also 
 been used for self-destruction, although it gives rise to an exces- 
 sive degree of torture. Its symptoms are the same as those of 
 strychnia, already enumerated. So severe are the spasms, that 
 the whole body is stiffened and straightened ; the legs pushed out 
 and forced wide apart ; no pulse or breathing perceptible ; the 
 face and hands livid, and the muscles of the face violently con 
 vulsed. 
 
 This poison seems to act on the spinal marrow alone. The 
 cause of death appears to be prolonged spasm of the thoracic 
 muscles of respiration. 
 
 In small doses, insufficient to cause death, there is pain and 
 heat in the stomach, burning in the gullet, a sense of rending 
 and weariness in the limbs ; succeeded by stiffness in the joints, 
 
poisons. 409 
 
 convulsive tremors, tottering, and at length violent and frequent 
 fits of tetanus, lb., 801. 
 
 The smallest fatal dose of the alcoholic extract yet recorded, 
 is three grains. A fatal case is mentioned as caused by two fif- 
 teen grain doses of the powder. 
 
 In relation to morbid appearances, they differ according to the 
 period at which death has occurred. Where it takes place speedi- 
 ly, they are insignificant ; where it is longer delayed, there are 
 usually appearances of inflammation in the stomach and intes- 
 tines. In one case, there was serous effusion on the surface of 
 the cerebellum, accompanied with a softening of the whole cor- 
 tical substance of the brain, but especially of the cerebellum. 
 So powerful are the spasms, that the body sometimes retains, for 
 some time after death, the attitude and expression fixed on it by 
 their terrible action during life. This may continue for some 
 hours, so long that the body passes into that state of rigidity 
 which precedes decay, without having gone through the prelimi- 
 nary stage of flaccidity immediately after death. Christison on 
 Poisons, 803. 
 
 Little can be said in relation to treatment. The stomach should, 
 as soon as possible, be evacuated, which should be attempted by 
 emetics or the stomach-pump. Iodine, bromine, and chlorine, 
 are stated to be antidotes for poisoning with the alkaloid of nux 
 vomica, forming with it a compound which is not deleterious. 
 Unless, however, they are on hand to be promptly administered, 
 a very little delay would prove inevitably fatal. Christison, 804. 
 
 Camphor, in a large dose, occasions giddiness, confusion, loss 
 of memory, and incoherence, attended with heat of skin, and 
 hurried pulse, followed by profuse sweating a feeling, of intoxi- 
 cation, and furious delirium. These are succeeded by sleep and 
 exhaustion. It has never produced fatal effects. Guy, 6-99. 
 
 There are several other substances that are included under the 
 class of narcotico-acrid poisons, but which are not of sufficient 
 importance in a medico-legal point of view to justify a separate 
 consideration. There is, however, one that may form an excep- 
 tion, viz : 
 
 Alcohol. This has been generally believed to act on the brain 
 
410 MEDICAL JURISPRUDENCE. 
 
 through, the medium of the nerves. There is little doubt, how 
 ever, but that it enters, the blood. It is a violent poison when 
 injected into the cellular tissue, and produces in such case, the 
 same general symptoms as when taken into the stomach. 
 
 The effect of a small dose is to produce excitement. When so 
 large as to justify the designation of poisonous, the symptoms 
 are violent excitement, flushed face, giddiness, confusion of 
 thought, delirium, and various mental affections, varying with 
 the character. They are followed by a strong tendency to doze. 
 Christison, 843. w 
 
 When it causes death, it usually does so, by the coma becoming 
 deeper and deeper, or by its developing an apoplectic state, or 
 by the occurrence of some accident. 
 
 When the alcohol is swallowed in very large quantities, the 
 coma comes on in a very few minutes, and soon becomes deep 
 and profound, as in apoplexy. The face is livid or ghastly pale ; 
 the breathing stertorous ; the pupils either much contracted, or, 
 more commonly, dilated and insensible. It is said a recovery 
 may take place if the iris of the eye remain contractile ; but if, 
 on the approach of light, it continues dilated and motionless, a 
 recovery is extremely improbable. Christison, 848. 
 
 The kind of action thus far described is narcotic. Sometimes 
 after its narcotic symptoms have passed away, another set ap- 
 pear, which indicate inflammation of the alimentary canal. 
 These cases, however, are very rare. 
 
 In regard to morbid appearances, the villous coat of the 
 stomach, in animals poisoned by it, exhibits generally a cherry- 
 red color. In man, this is not always exhibited. Sometimes the 
 appearance is natural, and sometimes there is injection of the 
 small intestines. Dark fluid blood is often found in the heart 
 and' large vessels. Sometimes there is congestion of the brain, 
 and in rare cases, extravasation of blood in the brain. There 
 has also been found a very extensive softening of the mucous 
 coat of the stomach. 
 
 The same general principles in regard to treatment that were 
 mentioned in the case of poisoning with opium, should also be 
 resorted to in that by alcohol. The two great objects to be kept 
 
POISONS. 41 1 
 
 in view are, to remove the poison from the stomach, either by 
 emetics or the stomach-pump, and to keep the patient roused as 
 much as possible. To accomplish the latter, water may be injected 
 into the ears and cold affusion applied to the head. Ammonia 
 and its acetate, have been sometimes found useful as internal 
 stimulants. 
 
 The subject of compound poisoning, or the result produced 
 when two poisons of varying or opposite properties are adminis- 
 tered in poisonous doses, is both curious and interesting. Very 
 few facts, however, have been as yet collected, and not much, 
 therefore, is known in reference to it. The general results are 
 one of tw'o things : either the poisons modify the action of one 
 another, or one of them overpowers and prevents the action of 
 the other. 
 
 Thus, in a case of poisoning with arsenic and alcohol, where, 
 under the excitement of a debauch, a large quantity of arsenic 
 was taken seven hours after a meal, and although it remained in 
 the stomach one hour, before its contents could be extracted by 
 the stomach-pump, yet no symptom of poisoning with arsenic 
 followed. The reason probably was, that the narcotism induced 
 by the alcohol, impeded or prevented the action of the arsenic. 
 Christison on Poisons, 860-61. 
 
 In another case of the same kind of poisoning, the quantity of 
 arsenic taken was very large, so that it proved fatal ; but no con- 
 stitutional symptom of poisoning with it, except vomiting, ap- 
 peared under eighteen hours, and life terminated in forty-one. 
 The stomach presented signs of violent irritation. 
 
 Where alcohol and laudanum were taken, the usual effects of 
 opium were very greatly retarded, no great degree of stupor oc- 
 curring under five hours. After that, the narcotic symptoms 
 appeared, which continued until death. 
 
 Where laudanum and corrosive sublimate were taken, no 
 violent symptoms of the latter occurred at first ; afterwards, fre- 
 quent purging and tenesmus, with bloody stools, but no pain or 
 tenderness of belly, nor vomiting. A violent salivation com- 
 menced on the fourth day, and under this, and dysenteric affec- 
 tion, he became exhausted, and ultimately died. There the ac- 
 
412 MEDICAL JURISPRUDENCE. 
 
 tion of the narcotic agent veiled, or retarded that of the irritant 
 poison. 
 
 Dr. Christison, page 864, is of the opinion that it is probable 
 the modifying influence is established in one of two ways : either 
 by one poison producing a state of venous plethora or distension, 
 which impedes, or for a time prevents, the absorption of the 
 other ; or by one poison producing an insensibility of the mem- 
 brane with which the other is in contact ; so that not only the 
 local injury actually done has not the usual remote effect on the 
 constitution, or on distant organs, but likewise is at times sub- 
 stantially less extensive than in ordinary circumstances. 
 
 IV. PERSONS FOUND DEAD. 
 
 The fourth and last division of the second class embraces the 
 extensive and important subject of persons found dead. This 
 will best be considered under the following heads of enquiry : 
 
 1 . What is death 1 In what does it consist 1 
 
 2. Is the death real or apparent 1 and what are the signs and 
 indications of real death, and the value of each 1 
 
 3. What are the duties of the coroner and the medical witness 
 in the case of a person found dead 1 
 
 4. What are the principal causes of sudden death 1 How do 
 they operate, and what traces do they leave in the organization ? 
 
 5. What are the circumstances under which the body is found 1 
 Its position, place, relations, &c, with a view to discriminate by 
 what agency it became divested of life. 
 
 6. What are the causes, appearances, signs and indications of 
 death by drowning, and the medico-legal questions connected 
 with it 1 
 
 7. The same of death by hanging. 
 
 8. The same of death by strangulation. 
 
 9. The same of death by smothering. 
 
 10. The same of death from cold. 
 
 11. The same of death from burning. 
 
 12. The same of death from lightning. 
 
 13. The same of death from starvation 
 
PERSONS FOUND DEAD. 413 
 
 1. What is death! In what does it consist? , Death is the 
 negation of life, as darkness is of light. Life has been defined to 
 consist in the " sum of the functions by which death is resisted." 
 It is, therefore, as defined by Brown and Rush, " a forced state ;" 
 a state in which the energy of its functions is constantly exerted 
 to resist the tendency to decay and dissolution. It is obvious, 
 that during life the organism is reared up and sustained under 
 the action of forces that are sufficiently strong to resist the ag- 
 gressions of the chemical affinities, and the operation of the laws 
 that act upon dead matter. When, however, for anv cause these 
 forces cease, the organism is handed over to the action of those 
 affinities, and the operation of those laws. Without designing to 
 embark in physiological speculation, I will lay down a few plain 
 propositions relative to life, with a view of attempting to throw 
 some light on the phenomena of death. 
 
 To the highest form of life, three orders of functions are made 
 to contribute. These are the muscular, nervons and sensorial. 
 The first appropriates to itself the contractile power, developed 
 through the action of the voluntary and some of the involuntary 
 muscles. The muscles of locomotion are an instance of the for- 
 mer, the heart is one of the latter. 
 
 The nervous function expresses that peculiar nervous influence 
 which is instrumental in exciting the muscle to contract, the 
 gland to secrete, the organs of assimilation to carry on their pro- 
 cesses ; which is the active agent in the generation of animal 
 heat, and in all those operations which contribute to the nutri 
 tion and growth of the system. The organs from which this in- 
 fluence is derived are the brain and the spinal marrow; the 
 nerves being its agents or instruments of transmission. Of this 
 influence there are two orders : the one which contributes to 
 those processes in the system which are entirely involuntary; 
 the other, to those changes and operations which are voluntary. 
 The first is derived from the entire cerebrum, cerebellum, and 
 medulla spinalis, including all the ganglions and plexuses ; the 
 other, from those parts of the great nervous centre, from which 
 the nerve proceeds that conveys the sensation, or is the agent by 
 which the volition becomes outwardly manifested. 
 
414 MEDICAL JURISPRUDENCE. 
 
 The sensorial function is identified as that which feels and 
 wills. It is through this that the highly organized system is en- 
 abled to sustain relations with objects and things around it. It 
 is this that appropriates that order of nervous influence that per- 
 vades the voluntary organs. 
 
 During life, these three functions exist together, and act in 
 harmony. The sensorial is, in general, the most drawn upon, 
 and hence requires alternations of rest. Hence the state of sleep 
 is rendered necessary, in order that the powers of the sensorium 
 may become refreshed and invigorated. 
 
 Of these three functions, the sensorial is the last that com- 
 mences its action in the organism, and usually and naturally the 
 first that ceases to act. The muscular and nervous functions 
 are active in the foetal state, before the sensorial manifests any 
 existence. So, also, the sensorial is the earliest to cease. In- 
 deed, it is the cessation of the sensorial function that constitutes 
 death. 
 
 A fact somewhat singular in relation to these functions is, that 
 the muscular and nervous are independent of the sensorial, and 
 even continue to act, for a longer or shorter period of time, ac- 
 cording to circumstances, after its cessation, or after death has 
 actually taken place. The animal heat is kept up for some time 
 afterwards, the solvent power of the gastric juice continues, the 
 circulation of the blood in the capillaries goes on for one or two 
 hours after death ; and this furnishes one, and perhaps the prin- 
 cipal reason, why no blood is found in the arteries on dissection. 
 
 If these two functions are independent of the sensorial, and 
 continue after death, it . may reasonably be asked through what 
 agency they are at last quieted and finally cease. 
 
 This enquiry brings to view an important fact, which fur- 
 nishes the principal reason why I have laid down the foregoing 
 propositions. Respiration is a voluntary act, and belongs, there- 
 fore, to that class of phenomena which are purely voluntary. The 
 muscles through whose agency it is performed are voluntary 
 muscles. At times, when respiration is difficult or obstructed, 
 a greater number of them are brought into operation than at 
 other times. The want of fresh air in the lungs after an expira- 
 
PERSONS FOUND DEAD. . 415 
 
 tion, creates a necessity for the action of the sensorial function , 
 this function being always exercised in all voluntary operations. 
 Through its means a sufficiency of nervous influence is furnished 
 to stimulate the muscles of respiration to act, and their action 
 produces an inspiration. The want is thus satisfied, and the 
 sensorial function may rest until another inspiration is required. 
 It may be asked how respiration can continue during sleep, 
 when the sensorial power seems to be quiescent. We answer, 
 that the function can be exercised without consciousness, as is 
 actually seen in the movement of limbs, or change of position, 
 during sleep, when affected by an unpleasant sensation, without 
 one being in the least degree conscious of it. The suspension of 
 respiration prevents the oxygenation of the blood, and leads ne- 
 cessarily to the cessation of the heart's action. Thus the nervous 
 and muscular functions both cease in consequence of the suspen- 
 sion of respiration. M. Lallemand has published the history of 
 a fcetus, in which the brain and spinal marrow were equally de- 
 ficient, notwithstanding which, it even exceeded the usual size, 
 the heart was perfect, and it was evident that the circulation had 
 been properly performed. Ng sooner, however, was it born, 
 than it perished ; because there was no sensorial function, and 
 perhaps not sufficient nervous influence to cause and continue 
 respiration. 2 Paris and Fonblanque's Med. Juris., 20. 
 
 Respiration, in.this view of it, forms a connecting link between 
 the sensorial and the nervous and muscular functions. To the 
 first it sustains the relations of an effect, to the other two, those 
 of an exciting cause. The answer, therefore, to the question in- 
 volving the first topic is — that death is the suspension or re- 
 moval of the sensorial function, and that it leads to the suspen- 
 sion of the others through the cessation of respiration. 
 
 2. Is the death real or apparent 1 And what are the signs 
 and indications of real death, and the value of each 1 
 
 It may appear strange to many that there should ever be any 
 real difficulty in discriminating between the dead and the living, 
 or any chance of mistaking the one for the other. Although the 
 accounts of premature interments are probably most, or at least 
 many of them, without foundation ; and although the length ol 
 
416 s MEDICAL JURISPRUDENCE. 
 
 time during which bodies are ordinarily Kept here and in Eng- 
 land before interment, is generally sufficient to afford all reason- 
 able assurance that accidents of this kind will not take place, yet 
 there are undoubtedly, states or conditions of the system, in 
 which the certainty of knowledge is attended with difficulty. 
 Take, for instance, the following account given by Dr. Cheney 
 of the voluntary attempt to simulate death by Col. Townsend. 
 He informed the doctor and two or three others, that he would 
 give -an account of an odd sensation he had for some time ob- 
 served and felt in himself, which was, that composing himself, he 
 could die or expire when he pleased, and yet, by an effort, or 
 somehow, he could come to life again ; which it seems he had 
 sometimes previously tried. We all three, says the doctor, felt 
 his pulse first. It was distinct though small and thready, and 
 his heart had its usual beating. He composed himself on his 
 back, and lay in a still posture some time ; while I held his right 
 hand, Dr. Baynard held his hand on his heart, and Mr. Skrine 
 held a clean looking glass to his moutB. I found his pulse sink 
 gradually, till at last I could not feel any by the most exact and 
 nice touch. Dr. Baynard could not feel the least motion in his 
 heart, nor Mr. Skrine discern the least soil of breath on the bright 
 mirror he held to his mouth. Then each of us by turns examined 
 his arm, heart and breath, but could not, by the nicest scrutiny, 
 discover the least symptom of life in him. This continued about 
 half an hour. As we were going away, (thinking him dead,) we 
 observed some motion about the body, and upon examination, 
 found his pulse and the motion of his heart gradually returning ; 
 he began to breathe gently and speak softly. This experiment 
 was made in the morning and he died in the evening. On open- 
 ing the body nothing was found but disease of the kidney, all 
 the other viscera being perfectly sound. Guy, 374 - 5. 
 
 This is a case of voluntary syncope. There is also another 
 condition of the system commonly called trance, which in many 
 respects resembles death. A very remarkable instance of this 
 occurred in the case of the Bev. William Tenant, of New Jersey. 
 Intense application to study brought him into a decline, and after 
 lingering for many months he fainted and apparently died. In 
 
PERSONS FOUND DEAD. 417 
 
 this state he remained perfectly motionless and senseless, and to 
 all appearance dead, for the space of three days, and, but for the 
 attachment of a young physician, who accidentally discovered 
 some warmth still lingering about the body, would undoubtedly 
 have been buried. He recovered slowly ; all his former ideas 
 were for some time blotted from his mind ; and it was a year 
 before he was perfectly restored. He ever after maintained that 
 he actually died, or that his soul left the body, and went to 
 heaven, where he heard and saw unutterable things, and was 
 about to join the celestial chorus, when one of the heavenly mes- 
 sengers said to him, " you must return to the earth." At that 
 instant, he said, he groaned and opened his eyes, and for three 
 years after, the sounds which he had heard were not out of his 
 ears. Guy's Principles of Forensic Medicine, 375. 
 
 Another instance of a very extraordinary character is quoted 
 as having been related by Dr. Crichton, formerly physician to 
 the Emperor Nicholas, while grand duke. A young girl had, for 
 some time, kept her bed with a nervous affection, and at length, 
 to all appearance, was deprived of life. Her face assumed all 
 the characteristics of death ; her body was perfectly cold, and 
 every other symptom or indication of death was present. She 
 was removed from her bed chamber, and placed in a coffin. On 
 the day fixed for her funeral, hymns, according to the custom of 
 the country, were sung before the door ; but at the moment the 
 coffin was about to be nailed, a perspiration was perceived upon 
 her skin, and, shortly afterwards, was succeeded by a convulsive 
 motion in the hands and feet. In a few moments she altered her 
 eyes, and uttered a piercing scream. In a few days, her health 
 was reestablished. The account she gave of her situation, was 
 exceedingly curious. She said, she appeared to dream she was 
 dead, but that she was sensible to every thing that was passing 
 around her, and distinctly heard her friends bewailing her death ; 
 she felt them envelope her in her shroud, and place her in the 
 coffin. This sensation gave her extreme agony, and she attempted 
 to speak, but that her soul was unable to act upon her body. 
 She described her sensations as very contradictory, as if she was, 
 and was not, in the body at the same instant. She in vain at* 
 
 27 
 
418 MEDICAL JURISPRUDENCE. 
 
 tempted to move her arms, to open her eyes, or to speak. The 
 agony ot her mind was at its height when she heard the funeral 
 hymn, and found they were about to nail down the coffin. The 
 horror of being buried alive gave a new impulse to the mind, 
 which, in consequence, resumed its power over the corporeal 
 organization, and produced the effects which excited the notice 
 of those who were about to convey her to a premature grave. 
 Forsytes Med. Juris., 155. 
 The principal signs of death relied upon, are, 
 
 1. Cessation of the circulation. This is usually determined by 
 applying the finger to the wrist, or the hand to the heart. There 
 may be motions of the heart which these means cannot detect, 
 and the cases related show that the heart's motion has apparently 
 ceased, and that for a long time, and yet life has not been extinct. 
 This is not, therefore, an infallible criterion. 
 
 2. Cessation of the respiration. There are several means by 
 which this is determined. Among these are the following. As- 
 certain whether a feather can be moved, or a looking glass soiled, 
 or whether any motion is communicated to a cup of water placed 
 on the chest or abdomen. These seem fully as effectual as those 
 resorted to for the purpose of determining the cessation of the 
 circulation ; and yet the respiration, or the power of respiring, 
 remains, although these proclaim the contrary. This is not, 
 therefore, a certain sign of death. Guy, 377. 
 
 3. The fades Hippocratica. This is thus described. "A 
 wrinkled and dry brow ; hollow eyes ; pointed nose, bordered 
 with a black discoloration ; a depressed, hollow, and wrinkled 
 state of the temples ; elevation of the ears ; the lips relaxed and 
 pendant ; the cheek bones sunk ; the chin wrinkled and pointed ; 
 the skin dry and livid or lead colored ; a dull white powder on 
 the hair of the nostrils and eye brows." To this there are seve- 
 ral objections : 
 
 1 . Where it exists, it does not long survive the extinction of 
 life: 
 
 2. It is by no means universally met with, being generally 
 wanting in cases of sudden death : 
 
PERSONS FOUND DEAD. 413 
 
 3. It is rather an indication of the act of dying than of actual 
 death : 
 
 4. It has been observed where recovery has taken place : 
 
 5. It is often observed in living persons. It may be produced 
 by a strong passion, as fear. 
 
 This, therefore, is not a reliable sign. 
 
 4. State of the eye. Two appearances have been relied upon. 
 The one consists in a loss of transparency of the cornea, a col- 
 lapsed and wrinkled state of that membrane, together with the 
 formation of a tough glairy mucous, almost of the consistence of 
 membrane, covering the conjunctiva. The other is a collapsed 
 and softened state of the eye, which is generally attributed to the 
 absorption of the aqueous humor. The first are not reliable as 
 they may occur during life. The second is not always present 
 in case of death, as where it has occurred from apoplexy, car- 
 bonic acid, hydrocyanic acid, &c. 
 
 5. State of the skin. The indications here are pallor, livid 
 discolor ations, and loss of elasticity. The last is a sign of value. 
 The two first may occur during life. 
 
 6. Insensibility and immobility. These may be present during 
 life, and are not, therefore, of any value. 
 
 7. Extinction of muscular irritability. Suppose the fact clear- 
 ly settled that muscular irritability is totally extinct, life may be 
 assumed to be so too. If a muscle will not contract upon being 
 pricked with a pin, or on application of the galvanic or electric 
 fluid, the person is undoubtedly dead. The muscles of the trunk 
 and extremities retain their irritability longer than the involun- 
 tary muscles, with the exception of the right auricle of the 
 heart. 
 
 8. Extinction of animal heat. The higher temperature of the 
 body is closely connected with the circulation of the blood. The 
 cessation of the latter is attended with a declension of the for- 
 mer. Hence the extremities often grow cold before death, the 
 circulation in them becoming languid, or ceasing. All parts of 
 the body do not become cold before the extinction of life. There 
 may be a great diminution of heat over the entire surface of 
 the body, in cases where the c'rcilation is very languid, or h 
 
420 MEDICAL JURISPRUDENCE. 
 
 apparently ceased, or where the powers of the nervous system 
 are greatly depressed. This may occur in syncope, asphyxia, and 
 trance. Great care must, therefore, be taken, or an appeal to 
 this sign will mislead, as a great diminution of animal heat may 
 take place, and yet be consistent with life. 
 
 The extinction of animal heat, at the termination of life, is a 
 gradual process, depending much upon the mode or manner in 
 which death takes place. The period usually varies from two 
 or three hours, to fifteen or twenty. It is influenced — 
 
 1 . By the temperature and moisture of the surrounding air ; 
 the motion of the atmosphere ; the exposed state of the body 
 itself: 
 
 2. The condition of 'the body, in regard to corpulency or ema- 
 ciation, occurring more slowly in the former than in the latter : 
 
 3. The age. The bodies of the aged cool much faster than 
 those of the young and vigorous : 
 
 4. The mode of death. In cases of chronic disease or haemor- 
 rhage, the body cools much quicker than in all forms of sudden 
 death. In the former, much of the heat may be parted with 
 during life. 
 
 9. Rigidity. This sets in whenever muscular irritability ceases, 
 which is generally a very few hours after death. It is confined 
 to the muscular system, and may be regarded as the first certain 
 evidence of death. It has no dependence on the nervous sys- 
 tem, for it does not commence until the nerves have ceased to be 
 excited by the galvanic fluid. It takes place in all positions of 
 the body, and is sometimes so strong that the body may be lifted 
 up by the head and feet. It is regarded by John Hunter as the 
 last act of the vital principle ; and by Nysten, as a concentra- 
 tion of the remaining vital powers in the muscles, preparatory 
 to the total disappearance of the vital principle. Guy, 381 . 
 
 This rigidity commences with the muscles of the trunk and 
 neck ; next it seizes upon those of the upper extremities ; and 
 lastly, those of the lower. Its disappearance is nearly in the 
 same order. Its degree and duration are directly as the muscu- 
 lar developement. The later it occurs, the longer it lasts ; and 
 the reverse. It takes place the more speedily in the bodies of 
 
PERSONS FOUND DEAU. 421 
 
 the aged, and of those who have died of diseased accompanied 
 with great debility ; while in those who have died from acute 
 inflammation of the stomach, or by irritant poisons, it is strong- 
 ly developed, and lasts for a considerable time. In case of death 
 from spasmodic cholera, it commences soon after the extinction 
 of the vital principle, and may continue four or five days. 
 Warmth retards, and cold accelerates, the period of time at 
 which rigidity commences. 
 
 This cadaveric rigidity is so peculiar, that it is not easily con- 
 fdunded with any state of the living body. It is true, there may 
 be a rigidity of the muscular system in cases of syncope, as- 
 phyxia, apoplexy, catalepsy, and tetanus ; but in such cases, the 
 contraction extends through the whole body, and animal heat is 
 also present. A surer method of distinguishing, is to bend the 
 extremity forcibly, and if the rigidity proceeds from a vital con- 
 traction, the limb will be restored to its original position, but Dot 
 in case of cadaveric rigidity. This, therefore, may be regarded 
 as a certain sign of death. 
 
 10. Putrefaction. This also is a certain sign of death. It 
 causes a softening,, and bluish, greenish, or brownish discolora- 
 tion of the structures, and is characterized by a peculiar odor. 
 It is liable to be confounded with no appearance of the living 
 body except gangrene ; but is distinguished from that by its odor, 
 and by having no precise limits, while the spots of gangrene are 
 limited, and the most generally are found on the extremities. 
 
 From the cessation of cadaveric rigidity, the system seems to 
 be surrendered up to the laws that act upon dead animal matter. 
 The skin becomes inelastic, the flesh less firm, and the blood, 
 obeying the laws of gravity, falls to the most depending parts 
 of the body. Hence the pallor of some parts, and the cadave- 
 rous lividity of others. The fluids contained in the gall bladder 
 and in the humors of the eye, exude, tinging the parts contigu- 
 ous to the former with bile, and in the latter case, giving the dull 
 and collapsed appearance to the cornea. Hence the relaxed and 
 softened appearance of the tissues, attributed by many to the 
 commencement of the putrefactive process. 
 
 This is followed by the development of gases in several of the 
 
422 MEDICAL JURISPRUDENCE. 
 
 cavities of the body, especially in the abdomen. This develop- 
 ment gives rise to several changes, altering the condition of the 
 body in relation to buoyancy ; thrusting the diaphragm upwards ; 
 forcing the blood in the larger vessels towards the head and neck ; 
 causing the face to swell, the eyes to become prominent, and the 
 mouth and nostrils to discharge a mucous or bloody fluid. 
 
 After a time, the cuticle becomes detached, the muscles grow 
 viscid and pulpy, acquiring a dark greenish color, and exhaling 
 a highly offensive odor. Finally, all the tissues become changed 
 into a soft semi-fluid mass, that gradually loses its moisture, dries 
 up, and forms a fibrous fatty residue, which gradually disappears. 
 The process of putrefaction, once commenced, under favorable 
 circumstances, progresses with rapidity ; the decomposed parts 
 acting upon others, and promoting their decomposition also. 
 The most important conditions, essential to the commencement 
 and rapid progress of putrefaction, are the following : 
 
 1. Temperature. Putrefaction is much more rapid in the sum- 
 mer than in the winter ; finds the most favorable temperature in 
 that varying between 70° and 100°, and is arrested by one as 
 high as 212°, as it evaporates the fluids, and as low as 32°, as it 
 congeals them. 
 
 2. Moisture. This is entirely an essential condition. Those 
 paits of the body which naturally contain the most moisture, as 
 the brain and eye, commence putrifying the soonest, and pro- 
 gress the fastest. It is from the same cause, that bruises and the 
 edges of wounds, are subject to a rapid putrefaction ; and so, 
 also, are bodies that have remained for some time in the water, 
 and are then exposed to the air. A dry air may arrest putrefac- 
 tion. In the deserts of Arabia, the bodies of travellers have been 
 preserved for years, from the want of access to moisture. So, 
 also, a rapid current of air has about the same effect as dry air, 
 suspending putrefaction by causing rapid evaporation. 
 
 3. Air. Some suppose this essential to putrefaction. Others 
 deny that it is a necessary element. The process is retarded in 
 case of subjection to the influence of hydrogen, carbonic acid, 
 and nitrous acid, instead of atmospheric air. Oxygen promotes 
 putrefaction ; but, combined with nitrogen, its activity is increas 
 
PERSONS FOUND DEAD. 423 
 
 ed. Heat, moisture, and air, are the three great agents that pro- 
 mote the putrefactive process. 
 
 4. Age. Of the bodies of children, adults, and aged persons, 
 the first putrify the soonest, and the last sooner than those of 
 adults. 
 
 5. Sex. The bodies of females putrify more rapidly than those 
 of males, their cellular membrane being loaded with a greater 
 quantity of adipose matter. 
 
 6. Condition of the body and cause of death. So far as the con- 
 dition is concerned, that state or condition of the body is the 
 most favorable to the most rapid putrefaction, in which there is 
 the greatest quantity of fluid. In death from asphyxia, it is 
 more rapid than in death from hsemorrhage. So, also, it is more 
 rapid in those dying from acute, than from chronic diseases. 
 Where mechanical injuries have been inflicted, the process first 
 commences, and progresses the most rapidly, in the parts that 
 have been injured. 
 
 7. Period of interment. The longer a body has been exposed 
 to the action of the atmosphere previous to its interment, the 
 more rapid will be the putrifying process afterwards. 
 
 8. Place and mode of interment Putrefaction is slower in dry 
 elevated situations, and more rapid in loose swampy grounds. 
 This is owing principally to the absence in the one, and the pre- 
 sence in the other, of a greater degree of moisture. In sand or 
 gravel, the process is slow ; in marl or clay, more rapid. It is 
 slower, the deeper the body is buried. 
 
 The rapidity of the progress of putrefaction became a subject 
 of medico-legal enquiry in the case of Desha, who was indicted 
 and tried in Kentucky, for the murder of Baker, in 1824. 2 
 Beck, 32 - 3, &c. They were last seen together on the second 
 November, Tuesday, 1824. The body of Baker was found six 
 days after, (Monday) ; his throat cut, and five wounds inflicted 
 on the side of his head, the skin being broken. It was in a hol- 
 low, the woods and undergrowth thick around it, and but little 
 if any exposed to the sun. The weather was unusually warm 
 for the season, the nights being cool. The body was at first a 
 little stiff, but afterwards became limber. It had no smell of 
 
424 MKDICAL JURISPRUDENCE. 
 
 putrefaction. No alteration on Tuesday, a trifle on Wednesday ; 
 on Thursday it turned black, and became somewhat offensive. 
 The wounds appeared fresh, and bled much ; body not swollen 
 when found, but became so on Wednesday or Thursday. Seve- 
 ral medical witnesses were examined. One thought that the body 
 of a man might be ten days without putrifying, if there was a 
 discharge of much blood, as there seemed to have been here. 
 He supposed that the contents of the stomach,. within that time, 
 would produce putrefaction, unless there had been spirits drank, 
 as it appeared in this case there had. The result was that Desha 
 was convicted, and went to Texas. 
 
 Adipocire is so called from its possessing the physical charac- 
 ters of a compound of wax and fat. It has a yellowish-white 
 color, and is formed in bodies which remain a long time in water, 
 as also in those buried in moist soils. It is formed by the fat of 
 the body becoming converted into the margaric and oleic acids ; 
 which, uniting with the ammonia generated during decomposi- 
 tion, form a sort of animal soap. 
 
 3. What are the duties of the coroner, and the medical wit- 
 ness, in the case of a person found dead 1 
 
 The coroner was an ancient officer at the common law. He 
 is even mentioned as early as the year 925. His duties, as also 
 the proceedings in his court, have been very much matters of 
 statute regulation, although the statutory enactments have been 
 sometimes merely affirming the common law. 
 
 In this State, his duties are prescribed by statute. (2 R. S., 
 827-8, third edition.) Whenever he receives notice that any 
 person has been slain, or has suddenly died, or been dangerously 
 wounded, he is to repair to the place where such person shall 
 be, and forthwith summon not less than sixteen, nor more than 
 twenty-three persons, qualified by law to serve as juror?, and 
 not exempt from such service, who must appear before the coro- 
 ner at such place as he may appoint, to make inquisition con- 
 cerning such death or wounding. 
 
 As soon as twelve or more shall appear, they must be sworn 
 by the coroner, to enquire how, and in what manner, and when 
 and where, such person came to his death or was wounded, and 
 
PERSONS FOUND DEAD. 425 
 
 vvho such person was, and into all the circumstances attending 
 such death or wounding. They are to make a true inquisition, 
 according to the testimony offered to them, or arising from the 
 inspection of the body. 
 
 The coroner is empowered to issue subpoenas for witnesses, 
 and it is also enjoined upon him as a duty, to cause some sur- 
 geon or physician to be subpoenaed to appear as a witness upon 
 the taking of such inquest. 
 
 The coroner must reduce to writing the testimony of all the 
 witnesses examined before his jury; which, together with the 
 inquisition of the jury, and all recognizances and examinations 
 taken by him, must be returned to the next criminal court of 
 record to be held in the county. 
 
 The jury, after hearing the testimony and inspecting the body 
 of the person found dead or wounded, must deliver to the coro- 
 ner their inquisition in writing, signed by them ; in which they 
 shall find and certify, how, and in what manner, and when and 
 where, the person so dead or wounded, came to his death, or 
 was wounded, and who such person was ; and all the circum- 
 stances attending such death or wounding ; and who were guilty 
 thereof, either as principal or accessory, and in what manner. 
 
 In case murder, manslaughter, or assault has been committed, 
 the coroner must bind over the witnesses to appear and testify 
 at the next criminal court, and he may also issue process to ap- 
 prehend the party charged with the offence. 
 
 The inquisition found by the jury, and returned by the coroner, 
 is not final or conclusive upon any party. The great object is 
 to ascertain the cause and manner of death, the name of the 
 deceased, and the party, if any, who has been guilty of the 
 crime. It is the only court where the mere fact of sudden death 
 unaccounted for, or severe wounding, gives jurisdiction to act. 
 In any other court, a charge must first be made against the party 
 supposed guilty, and then the same enquiries may be gone into 
 relative to the cause of death, and the instrumentalities by which 
 it has been effected, as are made in the court of the coroner. 
 
 The coroner's inquest need not be held upon the spot where 
 
426 MEDICAL JURISPRUDENCE. 
 
 the body is found ; but the jury, before, they can render theii 
 inquisition, must first view the body. 
 
 In England, provision is made for remunerating the medicaJ 
 witness for his time and attendance before the coroner's court, 
 and also for any post-mortem examination he may make of the 
 body of the deceased. In the United States, no compensation is 
 allowed the medical witness for any services of this description. 
 But although he is bound to appear and testify, in obedience to 
 subpcena, and that without any compensation, yet he is not 
 bound, in addition to that, to make a post-mortem examination, 
 or analyze the contents of the stomach. Although he might be 
 required to inspect the body while on the witness'- stand, yet he 
 could not be compelled to leave the stand for that purpose ; or, 
 in general terms, to make any efforts to gain any particular in- 
 formation for the purpose of testifying. Guy, 370 - 71 . 
 
 Should the medical witness incline to make an examination of 
 the body, he should make a thorough one ; noting first, in case 
 the deceased was unknown, all those peculiar circumstances, 
 such as age, sex, stature, and peculiar marks that may serve the 
 purpose of identification. So, also, the presence or absence of 
 animal heat, of cadaveric rigidity, and putrefaction, may indi- 
 cate the length of time the body has been divested of fife. 
 
 The suggestions heretofore made in reference to examinations 
 in cases of death by poisoning and wounds, will supercede any 
 extended discussion relative to anything of the like character 
 here. It will be important to examine every cavity of the body, 
 even when the cause of death is very apparent ; because, other- 
 wise, it may be urged that disease may have been present in the 
 cavities unexamined, which may have produced the fatal result. 
 Guy's Principles of Forensic Medicine, 369. 
 
 4. What are the principal causes of sudden death ? How do 
 they operate, and what traces do they leave in the organiza- 
 tion 1 
 
 Sudden death generally arises from a powerful invasion of the 
 living forces as they are developing themselves in the action of 
 the heart, the brain, or the lungs, v 
 
 A. cessation of the heart's action is called syncope. An invi 
 
PERSONS FOUND DEAD. 427 
 
 sion of the action of 'the brain, apoplexy ; and of that of the 
 lungs, asphyxia — although a term certainly not well chosen. 
 The first, syncope, may arise from several causes ; as, 
 
 1 . From organic lesions in the structure of the heart itseii, or 
 in that of its vessels. 
 
 2. From destroying, or essentially impairing, the action of the 
 brain ; to the extent that the nervous influence would cease to 
 be furnished. This may arise from inflicting such a degree of 
 violence upon that organ as to annihilate its power of action ; 
 or, some sudden passion or emotion may so shock the general 
 nervous system, as at once to destroy that nervous influence 
 which is necessary to secure the heart's action. 
 
 3. From the operation of certain poisons. 
 
 4. From asphyxia, destroying the action of the heart by anni- 
 hilating the functions of the lungs. 
 
 In death from the first cause, haemorrhage would be likely to 
 occur, and the phenomena exhibited would be, pallor of the face 
 and lips, cold sweats, dizziness, dimness of vision, dilated pupils, 
 gasping and sighing respiration, a slow, weak and irregular 
 pulse, and sometimes nausea and vomiting, restlessness and toss- 
 ing of the limbs, transient delirium, and convulsions. Dissec- 
 tion will not only reveal the organic lesions, but will also disclose 
 the fact, that the heart and its great vessels are either empty, or 
 contain in their cavities a very insufficient quantity of blood. 
 The heart here ceases to act, because both cavities receive a 
 quantity of blood too small to excite them to contraction. 
 
 In death from the second cause assigned, if violence be done 
 to the brain, or the power of innervation is made to cease from 
 any inorganic lesion of that organ, it will, in general, be render- 
 ed evident upon post-mortem dissection. In such case, the heart, 
 instead of being found empty of blood, is much distended, and 
 the blood in the left auricle and ventricle is generally of a florid 
 color, resembling arterial more than venous blood. Several well 
 attested instances have occurred, in which the action of the 
 heart has suddenly ceased from the influence of some violent 
 passion. In such cases, there has probably been some organic 
 affection of the heart, or its vessels. Thus Philip V. died sud- 
 
428 MEDICAL JURISPRUDENCE. 
 
 denly, on being informed that the Spaniards had been defeated. 
 On opening the body, the heart was found ruptured. The cele- 
 brated John Hunter expired suddenly, from mental emotion, but 
 the valves of the heart had long been diseased. It has been as- 
 serted, that sudden joy was more likely to terminate life than 
 grief. The effect of the former is rather to accelerate, of the 
 latter to retard, circulation. 2 Paris §• Fonblanque's Medical Juris- 
 prudence, 28 - 9. 
 
 In death from the fourth cause, the right side of the heart is 
 found distended with blood, while the left is comparatively 
 empty. 
 
 The apoplectic mode of death, or that which occurs through 
 an invasion of the brain, is neither rare nor uncommon. It may 
 prcduce death directly or indirectly. In the first, it acts imme- 
 diately upon the heart. The innervation ceasing, the circulation 
 is immediately arrested ; each side of the heart contains its due 
 proportion of blood, and all the cavities are distended from the 
 sudden loss of power in the heart to propel its contents. In the 
 second, it acts upon the lungs, paralyzes the respiratory muscles, 
 and thus produces death by what is termed asphyxia, which 
 will come presently to be noticed. 
 
 It may happen that apoplexy may terminate life suddenly, and 
 in situations where no one was present at the time. In such 
 cases, what shall be the criterion, or method, of distinguishing 
 death from that cause, from any other sudden death 1 Attention 
 may here be paid — 
 
 1 . To a certain apoplectic make, or peculiar conformation of 
 the body : this consists, principally, in a large head, short neck, 
 and plethoric frame : 
 
 2. To the peculiar posture in which the person may be found : 
 
 3. To the food that he has recently eaten : 
 
 4. To any ligatures that may be found surrounding any part : 
 
 5. To the appearajwee revealed by dissection, particularly in 
 the head. 
 
 The simple apoplexy of Dr. Abercrombie, often proving fatal 
 in twenty-four hours, and leaving no traces in the dead body, 
 may create much difficulty in discriminating. 
 
PERSONS FCUND DEAD. 429 
 
 Sudden death commencing at the lungs, and embracing all the 
 forms of asphyxia, is the most essential to investigate in con- 
 nexion with persons found dead. Asphyxia, strictly, means 
 pulselessness ; but it is understood to embrace those cases in which 
 there occurs a cessation of the heart's action through the inter- 
 ruption of the respiration. This may be produced in a variety 
 of ways. The muscles of respiration may cease their action ; 
 the lungs may cease to act ; or atmospheric air may be excluded 
 from them. The first may arise from several causes. The 
 muscles may become inert from cold or debility. A stroke of 
 lightning, division of the spinal marrow, or pneumogastric and 
 phrenic nerves, will destroy the nervous influence, so necessary 
 to produce innervation. Mechanical restraint will have the same 
 effect, and so also will tonic spasm, as occurs in death from teta- 
 nus or hydrophobia. The lungs may also cease their action in 
 consequence of a division of the eighth pair of nerves, or of 
 their being mechanically compressed by air gaining admission 
 into the pleura. All the numerous ways by which atmospheric 
 air is excluded from the lungs, are also so many distinct methods 
 of producing asphyxia. 
 
 The symptoms which accompany asphyxia, will vary consider- 
 ably according as the cause producing it acts with celerity or 
 slowness. In case of entire exclusion of atmospheric air, the 
 symptoms are strongly marked, and succeed each other with 
 great rapidity. The first struggle is for breath, and a strong ef- 
 fort is made to expand the chest. The effort brings the blood 
 into the head, causing the face at first to flush, and very soon to 
 grow turgid and livid. The veins of the head and neck swell, 
 and the eye-balls are starting from their sockets. 
 
 The distress passes away, and is even followed by sensations 
 of an agreeable kind, by giddiness, a great variety of brilliant 
 colors appearing before the eyes. Next comes loss of conscious- 
 ness, convulsive movements, and relaxation of the sphincters. 
 The whole course of symptoms is run between two and three 
 minutes. 
 
 If the cause acts slowly, the symptoms are somewhat modified, 
 and the intervals between them longer. The partial admission 
 
430 MEDICAL JURISPRUDENCE. 
 
 of air serves to protract the struggle, the efforts being followed 
 by a sense of heaviness, and pain in the head. This is succeeded 
 by dimness of sight, torpor of intellect and sensation, vertigo, 
 and loss of voluntary motion. The lungs and heart still keep 
 up a very feeble and languid action, until, at length, that also 
 ceases. The greater protraction of the struggle brings the- blood 
 more generally into the capillary system ; the face becomes in- 
 jected, and exhibits a deep violet discoloration, extending to the 
 hands and feet. When the capillary circulation ceases, the state 
 of asphyxia is complete. Guy, 394-5. 
 
 The appearances in the dead body are the following : On the 
 face, and other parts of the body, are violet discolorations. These 
 spots differ from cadaverous lividity, in the fact, that they may 
 be found on any part of the body, and are not confined to the 
 depending parts. Their seat is chiefly in the mucous membrane 
 of the skin. The eyes are prominent, firm . and brilliant. The 
 occurrence of cadaveric rigidity is early, well marked, and con- 
 tinues for a long time. In cases of violent struggle, the venous 
 system of the brain may be found full of blood ; its substance 
 presenting bloody points. At times, serum may be found effused 
 into the ventricles, and blood m.1 the base, or in the substance of 
 the brain. The lungs are much distended with a thick dark- 
 colored blood. So also the liver, spleen, and kidneys are gorged. 
 The right cavities of the heart are much distended and gorged 
 with thick, black, and liquid blood. The left cavities are empty, 
 or contain but a small quantity of blood. 
 
 Various theories have been proposed, to account for asphyxia. 
 The active cause of death has formerly been sought, and sup- 
 posed to have been found, in the change produced in the blood 
 by depriving it of its process of oxygenation in the lungs. Re- 
 cent experiments have tended to disprove this ; and the cause is 
 now generally supposed to consist in the accumulation of blood 
 in the lungs, and a consequent diminished supply to the left 
 cavities of the heart ; the quantity of blood thus constantly di- 
 minishing, until the circulation entirely ceases. Hence the empti- 
 ness of the left cavities of the heart. 
 
 5. What are the circumstances under which the body is found l 
 
 l l 
 
PERSONS FOUND DEAD 431 
 
 Its position, place, relations, &c, with the view to discriminate 
 by what agency it became divested of life. 
 
 1. Its Position. Not unfrequently, a murderer, having dis- 
 patched his victim, endeavors so to dispose of the body, as to 
 create the conviction that the deceased had died by his own hand. 
 
 It most usually happens in such cases, that the criminal has 
 omitted something either in the arrangement of the body, or of the 
 surrounding objects, by means of which the fraud has been de- 
 tected. The question is, whether the position corresponds with the 
 cause of death. Suppose a man killed by a blow on the head were 
 found in an upright position, the just inference would be that the 
 body had been placed in that position after death. 
 
 2. The place where the body is found. One fact to be deter- 
 mined here is, whether the death occurred on the spot, or else- 
 where ; the body having been brought to the spot where found, 
 after it was divested of life. It must, accordingly, be ascertained, 
 if possible, what amount of haemorrhage has taken place ; whether 
 there is any stone or other hard substance which, by a fall upon 
 it, would have caused a severe contusion ; whether there is any 
 nail, or other instrument, that may have produced a lacerated 
 wound j and whether any foot-prints are to be found in the 
 vicinity of the body ; or any evidence of a struggle is there to be 
 found. 
 
 3. Its relations with surrounding objects. One point to ob- 
 serve is, the proximity of the instrument of death. Not only its 
 distance must be ascertained, but also its peculiarity of position, 
 as compared with that of the body. A case in which these re- 
 lations became of great importance to investigate was that of the 
 Prince de Conde, who was found suspended by the neck in his 
 bedroom, and the question was, whether it was a case of suicide 
 or of murder : the body having been suspended after death to 
 create the belief that the death was suicidal. On the legs, and 
 one of the shoulders, were found abrasions, which corresponded 
 closely with the position of surrounding objects ; the former with 
 a heavy chair placed near the body, and the latter with a pro- 
 jecting part of the window to which he was found suspended. 
 Thus, it was rendered pretty evident that these bruises arose 
 
432 MEDICAL JURISPRUDENCE. 
 
 from the struggles after suspension, and that the case was, the?," 
 fore, one of suicide. 
 
 4. The clothes on the body should be examined. The princi 
 pal things to be had in view on such examination are, the stain A 
 that may be found on them, and the rents and cuts that may be 
 discovered. The direction of the two last mentioned must be 
 carefully noted ; as, also, whether the size, shape and direction 
 coincide in the several garments, and correspond with wounds 
 found on the body itself. 
 
 6. What are the causes, appearances, signs and indications of 
 death by drowning, and the medico-legal questions connected 
 with it 1 
 
 1 . What are the causes of death by drowning 1 Of these there 
 are several. That which is probably the most common is what 
 may be termed asphyxia by suffocation. This mode of death is 
 accomplished by the exclusion of atmospheric air from the lungs. 
 It occurs when a man, in the full possession of his faculties, fells 
 into the water. As he rises to the surface after sinking, attempts 
 are made at respiration, in which the most generally some air, 
 along with water, is received. The water taken in by an act of 
 deglutition passes into the stomach. Unless he can swim, he 
 again sinks ; and, on again rising to the surface, repeats the same 
 attempts. All self-control is very soon lost. There occur, ir- 
 regular movements of the arms and legs, the hands grasping at 
 all objects within reach. The water, coming in contact with the 
 larynx, causes coughing, which may result in ejecting the fluid 
 with a portion of the air which was contained within the lungs. 
 The intensity of the struggle determines the blood to the head, 
 and as it ceases to be oxygenated, its venous qualities act on the 
 brain. The lungs, at length, become unable to perform theii 
 functions ; the elastic re-action of the parieties of the chest force 
 out of them the remaining air, which arises in the form of bub- 
 bles to the surface j a feeling of delirium supervenes ; a ringing 
 sensation in the ears is experienced ; all consciousness is lost ; 
 and death occurs from asphyxia. This is, by far, the most com- 
 mon mode of death ; and the quantity of water that finds its way 
 into the stomach and lungs will depend very much upon -the 
 
PERSONS FOUND DEAD. 433 
 
 strength of the individual, and the length of time to which his 
 struggles have been protracted. Guy, 405-6; Taylor, 401 ; 2 
 Beck, 148. 
 
 Another form of death has been termed nervous or syncopal as- 
 phyxia. This occurs when sudden fright, an impression of cold, 
 an attack of hysteria or catalepsy, seizes upon the person, anni- 
 hilating all consciousness at the moment of immersion. Here, 
 there is no effort, no struggle, the death being, in fact, owing to 
 syncope. 
 
 Another, or third form, has been styled asphyxia from cerebral 
 congestion. This occurs where the impression of cold, or some 
 other cause, developes apoplexy in those of an apoplectic habit. 
 
 One or two other forms have been mentioned, but they are of 
 little practical importance. Indeed, the mode first mentioned is 
 far more important than all the others put together. 
 
 2. What are the appearances presented in death by drowning 1 
 These will, of course, depend upon the mode of death. Where 
 it occurs from the first mode, the face will be found generally 
 pale, although, sometimes of a violet hue ; a frothy foam at the 
 mouth, and the tongue often between the teeth. A froth, some- 
 times tinged with blood, is often found in the larynx, trachea, 
 and bronchi. Water may be found in the trachea, and some- 
 times even in the minute ramifications of the bronchia. The 
 lungs have a violet hue, and contain a quantity of black fluid 
 blood. As, in other modes of asphyxia, the right cavities of 
 the heart and the venae cavse contain a considerable quantity of 
 blood ; while the left cavities and the aorta are nearly empty. 
 The stomach contains a portion, sometimes considerable, of the 
 fluid in which the body is immersed. The liver and spleen are 
 gorged with blood. The medullary substance of the brain pre- 
 sents, when sliced, a number of bloody points. Sand and mud 
 are sometimes found in the hollow of the nails. Guy's Prin. of 
 Form. Med., 400 -"7. 
 
 In the syncopal mode of death, the face and skin generally are 
 pale, owing to a spasm of the cutaneous vessels. The trachea 
 is empty ; or, if it contain a small quantity of water, it will not 
 contain froth. The lungs are only slightly developed, and have 
 
 28 
 
434 MEDICAL JURISPRUDENCE. 
 
 their natural color. The brain and other organs are in a natural 
 state. There is no water in the stomach ; and the right and left 
 cavities of the heart contain about equal quantities of blood, but 
 those quantities are small. 
 
 In the apoplectic mode, which is extremely rare, the usual in 
 dications of death by apoplexy will be found in the brain. 
 
 3. The signs and indications of death by drowning ; and under 
 this may be included the consideration of the first medico-legal 
 question, viz : What are thl signs and indications, if any, which 
 distinguish death by submersion from death previous to it 1 Or, in 
 other words, What are the means of discriminating death from 
 drowning from death arising from any other cause ? 
 
 It may be well to pass in brief review some of the appearances 
 that characterize death by drowning, to see how far they may be 
 relied upon as distinctive. 
 
 1 . Pallor of the face, with the violet hue occasionally found. 
 Neither of these are peculiar to this kind of death. The color 
 varies with the length of time the body remains immersed in 
 water. If it be soon removed, the surface is pale ; but, if suffered 
 to remain some days, it becomes livid and bloated. This may, 
 therefore, be a means of furnishing some evidence in regard to 
 the length of time the body has lain in the water. 
 
 2. The position of the tongue, and the injected state of its base. 
 The tip of the tongue is sometimes found in contact with the 
 incisor teeth, and sometimes between the closed jaws. The jaws 
 are generally found firmly closed, and the tongue is often wounded. 
 The injected state of the base of the tongue is found in several 
 other kinds of death, as that by hanging, strangulation, &c, and 
 cannot, therefore, be relied upon as indicating death from drown- 
 ing. Guy, 408. 
 
 3. The existence of a froth, sometimes bloody, founjl in the 
 larynx, trachea, and bronchi. This froth is generally found of a 
 white color, consisting of a number of very small bubbles, all 
 having a watery envelope easily broken. It is, undoubtedly, the 
 result of vital action, and is formed only in those cases where the 
 drowning man has risen to the surface, and inspired small quan- 
 tities of air which has been received along with water. It is 
 
PERSONS FOUND DEAD. 435 
 
 more easily formed in the last bronchial ramifications than in 
 the trachea ; and the part where it is preserved for the longest 
 period, is at the bifurcation of the trachea. 2 Beck, 156-7. The 
 objections to it as distinctive are two, — the one that it may be 
 found in other forms of death ; as, in death from hanging, 
 apoplexy, and epilepsy ; the other, that it is by no means invaria- 
 bly found in those who have been drowned. Thus, it may not 
 be found in the following cases : — where no air was inhaled while . 
 in the act of drowning ; where the body remained long in the 
 water after death ; where it is exposed to the air several days 
 before it is examined ; or even where it is removed from the 
 water with the head depending. 
 
 4. The existence of water in the trachea, or in the minute rami- 
 fications of the bronchia. In regard to this, considerable diversity 
 of opinion has formerly existed, but there is now less doubt. Not 
 only water, but sand and mud have entered the air passages. 
 
 Dr. Coxe claims to have proved by experiment : 1 . That when 
 an animal is immersed in any fluid, and taken out previous to 
 the last efforts at respiration, none of the fluid will have entered 
 the lungs ; and 2. That when water is found in the lungs of an 
 animal, it is absolutely necessary that the animal be under water 
 when making its last efforts to breathe. 2 Beck, 158. It is, there- 
 fore, influenced by the depth of water, and the access to air, and 
 is not universally found in those who have died from drowning. 
 
 There appears to be no doubt now but that water may find its 
 way into the "lungs of bodies thrown into it after death. The 
 quantity will depend very much on the position of the body. If 
 upright, a larger quantity will gain access ; if horizontal, a less 
 quantity ; and if the head be entirely depending, probably none 
 would enter at all, or if any had entered, it would flow out. 
 
 5. The fullness of the right cavities of the heart, and the empti- 
 ness of the left. This is common to all the forms of asphyxia, by 
 whatever means it may be produced, and is not, therefore, pecu- 
 liar to drowning. 
 
 6. Tie existence of water in the stomach. When water is found in 
 the stomach of the recently drowned, it is presumed to have got 
 there by deglutition, and hence the proof of life at the time is 
 
436 MEDICAL JURISPRUDENCE. 
 
 clear and complete. It may, however, have been received prior 
 to drowning ; and in order to afford clear evidence that the death 
 was caused by drowning, it should be identified with the water 
 in which the body is found. This may be difficult unless the 
 water be of a peculiar character, or some fragments of plants 
 floating on it be swallowed. 
 
 It has been claimed by som< , that where a dead body is thrown 
 into water, the fluid may gain access to the stomach ; and that 
 thus the fact of the presence of water in the stomach, proving 
 death by drowning, is done away with. It may be stated as 
 generally true, that the parieties of the oesophagus close so firmly 
 after death, that no water can gain access to the stomach. There 
 may be two possible exceptions ; the one where the body is at so 
 great a depth in the water that the columnar pressure will be 
 sufficient to overcome the resistance, and the other, where putre- 
 faction has produced a general relaxation of the tissues, and thus 
 removed the obstacle offered in their more unyielding state. In 
 the latter case, the appearances about the body might be sufficient 
 to indicate that its entrance was from that cause. In general it 
 may be stated, that the presence of water in the stomach, identi- 
 cal with that in which the body was found, is regarded as afford- 
 ing very satisfactory evidence of death from drowning. 
 
 7. The fluid stale of the blood. This was formerly much in- 
 sisted on as a test, but it is obvious it can be of little real value, 
 as it cannot be relied upon when putrefaction exists, and when 
 it does not, it is by no means a certain sign, as it may be the 
 consequence of other forms of death. 
 
 8. The state of the brain. An injected state of this organ occurs 
 in many other forms of death. It is not always present in death 
 by drowning. It clearly would not be in the syncopal form of 
 death. 
 
 9. The existence of bloody urine in the bladder. This is not only 
 of rare occurrence, but may also be found in death by hanging, 
 and in some cases of poisoning, and is not, therefore, distinctive. 
 
 10. Excoriations of the fingers, and the presence of sand or dirt 
 under the nails. This has been supposed to indicate the last effort 
 of the living individual to save himself from death. It would 
 
PERSONS FOUND DEAD. 437 
 
 not occur where the water was so deep that the bottom was not 
 reached, nor where the form of death was syncopal, nor where 
 the individual was in a state of intoxication. It is not really re- 
 garded as possessing much value. 
 
 1 1 . Froth in the mouth and nostrils. This, like froth in the ail 
 passages, is often wanting ; but where it is found, is regarded as 
 an indication possessed of considerable value. It may depend 
 upon the putrefactive process ; the air generated, forcing the 
 froth in the larynx and trachea into the fauces. 
 
 In summing up the value of all these signs and indications of 
 death by drowning, it will be apparent, that but few can be re 
 lied upon as possessing sufficient force to entitle them to be re- 
 ceived as evidence ; that those the most reliable are froth in the 
 trachea and bronchia, froth in the mouth and nostrils, and water 
 in the stomach ; and that the effect to be given to this species of 
 evidence, is derived rather from the concurrence of a number of 
 them, than from the force of any one singly. 
 
 2. Another medico-legal question may be, at what period does 
 death take place from drowning 1 This question, so far as it re- 
 lates to the time at which individuals who have fallen into the 
 water die, must obviously be extremely indefinite. Some have 
 more strength and more presence of mind than others, and can, 
 therefore, keep themselves more at the surface, and hold out 
 much longer. The more definite question is, how long can a 
 person remain beneath the surface of water without becoming 
 drowned 1 The answer to this is, that when the mouth is so 
 covered that air cannot enter, asphyxia supervenes in the course 
 of one or two minutes at the farthest. This applies with little 
 variation to all individuals, and can be little, if at all, varied by 
 habit It has been observed of sponge divers, who are accus- 
 tomed to the practice of diving, that no one could sustain entire 
 submersion of the body for two consecutive minutes. 
 
 In ordinary cases of drowning, the individual has more or less 
 access to air, and hence the time intervening between his falling 
 into the water, and expiring, is considerably various. There 
 have been some singular cases of resuscitation, where the immer- 
 sion has been for much longer periods of time than those already 
 
438 MEDICAL JURISPRUDENCE. 
 
 mentioned. One well authenticated case is mentioned, where 
 the individual was resuscitated after an entire submersion of five 
 consecutive minutes. Taylor, 404. So also another is recorded 
 after an immersion for the same time. Another is mentioned, 
 of a boy recovered after a submersion of from five to ten minutes. 
 Another case is mentioned of recovery after six minutes immer- 
 sion. Another very extraordinary case has been cited, where an 
 individual is stated to have been resuscitated after fourteen 
 minutes submersion. This seems to be the longest authentic 
 period known, although there are cases of alleged recovery, after 
 half, and even three-quarters of an hour's submersion. Taylor, 
 404. Much probably is to be set down to the credit of inaccu- 
 racy of observation, although it is readily conceivable, that in 
 cases of purely nervous or syncopal asphyxia, there may be a 
 recovery from submersion after a much longer period than where 
 the asphyxia occurs from suffocation. These facts should ad- 
 monish us not to give over too readily the use of the appropriate 
 means to resuscitate^ although the submersion may have been 
 for a considerable time. 
 
 3. A third medico-legal question relates to the marks of violence 
 that can he traced on the bodies of those found in the water. 
 Whether any such were inflicted before or after death ; and 
 whether they were designed or accidental ; and whether self-in- 
 flicted or the act of another ; are all questions elsewhere discussed. 
 One of the principal points to be determined here is, whether the 
 injuries are of such a nature as to account for death before 
 submersion. Injuries may occur to the body, after it is divested 
 of life, in consequence of its being borne by the violence of the 
 stream against some obstacle. In this case it will present the 
 appearance of wounds inflicted after death. The individual may 
 have been murdered and then thrown into the water. In this 
 case, the wounds will present the appearances of those inflicted 
 during life, while no indications of death by drowning will be 
 present. So also severe injuries may be sustained, and yet the 
 individual, still- ajive, may be thrown, or throw himself, into the 
 water. In this case, the indications of death by drowning will 
 be present, but they may be much feebler than ia those instances 
 
PERSONS FOUND DEAD. 439 
 
 whore deatu by drowning occurs in a healthy, sound individual. 
 The rapidity of the stream, the situation of its banks, the pre- 
 sence or absence of obstacles, may enable the medical jurist to 
 judge whether the injuries perceived are due to any of those 
 causes. The height fallen from, aDd the obstacles in the way, 
 should be carefully observed. 
 
 4. The fourth question regards the effects of immersion on the 
 dead body, and the changes produced by it. The specific gravity 
 of the body is a little greater than that of water, hence it will 
 sink in it whether living or dead. So slight, however, is the 
 difference, that the body may float when its cavities have been 
 previously filled with air. It has even been suggested that 
 where death has occurred from strangling, the cord still remain- 
 ing about the neck, there may be sufficient air confined within 
 the body to make it float in water. Ordinarily, at the termina- 
 tion of life, the body sinks, and remains sunken some four or five 
 days, when the gases developed by putrefaction render it specifi- 
 cally lighter than water, and it rises to the surface and there 
 floats ; the bodies of males generally with the back upward, those 
 of females with the abdomen. Taylor, 410. 
 
 It may sometimes become material to determine how long a 
 body has lain in water. Inferences in relation to this are de- 
 rived from the appearances which the parts present ; the pro- 
 gress of putrefaction ; and the fact whether that fatty compound, 
 termed adipocere, has been produced. Water, whether stagnant 
 or running, will produce this, but the latter the most readily. 
 In stagnant water the formation of it is not complete under a 
 period of two months. A month is about the earliest period at 
 which it may be observed. A body interred in the soil requires 
 a much longer time. Taylor, 410. 
 
 5. Was the drowning the result of accident, suicide or homicide 1 
 Little can be said that will throw any light on this subject. If 
 there is no mark of violence found on the body, there can be no 
 means of determining whether the drowning was the result of 
 accident, suicide or homicide. If there are marks of violence 
 found, then the question will arise whether they are of such a 
 character as to lead to the conclusion that they were inflicted by 
 
440 MEDICAL JURISPRUDENCE. 
 
 another, or self-inflicted previous to immersion, or accidentally 
 inflicted by striking the body against an obstacle. The wound 
 may be in some concealed part, or beyond the reach of the indi- 
 vidual himself, and by that means be rendered clear that it was 
 the act of another. The great majority of injuries are of such a 
 character that they may be homicidal or suicidal. These ques- 
 tions have been investigated under the head of wounds. 
 
 7. What are the causes, appearances, signs and indications of 
 death by hanging, and the medico-legal questions connected with 
 it? 
 
 1. The cause of death from hanging. This may depend some- 
 what upon circumstances. The cause which probably operates 
 in the majority of cases, is the suspension of respiration by com- 
 pression of the larynx. Dr. Monroe suspended a dog, having 
 made an opening into his trachea below the place where the cord 
 encircled his neck. The suspension continued three-quarters of 
 an hour, and no apparent injury was sustained, respiration hav- 
 ing been carried on through the aperture. When, however, the 
 c^rd was placed below the aperture, and the animal was sus- 
 pended, life became extinct very soon. Kay on Asphyxia, 290. 
 
 An attempt was once made to save a criminal upon this prin 
 ciple. An incision was made in the neck, and a tube introduced 
 into the trachea to provide for a continuance of respiration. 
 After being taken down, blood was drawn from the jugular vein, 
 the malefactor once opened his eyes and sighed, but did not re- 
 cover. He was a very heavy man, and probably some other 
 cause of death operated, in his case, beside the suspension of re- 
 spiration. One extraordinary case of suspension is related by 
 Dr. Plott, of a woman in the reign of Henry VI., who remained 
 suspended one whole night, and was still alive, owing as it was 
 said, to her larynx having been ossified. A case is well authen- 
 ticated ot a woman convicted in Edinburgh in 1728, who after 
 having the sentence of the law executed upon her, or attempted 
 so to be, recovered, and afterwards lived twenty -five years. Kay 
 on Asphyxia, 292. 
 
 Sometimes the cord may be so placed between the lower jaw 
 and the larynx, as that there will not be a complete obliteration 
 
PERSONS FOUND DEAD. 441 
 
 )f the air passages. In such case the small supply of air enables 
 the system to struggle on for a longer or shorter period, and life 
 may be prolonged until congestion occurs in the brain. 
 
 This introduces to the second cause of death, viz., apoplexy, 
 arising from pressure on the large blood vessels sufficient to pro- 
 duce an interruption of the circulation. The veins lying nearer 
 the surface, and being more exposed than the arteries, are so 
 pressed by the cord, that the return of the blood from the head 
 is interrupted ; and thus congestion produced in the vessels of 
 the brain. Death resulting from this cause would be produced 
 more slowly than from the suspension of respiration. Probably 
 in most cases, both these causes are in operation, but the former 
 would be the most efficient. 
 
 A third cause of death may be found in a laceration of the 
 trachea or larynx, or a luxation or fracture of the cervical verte- 
 bra, from a rupture of the ligaments of the neck. Death from 
 this cause is the most speedily effected, and occurs without a 
 struggle. It is accomplished by a careful adjustment of the cord, 
 and by giving a twisting motion to the body at the moment it is 
 cast into the air. The height of the fall, in connexion with the 
 weight of the person, has something to do with this form of 
 death. 
 
 A fourth cause is ascribed to the compression of the nerves of 
 the neck. To ascertain the effect of this, Mr. Brodie passed a 
 ligature under the trachea of a Guinea pig, and tied it tight on 
 the back of the neck with a knot. The ligature was removed at 
 the end of fifteen minutes, and the animal was found dead on the 
 following morning. The lungs were out dark and turgid, pre- 
 senting an appearance similar to that which is observed after the 
 division of the eighth pair of nerves. 
 
 The last mentioned, is probably seldom or never the sole cause 
 of death. It may operate to prevent resuscitation, provided the 
 other causes have proved insufficient to produce death. 
 
 Death from hanging, from whatever immediate cause it may 
 proceed, generally takes place speedily. Restoration to life has 
 often been found impossible after a few minutes suspension. If 
 the neck has suffered no serious injury, resuscitation may some 
 
442 MEDICAL JURISPKUDKNCK. 
 
 times take place after a suspension of five minutes and ever 
 longer. In other cases, a much shorter period, without the oc- 
 currence of such injury, will extinguish the vital principle. 
 
 Some instances have occurred, especially in the French revolu- 
 tion of 1793, in which recoveries were had of several persons 
 who attempted to commit suicide by hanging. It seems from 
 the accounts given by such, of their sensations, that they were 
 not always the same ; owing probably to different degrees of pres- 
 sure upon the larynx and blood vessels. One instance is given 
 of a man and woman who survived hanging. The woman re- 
 membered nothing, but the man stated, that on the application 
 of the cord, he felt no pain, but sank, as it were, into a profound 
 sleep. In another case, the first sensation was flashes of light 
 before the eyes, and then a sinking into the same sleep. Guy, 
 422-3. 
 
 From the results of all the experiences that can be gathered 
 upon this subject, either from the suicide who has been seeking 
 to destroy life, or the philosopher whose only object is to experi- 
 ment, it would appear that sometimes there is an immediate loss 
 of sense and motion ; in others the sensations are pleasurable 
 though short, being followed by an indistinctness of vision, and 
 subsequently by the appearance of a bluish flame, or brilliant 
 circles of colors before the eyes, and at the same time there is a 
 singing or hissing sound in the ears. Then all consciousness is 
 lost, and death sooner or later supervenes. These symptoms are 
 obviously referable to a disturbance of circulation in the brain, 
 and hence incline to the belief that very often death is due both 
 to the suspension of respiration, and also the interruption of the 
 circulation, giving rise to congestion in the vessels of the brain. 
 
 2. What are the appearances, signs and indications of death by 
 hanging 1 These will depend much upon the cause of death. 
 They have been principally collected from an examination of the 
 bodies of executed criminals, in which more or less violence has 
 been used, and the countenance is expressive of suffering. They 
 are to be found — 
 
 1 . In the countenance, which appears livid and swollen ; the 
 lips appearing distorted ; the eyelids swollen and of a bluish color 
 
PERSONS FOUND DEAD. 443 
 
 the eyes red and projecting, sometimes seeming to start from 
 their orbits ; the tongue enlarged, livid, compressed between the 
 teeth, or frequently protruded ; a froth appearing about the lips 
 and nostrils : 
 
 2. The neck exhibits the mark of the cord, being a deep ecchy- 
 mosed impression, the skin sometimes excoriated, the muscles 
 and ligaments in the hyoideal region at times lacerated, as also 
 the larynx and upper part of the trachea. 
 
 3. There are not unfrequently ecchymosed patches, of different 
 extent, about the upper part of the trunk, and on the extremities, 
 with a discoloration of the hands : 
 
 4. The fingers are either contracted or firmly clenched : 
 
 5. The urine, faces, and seminal fluid, are sometimes involun- 
 tarily expelled at the moment of death : 
 
 6. The body retains its animal heat longer than in other modes 
 of death : 
 
 7. If the inspection is made soon after death, the right side of 
 the heart and large veins are found distended with blood : 
 
 8. The substance of the brain presents increased vascularity, its 
 vessels being usually congested, but rarely presenting bloody extra- 
 vasation : 
 
 9. A mucous froth, sometimes bloody, is found in the trachea, 
 and the mucous membrane of the stomach congested. 
 
 The peculiarity and distinctive character of most of these signs 
 and indications, will come up for consideration under the first 
 medico-legal question, which is — 
 
 1. Did the /tanging occur during life or after death? This 
 question may arise when there exists the suspicion that the per- 
 son found dead has been first murdered, and then suspended, 
 with the view of deceiving as to the true cause of death. 
 
 1. The state of the countenance. Little can be collected from 
 this, except from the degree of injection of the vessels of the 
 head and face. This will be likely to be the most marked, the 
 longer the system has struggled on under an imperfect suspen- 
 sion of respiration. • 
 
 2. The mark of the cord. The impression produced by the 
 cord was formerly supposed to be invariably ecchymosed, and 
 
444 MEDICAL JURISPRUDENCE. 
 
 hence to indicate with great certainty that death occurred from 
 suspension. The size and material of the cord varied the im- 
 pression, a soft handkerchief leaving one far less marked than a 
 hard rope or other like ligature. There is seldom injury done 
 to the blood-vessels of the neck sufficient to cause real ecchymo- 
 sis, or effusion of blood into the cellular tissue. The livid circle 
 around the neck is the most commonly found in criminals who 
 have been executed, as more violence is usually done in such 
 cases than in those of suicide. 
 
 More recent examination in regard to this feature, has led to 
 the very general conclusion, that it is not invariably present 
 where death has occurred from hanging. In fifteen cases ex- 
 amined by M. Klein ; in twelve, examined by M. Esquirol ; and 
 in twenty-five, of suicidal hanging, which occured to M. Dever- 
 gie, there was no ecchymosis whatever. Dr. Remer collected one 
 hundred and one cases, and of these no less than eighty-nine pre- 
 sented a well marked ecchymosis. Of six cases observed by Dr. 
 Fleichman, there was no ecchymosis in two of them. In a case 
 mentioned by Taylor, 419-20., of a young man who attempted 
 to commit suicide in a state of intoxication, and was cut down 
 after hanging about half an hour, no ecchymosed mark was observ- 
 ed until signs of vital re-action had appeared, and on their disap 
 pearance, the mark on the neck became deeply ecchymosed. 
 
 Perhaps the production of the ecchymosed circle may depend 
 much upon the manner in which death occurs. If it takes place 
 through syncope, there will not be sufficient blood in the vessels 
 of the surface to occasion ecchymosis ; but, where violent and 
 protracted struggles precede death, it will be always likely to be 
 produced. It may be asked whether the appearances occasioned 
 by the cord in an individual suspended during life, may be pro- 
 duced after death. There seems to be no good reason why the 
 same principle which is applicable to ecchymosis generally, should 
 not also apply to this form of it. If such be the fact, the livid 
 circle supposed to characterize hanging during life, may be pro 
 duced by suspension soon after death. Accordingly, Orfila has 
 proved, by experiments, that up to eighteen hours after death, 
 precisely the same appearances may be produced as in suspen- 
 
x PERSONS FO'.ND 1 EAD. 445 
 
 sion during life. Dr. Casper also succeeded in producing the 
 same effects up to two hours after death The ecchymosed circle 
 cannot, therefore, be claimed as evidencing the fact of suspension 
 during life, although any very considerable effusion of blood, or 
 injury done to the neck, would afford a strong probability of sus- 
 pension during life. Guy, 426. 
 
 3. Stale of the genital organs. The genital organs of both sexes 
 have been affected in death by suspension : congestion and tume- 
 faction have occurred in both. At the moment of strangulation, 
 the penis has been several times discovered to become erect, and 
 sometimes the emission of semen has been observed. Redness of 
 the labia, and discharge of blood, have been observed in the fe- 
 male. This effect produced upon the genital organs is probably 
 caused by the action of the cord upon the cerebellum. The pres- 
 ence of erection and emission would, therefore, be evidence of 
 death by hanging ; but the absence of either, or both, would not 
 furnish evidence to the contrary. 
 
 2. The second medico-legal question is, was the hanging acci- 
 dental, suicidal, or homicidal ? The occurrence of accidental 
 hanging must, of course, be extremely rare ; but, nevertheless, 
 it has happened. Some three cases are given by Mr. Taylor, p. 
 424-5, in which it was purely accidental. Although, therefore, 
 its accidental • occurrence is possible, yet the principal points of 
 enquiry will have reference to its suicidal or homicidal character. 
 
 As between these two, the prima facie presumption is always 
 in favor of the former. Hanging, as a means of murder, has 
 seldom ever been resorted to. The very great disproportion of 
 strength required to accomplish it, would render it, in most cases, 
 entirely inadmissible. The possibility of death from this cause 
 must, however, be admitted. The one party may be feeble, the 
 other strong and healthy. So, also, there may exist intoxication, 
 stupefaction by narcotics, or exhaustion from any cause. Or, 
 there may be a combination of two or three against one individual. 
 In general, there would be found about the body marks of injury 
 inflicted during life, as there might be expected to be severe op- 
 position offered on the part of the victim, unless weakness, in- 
 toxication, or stupefaction prevailed to so great an extent as to 
 
446 MSDICAL JURISPRUDENCE. 
 
 preclude it. It should be borne in mind, however, that marks 
 of injury may be inflicted upon himself by a suicide ; or they 
 may possibly be of accidental occurrence after suspension, arising 
 from the body's coming in contact with articles of furniture or 
 other things around it. 
 
 It was once supposed that a certain position of the body — for 
 instance, the feet or some part of it touching the ground or floor — 
 was inconsistent with the fact of suicide. This has been discov- 
 ered to be an error. Death has been caused by suicide, when 
 the posture was such that it must clearly have been the result of 
 strangulation, the suicide leaning forward so as to compress the 
 wind-pipe. In one case of suicide, the body was found partly 
 reclining on a bed, but suspended by the neck from a cord which 
 was fastened to a nail. Guy, 429. This is probably owing to the 
 quick abolition of all consciousness when respiration is suspended, 
 and the free return of the blood from the head is prevented. 
 
 8. What are the causes, appearances, signs and indications of 
 death from strangulation, and the medico-legal questions con- 
 nected with it 1 
 
 This mode of death is essentially the same as that of hanging. 
 It may be effected either by the uniform pressure of the ligament 
 around the neck, or by pressing directly upon the trachea. The 
 differences observable between the former and death by hanging 
 are, 
 
 1. The mark of the cord, in case of strangulation, is usually 
 lower down on the neck than that observed in case of hanging. 
 
 2. It is more horizontal, that produced by hanging being 
 generally more or less oblique. 
 
 3. 14; is plainer, and more distinctly ecchymosed, than that 
 made by hanging, as it is a mode of murder generally more vio- 
 lent. The distinctness and extent of this ecchymosed circle will 
 depend mainly upon the nature of the instrument with which 
 death is produced, and the amount of force used in its produc- 
 tion. Where the instrument is merely a handkerchief, and soft 
 and yielding, the circle will be far less livid and ecchymosed than 
 when a hard / cord is made use of There is considerable variety 
 in the instruments used, and these will somewhat vary the kind 
 
PERSONS FOIKVD DEAD. 447 
 
 of death and the appearances presented by the body. In using 
 the bowstring, as practised by the Turks, the ligature is drawn 
 so tight as at once to cut off all communication between the lungs 
 and the atmosphere. Here, the death is sudden. In other cases, 
 where a feeble and imperfect respiration is for some time kept 
 up, there is more or less struggling, and not unfrequently suffusion 
 and distortion of the face 2 Beck, 129. 
 
 The appearances internally presented on a post-mortem ex- 
 amination, will not vary essentially from those observable in the 
 case of hanging. The more sudden the death, through the total 
 interruption of respiration, the more distinctly marked will be 
 the peculiar indications appearing on such an examination. 
 
 1 . The first medico-legal question presented may be thus stated, 
 Was the strangulation the cause of death, or was it resorted to after 
 death to conceal the real cause 1 That which is most relied upon 
 to furnish evidence that the strangulation occurred during life, 
 and was the cause of death, is the well defined ecchymosed circle 
 around the neck, where a ligature has been employed, taken 
 in connexion with the indications of turgescence about the 
 countenance. The application of a ligature, a short time after 
 death, may cause some degree of ecchymosis ; but, in that case, 
 there will be no turgescence of the countenance. The applica- 
 tion of the ligature six hours after death, will produce no livid 
 ecchymosed circle, resembling that caused by it during life. 
 It is asserted, with considerable confidence, that the reddish 
 ecchymosis left by the cord will be found only in those cases 
 where it has been applied previous to death. 
 
 The most perplexing case that has been brought forward, in 
 which this question came up for settlement, was that of Sir Ed- 
 mundbury Godfrey, which occurred in 1677. His body was 
 found in a ditch, his own sword passed through his chest, his 
 gloves and other articles of dress so disposed as to create a sus- 
 picion of suicide. Although the sword had passed through the 
 heart, yet no blood was found at the wound ; around the neck 
 was an ecchymosed mark an inch broad ; the face was livid and 
 suffused, and the eyes blood-shot. The cervical vertebrae were 
 fractured ; and the neck was so flexible that it could be turned 
 
418 MEDICAL JURISPRUDENCE. 
 
 from one shoulder to the other. There were, also, two wounds 
 found on the body ; the one going no further than the bone, hav- 
 ing struck on a rib ; and the other through his back. He was of 
 a melancholy temperament, and labored under a great depression 
 of spirits. This was probably a case of strangulation, accom- 
 panied with the infliction of other injuries. Guy, 432 ; 2 Beck, 
 130. Strangulation is sometimes effected by the hands as well 
 as by a cord. In such cases of manual strangulation, there will 
 be no livid ecchymosed circle around the neck ; but, in place of 
 it, will be found partial discolorations of an indistinct form, and 
 occasionally the positive marks of fingers. More or less re- 
 sistance in such a case is generally offered. Life continues for 
 some time, and the internal evidences of death by strangulation 
 are less strongly marked. In one case of strangulation, there 
 were patches of extravasated blood found on the throat, with 
 abrasions corresponding to the nails. Bruises were also observed 
 on the chest. The brain, on dissection, was found turgid with 
 blood. The victim had been strangled with a pocket-handker- 
 chief ; the knees of the murderer having been pressed on the 
 chest. 
 
 2. A second medico-legal question is, Was the strangulation 
 accidental, suicidal, or homicidal 1 So far as the first is concern* d, 
 it is very unfrequent, but not impossible. Several instances aire 
 on record of accidental strangling. In one case, a woman Avent 
 to bed with her bonnet on, in a state of intoxication. In the 
 morning, she was found strangled in her bonnet strings. So, 
 also, accidental strangulation has occurred from individuals car- 
 rying weights on their backs, which were supported by bands 
 passing round the head or chest. The slipping of these has 
 sometimes caused strangulation, by compressing the trachea. In 
 all such cases, the position of the body, and other circumstances, 
 will generally afford sufficient indication as to the particular man 
 ner and cause of death. Taylor, 434 ; Guy, 433. 
 
 Suicide by strangulation is certainly not a very common occur- 
 rence, as it may be naturally supposed that the hand of the indi- 
 vidual would lose its strength at the moment of compression. 
 There are, however, several instances of suicide committed by 
 
PERSONS FOUND DEAD. 449 
 
 such means. In one case, the suicide was found lying dead in 
 his bed, with two cravats twisted several times round his neck. 
 More frequently, some kind of stick is used to produce the neces- 
 sary compression. In one case, a poker ; in another, the handle 
 of a pot was thrust through the tie of the handkerchief, and then 
 twisted round and round, until the purpose was accomplished. 
 The place and circumstances are much relied upon to indicate 
 whether it be a case of suicide or homicide. The occurrence of 
 a case of pressure on the trachea would afford a very clear indi- 
 cation of homicide. In general terms, hanging may be said to be 
 the more frequently suicidal, and strangulation homicidal, in their 
 occurrence. 
 
 9. What are the causes, appearances, signs and indications of 
 death by smothering, and the medico-legal questions connected 
 with it 1 
 
 Death by smothering is accomplished by covering the mouth 
 and nostrils, in such a way as to exclude the ingress of atmos- 
 pheric air into the lungs. This may take place through accident, 
 or force ; and this may perhaps be stated as the only medico- 
 legal question that will be likely to present itself in this form of 
 death. A person intoxicated, or one who is helpless from any 
 other cause, may fall on the face, and become suffocated by water 
 or loose earth. In all such cases, the situation and circumstances 
 under which the>body is found, would indicate the accidental 
 character of the event. 
 
 In 1828, the city of Edinburgh was the scene of excitement, 
 arising from the discovery that two persons, by the names of 
 Burke and Hare / were in the practice of killing individuals by 
 smothering, and then selling their bodies for the purpose of dis- 
 section. The course pursued was, first to intoxicate the victim, 
 and when he was on the floor, one would keep him down by 
 throwing on him the weight of his body, covering the mouth 
 and nose with one hand, applying the other under the chin, thus 
 continuing to hold for ten or twelve minutes, until life was ex- 
 tinct. 2 Beck, 145. 
 
 In the case of Margery Campbell, the last one of Burke's vic^ 
 tims, the body presented the following appearances ; the exami^ 
 
 5J9 
 
450 MEDICAL JURISPRUDENCE. 
 
 nation having been made two days after death : The joints flac- 
 cid ; features composed, red, and rather more turgid than natu- 
 ral ; lips dark ; conjunctivse of the eyes, even in the horizontal 
 position of the body, much injected with blood ; a little fluid 
 blood on the left cheek, apparently from the nostrils ; tongue not 
 protruded ; the scurf skin under the chin much ruffled, and the 
 surface of the true skin dry and brown when denuded, but with- 
 out blood or surrounding ecchymosis ; the integuments every 
 where free from lividity, except on. the face ; no injury or effu- 
 sion about the wind r pipe or cartilages, but the os hyoides and 
 thyroid cartilage were further apart than usual, in consequence 
 of the stretching of the interposed ligament. The internal or- 
 gans were healthy, and particularly the lungs. The blood 
 throughout the bqdy was black and fluid, and accumulated in 
 the large veins, and in the right cavities of the heart. 
 
 This mode of death, particularly where opium or alcohol has 
 previously been administered, to stupify and render the system 
 insensible, leaves very few and imperfect traces upon the organi- 
 zation. The rapidity with which, death takes place leaves no 
 opportunity for the accumulation of blood in the venous system. 
 There will be, therefore, no discoloration of skin, no turgescence 
 of veins, no engorgement of pulmonary vessels. 
 
 10. Of persons found dead from Cold : Cases of this kind will 
 sometimes arise for medico-legal investigation, but the exposed 
 condition and circumstances under which the body is found ; the 
 season of the year ; the absence of any injuries, or other obvious 
 cause of death, will generally be sufficient to indicate the true 
 cause from which it has proceeded. 
 
 The effect of a moderate degree of cold is to invigorate the 
 system, but when it becomes intense, it creates a sensation of 
 •numbness and stiffness in the muscles of the limbs and face, 
 accompanied with paleness of the skin. Loss of sensibility, tor- 
 por, and profound sleep follow, all the vital functions gradually, 
 becoming more and more languid, until life entirely ceases. 
 
 The effect of cold upon the surface, is to contract the capilla- 
 ries of the skin, and thus drive the blood into the internal or- 
 gans. The great vessels of the spleen, liver, lungs, and brain 
 
PERSONS FOUND DEAD 451 
 
 arc more or less gorged with blood. The nervous system, under 
 the influence of intense cold, gives rise to various phenomena, 
 such as numbness, torpor, somnolency, giddiness, dimness of 
 sight, tetanus, and paralysis. 
 
 The effects of cold vary much according to the age, strength, 
 and habits of the individual. Of these, the young, the aged, the 
 weak and infirm, and those accustomed to habits of intoxication, 
 are much sooner frozen to death than those possessing firm, vig- 
 orous, healthy constitutions. Some individuals seem to have a 
 peculiar power of resisting cold far beyond others. From the 
 calm, quiet manner in which death generally supervenes, and from 
 the absence of all acute suffering, it seems probable that the 
 principle of vitality is equally diminished in every part, and 
 that the functions of no particular organ are exclusively dis- 
 turbed. 
 
 It was remarked by the French soldiers in their retreat from 
 Moscow, that those affected by cold, often reeled about as if in a 
 state of intoxication ; that they complained of vertigo and indis- 
 tinctness of vision ; and, under a feeling of lassitude, finally sank 
 into a state of lethargic stupor, from which it was impossible to 
 rouse them. 
 
 The traces left in the system, by this kind of death, are not 
 very peculiar or well marked. There is paleness of the surface, 
 and general congestion of the internal organs, particularly of 
 the lungs and gastro enteritic mucous membrane. So also there 
 is congestion, but not extravasation, of the vessels of the brain. 
 There has been observed to be serum effused in the ventricles 
 of the brain. The lethargic state has been attributed by some 
 to the greater determination of blood to the brain. 
 
 11. Of persons found dead from Burning : 
 
 The first question that will here naturally arise, regards the 
 accidental or intentional character of the burn. If accidental, 
 it will have occurred during life. If intentional, its occurrence 
 will be after death, the object being to conceal the real cause and 
 mode of death. This directly involves the question whether tht 
 burt,vng took place during life or after deathl The merit of in- 
 
152 MEDICAL JURISPRUDENCE. 
 
 vestigating and settling this question, appeals t j be due to Di . 
 Christison. The following are the conclusions be arrived at : 
 
 A burn inflicted during life, presents these appearances, viz : 
 Immediately surrounding the burnt spot, there is a narrow white 
 line; external to this, a second, of a deep red tint; and this lat- 
 ter, at its outer edge, runs by insensible degrees, into a diffused 
 redness. The diffused redness may be removed by gentle pres- 
 sure, and disappears after death. The deep red line, however, 
 is permanent. These appearances are observable in from five to 
 fifteen, and occasionally as late as thirty seconds after the burn. 
 The next appearance, in point of order, is that of blisters filled 
 with serum. The period at which the blisters rise has not been 
 accurately determined, but in most cases, a very few minutes 
 only are required. If, therefore, life is extinct within a few 
 minutes of the injury, blisters may be altogether absent. 
 
 After scalds, vesications make their appearance in a very few 
 minutes, but in young children it is said that some hours trans- 
 pire before they appear. Vesication" is not an invariable effect 
 of the application of heated bodies. Guy, 495. 
 
 The Doctor also made experiments testing the effect of fire 
 upon bodies soon after the extinction of life. He was unable at 
 all to produce in such, the deep red line not removable by pres- 
 sure. In some of the experiments, blisters were produced, but 
 there was this material difference between those, and such as 
 were raised during life, the former were filled with air, and the 
 latter with fluid ; and on the removal of the cuticle, the cutis 
 was found free from moisture. 
 
 In experiments made an hour after death, there were no ap- 
 pearances presented that could be mistaken for vital changes ; 
 all the effect beiDg a ruffling of the cuticle, and a drying up of 
 the parts to which the heated body was applied. 
 
 From all his experiments, therefore, the deep red line, and 
 the vesicle filled with serum, are to be regarded as vital changes 
 and the results of vital reaction. 
 
 Another medico legal question that may become important to 
 settle, regards the possibility of spontaneous combustion, human 
 combustion, or the preternatural combustibility of the human body. 
 
PERSONS FOUND DEAD. too 
 
 This, if it occurs at all, is so seldom, that it seems unnecessary 
 to dwell upon it at much length. There are several curious 
 cases on record, that seem, some of them, so well attested, as to 
 incline the belief to their possibility. Orfila has described, par- 
 ticularly, the phenomena attending spontaneous human combus- 
 tion. He says a bright flame appears over the part that is about 
 to be attacked. The flame is not readily extinguished by water, 
 and, indeed, frequently the addition of water only serves to in- 
 crease its activity. Deep eschars form on the part affected, ac- 
 companied by convulsions, delirium, vomiting, and diarrhoea, 
 followed by a peculiar state of putrefaction and death. The pro- 
 cess is said to advance with extreme rapidity, but the body is 
 never entirely consumed. While some parts are half burnt, 
 others are completely incinerated, a carbonaceous, fetid, unctu- 
 ous ash remaining. The hands and feet commonly escape de- 
 struction, while the trunk is usually entirely dissipated. The 
 wooden, or other combustible articles of furniture, situated near 
 the individual, are either uninjured, or but imperfectly con- 
 sumed. The clothes covering the body are commonly destroy- 
 ed. The walls and furniture of the apartment are covered with 
 a thick, greasy soot, and the air is impregnated with an offensive 
 •Mnpyreumatic odor. 
 
 This phenomenon is stated to have been chiefly observed in 
 corpulent females, advanced in life, and especially in those sub- 
 jects who had been long addicted to the abuse of spirituous 
 liquors. Guy, 497. 
 
 There seems to be no authenticated case on record, of the oc- 
 currence of spontaneous combustion, that is, of combustion taking 
 place merely from the operation of internal causes. In all the 
 recorded cases, an ignited body has been present, so as to afford 
 a very clear presumption that the fire was communicated to the 
 dress of the individual. 
 
 That some peculiar circumstances have rendered the human 
 body preternaturally combustible, and that some occasions have 
 occurred when this has been fully demonstrated, seems now to 
 admit of little doubt. What those circumstances are, is not 
 clearly settled. As the subjects to whom this has occurred, have 
 
454 MEDICAL JURISPRUDENCE. 
 
 been almost, or quite, uniformly addicted to the use of spirituous 
 liquors, it has been urged that an alcoholic impregnation of the 
 body may be sufficient to account for all the phenomena. By 
 others, this seems, with very good reason, to be doubted. The 
 facts that have been observed and recorded, are probably too 
 few in number, as yet, to admit of our coming to any very satis- 
 factory conclusion in regard to the cause or causes of this singular 
 phenomenon. 
 
 In a late number of the Liverpool Mercury, is a statement of 
 the following singular case : A man noted for his intemperate 
 habits, while drinking with his comrades, laid a wager that he 
 would eat a lighted candle. His bet was taken, and scarcely had 
 he introduced the naming candle into his mouth, when he utter- 
 ed a slight cry and fell powerless to the ground. A bluish flame 
 was seen to flicker about his lips, and on an attempt being made 
 to offer him assistance, the bystanders were horror-struck to 
 find that he was burning internally. At the end of half an hour, 
 his head and part of his chest were reduced to charcoal. 
 
 12. Of persons found dead by Lightning : 
 
 The electric fluid seems to be guided in its direction by the 
 best conductors. Where, in this respect, there is an equality, lofty 
 objects are more likely to be struck than low ones. Hence tho 
 human body, unless under circumstances that create an excep- 
 tion, is likely to escape when surrounded by more elevated ob- 
 jects. As the human body is itself a very good conductor, it is 
 not perfectly safe during a thunder-shower, when in an open 
 space, and at a distance from any other object, as it would then 
 be the most prominent, and the best conductor. 
 
 Whenever the electric fluid strikes an individual, it produces 
 a shock upon the brain and entire nervous system. It was the 
 opinion of Dr. John Hunter, that it caused the instantaneous and 
 entire destruction of the vital principle in every part of the 
 body,-and as a consequence, produced a great relaxation of the 
 muscles. Where it does not prove immediately fatal, it causes 
 insensibility ; deep, slow and interrupted respiration ; pulse soft 
 and slow, and pupils dilated, but sensible to light. A slight 
 shock produces a stunning effect. 
 
PKJRSONS FOUND DEAD 455 
 
 The post-mortem appearances exhibit considerable variety. 
 In some cases, no marks of violence will be discovered on the body ; 
 in others, there will be found marks of violence which will be 
 sometimes very severe. More generally, a contused or lacerated 
 wound will be found about the spot where the electric fluid en- 
 tered and passed out. Sometimes an extensive ecchymosis will 
 appear, the more commonly on the back, along the course of 
 the spinal marrow. In cases where the clothes have been set on 
 fire, there may be seen marks of burns, but these will not be 
 produced by the electric fluid. The clothes are very generally 
 torn and singed, giving off a peculiar odor. If there are metal- 
 lic substances about the individual, they will present traces of 
 fusion. 
 
 The wounds are sometimes of such a character that they re- 
 semble injuries produced by mechanical force, and are liable to 
 be confounded with them. Thty generally present the appear- 
 ance of lacerated punctures, similar to a stab produced by a blunt 
 dagger. In one case, a deep wound was produced in one thigh, 
 almost laying bare the femoral artery. This should induce great 
 caution to avoid mistaking the effects of the electric fluid for vio- 
 lence effected by mechanical means. ' In doubtful circumstances, 
 the situation of the, body and the place where it is first discover- 
 ed, may afford an indication as to the cause of death ; also, the 
 melted state of any metallic substances found about it, together 
 with the rent or torn and burnt condition of the clothes. 
 
 13. Of persons found dead from starvation. 
 
 Death by starvation may be the result of accident or homicide, 
 but very rarely the latter. It has, also, been a means of suicide ; 
 but seldom, unless in case of insanity. When abstinence has 
 been for a long time practiced, there is pain experienced in the 
 epigastrium, which is relieved by pressure ; a general emaciation 
 of the body ; the eyes and cheeks sunken ; the bones projecting ; 
 the face pale and ghastly ; the eyes Wild and glistening ; the 
 breath hot ; the mouth dry and parched ; an intolerable thirst 
 prevails ; delirium ; great prostration of strength ; a fetid odor 
 exhaling from the body ; some of the mucous membranes becom- 
 ing red and inflamed ; and finally death takes place in a fit of 
 
456 MEDICAL JURISPRUDENCE. 
 
 maniacal delirium, or in horrible convulsions. Guy, 516 ; Taylor, 
 456. 
 
 There is considerable difference in the period of time at which 
 death takes place from this cause. It will differ with the age, 
 sex and strength of the individual. It will, also, depend much 
 upon whether free access has been had to liquids during the 
 period of abstinence. It has been ascertained, by experiment, 
 that animals live more than twice as long when they have access 
 to water, as when they are excluded from it. It is said, that 
 where the abstinence was perfect, death would not probably take 
 place under a week or ten days. There are, however, some 
 cases of voluntary starvation on record, in which life has been 
 prolonged for a considerable period of time. In the case of 
 Viterbi, death was protracted to the twenty-first day ; and in the 
 more remarkable case of Guillaume Granet, who resorted to star- 
 vation to avoid punishment, life was prolonged to the fifty-eighth 
 day, when he expired in convulsions. 
 
 The post-mortem appearances are, great .emaciation of body, 
 and the exhalation from it of a fetid odor. The eyes are found 
 red and open, the skin, mouth and fauces dry, and the stomach 
 and intestines empty and contracted. The gall-bladder is large, 
 and distended with limpid, greenish yellow bile. The heart, 
 lungs and large vessels are collapsed and destitute of blood. The 
 process of putrefaction commences soon after death, and runs its 
 course very rapidly. 
 
 The post-mortem appearances are hardly sufficient to furnish ' 
 alone clear and satisfactory indications of death from starvation. 
 It is seldom, probably, that the medical jurist will be called upon 
 to decide from these alone, whether death has resulted from that 
 cause or not. When accidental, it is usually coupled with cold 
 or exposure, in which case all the accompanying circumstances 
 will generally afford proof quite sufficient, at least when sustained 
 by the post-mortem appearances. 
 
MENTAL ALIENATION. 457 
 
 CLASS III. 
 
 Under this class will be embraced questions arising out of 
 diseases, or affections in the nature of disease, that disqualify ; 
 principally insanity, including all the different forms of mental 
 alienation. This is, probably, the only topic in this class that 
 will require discussion. It is not very material by what name 
 it is called. Its usual appellation has been Insanity ; but that 
 term, according to its true signification, will not cover all the 
 different forms intended to be included under it. Perhaps, the 
 better term to select is mental alienation ; although even that 
 will hardly be deemed broad enough to apply to those diseased 
 affections which, like idiocy, are congenital. 
 
 MENTAL ALIENATION. 
 
 What we have to say upon this general subject will be em- 
 braced under the following heads, viz. : 
 
 1. Its definition. 
 
 2. Its seat. 
 
 3. Its history. 
 
 4. It's causes. 
 
 5. The principle upon which legal exemption proceeds, the 
 division legally recognized, together with the methods of proce- 
 dure known to the law. 
 
 6. Its classification ; its different forms ; each being considered 
 m reference to the appearances and proofs that establish it ; and 
 the legal consequences that attach to each. 
 
 1. Its definition. To define Insanity, or mental alienation, in 
 such a way as shall cover all its phenomena, and yet be suf- 
 ficiently distinctive, is a matter of extreme difficulty. So widely 
 have definitions varied, that " some," says Dr. Good, " are so 
 narrow as to set at liberty half the patients at Bethlehem or the 
 Bicetre ; and others so loose and capacious, as to give a straight- 
 waistcoat to half the world." The difficulty has generally been 
 
458 MEDICAL JURISPKCDENCE. 
 
 that definitions have been adopted based only upon some parti- 
 cular forms or phases of the disease, and although true as to 
 them, are untrue as to others. Dr. Reid, for instance, places the 
 seat of the disease in the imagination, and says that " exalted 
 imagination is insanity." John Locke considered madmen as not 
 having lost the reasoning faculty, but that in joining together in- 
 congruous ideas, they mistake them for truths, and err as men 
 do that argue right from wrong principles ; the violence of their 
 imaginations taking their fancies for realities. Dr. Battie defines 
 madness to consist in false perceptions. Dr. Arnold divides the 
 disease into two grand species, one of which he calls notional, and 
 the other ideal insanity. Dr. Criehton defines the disease as con- 
 sisting in general derangement of the mental faculties, in which 
 deceived perceptions are mistaken for realities ; with incoherent 
 language and unruly conduct. Dr. Conolly considers mental de- 
 rangement to consist in the impairment of any one or more facul- 
 ties of the mind, accompanied with, or inducing, a defect in the 
 comparing faculty. Mr. Neville defines it to consist in disordered 
 "function of the brain generally, or of one, or of several of its 
 parts, without consciousness of this derangement on tbe part of 
 the individual affected, and without notable or necessary impli- 
 cation of the functions of any other system in the body. Idiocy, 
 he defines to be deficiency of mental manifestation, from lesion, 
 imperfect development, or absence of one or more of the cerebral 
 organs. Dr. Spurzheim defines insanity to be an aberration of 
 any sensation or intellectual power from the healthy state, with 
 out being able to distinguish the diseased state ; and the aberra 
 tion of any feeling from the state of health, without being able to 
 distinguish it, or without the influence of the will on the actions 
 of the feeling. In other words, the incapacity of distinguishing 
 the diseased functions of the mind, and the irresistibility of our 
 actions, constitute insanity. The last definition is, perhaps, the 
 most elaborate, but is not in all respects true ; as there may be 
 derangement on a particular topic, with the perfect ability to 
 distinguish it from the sounder views of others. Perhaps the 
 definition the least exceptionable is that suggested by Dr. Spurz- 
 heim, viz. : An aberration of the manifestations of the mind from 
 
MENTAL ALIENATION. 459 
 
 their ordinary, normal, healthy stale. This, it is true, is very 
 genera], little distinctive, and cannot be said to cover all its forms, 
 •is the term aberration can hardly be applied to those diseased 
 affections which, like idiocy, are congenital. Still, as the defini- 
 tion is plain and obvious ; has a direct reference to the mental 
 character of the disease ; and really embraces the great fact which 
 in any given case always presents itself as a distinct subject of 
 inquiry, viz.- : The nature and extent of change which has taken 
 place in the action of the faculties composing the mind, in refer- 
 ence to which the enquiry is made, we shall adopt it. 
 
 2. Its seat. This, in reference to its bearings on medical juris- 
 prudence, is not very material to be considered. It must either 
 be seated in the mental faculties themselves, and thus be a dis- 
 ease of the spiritual nature ; or in the brain, the material organ, 
 through which the mind here displays itself. We suppose its 
 seat to be the latter, for the following briefly alleged reasons. 
 
 1. It is more reasonable in itself than the supposition of a 
 diseased soul ; because, if the latter be diseased, we can perceive 
 nothing in the nature of death to divest it of that disease ; and, 
 also because, as far as our experience goes, whatever is subject 
 to disease is also subject to death. 
 
 2. It is in harmony with all other diseased affections, as they 
 all proceed from suffering organs. 
 
 3. It is quite obvious from an investigation of some of the 
 causes. Idiocy, for instance, may result from defective develop- 
 ment of brain, or from structural derangement. Blows, or other 
 injuries affecting the brain, may result in mental alienation. 
 
 4. From the physical phenomena attending it, is drawn an ar- 
 gument. The increased pulsation, the furred tongue, the consti- 
 pation of the bowels, the peculiar caste of countenance, and the 
 preternatural heat, sometimes observable, either of the whole 
 brain or of some one particular part of it, are all indicative of 
 physical disease. 
 
 5. The morbid phenomena, or pathological changes, sometimes 
 discoverable in the brains of those who have been afflicted with 
 mental alienation. These, it is true, are not always such obvious 
 lesions as are perceptible on dissection. The brain is an ex- 
 
460 .MEDICAL JURISPRUDENCE. 
 
 tremely delicate organ, and it is not every kind of irritation that 
 will leave its traces there after death. Some pathological changes 
 may exist, without becoming the objects of the senses. Where- 
 ever the alienation has been long continued and severe, and the 
 death has finally resulted from it, there will be likely to be such 
 lesions occurring in the brain as will be obvious on dissection. 
 
 But, although a disease of the material organ, yet the symp- 
 toms disclosing it to the medical jurist, consist in the defective, 
 deranged, or perverted action and manifestation of the faculty 
 or faculties of the mind. 
 
 3. Its history. There are fewer pages in the history of human 
 progress more marked or peculiar, than those on which are re- 
 corded the varying views of men in reference to mental aliena- 
 tion. It was once looked upon' as a special judgment from God; 
 as beyond the reach of remedies ; as an infliction that would 
 justly warrant barbarity and savageness of treatment, and right- 
 fully exclude its suffering subject from all the privileges of so- 
 cial intercourse, and all sympathy with human feelings. Hence, 
 chains, and imprisonment, and darkness, and dungeons, with the 
 infliction frequently of horrid cruelties, have, in times past, been 
 the almost invariable lot of those whose only crime was the loss 
 of their reason. It is shocking to know that men could ever be 
 led to commit such horrid enormities. Nor have their views, or 
 their conduct, been changed until within the last half century. 
 The early part of the nineteenth century was signalized by the 
 strong efforts of Pinel in France, to impress upon the mind ot 
 man different views in relation to mental alienation, and more 
 especially to the conduct to be pursued towards the insane. He 
 knocked the chains from his swollen limbs, gave Mm free access 
 to the atmosphere and to light, and showed that he reposed con- 
 fidence in himas a moral being. The result was successful be- 
 yond all measurable calculation. The world owes a debt of 
 gratitude to Pinel, which it will never find it in its power to re- 
 pay. He had the moral courage to stand up against the public 
 opinion of his fellow-men, and the raving of the maniac, and in 
 the face of both to proclaim and enforce the truth. Since his 
 time, public opinion has essentially changed. This terrible in- 
 
MIINTAL ALIENATION. 4C1 
 
 friction is now mourned as a misfortune, instead of being visited 
 as a crime. It is no more regarded as furnishing just matter of 
 reproach, than the bereavement of motion in a paralyzed muscle. 
 The sounder views that have been entertained in reference to 
 mind, both in its normal and abnormal action, have also resulted 
 in more clearly understanding the deranged or diseased condi- 
 tions to which it is occasionally subject. 
 
 4. Its causes. With these, the mere medical jurist has little 
 concern. A very brief allusion, therefore, will only be made to 
 them. 
 
 The brain is the centre of many distinct and differing rela- 
 tions. Of these there are at least three different kinds : 
 
 1. The first set of relations are those which it sustains with 
 the different organs in the organism in which it is found. 
 It supplies to these the nervous power or energy, and derives 
 from, them that which contributes to its growth and continued 
 support. Hence a system of mutual and reciprocal influences 
 exists between the brain and every other important organ in the 
 animal economy. These may be termed organic relations. 
 
 2. The brain is the great sensitive centre. Between it, there- 
 fore, and external nature, exist the relations of sensation. In 
 virtue of these, the objects in the material world make their im 
 pressions, and are recognized as pleasant or painful. These are 
 the physical relations. 
 
 3. In the brain are the organs of thought, reflection, emotion, 
 volition ; all, in fine, that goes to constitute the mind. Here, 
 then, is the source of the higher relations, those existing be- 
 tween it and the unseen, spiritual world. It is in virtue of these 
 that man becomes a being of, reason, and a subject of God's 
 moral government. These may be termed the moral relations. 
 
 It is proper to premise here, that we know little or nothing of 
 the essence of mind. Our knowledge of it is derived from what 
 we are conscious of in ourselves, and from what we observe of 
 its sane and deranged action in others. From all we are able to 
 glean from these two sources of knowledge, we are not disposed 
 to regard the mind as a unit, or single general power, capable, 
 originally, of acting with equal energy in every direction or dis- 
 
462 MEDICAL JURISPRUDENCE. 
 
 tinct department, to which its operations might extend; but 
 rather as a congeries, or assemblage of faculties, connected to- 
 gether by a common consciousness, and by modes of activity en- 
 joyed by all those which possess the same general character. 
 These faculties are so many powers or instruments of thought or 
 of feeling, of a definite nature, and having specific functions. 
 In virtue of that nature and of those functions, each is indepen- 
 dent of every other ; may act or rest singly ; be strong or weak ; 
 sane or deranged in its manifestations. Upon this principle only 
 is mental alienation intelligible ; and hence its general assumption 
 by the most approved writers upon that subject. 
 
 The causes of mental alienation are in accordance with the 
 three systems of relations just enumerated. They are organic, 
 physical, and moral. 
 
 1. The organic, or, as they have been termed, sympathetic 
 causes, are to be found in the relations existing between the 
 brain and other large organs of the body. The existence of 
 these admits of the transference of disease from other organs to 
 this. Thus erysipelas, gout, rheumatism, and repelled cutaneous 
 affections, may be productive of mental alienation. More espe- 
 cially will suppressed lochia, menses, milk in nurses, hsemo- 
 rhoides, old drains dried up, as setons, issues, &c, result in de- 
 rangement. Sometimes general diseases, such as small pox, 
 measles, scarlatina, and fevers of various sorts, affect the whole 
 body, but occasionally they are productive of morbid changes in 
 the brain, resulting in mental alienation. 
 
 2. The physical causes of mental alienation may arise either, 
 
 1 . From defective development, or derangement of structure 
 of the brain, from the operation of internal causes. From the 
 first may result idiocy, and from the second, hydrocephalus imer- 
 nus. Or it may arise, 
 
 2. From external violence, or from the action of local causes 
 expending their hurtful influence upon the brain. A severe blow 
 on the head may entirely suspend all mental action ; a fracture 
 of the skull and wound of the brain, may give rise to acute in- 
 flammation, to delirium, and sometimes to more permanent men- 
 
MENTAL ALIENATION. 463 
 
 tal derangement. Intense cold may derange the operations of 
 the mind. 
 
 Baron Larry states that in the retreat of the French army 
 from Moscow, many cases of insanity, in every variety of form, 
 accompanied by a great number of deaths, were produced by the 
 continued action of the intense cold upon the brain. So also 
 great heat may derange the health of the brain, and give rise to 
 mental alienation. If the uncovered head be long exposed to 
 the direct rays of the sun, a severe and long continued paroxysm 
 of mania may be the result. It may also give rise to more acute 
 cerebral disease, accompanied, or in part manifested, by violent 
 delirium. Thus it must be apparent, that the physical causes 
 of mental alienation are very numerous. 
 
 3. The moral causes are probably the most fruitful in the pro- 
 duction of all the forms of mental alienation. There may be 
 two distinct modes in which these causes may operate : 
 
 1 . One or more of the mental faculties may be possessed of 
 such inordinate, disproportional strength, as that by its own in- 
 herent activity, it may be pushed into an abnormal state or con- 
 dition : 
 
 2. One or more faculties possessing less comparative strength, 
 may, in consequence of their union with others, be urged on to 
 an intenser degree of action than they are able to endure, and 
 thus become deranged in their manifestations. The attainment 
 of wealth, honor, power,' furnish to some the strongest possible 
 inducements, and lash up those faculties that are the most in- 
 strumental in procuring them to their highest possible degree of 
 action : And then all the sentiments and emotions, hope and 
 fear, joy and sorrow, are in unremitted activity, and often at the 
 extremest degree of tension. Losses, failures, unfortunate oc- 
 currences, strike with a force severe in proportion to the antici- 
 pated success. Whatever stirs deep emotion, or excites to in- 
 tense and continuous thought, may be productive of excessive 
 and irregular action. These causes, operating upon the patient, 
 have been known to affect even the unborn child. Esquirol 
 has observed that during the agitated periods of the French re- 
 volution, many ladies then pregnant, and whose minds were kep J 
 
46 1 MEDICAL JURISPRUDENCE. 
 
 constantly on the stretch by the anxiety and alarm inseparable 
 from the epoch in which they lived, and whose nervous sys- 
 tems were thereby rendered irritable in the highest degree com- 
 patible with sanity, were afterwards delivered of children whose 
 brains and nervous systems had been similarly affected by the 
 state of the parent, to such a degree, .that, in future life, as chil- 
 dren, they were subject to spasms, convulsions, and other ner- 
 vous affections; and in youth, to madness, imbecility, or de- 
 mentia, almost without any exciting cause. 
 
 He relates one instance of a pregnant woman being terrified 
 by the threats of her husband when intoxicated, and the child, 
 after its birth, was so much affected by its mother's agitation, 
 that it continued subject to panic terrors until the age of eighteen , 
 and then became completely maniacal. Combe's Insanity, 98-9 
 
 It is principally from these causes that an advanced civiliza 
 tion is so productive of the different forms of mania. It carries 
 in its train so much that contributes to the excessive excitement 
 of the different faculties, and that which administers to the mor- 
 bid growth of some, that much insane manifestation is the in- 
 evitable result. Among the savage tribes of men on this conti- 
 nent, insanity was unknown. It has followed in the wake of 
 civilization, and seems to prevail the most extensively where 
 there is the largest liberty of thought, speech, and action. In 
 Great Britain it abounds much more than on the continent, and 
 in England it is more frequently to be met with than in other ' 
 parts of Great Britain. Spurzheim's Insanity, 123. 
 
 In the United States it is probably much more frequently to be 
 found in proportion to the population, than among any other 
 people. The exciting scenes of our politics, the deep and ab- 
 sorbing interest that sometimes attaches to religious revivals, the 
 rage for pecuniary speculation that occasionally seizes upon a 
 whole community, are all in themselves peculiarly well fitted to 
 impart intense activity to those moral causes that dethrone the 
 reason, and subvert the laws of mind. 
 
 5. The principle upon which legal exemption proceeds, the 
 division legally recognized, together with the methods of pro- 
 cedure known to the law. 
 
MENTAL ALIENATION. 465 
 
 Law is understood to mean " a rule of civil action, prescribed 
 by the supreme power in the state, commanding what is right, 
 and prohibiting what is wrong." The rule of civil action thus 
 prescribed is specific, and has its own appropriate sanctions, 
 consisting in the rewards offered to the obedient, and the punish- 
 ments inflicted upon the disobedient. In order, however, that 
 any law should be binding, two conditions are essential ; the one 
 is, that the being who is the subject of it, should possess suffi- 
 cient mental capacity to understand the rule and comprehend 
 the consequences of its violation ; and the other is, that super- 
 added to that capacity, he should be a free moral agent, the mas- 
 ter of his own actions, and capable of proceeding upon motives 
 common to the race to which he belongs. All, then, on the one 
 hand, in any civilized community, who are sunk so low in intel- 
 ligence and comprehension as that the rule and its sanctions are 
 beyond their reach, should be visited only for the purposes of 
 protection against the injurious acts of others ; and all those on 
 the other, who by reason of delusion or halucination, or from 
 perversion of the intellectual or moral powers, are unable to act 
 upon commonly received motives, or who have ceased to be mas- 
 ters of their own actions, should be visited also for the purpose 
 of protection ; but very frequently it would be required to be a 
 protection of the community against them. Thus the principle 
 of legal exemption is derived from the moral nature of the law 
 itself; it being as manifestly absurd and irrational to punish 
 either one of these classes for disobedience, as it would be to 
 punish a mere machine, either because it would not go at all, or 
 because when it did go, it went all wrong. 
 
 The jurisprudence of all civilized nations has never failed to 
 recognize these two great classes of human beings who are de- 
 prived of their reason. 
 
 The Roman law divided the insane, or dementes, as they were 
 termed, into two classes. In the one was included all the mente 
 capti, or those whose understanding was weak or null ; and in 
 the other, all the furiosi, or those who were restless and furious. 
 The French and Prussian codes make use of the terms demence, 
 fureur and imbecilite, without undertaking to define them. 
 
 30 
 
466 MEDICAL JURISPRUDENCE. 
 
 The English common law originally recognized but two forms 
 of mental alienation, and these were termed idiocy and lunacy. 
 
 An idiot was legally defined by Fitzherbert, at a very early 
 period, to be a person who cannot count or number twenty pence, 
 nor tell who was his father or mother, nor how old he is, or that 
 hath no understanding or reason — what shall be for his profit, 
 or what for his loss : but if he have such understanding that he 
 knows and understands his letters, and to read by teaching i or 
 information of another man, then it seems he is not an idiot, 
 which seems more properly to belong to one who has had no un- 
 derstanding from his birth, and is, therefore, by law, presumed 
 never likely to attain any. Fitz. N. B., 583, ed. 1652. This de- 
 finition the medical profession, and probably the legal also, would 
 now consider altogether too restrictive for the term idiot, as there 
 are some degrees of idiocy much in advance of those necessarily 
 embraced in this definition.. 
 
 Lunacy was derived from the term luna, the moon, and was so 
 called from the supposed influence which the moon exerted, or 
 was presumed to exert, over the disorder. This term signifies 
 in its legal acceptation, one who has had understanding, but, by 
 disease, grief, or other accident, hath lost the use of his reason. 
 A lunatic is properly one that hath had lucid intervals, sometimes 
 enjoying his senses and sometimes not. 4 Coke, 123 ; 1 Black. 
 Com., 304. 
 
 At. a very early period a general term was sought, under which 
 might be included all the possible forms of mental alienation. 
 For this purpose the term non compos mentis was adopted, and it 
 was used to signify a person " out of his senses." The English 
 phrase equivalent to it is " of unsound mind," which was once 
 understood to import a total deprivation of sense./ 
 
 After thus including under one generic term all cases of de- 
 ranged mind, an effort was made by Lord Coke to define the dif- 
 ferent classes that are included under it. He divides them into 
 four classes : 
 
 1. Idiot, or fool natural, who from his nativity by a perpetual 
 infirmity is non compos mentis : 
 
 2. A person who was of good and sound memory, but by sick- 
 
MENTAL ALIENATION. 467 
 
 ness, grief, or other accident, wholly loses his memory, and un- 
 derstanding : 
 
 3. A lunatic — lunaticus, who has sometimes his understanding 
 and sometimes not ; qui guadet lucidis intervallis, and, therefore, 
 he is called non compos mentis so long as he has not understand- 
 ing: 
 
 4. A person who by his own vicious act, for a time deprives 
 himself of his memory and understanding, as he that is drunken ; 
 but such a person has no privilege by this voluntary contracted 
 madness. Co. Litt., 247, a; 4 Bl. Com., 25 ; Shelford on Lunacy, 
 1-2. 
 
 The law interferes on three different occasions to afford relief 
 to the non compos mentis : 
 
 1. On the occasion of their general action while in that state 
 and condition. The object and effect of this interference is to 
 establish the general fact of unsoundness of mind, upon the well 
 ascertained proof of which, they are deprived of all control over 
 their property 5 divested of their civil rights in relation to their 
 estates ; absolved from all duties ; and protected against the in- 
 jurious acts of others. This has reference to the future : 
 
 2. On the occasion of a single act done, as a contract made, 
 property conveyed, or any thing of that kind transacted ; the 
 object of which is, to avoid the act as done by a mind deranged, 
 and therefore incompetent to its performance. This has reference 
 to the past, and not the future : 
 
 3. On the occasion of a criminal act done, as the taking, with- 
 out consent, the property of others ; the commission of incendi- 
 arism ; or the taking away of life. The object of interference 
 here is to exonerate the non compos from the legal consequences 
 of an act, in others criminal., but in him innocent, on account of 
 the malady under which he labors. This also has reference to 
 the past. 
 
 The first is accomplished by the issuing, execution, and return 
 to a commission. The second, by the trial of an issue upon the 
 very act sought to be avoided ; and the third, by his triai upon 
 the commission of an alleged crime, in which his sanity or in- 
 sanity is tested in reference to such commission. 
 
4GS MEDICAX JURISPRUDENCE. 
 
 Originally commissions were issued for the purpose of enquir- 
 ing whether the individual was an idiot ex nativitate, or a luna- 
 tic, and in consequence thereof, incapable of governing himself 
 and managing his worldly affairs. The finding in the one case 
 had a different consequence attached to it from what it had in 
 the other. An idiot ex nativitate, having been such from his 
 birth, was legally presumed to remain so through life, while a 
 lunatic, having once had the possession of his reason, was pre- 
 sumed capable of again regaining it. Hence the commission 
 might be superceded in the latter case, and the individual on 
 his recovery, be restored to his rights and property, but not in 
 the former. In the former case, it is usual to state in the inqui- 
 sition the period of time during which the person under exami- 
 nation has been a lunatic or of unsound mind, but not in the 
 latter, although if stated, it is regarded as surplusage and does 
 not vitiate. 
 
 In England the jurisdiction over all cases of idiocy, lunacy and 
 unsoundness of mind, has been exercised by the lord chancellor, 
 not, however, acting as the court of chancery, but under a special 
 separate commission from the crown, authorising him to take 
 care of the property, and for the benefit of the lunatic. . The 
 care and custody both of the idiot and lunatic, and their estates 
 respectively, originally belonged to the king alone. Shelford en 
 Lunacy, 10 ; ex parte Phillips, 19 Vesey, 122. Anciently the 
 king could grant the care of an idiot's person, and the profits of 
 his estate during his lite, without account, except for necessaries; 
 but since the revolution, the crown has always granted the sur- 
 plus to some of his family, note c in 1 Paris fy Fonllanque, 290. 
 
 In New- York, the Revised Statutes, 2 R. S., 52, §1, provide 
 that the chancellor shall have the care and custody of all idiots, 
 lunatics, persons of unsound mind, and persons who shall be in- 
 capable of conducting their own affairs in consequence of habitual 
 drunkenness ; and also of their estates whether real or personal. 
 In consequence of the recent abolition of the court of chancery, 
 the same power and jurisdiction devolved upon the supreme 
 court. 
 
 The method by which it is ascertained whether any one is a 
 
MENTAL ALIENATION. 469 
 
 fit subject for the exercise of this power and jurisdiction, both in 
 England and in this country, is by the issuing of a commission, 
 and the proceedings based upon it. 
 
 "When persons non compotes mentes became divided into the 
 two classes of idiots and lunatics, distinct commissions in the 
 nature of the old writs were framed for each of them ; one de , 
 idiota inquirendo, and the other de lunatico inquirendo. Shelford 
 on Lunacy, 52. After the general term unsoundness of mind came 
 into more general use, and as it was sometimes difficult to deter- 
 mine in advance whether the examination would result in show- 
 ing idiocy or lunacy, the commission took a different style, and 
 was called a commission in the nature of a writ de lunatico inquir- 
 endo. 
 
 The general method pursued, both in England and in this 
 country, in the issuing of the commission, and the proceedings 
 under it, is much the same. The following is a brief summary 
 of the method of procedure. A petition is presented to the chan- 
 cellor, or, in this state, to the supreme court, by some near rela- 
 tive of the alleged lunatic, accompanied by affidavits setting forth 
 the facts on which the application is founded. The application 
 is ex parte. If a case is made out sufficient to justify or require 
 the interference of the law, a commission now generally styled in 
 the nature of a writ de lunatico inquirendo, is issued, directed to 
 a certain number of commissioners, generally three, who are 
 named therein, and who are required to execute the commission. 
 This must be done by means of a jury, consisting of at least 
 twelve disinterested men, who are to meet for that purpose hear 
 the place of abode of the supposed lunatic. In the execution of 
 the commission, the commissioners constitute the court, and as 
 such, lay down the law to the jury, to whom it belongs, as in all 
 other cases where their aid is invoked, to find the facts that are 
 submitted to them. The alleged lunatic must have due notice 
 both of the time and place of executing the commission, so that 
 he can, if he desires, appear and contest the finding of the jury. 
 Witnesses may be sworn, and the trial proceed as in ordinary 
 cases, except that the cause must be submitted to the jury with- 
 out the arguments of counsel. The jury either disagree and are 
 
470 MEDICAL JURISPRUDENCE. 
 
 discharged, or agree upon the verdict embraced in the inquisition, 
 which is intended to be the answer to the commission, and to 
 furnish a full and precise response to all the enquiries contained 
 in it. 
 
 The legal questions that have generally arisen have had refer- 
 ence either to the form and contents of the commission, or to the 
 inquisition which furnishes the response to it. One great point 
 in controversy has been, how far relief can legitimately extend 
 in cases of alleged unsoundness of mind and incapacity to con- 
 duct the ordinary affairs of life. This point first distinctly arose 
 in the case ex parte Barnsley, ZAtk,, 168, in which on a commis- 
 sion to inquire whether Barnsley was a lunatic, the inquisition 
 found that from weakness of mind he was incapable of governing 
 himself or his estate. This case was elaborately discussed, and 
 Lord Hardwicke finally quashed the inquisition for insufficiency, 
 holding that the finding must be that he was a lunatic, or, what 
 was correspondent to it, that he was of an unsound mind. It 
 was not sufficient in his judgment that he was weak and worn 
 out with age, and incapable of managing his estate; The same 
 doctrine was subsequently declared in Lord DonegaPs case, 2 
 Vesey, 407. 
 
 The first departure from the strict technical rules laid down 
 by Lord Hardwicke relative to these commissions is in 6 Vesey, 
 273 ; where Lord Eldon lays down the principle, that evidence 
 may support a commission not of lunacy, but in the nature of a 
 writ de lunatico inquirendo, in which he says it must be remem- 
 bered, that it is not necessary to establish lunacy ; but it is suf- 
 ficient tltat the party is incapable of managing his own affairs. In 
 the case of Ridgeway vs. Darwin, 8 Vesey, 65, the subject under- 
 went a still further investigation, and in ex parte Cranmer, 12 
 Vesey, 4A5, Lord Erskine distinctly held that the jurisdiction of 
 the chancellor embraced cases of imbecility resulting from old 
 age, sickness, or other causes. The question he said was whether 
 the party had become mentally incapable of managing his affairs. 
 Previous to this, Lord Eldon had held that on the execution of a 
 commission it was not necessary to establish lunacy, but that it 
 was sufficient if the party was shown to be incapable of managing 
 
MENTAL ALIENATION. 471 
 
 his own affairs. In all these cases, however, it was deemed ne- 
 sgssary, in order to support the commission, that the jury should 
 find the fact of unsoundness of mind, which Lord Hardwicke un- 
 derstood as correspondent with lunatic, and which Lord Eldon 
 denned to be " such a state of mind as to be contradistinguished 
 from idiocy, and also from lunacy, and yet such as made one a 
 proper object of a commission in the nature of a commission to 
 inquire of idiocy or lunacy." 
 
 This point came up for investigation and decision in the courts 
 of New-York, in the matter of Barker, 2 Johnson's Chan. Rep., 
 232, in which Chancellor Kent gave a somewhat elaborate opinion, 
 sustaining the commission where the inquisition found the party 
 an old man of eighty-five years of age, to be of " unsound mind 
 and mentally incapable of managing his affairs." In the matter of 
 Wendell, 1 John. Chan. Rep., 600, the same chancellor directed 
 an issue to be made and settled to try the question, whether 
 Wendell " be a lunatic or mentally incapable of managing his own 
 affairs," thus clearly indicating, by placing these terms in the 
 alternative, that he considered the one as equivalent to the other. 
 
 In the matter of Mason, 1 Barbour's Supreme Court Reports, 
 436, the sufficiency of a commission came up for adjudication, 
 in which the inquisition simply found that the party was " so 
 far weakened and impaired in the faculties of his mind, as to be 
 mentally incapable of the government of himself, and of the man- 
 agement of his goods and chattels, lands and affairs," without 
 finding any unsoundness of mind. The subject is ably discussed 
 by Harris, J., in which he sustains the commission and inquisi- 
 tion, suggesting as a reason why a stricter technicality is insisted 
 upon in England than in this country in reference to commis- 
 sions of this character is, that there the inquisition on its return 
 may be traversed by the party returned a lunatic or of unsound 
 mind, and hence the necessity of certainty in the form of the 
 finding ; and as the right of traverse does not here exist, there 
 can be no necessity of any strictness of form. 
 
 This decision places the jurisprudence of this state in reference 
 to these commissions on a proper foundation. It does away with 
 the useless distinction between a mind that is incompetent for 
 
472 MEDICAL JURISPRUDENCE. 
 
 the transaction of business through unsoundness, and one equally 
 incompetent through age and the decay of its faculties. Prior to 
 this decision, no one could realize the protection he required, 
 without being judicially branded with mental alienation, which 
 in reference to himself and more especially his descendants, was 
 a thing extremely painful to submit to. Now, no imputation of 
 that kind is necessarily incurred, as the mere decay of the facul- 
 ties which is so frequently incident to old age, is alone sufficient 
 to warrant legal interference, and the extension of that protection 
 so necessary under the circumstances of the case. 
 
 In relation to the investigation of a civil or criminal act done 
 by a person alleged to be mentally alienated, there is no peculiar 
 method to be observed in conducting the trial, and, therefore, 
 nothing necessary need be said here in reference to it. 
 
 6. Its classification, its different forms, each being considered 
 in reference to the appearances and proofs that establish it, and 
 the legal consequences to which it is subject. 
 
 The classification which appears to be the least objectionable, 
 and which is essentially that adopted by Dr. Guy and Dr. Ray, 
 is the following, thrown into a tabular form : 
 
 o 
 
 From defective 
 development, 
 
 'Congenital, or "1 
 occurring in > 
 childhood. J 
 
 Amentia, 
 
 (1. Idiocy. 
 (_2. Imbecility. 
 
 < 
 
 w 
 
 diminished activity 
 of the faculties. 
 
 Occurring' sub- ] 
 sequent to the l 
 development of f 
 the faculties. J 
 
 Dementia 
 
 f 1. Consequent on mania, 
 J mental shocks, or iuju- 
 | riesofthe brain. 
 12. Senile. 
 
 < 
 
 H 
 K 
 
 From deranged, ex- 
 cessive action, or 
 undue excitement 
 of the faculties, 
 
 ! { 
 
 Mania, 
 
 (1. General, 
 
 2. In.eUecma^ ™ 
 [ 3 .Mo ra >, (l;Ge S . 
 
 This method of classifying, it will be perceived, is psychologi- 
 cal, not physiological. It is founded on the deviations from the 
 normal state, observable in the faculties themselves, and not in 
 the brain. This is the view which is proper, if not essen- 
 tial, to be taken in reference to medical jur'sprudence ; while, in 
 a mere medical point of view, reference should be had to the 
 diseased organ. One great division, it will be perceived, em 
 
MENTAL ALIENATION 173 
 
 braces all those cases which occur in consequence of a preter- 
 natural defect in the development, or a greatly diminished 
 activity of the faculties. One branch of this division is congeni- 
 tal, embracing 
 
 Idiocy. To this, the law has given various definitions ; as, 
 that an idiot is of non-sane memory, a nativitate, as one who 
 from his nativity, by a perpetual infirmity, is non compos mentis, 
 as one who has no understanding from his nativity. Again, that 
 he is such a person who cannot count and number twenty, and 
 tell who was his father or mother, nor how old he is, so that it 
 may appear that he hath no understanding of reason what shall 
 be for his profit, or what for his loss. Again, it is stated, if he 
 be able to beget either son or daughter, he is no fool natural. 
 The difficulty seems to be, that the law attempts to give too 
 rigorous a definition, not seeming to concede that idiocy admits 
 of degrees, which every one knows to be the fact. 
 
 Idiocy may be defined to be " that condition of mind in which 
 the reflective, and all, or part, of the affective powers are either 
 entirely wanting, or are manifested to the slightest possible ex- 
 tent." Ray's Medical Jurisprudence of Insanity, C9, § 37. This 
 condition may be recognized and known, 
 
 1. By the size of head. The brain is generally much below 
 the usual size. The deficiency is more particularly noticeable in 
 the anterior lobes. The circumference over the obitar arch and 
 most prominent part of the occipital bone, is put down at between 
 eleven and one-third and fourteen and one-half inches, about 
 equaling that of a new-born infant. The convolutions of the brain, 
 particularly in the anterior part, are less thick, less deep, and 
 often less numerous. Besides a great depression of the forehead, 
 there is usually a flattening of the sides, the head being frequently 
 grotesquely shaped. Pinel and Esquirol mention one who re- 
 sembled a sheep in her inclinations, manner of action, as well as 
 in the shape of her head. Pritchard on Insanity, 210. In the form 
 of head there is observable about as much variety as in that of 
 adults. 
 
 2. In the features there is much irregularity. The forehead 
 low ; the eyes deeply set, small, often squinting, meaningless and 
 
474 MEDICAL JURISPRUDENCE. 
 
 objectless ; the lips thick, mouth large, open and gaping ; gums 
 spongy ; teeth imperfect ; limbs ill-formed, crooked and defective 
 in their motions. 
 
 3. There is great imperfection in the senses. They are dull, 
 or altogether wanting. The sight and hearing are often defec- 
 tive ; the smell and taste so much so, as to make it entirely im- 
 material what food they subsist upon. They are short-lived, 
 seldom living beyond the twenty-fifth year. They have little, if 
 any, use of articulate speech. 
 
 There is some variety in the power of mental manifestation by 
 idiots. While some are sunk below the brute creation, in the 
 scale of animal existence, there are others that display faint glim- 
 merings of intelligence. They are the most uniform in mani- 
 festing some or all the propensities. Of these, that which seems 
 to be the most commonly possessed is the sexual propensity. 
 They are, also, sometimes cunning, combative and destructive. 
 Although some of them arise to the possession of the power of 
 perceiving, and hence of becoming acquainted with surrounding 
 objects, their nature and qualities, yet they seem uniformly to lack 
 the power of reflection. They are unable even to compare two 
 ideas together. Sometimes, they are found to possess some of 
 the moral sentiments, as self-esteem, love of approbation, religi- 
 ous veneration, and benevolence. Dr. Rush speaks of one who 
 was remarkable for kindness and affection, and even spent his 
 life in acts of benevolence, though he showed no one mark of 
 reason. Others have showed inclination for religious worship. 
 Some can recollect names, numbers, or 'historical facts, and repeat 
 them mechanically ; but have no power of combining them. 
 Others are able to sing a few airs, and even 'to play on musical 
 instruments. 
 
 Idiotism is more frequently met with in mountainous, than in \. 
 plain districts of country. There is a form of it, termed cretin- _ 
 ism, endemic in the Vallais, among the Alps of Switzerland, and 
 in some other mountainous countries. There are three classes, 
 viz. : cretinism, semi-cretinism, and cretinism of the third degree. 
 In the first, life is little more than automatic. In the second, 
 there exists the powor of bestowing a slight attention upon sur 
 
MENTAL ALIENATION. 475 
 
 rounding objects ; of remembering simple events, and of using 
 language to express their common wants. In the third, there is 
 a higher degree of intellect ; a stronger power of recollecting 
 events ; a capacity to learn even reading and writing, but with- 
 out any adequate conception of their purposes. Some can even 
 learn music, drawing, painting, and machinery ; while others 
 have attempted poetry, succeeding, however, in nothing but the 
 rhyme. 
 
 It is unnecessary to consider separately the legal consequences 
 of idiocy : so far as they are peculiar to that state, they will be 
 noticed hereafter. 
 
 Imbecility. This is defined to be " an abnormal deficiency, 
 either in those faculties which acquaint us with the qualities and 
 ordinary relations of things, or in those which furnish us with 
 the moral motives that regulate our relationsand conduct towards 
 our fellow-men ; and frequently attended with excessive activity 
 of one or more of the animal propensities." Ray's Medical Juris- 
 prudence of Insanity, 74, § 41. 
 
 There are two somewhat important particulars in which this 
 state or condition is distinguishable from that which immediately 
 preceded it. The first is, that it is not congenital, but occurs 
 subsequent to birth ; although in it the development of the moral 
 and intellectual powers is arrested at a very early period of ex- 
 istence. The second is, that there is a higher decree of intelli- 
 gence, and more moral power possessed by the imbecile than the 
 idiot. In regard to the legal responsibility and liability of the 
 former, there often occur vexed and difiicult questions, but never 
 as to the latter. It becomes, therefore, important that this state 
 or condition of mind should be well understood. While in idiocy 
 reason was never enthroned, and articulate speech rarely made 
 use of, in imbecility there is possessed some intellectual and moral 
 capacity, and some use, though a limited one, of speech. 
 
 The imbecile is generally susceptible of some degree of educa- 
 tion. He can rise to the comprehension of a few simple ideas. 
 He is capable, under some circumstances, of making some pro- 
 gress in reading, writing, arithmetic, music, and the mechanic 
 arts. There seems, however, to be an impassible barrier in the 
 
476 MEDICAL JURISPRUDENCE. 
 
 way of their attaining that degree of knowledge and practical 
 skill which those, in other respects, of their own station in life 
 generally attain. In their character, both moral and intellectual, 
 there is observable the same kind of variety as that which pre- 
 vails among sound minds. While, for instance, some are fickle 
 and changeable, others exhibit great firmness, and even obstinacy, 
 in their pursuits. Some are capable, assisted by the occasional 
 advice of others, of managing their property, and of attending to 
 some of the simpler business pursuits. They are often capable 
 of conversing ordinarily well on such every day matters as are 
 constantly brought before their minds ; but are utterly incapable 
 of argument, or of carrying out a well sustained conversation. 
 They are, in general, thoughtless, improvident, timid and way- 
 ward ; incapable of strong attachment ; strangers to the higher 
 sentiments ; are uneasy, and manifest a constant restlessness of 
 disposition. 
 
 The German writer, Hoflf bauer, has endeavored to systematize 
 imbecility, and to define and mark out, by precise limits, the 
 different degrees of which it is ■ susceptible. He first distin- 
 guishes the two forms under which it is manifested. The one, 
 he styles imbecility or silliness; the other, dullness or stupidity. 
 The first, he supposes, arises from a defect of the intensity, or 
 power of the mind to examine the data presented to it by the 
 senses, corresponding to a defect in reflective power. The last 
 flows from a defect in the extensity, or power by which the mind 
 is enabled to perceive and embrace all the data furnished from 
 without; clearly corresponding to a defect in the perceptive 
 power. 
 
 The great distinction between the two, in reference to the 
 faculty of judgment is, that while the imbecile can, with great 
 difficulty, arrive at any conclusions at all, the stupid can with 
 greater facility, arrive at them, but is the most liable of the two 
 to be erroneous. This error arises, not from judging erroneously 
 in regard to these subjects to which his attention has been di- 
 rected, but from his neglect of some considerations which ought 
 to have formed the ground work of his judgment. The imbecile, 
 on the contrary, finds it difficult to arrive at the most simple 
 
MENTAL ALIENA'lION. 477 
 
 act of judgment. The stupid will more readily correct his mis- 
 takes, on the suggestion of the circumstance which has led to it ; 
 while the imbecile is unable to concentrate his attention suffici- 
 ently on any particular subject to enable him to do it. Weak- 
 ness of intellect is displayed in both ; and when the defect is 
 well marked, it is displayed in the same manner, viz., by a pro- 
 pensity to talk to themselves. 
 
 The stupid is much more apt than the imbecile to imagine 
 himself equal, if not superior, to other men in intelligence. He 
 acts precipitately, and without reflection ; while the imbecile can 
 hardly bring himself to act at all. He has assigned to imbecility 
 five gradations or degrees, and to stupidity three, which he has 
 done for the purpose of facilitating the application to them of 
 legal principles. 
 
 In the first degree of imbecility, there exists the inability to 
 form a judgment respecting any new object, when the proper 
 data are furnished, and the question not one of difficulty. When 
 called upon to judge in reference to objects with which he is 
 daily familiar, he is found to exercise a tolerably correct judg- 
 ment. He is subject to sudden gusts of passion, which are as 
 easily appeased as they are easily excited. 
 
 The second degree applies also to dementia, hereafter to be 
 considered. 
 
 The third degree unfits for all matters requiring more than a 
 mechanical mode of action. There is found in this degree a con- 
 sciousness of weakness and inferiority. His memory is defective, 
 as ideas have made no strong impression on his mind. He has 
 a great propensity to pass rapidly from one subject to another : 
 is irritable and suspicious in reference to the designs and inten- 
 tions of those around him. 
 
 In the fourth degree there is a clouded state of the understand- 
 ing and memory ; great insensibility, but a confused idea of his 
 weakness. 
 
 The fifth degree corresponds to the last stage of dementia, or 
 the fatuity which is the result of some cerebral disease. 
 
 In stupidity, the first degree only incapacitates when it be- 
 comes necessary, in judging, to weigh opposing motives. 
 
478 MEDICAL JURISPRUDENCE. 
 
 In the second degree he is embarrassed in any train of reason 
 ing. His memory is slow, but his judgment may still be accu- 
 rate in reference to things by which he is habitually surrounded, 
 although he is incapable of exerting any vigor of judgmet. 
 
 In the third and highest degree, the individual is incapable of 
 going beyond a single idea; and must completely lose that one, 
 before he can pass to another. As judgment is always based 
 more or less upon a comparison of ideas, it will be perceived 
 that this degree renders the individual more incapable of exer- 
 cising this faculty than the imbecile. 
 
 The classification, thus briefly alluded to, certainly has its 
 merits, and^may be useful in its practical application. It will be 
 perceived, however, that it has reference solely to man's intel- 
 lectual nature, afibrding no guide whatever to determine the ex- 
 tent of imbecility when it happens to occur in the moral nature. 
 The French writer Georget has, to some extent, supplied this 
 deficiency ; his large experience enabling him td do that with 
 great correctness. 
 
 He remarks that in hospitals for the insane, there is always a 
 certain number of imbeciles who do the coarse work of the 
 house, or serve as domestics and assistants to the regular officers. 
 They are sufficiently intelligent to perform their duties, sweep 
 the courts, carry burdens, move machines, execute some com- 
 missions, know the use of money, and procure various enjoy- 
 ments. They have a very imperfect idea, if any, of society, 
 laws, morality, courts and trials ; and though, they may have the 
 idea of property, yet they have no conception of the conse-, 
 quences of theft. Although they may have been taught to re- 
 frain from injuring others, yet they are ignorant of what would 
 be done to them if guilty of incendiarism or. murder. Theft is 
 extremely common both among imbeciles and idiots, and one 
 great reason is, that some of them have no conception of pro- 
 perty, nor of the distinctions of meum and tuum. When capable 
 of experiencing the sentiment of fear, they are solely actuated by 
 the dread of punishment, and by their own desires. Others have 
 some notions of property, but neither a sense of morality, nor a 
 fear of punishment, furnish motives sufficiently powerful to pre 
 
MENTAL ALIENATION. 479 
 
 vent them from stealing. The sentiment of cunning, too, may 
 be very much developed, while the other faculties are more or 
 less deficient. 
 
 Among the lower orders of society are many imbeciles a little 
 more intelligent than these, and not considered as utterly devoid 
 of understanding, who, nevertheless, have but vague and imper- 
 fect notions of social duties, and of justice. They engage in 
 occupations that require no great extent of intellect, and even 
 in the simplest of the mechanic arts. If they do not pass among 
 their acquaintances for imbeciles, they are at best regarded as 
 singular beings, with feeble understandings, and are teased and 
 tormented in innumerable ways. Many of them, for want of 
 some powerful restraining motive, indulge in drinking, and be- 
 come lazy, drunken and dissipated, and finally fall into the hands 
 of justice in greater numbers than is generally suspected- They 
 steal adroitly, and hence are considered as very intelligent; they 
 recommence their offences the moment they are released from con- 
 finement, and thus are believed to be obstinately perverse ; they are 
 violent and passionate, and the slightest motive is sufiicient to 
 plunge them into deeds of incendiarism and murder. Those who 
 have strong sexual propensities, soon become guilty of outrages 
 on female chastity. 
 
 I have had occasion, says Georget, to see many examples of 
 this class in prisons, who had been judicially decided to be ra- 
 tional, but whose demi- imbecility was manifest enough to me. 
 Ray's Medical Jurisprudence of Insanity , 82-3. 
 
 The character of the imbecility has generally been supposed 
 to be sought only in the intellect. By means of this deficiency, 
 they have been found to lack depth in thought and reasoning. 
 They have failed to perceive the remoter relations, and higher 
 purposes of things. They lack the power of forecast, and are 
 beings of the present rather than the future. They seem in- 
 capable of adopting any settled plan or purpose, and are with- 
 out any definite, final aim or object in their efforts. 
 
 Imbecility may as well attach to the moral as the intellectual 
 faculties of man. The remarks of Georget just cited, bear di- 
 rectly upon that point. 
 
480 MEDICAL JURISPRUDENCE. 
 
 Dr. Ray, page 84-5, cites the case of one E. S., as one in 
 which there was the greatest difficulty in drawing the line be- 
 tween extreme moral depravity and insanity, and in deciding at 
 what point an individual should cease to be considered as a re- 
 sponsible moral agent, and amenable to the laws. He was entire- 
 ly callous to every moral principle and feeling ; totally uncon- 
 scious of ever having done anything wrong ; and completely des- 
 titute of all sense of shame or remorse when reproved for his 
 vices or crimes. He was utterly incorrigible through life ; was 
 dismissed several times from the asylum, and was returned again, 
 the last time, for attempting to poison his father. There was 
 never any symptom of diseased action of the brain, bat he was 
 obliged to be kept under restraint as a moral lunatic. 
 
 This was indeed a most extraordinary case; and it would 
 seem as if he were denied by Dature the possession of those 
 moral powers, the due exercise of which, is essential to render 
 an individual accountable. 
 
 Moral imbecility is probably of more frequent occurrence than 
 is generally supposed. Dr. Rush, in the course of his life, was 
 consulted in three cases of moral imbecility. In all these, he 
 says, there is probably an original defective organization in those 
 parts of the body which are occupied by the moral faculties of 
 the mind. 
 
 It might, perhaps, be possible for one having the ingenuity of 
 Hoflbauer, to attempt successfully a classification of the different 
 degrees of moral imbecility. There are probably as many differ-' 
 ent degrees of this, as of the intellectual, and possibly as dis- 
 tinctly marked. There may, and often does exist, the usual in- 
 tellectual power ; but coupled with it, a feebleness of purpose, 
 inaptitude for business, disregard of duty, want of probity, and 
 sometimes strength of passion, clearly indicating that the lack is 
 not in the intellectual, but in the moral department. The dis- 
 play of passion, which not unfrernently occurs, arises probably 
 from the relatively greater strength possessed by the propensi- 
 ties over the higher sentiments which ordinarily control and di- 
 rect them. The harmonious movement of the mind is destroy- 
 ed by this relative disproportion of strength, the higher senti- 
 
MENTAL ALIENATION. 481 
 
 meats being unable, through weakness and imbecility, to influ- 
 ence and direct the action of the propensities, in consequence of 
 which, they rush into irregular manifestations. 
 
 Such individuals may pass through life weak, wavering, fickle, 
 and self-willed; frequently the prey of designing knaves, and 
 often " the inmates of jails and lunatic asylums. No attempt 
 could be successfully made to prove them imbecile, in a court of 
 justice, because they are possessed of intellect, and hence can- 
 not in public estimation be imbecile. Their imbecility essential- 
 ly consists in an absence of moral feeling, and a corresponding 
 want of self-control. Sometimes a singular fancy takes posses- 
 sion of the mind, and exerts over it a power very similar to a 
 delusion or hallucination in a case of intellectual mania. 
 
 This was manifested in the case of one William 0. Tillard, who 
 entertained a childish fancy for wind-mills, with an equally strong 
 aversion to water-mills. On one occasion, he cut the calves of a 
 child's legs through to the bone, and stated that he should have 
 taken away its life, in order that he might be tried for his act, 
 and removed from a place where there were no wind-mills. 
 
 The legal (consequences of imbecility will be deferred until we 
 come to treat of those of Dementia 
 
 The third form of alienation arising from defective ( develop- 
 ment, or deficient power of mental manifestation, is Dementia. 
 This form of mental alienation is attended by a general enfeeble- 
 ment of the moral and intellectual faculties, and is consequent 
 on mania, mental shocks, or injuries of the brain, or sometimes 
 it exists in old age, and is then termed senile dementia. One 
 great point of difference between this and idiocy, and imbecility, 
 is, that in both the latter, the faculties are imperfect, while in 
 the former they are enfeebled. In idiocy, the effect is congeni- 
 tal ; in imbecility, it occurs in early life, while in dementia, it 
 supervenes in a mind which is already fully developed. 
 
 In idiocy and imbecility, the faculties are always childish, al- 
 ways bear upon them the stamp of an original weakness. Their 
 action is like the stream that never rises above its fountain-head, 
 although it always rises to it. In dementia, there still remains 
 the foot prints of manhood, the evidences of a power that is 
 
 31 
 
482 MEDICAL JURISPRUDENCE. 
 
 gone, the glimmerings of a light that is nearly extinguished. It 
 is like the efforts of a stream to rise as high as its fountain-head, 
 but is unable to accomplish it, from obstructions or other causes. 
 The former are congenital, or appear in early life, while the lat- 
 ter never takes place until after puberty ; is most apt to occur as 
 the sequel of other diseases, especially of the more active forms 
 of mania, or to manifest itself at the close of a long life. When 
 once firmly seated, it may continue for years, as in the case of 
 Dean Swift ; and not unfrequently, after death, lesions of struc- 
 ture, or diminutions in size, are found to have taken place in 
 the brain. 
 
 There are_ several points that serve to distinguish it from 
 mania. While mania arises from a morbid excess of activity, 
 and is characterized by great force and unusual rapidity ; de- 
 mentia proceeds from enfeeblement in the action of the faculties, 
 and consequent weakness and inefficiency in their displays. The 
 maniac discerns not the ordinary characters of objects, and re- 
 lations of things, amid the mass of ideas that crowd upon his* 
 mind. The demented, through failure of strength, mistakes 
 things, and is unable to rise to the comprehension of general 
 truths. The maniac fails not so much in the force and logic of 
 his conclusions, as in the incorrectness of his assumptions. In 
 dementia, there is a paucity of ideas, a general feebleness of the 
 perceptive and reflective powers. The memory of the maniac 
 is defective because new ideas crowd in and mingle with the 
 past. In dementia, there is an obliteration of impressions from 
 insufficient power to retain them. Hurry and confusion are 
 characteristic of mania ; slowness and suspension of the think- 
 ing power, of dementia. 
 
 When the dementia arises from a sudden mental shock, the 
 disease generally takes its hue from that circumstance, and often 
 presents great singularity in its character. The mind, in such a 
 case, may remain fixed for the remainder of life upon one single 
 event. 
 
 This may be illustrated by the following case, found in Guy's 
 Principles of Forensic Medicine, 296 : A fisherman in Norway 
 was about to be married to a girl who resided in a distant vil 
 
MENTAL ALIENATION 483 
 
 lage, and Ihe day previous to that appointed for the wedding, he 
 took his boat to go to his bride's house, to spend the night in 
 feasting. She came to meet him, accompanied by her parents, 
 and while the two boats were returning together, a sudden squall 
 overset the boat which carried the bride, and she and her friends 
 perished. From that moment, the fisherman became insane, his 
 insanity having impressed upon it a peculiar character. He was 
 accustomed to sit from morning till, night upon a small stool, 
 which he fancied a boat, his arms and body constantly in the at- 
 titude of rowing; and if any one appeared at the door, he 
 warned his visitor to beware how he approached, as the water 
 was deep. 
 
 In another case, a man of great strength, of understanding, 
 having performed important negotiation, under a promise of re- 
 ceiving £300,000, upon being suddenly informed that he was to 
 have nothing, fell back insensible, into the arms of his attend- 
 ants ; his mind, from that time, sinking gradually into imbecility. 
 He squandered the remains of his fortune in childish trinkets, 
 and loved to exhibit himself dressed in rich garments, and hung 
 with precious stones. 
 
 One of the most striking characteristics that are observable in 
 dementia, and which goes to show that the faculties are really 
 deranged, as well as enfeebled, is the occurrence of incoherence. 
 This feature we have not observed either in idiocy or imbecility. 
 This incoherence is sometimes found to prevail in every intel- 
 lectual department Persons, places, times, circumstances, are 
 jumbled together; occur disjointedly ; succeeding each other 
 without any regular order. It may be in part accounted for from 
 a failure in the power of clearly distinguishing one thing from 
 another. Objects dissimilar are mistaken for each other; and 
 different times, as morning, neon, and evening, are blended to- 
 gether. 
 
 " Dementia," says Esquirol, " deprives men of the faculty of 
 adequately perceiving objects, of seeing their relations, of com- 
 paring them, of preserving a complete recollection of them, 
 whence results the impossibility of reasoning correctly. De- 
 mented persons are incapable of reasoning, because external ob- 
 
484 MEDICAL JURISPRUDENCE. 
 
 jects make too feeble an impression on them ; because the organs 
 of transmission have lost a part of their energy ; or, lastly, be- 
 cause the brain itself has no longer sufficient strength to receive 
 and retain the impression which is transmitted to it ; hence it 
 necessarily results, that the sensations are feeble, obscure, in- 
 complete. Being unable to form a true and just idea of objects, 
 these persons cannot compare them, or exercise abstraction or 
 association of ideas. They are not capable of a sufficiently strong 
 attention ; the organ of thought has not energy enough ; it has 
 been deprived of that vigor which is necessary for the integrity 
 of its functions. Hence the most incongruous ideas succeed each 
 other ; independent of each other, they follow without order and 
 connexion. Patients repeat words and entire sentences without 
 attaching to them any precise meaning ; they talk without be- 
 ing conscious of what they say. It seems as if unreal expres- 
 sions were heard by them, in their heads, which they repeat in 
 obedience to some involuntary or automatic impulse, the result 
 of previous habits, or of fortuitous association with objects which 
 strike their senses." 
 
 Senile dementia, or that which sometimes occurs to the aged, 
 presents an instance of what is often termed chronic dementia. 
 It does not consist alone in enfeeblement of the faculties, be- 
 cause if it did, we should find every old man demented. There 
 are several degrees or stages of it. In the first occurs a loss of 
 memory, particularly of recent events, without any serious im- 
 pairment of the reasoning faculties. Early impressions and ideas 
 long retained, now come up fresh from their long resting place 
 From forgetfulness of recent events, accompanied by recollec- 
 tions of early ones, occur many of those gaps in ideas and inco- 
 herences that, in part, constitute dementia. This defect, or loss 
 of memory, generally marks the commencement of dementia 
 from this cause, but not invariably. Sometimes it begins with 
 nervous excitement, accompanied with the excitement of some 
 faculty, function, or active power, which may act with great 
 energy. Some become irritated by the slightest circumstance ; 
 others experience venereal desires long since extinguished ; while 
 others still, of regular, temperate, and sober habits, all at once 
 
MENTAL ALIENATION. 485 
 
 manifest an appetite for high seasoned dishes, and intoxicating 
 drinks. These symptoms are soon succeeded by those of de- 
 mentia. 
 
 The second degree is characterized by a loss of the reasoning 
 power. Either the reflective faculties are so completely impair- 
 ed that they are unable to exercise their functions, or the other 
 faculties, particularly the affective, are so much enfeebled, that 
 the will does not possess sufficient strength and energy to carry- 
 out any process of reasoning. The premises are scarcely laid 
 down, before they are forgotten. Hence the inability to draw 
 any conclusions from them. The transaction of any business 
 which requires a sustained attention, becomes impossible. Any 
 slight or irrelevant idea, by disturbing the attention, draws the 
 mind off from what it was considering, and thus destroys all at- 
 tempts at continuous efforts. Some individuals in this stage re- 
 cognize their friends, but seldom display signs of emotion on see 
 ing them. 
 
 The next stage, or third degree, is termed incomprehension, and 
 is attended by inability to comprehend the meaning of any prin- 
 ciple, or proposition, however simple, that is proposed. Atten- 
 tion, memory, reason, all but the mere instincts, are entirely lost. 
 Here is sometimes found a great degree of physical activity ; 
 some jumping, running, walking ; others dancing, singing, and 
 vociferating. Some are talking unmeaning jargon ; others mut- 
 tering half sentences, or broken expressions ; while others are 
 found sitting in silence, scarcely pronouncing a syllable for weeks, 
 months, or even years. 
 
 The fourth and last degree, consists in a loss of instinctive ac- 
 tion. The very animal instincts are here lost. The mode of 
 existence is merely organic. There is neither desire or aversion, 
 hardly a consciousness of life. 
 
 The following description of those reduced to this last stage 
 of dementia, is taken from Dr. Prichard's Different Forms of 
 Insanity, 238-9: 
 
 " Sometimes an individual may be seen standing erect, and im- 
 movable, with his head and neck bent almost at right angles with 
 his trunk; his eyes fixed upon the ground, never appearing, by 
 
486 MEDICAL JtTBISPRUDENCE. 
 
 any movement or gesture, to be conscious of external impres- 
 sions, or even of his own existence. Another sits on a rocking- 
 chair, which she agitates to and fro, and throws her limbs into 
 the most uncouth positions, at the same time chaunting or yell- 
 ing a dissonant song, only capable of expressing a total inanity 
 of ideas and feelings. Many sit constantly still, with their chins 
 resting upon their breasts, their eyes and mouths half open, un- 
 conscious of hunger or thirst, and almost destitute of the feel- 
 ings which belong to mere physical life ; they would never rise 
 or lie down, were they not placed in bed. A great proportion 
 of the patients who are reduced to this degree of fatuity, are 
 found to have lost the use of their limbs, in a greater or less de- 
 gree, by partial or general paralysis." 
 
 The second class embraces that extensive range of cases in 
 which the insane character arises from the excessive and de- 
 ranged action of the faculties. We have here the active forms 
 of mania, which in their exhibition give rise to many varieties. 
 This in general does not consist so much in manifesting any par- 
 ticular extravagance of thought or feeling, as by a change of 
 character, or a departure from ordinary habits of life. It has 
 been well laid down by a distinguished writer, that " it is the 
 prolonged departure, without an adequate external cause, from 
 the state of feeling, and modes of thinking, usual to the indi- 
 vidual when in health, that is the true feature of disorder in 
 mind." 
 
 To judge, therefore, of the existence of mania in any alleged 
 case, it is as important to know what have been the temper, dis- 
 position, and habits of the individual, as the present symptoms 
 which are supposed to evidence the disease. 
 
 Mania is generally preceded by what has been termed its in- 
 cubation. This is marked by several pretty clear indications. 
 The individual often becomes conscious of having new and odd 
 notions, unusual inclinations ; his affections changing ; he be- 
 comes sleepless, his appetite diminishes, constipation supervenes, 
 the features alter ; the gay and communicative become sad, mo- 
 rose, and averse to society ; the economical, prodigal ; the open 
 and candid, suspicious and jealous. Business is neglected, tears 
 
MENTAL ALIENATION. 487 
 
 and laughter succeed each other without any apparent cause or 
 reason. 
 
 This state may continue longer or shorter, according to cir- 
 cumstances. In one case, it was in progress for fifteen years. 
 When this state has continued for some time, a disappointment, 
 a slight contradiction, or a paroxysm of anger, may give rise to 
 the sudden explosion of mania. 
 
 In the active forms of mania, the physical indications are not 
 to be disregarded. A febrile excitement prevails ; the pulse is 
 accelerated ; the eye is wild and glassy ; the sensations have be- 
 come changed, being either more acute or more obtuse. They 
 are -frequently erroneous. The countenance is changed, exhibit- 
 ing physical pain or mental disquietude. There is often a great 
 insensibility to external impressions; heat, cold, hunger, and 
 thirst, being more or less entirely disregarded. The muscular- 
 power is often inordinately developed, giving rise to the perform- 
 ance of acts far beyond the presumed strength of the individual. 
 He sleeps little, and his slumbers are much disturbed. 
 
 One great difficulty seems to consist in the destruction or per- 
 version of that influence which, in the healthy state, is mutually 
 exercised by the faculties over, or in relation to, each other ; the 
 right exercise 'of which constitutes the harmonious result of all 
 the possible exhibitions of mind. The control of mind over it- 
 self seems to be lost. In a state of sanity, the different faculties, 
 like the different parts of a machine, all conspire together in 
 their mutual action to one harmonious result. In mania, the 
 same faculties may act with power and energy, but independent- 
 ly of each other, and thus the result be discord, derangement, 
 and disorder. That modification of mind which constitutes a 
 sane will is wanting, and hence the strange perversions and sin- 
 gular eccentricities exhibited. ' 
 
 It is probably beyond the power of the sane man to conceive 
 the confusion which reigns in the mind of the madman. " A 
 series of delusions, the offspring of some one excited passion or 
 emotion, or one single delusion, the work of fancy, the interpre- 
 ter of every sensation, the source of every thought, the main- 
 spring of every action, holding every faculty in stern subjection, 
 
488 MEDICAL JURISPRUDENCE. 
 
 making the senses its dupes, the reason its advocate, the fancy its 
 sport, and the will its slave ; now whispering in the ear things 
 unspoken, now painting on the eye things unseen ; changing hu 
 man beings at will into fiends or angels; converting every sen- 
 sation into a vision ; every sound into articulate speech ; the un- 
 real world within in constant conflict with the real world with- 
 out ; understood of no one, yet believing himself to be compre- 
 hended by all ; punished for the very actions which he supposes 
 his tyrants to have commanded ; controlled in everything which 
 he thinks it his duty to perform. There is no wish, however 
 presumptuous — no fancy, however monstrous — no action, how- 
 ever absurd — no crime, however heinous, that his delusion can- 
 not create, prompt, and justify. 
 
 That a sane man might form a conception, however faint, of 
 the distraction of such a state as this, it would be necessary to 
 combine into one whole, the strange confusion of a dream, and 
 the sleeper's entire belief in its reality ; the varying impressions 
 and changing scenes of his waking hours, and the conduct, to 
 him wholly unintelligible, of those about him." Guy, 328. 
 
 Mania has two divisions : 
 
 The first embraces Intellectual Mania, both General and 
 Partial : 
 
 The second, Moral Mania, both General and Partial. 
 
 This division or classification of the active forms of Mania, 
 will fail to be clearly understood, except by those who have ac- 
 customed themselves to look at the mind, in its sane state, as be- 
 ing made up of intellectual and moral powers and faculties, and 
 of clearly discriminating the differences between them. The dis- 
 tinct office of the one, is to originate and elaborate all the diver- 
 sified forms of thought ; to perceive, conceive, imagine, remem- 
 ber, judge, associate, reason. That of the other, is to produce 
 every modified form of feeling, to give birth to emotions, pas- 
 sions, desires, everything that impels, or in any degree feels. 
 
 The relations in which these two departments stand to each 
 other, are in the highest degree interesting. The moral faculties, 
 embracing as they do, all the instincts, propensities, sentiments, 
 and affective powers, are, in themselves, perfectly blind, and ab- 
 
MENTAL ALIENATION. 489 
 
 solutely require the aid of the intellect to enlighten, to guide 
 and to enable them to work out their various purposes. 
 
 On the other hand, the intellectual faculties derive all their 
 motives to exertion from the moral department, without the 
 promptings of which, they probably never would exert them- 
 selves except in the feeblest manner. In the moral or affective 
 department is lodged the immense magazine of motives, that ex- 
 ert their ceaseless, and widely diversified influence, over all the 
 stirring activities of life. 
 
 The relations of mutual dependence in which these two depart- 
 ments stand to each other, are very nearly analogous to those ex- 
 isting between the heart and brain in the animal economy. The 
 continuance of the heart's action is -necessary to enable the brain 
 to furnish that nervous influence without which that action would 
 cease ; while, on the other hand, the brain must continue to fur- 
 nish that influence, or the heart would speedily cease its pulsa- 
 tions. 
 
 The first we shall here take up is, 
 
 GENERAL INTELLECTUAL MANIA. 
 
 This form of mental alienation is accompanied with the utmost 
 Cu.ixusion and disorder in the action of the intellectual faculties. 
 The exalted and perverted action of all these must produce a 
 complete chaos of intellect. 
 
 It is extremely difficult to define in what intellectual mania 
 essentidly consists. In regard to consciousness, which is a mode 
 of action common to all the faculties, intellectual and moral, the 
 maniac undoubtedly possesses it. Not only is he conscious of 
 his state, but also very frequently of the legal relations in which 
 it places him. A madman had contrived to give a piece of iron 
 the shape of a dagger, and had firmly fixed into it a handle. On 
 its being taken away from him he became excessively abusive, 
 and, in a fit of fury, exclaimed to the keeper, " Vll murder you 
 yet : I am a madman and they cannot hang me for it." The firing 
 of York Minster by Martin, gave rise to a discussion in relation 
 to his probable fate in a neighboring mad-house. In the midst 
 of it one of the inmates exclaimed, " he (Martin) will not be 
 
490 MEDICAL JURISPRUDENCE 
 
 hanged, of course lie will escape." " For what reason," asked 
 several. " They cannot hang him" replied the lunatic, " because 
 he is mad, he is one of ourselves." 
 
 The sensation of the maniac is often influenced by some dis- 
 eased affection. The female mentioned by Esquirol, who fancied 
 she had a living animal in her stomach, was found to lr ve beet 
 laboring under a cancer of that viscus ; and the woman who be- 
 lieved that the pope and his cardinals were holding a co'incil in 
 her belly, was discovered to have labored under a chronic 'nflam- 
 mation of the peritoneum. Independent of disease, the senses 
 do not always seem to furnish correct reports to the semorium. 
 In the autobiography of the maniac he says : " My senses were 
 all mocked at and deceived. In reading, my eyes saw words on 
 the paper which, when I looked again, were not. The forms of 
 those around me, and their features, changed even as I looked 
 on them : I heard the voices of invisible agents, and notes so 
 divine, so pure, so holy, that they alone, perhaps, might recom- 
 pense me for many sufferings: My sense of feeling was not fchfi 
 same ; my smell, my taste, gone or confounded." 
 
 The perception of the maniac may be correct, although morbid 
 impressions may influence the judgments based upon them. For 
 instance, an insane female entertained the firm conviction that 
 her husband was dead, and when he came jto visit her she insisted 
 upon it that it was the devil in his shape. The perception of 
 what constituted her husband was correct, but her judgment 
 based upon it was erroneous. 
 
 The memory, so far as the simple recollection is concerned, 
 does not appsar to be affected in this form of mania. The maniac 
 undoubtedly exercises memory, but he remembers his own halu- 
 cinations or delusions, as much or more clearly than he does real 
 events. 
 
 The judgment is the most generally perverted. The lady who 
 insisted that a tooth which a dentist had removed, had slipped 
 from his fingers and stuck in her throat, and that she could not 
 swallow a morsel, while she eat and drank heartily all the time, 
 was wrong both in her premises and conclusion ; and Bellingham, 
 who imagined that the government had been culpably negligent 
 
MENTAL ALIENATION. 491 
 
 of his private interests, and, therefore, he proceede to take the 
 life of a man whom he believed to be perfectly innocent, in order 
 that he might have an opportunity of bringing his affairs before 
 the country, erred in almost every act of his judgment. The 
 mere judgments formed, however, are often correct in themselves, 
 although they may be exercised in reference to some erroneous 
 impression, or utterly unfounded notion, which may constitute 
 the main feature of the alienation. The man who imagines Ms 
 legs to be made of glass, entertains a very erroneous impression, 
 but in acting upon that imagination, he judges very correctly 
 when he avoids a blow with a stick, because on the supposition 
 that they were glass, they might, in that manner, easily be broken. 
 So also the man who supposes himself a plant, and, under that 
 impression, stationed himself in his garden to be watered, judged 
 correctly admitting the truth of his supposition. 
 
 The reasoning power of the maniac is by no means abrogated, 
 but the misfortune is, that it is exercised in reference to his de- 
 lusions or hallucinations, and not to facts as they really exist. 
 The power of reasoning is sometimes very acute. An instance 
 is given of a Jesuit, named Sgambari, who believed himself a 
 cardinal, and claimed to be addressed by the title of eminence. 
 A friend was anxious to convince him of Ms error, and obtained, 
 on one occasion, a patient hearing. When he had finished the 
 madman replied, " Either you consider me insane or rational ; 
 on the latter supposition you do me injustice by your remon- 
 strances ; on the former, I hardly know which is most mad, I 
 for believing myself a cardinal, or you, for tMnking to cure a 
 madman by such reasonings." 
 
 The associations of the maniac are wild, strange, and unnatural. 
 This mode of activity of the faculties, is usually extremely dis- 
 ordered. The power of association remains, but its exercise is 
 strangely perverted. It is obedient to the prevailing delusion or 
 hallucination. The maniac, for instance, who wrote his auto- 
 biography, associated the inmates of the asylum and his keepers 
 with supernatural beings. There was a maniac there whom his 
 spirit called the Lord Jehovah, supremely omnipotent, the trinity 
 in unity ; and one of the keepers was supposed by Mm to be the 
 
492 MEDICAL JURISPRUDENCE. 
 
 Savior of mankind. At other times these same persons assumed 
 other shapes, and according to the state of his mind, were either 
 fiends or angels. This delusion could give to any object any 
 shape it pleased. Gwy's Principles of Forensic Medicine, 324. 
 
 The feature which the most distinctly characterises intellectual 
 mania, both general and partial, is the entertainment of delusion 
 or hallucination. This is of two kinds. In the one, the maniac 
 believes in the reality of things that never existed, and acts in 
 conformity with his belief. In the other, he seizes upon things 
 that are not wholly unfounded, and carries them to erroneous 
 and extravagant lengths. The strange antics of the maniac, and 
 his violent conduct, are often traceable to the delusions that ty- 
 rannize over the movements of his mind. 
 
 As intellectual mania arises from the perverted action of the 
 faculties that form ideas, and moral mania from those that furnish 
 feelings, emotions, motives, and passions, we should naturally 
 expect to find the first more characterised by the conversation, 
 and the last, by the conduct, of the individual. This accordingly 
 will be found to be the fact, and it affords one of the best means 
 of discriminating between the two. 
 
 The maniac almost uniformly entertains the conviction of his 
 own sanity. He trusts in the truthi'ulness of his own feelings 
 and ideas, and no force of argument can, in the slightest degree, 
 shake his confidence in his opinions. The state of highest mani- 
 acal excitement has been ably described by Pinel. " The patient," 
 he says, " sometimes keeps his head elevated, and his looks fixed 
 on high ; he speaks in a low voice, or utters cries and vocifera- 
 tions, without any apparent motive. He walks to and fro, and 
 sometimes arrests his steps, as if excited by the sentiment of ad- 
 miration, or wrapt up in profound reverie. Some insane persons 
 display wild excesses of merriment, with immoderate bursts of 
 laughter. Sometimes also, as if nature delighted in contrasts, 
 gloom and taciturnity prevail, with involuntary showers of tears, 
 or the anguish of deep sorrow, with all the external signs of acute 
 mental suffering In certain cases a sudden reddening of the 
 eyes, and excessive loquacity, give presage of a speedy explosion 
 of violent madness, and the urgent necessity of a strict seclusion, 
 
MENTAL ALIENATION. 493 
 
 One lunatic, after long intervals of calmness, spoke, at first, 
 with volubility ; he uttered frequent shouts of laughter, and then 
 shed a torrent of tears ; experience had taught the necessity of 
 shutting him up immediately, for his paroxysms were, at such 
 times, of the greatest violence." 
 
 When intellectual mania prevails alone, there is no perversion 
 of the moral faculties. But it is often, perhaps, more generally 
 than otherwise, found complicated with moral mania. To this 
 fact is to be attributed the peevishness and unevenness of tem- 
 per, the sensitiveness and utter disregard of the proprieties of 
 life, and the great and apparently radical change that sometimes 
 takes place in the affections, that is oftentimes observable in 
 cases of intellectual mania. 
 
 Partial Intellectual Mania. This was formerly known by 
 the term melancholia, but more recently has been styled mono- 
 mania. , This last mentioned term is not quite as distinctive as 
 it should be, as it is equally applicable to any partial derange- 
 ment of the moral powers. 
 
 The first appearance, and most simple form of this species of 
 derangement, consists in the entertaining of some strange and 
 fantastic notion, against which the verdict of common sense would 
 be most unqualifiedly rendered. Thus, in the case mentioned by 
 Sir George Makenzie, the individual seemed a discreet person, 
 and could converse appropriately on every subject until the 
 moon was mentioned ; and, upon hearing that named, he would 
 fall instantly a-staring, and into great extravagancies, believing 
 himself to be secretary to that satellite. Guy, 305. Many find 
 singular have been these notions. Some have imagined they had 
 a living animal within them, and that they were gradually dying 
 from other animals preying upon different parts of their bodies. 
 Others, that they are converted into animals of other species, 
 such as geese, a cock, a dog, a cat, a hare, a cow, and the like. 
 In such cases, they adopt the noises and gestures of the animals 
 into which they suppose themselves to be transformed. Rush on 
 Diseases of the Mind, 78-9, 80. A prince of the house of Bour- 
 bon supposed himself a plant. Some have supposed themselves 
 transformed into glass. One believes that by discharging the 
 
494 MEDICAL JURISPRUDENCE. 
 
 contents of his bladder, he shall drown the world ; another, thai 
 he is dead, stretching himself out, and assuming the semblance 
 of his final sleep. One remarkable instance is the Reverend 
 Simon Brown, who for many years before his death, entertained 
 the belief that he had lost his rational soul. He supposed that 
 God had caused it gradually to perish, and that he had only re- 
 maining the animal life, which he enjoyed in common with the 
 brutes. A lunatic in Wartsburgh supposed there was a per- 
 son concealed within his belly, with whom he held frequent com- 
 munication, and that too, although he was, at the very time, 
 struck with the absurdity of the idea. 
 
 The delusive idea in which the derangement consists, may be 
 sometimes traced to some bodily sensation or disease. Thus, a 
 woman insisted that she was pregnant with the devil, and in her 
 womb, after death, was found a mass of hydatids. Another 
 imagined that a regiment of soldiers lay concealed in her belly, 
 and that she could feel them struggling and fighting with each 
 other. After death, the intestines were found agglutinated to- 
 gether, in consequence of chronic peritonitis. But this is not 
 always the cause, otherwise it would not admit of the kind of 
 curejthat may sometimes be effected, viz., an impression made 
 upon the mind. This was illustrated in the person who sup- 
 posed himself cured of a serpent in his bowels by a pretended 
 surgical operation, but suddenly took the idea that it had left }ts 
 ova behind, from which a brood of young ones would be hatched. 
 This delusion was quickly banished by the dexterous reply of 
 the physician, that this was impossible, because the snake was a 
 male. Guy's Principles of Forensic Medicine, 306. 
 
 The delusion not unfrequently bears a near relation to the for- 
 mer habits of business, or to the usual occupation, of the mono- 
 maniac. The son of an attorney who was frequently employed 
 in criminal prosecutions, fancied himself suspected of some hor- 
 rible crime, for which a process had been issued against him, 
 and whenever the door of Ms room was opened, he supposed the 
 officers of justice were coming to apprehend him. 
 
 The monomaniac, unlike the maniac, is often conscious of his 
 own derangement, and frequently succeeds, for a long period of 
 
MENTAL ALIENATION. 495 
 
 time, in concealing it. He thus furnishes evidence of the convic- 
 tion on his part, that the common sense of mankind believes him 
 insane on one particular topic, or train of ideas, at the same time 
 that he clings to that topic or train with a strong and unyielding 
 tenacity. 
 
 It must not be supposed that every affection of an intellectual 
 faculty amounts to mental alienation. Many of the perceptive 
 faculties may be disordered in their functions. Some of them may 
 be even entirely obliterated, and yet the mind retain the general 
 integrity of its powers. This, however, cannot probably happen 
 where those faculties that discern the relations of things are 
 disordered in their functions. There are instances where the 
 faculty of language has been impaired, and sometimes totally des- 
 troyed, without at all appearing to injure the general action of 
 mind, or to render it less sane in its operations. In one re- 
 markable instance, a gentleman of sixty totally lost the memory 
 of places, so that he could not recollect bis own house ; although 
 his intellect was sound in reference to all other things. 
 
 The simplest form of this species of alienation is where the in- 
 sane delusion is confined to a single topic, and this will, some- 
 times continue unchanged for a number of years. At other times, 
 t ae features of the derangement vary, and different delusions or 
 ljallucinations prevail, either successively or together. The 
 original tendency to become monomaniac on one subject, appearf 
 to render it less difficult to become so on any other, or a numbei 
 of others. 
 
 Where the alienation relates to a single topic or idea, the in- 
 tellect may be sane on all other subjects. There is, however, 
 much difficulty in marking out the precise barriers of insane de- 
 lusion. The particular topic or idea in which it consists, may 
 be so blended with others, as to pervert or derange them. It 
 may also happen that many cases of so called monomania, are ex- 
 amples of general mania, characterized by the immoderate activity 
 of some one faculty. 
 
 Of Mobal Mania. Hitherto, the attention has only been di- 
 rected to the exaltation and perverted action of those faculties 
 that constitute the intellectual part of man's nature. It is per 
 
496 MEDICAL JURISPRUDENCE. 
 
 fectly obvious, however, that the affective or moral powers are 
 equally as essential as the intellectual, in constituting a complete 
 human mind. Nor can the organs of these faculties claim an 
 exemption from disease ; nor the faculties themselves from per- 
 version and derangement. Hence, another form of active mania, 
 which has been termed moral mania. 
 
 This was never recognized as a distinct form of mental aliena- 
 tion, until the time of Pinel. He was the first to observe, about 
 the commencement of the present century, that where there was 
 no lesion of the understanding, no delusion or hallucination of 
 intellect, there might exist a kind of instinctive or abstract 
 fury, which could be referable only to the affective power's. It 
 is now very universally admitted by the most approved writers 
 on mental alienation. It is defined to consist in a morbid per- 
 version of the natural feelings, affections, inclinations, temper, 
 habits and moral dispositions, without any notable lesion of the 
 intellect or knowing and reasoning faculties, and .particularly 
 without any maniacal hallucination. Guy's Principles of Forens'ic 
 Medicine, 306. Moral mania, like intellectual, is divided into 
 general and partial. 
 
 General Moral Mania. This form of mania consists in a 
 general exaltation, perversion, or derangement of function, of ?11 
 the affective or moral powers. Those who have observed, and 
 written upon this form of mental alienation, unite in describing 
 those who labor under it as persons of singular, wayward, and 
 eccentric character. Their antipathies are violent, and suddenly 
 taken ; their suspicions unjust and severe, and their propensities 
 strong and eagerly indulged. They are generally proud, con- 
 ceited, ostentatious, easily excited, and obstinate in the main- 
 taining of absurd opinions. 
 
 It will be often found, on enquiry, that there is in the family an 
 hereditary tendency to insanity ; and, possibly, that the individual 
 himself has been afflicted with it in an earlier period of his life. 
 
 A strict enquiry must be made in relation to his former habits, 
 disposition, and modes of feeling and action. This will, probably, 
 result in the discovery of one of two things. Either a marked 
 change will be found to have occurred, which will be likely to 
 
MENTAL ALIENATION. 497 
 
 date from the period when he sustained some reverse of fortune, 
 or experienced the loss of some near and dear relative ; or the 
 alteration will be found to have been gradual and imperceptible, 
 consisting in an exaltation or increase of peculiarities which 
 'were always natural or habitual. There is, also, another tolera- 
 bly extensive class of cases, in which the change has been con- 
 sequent upon some shock which the bodily constitution has 
 undergone ; and this has been either a disorder affecting the head, 
 an attack of paralysis, a fit of epilepsy, or some fever or inflam- 
 matory disorder. 
 
 The change, however brought about, is always found in the 
 temper, disposition, habits, and moral qualities of the individual ; 
 and is uncomplicated with any delusion or other evidence of de 
 rangement of the intellectual faculties. It is properly described 
 by Hoffbauer as being " a state in which the reason has lost its 
 empire over the passions, and the actions by which they are 
 manifested, to such a degree, that the individual can neither re- 
 press the former nor abstain from the latter. It does not follow, 
 that he may not be in possession of Ms senses, and even his usual 
 intelligence ; since, in order to resist the impulses of the passions, 
 it is not sufficient that the reason should impart its counsels, we 
 must have the necessary power to obey them. The maniac may 
 judge correctly of his actions, without being in a condition to 
 repress his passions, and to abstain from the acts of violence to 
 which they impel him." 
 
 To an acute and accurate observer, a marked contrast will be 
 here presented between the intellectual and moral faculties. In 
 the former, there is no diminished force or perverted action. 
 The power of reasoning not only remains unimpaired, but gene- 
 rally displays a greater strength than natural, in accounting for 
 those eccentricities, and waywardness of character, and peculiar 
 displays of temper and passion, that mark the course of the moral 
 maniac. He can paint, with unabated force, the beauties of vir- 
 tue, and the excellency of truth, justice, mercy, and every other 
 moral quality ; while his conduct exhibits only the extreme of 
 folly, and is in direct opposition to all moral propriety. 
 
 This general derangement of the moral powers is very likely 
 
 32 
 
498 MEDICAL JURISPRUDENCE. 
 
 to pass into and affect the intellectual. Indeed, so frequently 
 does this occur, that it has actually been described by Georget 
 and others as belonging to the initiatory stage or incubation of 
 madness. It is, however, well settled, that either form of the 
 disease may exist independent of the other, and that either one 
 of them may be made the subject of distinct medico-legal inves- 
 tigation. 
 
 Whenever this form of mania, becomes the subject of legal 
 investigation, great difficulties are always presented. The popular 
 mind is accustomed to recognize insanity only in delusion, and 
 to couple it with raving, and lesions of intellect, never observable 
 in pure moral mania. Hence the extreme difficulty in proving 
 this form of it, and the different kinds of testimony offered by the 
 witnesses. One has seen the individual in connection with his 
 business, and observed him regular and methodical in all his busi- 
 ness arrangements, and to all appearance perfectly regular in the 
 use of his intellect. Another has had some opportunity of no- 
 ticing some strange and unaccountable eccentricity of conduct, 
 totally irreconcilable with the possession and exercise of a sane 
 mind. The facts, to which these two would testify, would ap- 
 parently be wholly at variance with each other, and yet when 
 the real form of the malady is known, would be entirely consis- 
 tent. 
 
 One general remark here will be found to be universally ap- 
 plicable. As we found the conversation to affordthe means of 
 indicating the existence of intellectual mania, so the conduct is 
 equally as clear a means of indicating that of moral mania. This 
 follows from the fact, that intellectual mania, resulting as it does 
 from a derangement of the faculties that form ideas, would be 
 recognized more readily in the derangement of those ideas of 
 which the conversation would be evidence ; while the conduct 
 being under the prompting and guidance of the affective or 
 moral powers, would naturally be regarded as affording clear in- 
 dications of the state and condition of those powers. 
 
 Many cases, illustrating this peculiar form of mania, are to be 
 found in writers on insanity, particularly in the works of Ray 
 and Priehard. The following, given simply as an illustration, is 
 
MENTAL ALIENATION. 499 
 
 one quoted from Prichard by Ray. Ray's Medical Jurisprudence 
 of Insanity, 172-3. 
 
 " J. K., a farmer, several of whose relatives had been the sub- 
 jects of mental derangement, was a man of sober and domestic 
 habits, and frugal and steady in his conduct, until about his 
 forty-fifth year, when his disposition appeared to have become 
 suddenly changed, in a manner which excited the surprise of his 
 friends and neighbors, and occasioned grief and vexation in his 
 family. He became wild, excitable, thoughtless, full of schemes 
 and absurd projects. He would set out and make long journeys 
 into distant parts of the country to purchase cattle and farming- 
 stock, of which he had no means of disposing ; he bought a 
 number of carriages, hired an expensive house ready furnished, 
 which had been inhabited by a person much above his rank, and 
 was unsuitable to his condition ; he was irascible and impetuous, 
 quarrelled with his neighbors, and committed an assault upon 
 the clergyman of the parish, for which he was indicted and bound 
 to take his trial. At length, his wife became convinced that he 
 was mad, and made application for his confinement in a lunatic 
 asylum, which was consequently eifected The medical practi- 
 tioners who examined him were convinced of his insanity, by 
 comparing his late wild habits and unaccountable conduct with 
 the former tenor of his life, taking into consideration the tendency 
 to disease which was known to prevail in his family. The change 
 in his character alone had produced a full conviction of his mad- 
 ness in his friends and relatives. When questioned as to the 
 motives which had induced him to some of his late proceedings, 
 he gave clear and distinct replies, and assigned with great ingenu- 
 ity some plausible reason for almost every part of his conduct." 
 
 In some instances, old men in the decline of life, who have led 
 long and virtuous lives, become amicted with this form of mania. 
 In such case, the whole moral character becomes changed, the 
 pious becoming impious ; the economical, profuse ; the liberal, 
 penurious ; the sober, drunken. Impulses that had long been 
 effete become suddenly excited, and a .strong tendency to the 
 formation of vicious habits is manifested. It would seem as if 
 the lower propensities, or some of them, had been gathering fresh 
 
500 MEDICAL JURISPRUDENCE. 
 
 vigor through a long life, in order to make their peculiar and 
 offensive displays near the close of it ; or, (what, perhaps, is the 
 most probable,) the guards placed over them in the in.ellect and 
 high moral feelings are relaxed through weakness, and hence 
 leave unrestrained the play of propensity and passion. 
 
 Partial Moral Mania consists in the deranged or perverted 
 action of one, or a few, of the aifective or moral powers and facul- 
 ties. The effect of it is to place the individual under the domin- 
 ion of some one vice, or ruling idea, which exercises a sway, 
 perfectly tyrannical, over the entire man and his actions. Every 
 moral power or faculty is liable to be perverted or deranged in 
 its manifestation ; but those which are the most prominent, and 
 the most frequently exhibited in the affairs and conduct of life, 
 are the most liable to deranged action. Hence, the propensities 
 are, in general, more frequently found deranged than the senti- 
 ments, and some of the sentiments much more frequently than 
 others. We will notice a few of the affective or moral sentiments 
 that are liable to derangement. 
 
 The sexual propensity is liable to deranged action, arising from 
 a morbid or diseased condition of its organ. An individual of 
 either sex, under the influence of it, is constantly haunted by a 
 crowd of voluptuous images, and hurried away into the perpetra- 
 tion of acts of the grossest licentiousness. It is known by the 
 term erotic mania. 
 
 An instance is mentioned of a very intelligent lady, who was 
 tormented, from early life, with the most inordinate desires. Her 
 good education alone, for some time, saved her from the rash in- 
 dulgences to which this propensity so violently urged her. Ar- 
 rived at maturity, she abandoned herself to the gratification of 
 her desires, but this only increased their intensity. Frequently, 
 she saw herself on the verge of madness ; and, in despair, she left 
 her house and the city, and took refuge with her mother, who 
 resided in the country, where the absence of objects to excite 
 desire, the greater severity of manners, and the culture of a gar- 
 den, prevented the explosion of the disease. After having 
 changed her residence for that of a large city, she was, after a 
 while, threatened with a relapse, and again she took refuge with 
 
MENTAL ALIENATION. 501 
 
 her mother. On her return to Paris, she complained like. a 
 woman in perfect despair. " Everywhere," she exclaimed, " I 
 see nothing but the most lascivious images ; the demon of lust 
 unremittedly pursues me, at the table, and even in my sleep. I 
 am an object of disgust to myself, and feel that I can no longer 
 escape either madness or death." Ray's Med. Juris, of Insanity, 
 188. 
 
 The case of Lord Dudley reported in 3 HowePs State Trials, 
 401, furnishes a remarkable instance of the perverted action of 
 this propensity. He was tried, found guilty and executed, k. 
 committing a rape upon his own wife, and for the crime against 
 nature. The testimony on this trial developed, to an extraordi- 
 nary degree, the action of this propensity. It appeared as the 
 constant theme of thought, and in all the possible varieties of 
 sexual intercourse, he appeared to take an intense and peculiar 
 interest. 
 
 A number of instances of this kind of mania are cited in Ray, 
 186, &c. A very remarkable fact is stated in Morrison's Physiog- 
 nomy of Mental Diseases, 76, going to show the extreme tenacity 
 with which insane ideas adhere to the mind. During the first 
 attack of the Asiatic cholera in the Lunatic Asylum at Hanwell, 
 in September and October, 1832, when only females were the 
 subjects of it, several patients, laboring under erotic mania, ex- 
 hibited lasciviousness in their words and actions, in the highest 
 degree, long after the pulse at the wrist had ceased to be percep- 
 tible, and the skin and the tongue had become quite cold, indeed, 
 until a very short time before they expired. 
 
 To show the irresistable character of the promptings of this 
 propensity, and the entire deprivation of moral liberty to which 
 it leads, reference may be had to Graham's Lecture, 201, in which 
 he gives extracts from a letter written by the chaplain of one of 
 our State prisons, in reference to the practice of self -pollution 
 among the prisoners. He speaks of one prisoner in particular, 
 who, when he first knew him, had a full and ruddy cheek, which, 
 in a little time, became pale and sunken, and who confessed that 
 he had become a slave to that vice, and feared it was doing him 
 harm ; for, said he, " 1 seem to have no power over myself. I awake 
 
502 MEDICAL JURISPRUDENCE. 
 
 from my sleep and find myself in the act. Three times a night, 
 for weeks in succession, I have yielded to it, and frequently 
 without being voluntary in the thing." The deranged action of 
 this propensity sometimes leads to a more general form of mania. 
 
 Cleptomania, or propensity to steal, is another instance of partial 
 moral mania. This form of it was observed by Dr. Rush. He 
 remarked " that there are persons who are moral to the highest 
 degree as to certain duties, but who, nevertheless, live under the 
 influence of some one vice. In one instance, a woman was ex- 
 emplary in her obedience to every command of the moral law 
 but one, — she could not refrain from stealing. What made this 
 vice more remarkable was, that she was in easy circumstances, 
 and not addicted to extravagance in anything. Such was the 
 propensity to this vice, that when she could lay her hands on 
 nothing more valuable, she would often, at the table of a friend, 
 fill her pockets secretly with bread. She both confessed and 
 lamented her crime." Rush's Medical Inquiries and Observations, 1 
 
 Many remarkable instances of the morbid action of this pro- 
 pensity may be found in writers on insanity, as Prichard, Ray, 
 and Guy. It sometimes exhibits itself as a leading feature, if 
 not sole characteristic, of moral mania ; as, in the lunatic who 
 would only eat what he had stolen, and his keeper made it a 
 constant practice to conceal his food, that he might find and get 
 possession of it furtively before eating it. 
 
 It is sometimes found coupled with abnormal conditions of 
 brain ; as, in one case, where it was ill organized and ricketty, 
 and another, where it was preternaturally small. 
 
 It is often found complicated with general mania. Instances 
 are given by Pinel of persons who, in their lucid intervals, were 
 considered models of probity, but who could not refrain from 
 stealing and cheating during the paroxysm. 
 
 It has been observed to follow diseases or injuries of the brain. 
 A young man, of correct habits, received a severe blow on the 
 temple, for which he was trepanned, and afterwards manifested 
 an invincible propensity to steal. Ray, 183. The late Dr. Smith, 
 of New-Haven, observed a similar effect to follow an attack of 
 typhus fever. 
 
MENTAL ALIENATION. 503 
 
 It is sometimes followed by general mania, as in the case that 
 fell under the observation of Fodere. 
 
 It has, in some cases, been found connected with certain states 
 and conditions of the animal economy. There are instances of 
 women who, when pregnant, were violently impelled to steal, 
 though perfectly upright at all other times. 
 
 The recorded instances are extremely numerous, showing the 
 lerangement of this propensity ; but the most extraordinary one 
 is of recent occurrence, in the case of Charles Sprague, reported 
 in 6 Vol. of American Journal of Insanity, page 254. He was the 
 son of a respectable clergyman. His paternal grandmother, great- 
 grandmother, and some other relatives on the same side, had been 
 insane. When young, and only about seven years of age, he ex- 
 perienced several severe injuries of the head, and would, at times, 
 complain of the headache, and, at such times, was observed to 
 have an unnatural prominence and dullness or glassiness of his 
 eyes, which continued after the headache had ceased. Simulta- 
 neously, or closely succeeding the first occurrence of these facts, 
 it was found that the shoes of the female members of the family, 
 occasionally the pair, although more generally one of them, were 
 missing ; and, after some time, would be found thoroughly soaked 
 in water, twisted up like a rope, and hid away in some secret part 
 of the house. After a time, it was traced to Charles. This strange 
 habit continued from that time forward, with occasional inter- 
 missions of perhaps three or four months, until in August, 1849, 
 he overtook a young lady in the street, in Brooklyn, threw her 
 down, snatched a shoe from one of her feet, and ran off with it, 
 for which he was indicted and tried for highway robbery. His 
 own account of the transaction to his father was, that he did not 
 know much, if anything, about it, except what the witnesses told 
 him ; that he did not deny it ; that he thinks he was going along 
 in the street, and caught sight of a shoe, and it flashed into his 
 mind like lightning that he wanted it, and he dove, for it ; that 
 he did not know what he wanted with it, nor what he ever 
 wanted with one; that he did not know how he got the girl 
 down ; that the whole affair was a kind of haze before his mind, 
 that his first distinct recollection of what took place that morn- 
 
504 MEDICAL JURISPRUDENCE. 
 
 ing was of being near the printing office, after the affair had hap- 
 pened, about half a mile beyond where it occurred. In every 
 other respect, his moral character was shown to have been per- 
 fectly faultless, and his habits all correct. He was respectably 
 married, and had one child. Of the hundreds of instances in 
 which he had exercised this singular propensity, he had been seen 
 to take a shoe but twice. He never took any but women's slioes. 
 It seems clearly to have been a case of irresponsibility. 
 
 Another insane manifestation occasionally witnessed is that of 
 lying, in persons otherwise of irreproachable morals and good 
 education. This seems to result from an inability to tell the 
 truth, rather than from any other cause. It must be admitted, 
 however, that this vice may be owing to circumstances purely 
 moral, such as faulty education, evil examples, and a lax morality, 
 and hence that there may be great difficulty in discriminating 
 between that which proceeds from moral and physical causes. 
 If it proceed from the physical, and be a case of partial moral 
 mania, there will most probably have been a change observable 
 in the individual. There may also be present some physical 
 indications of mental alienation. That it does occasionally pro- 
 ceed from those causes appears pretty evident from the fact, that 
 it is liable to degenerate into unequivocal mania, and is also quite 
 a common feature of this disease. 
 
 Another faculty in the moral constitution of man which is ex- 
 tremely liable to derangement is cautiousness, or that w r hich gives 
 birth to the sentiment of fear. The influence of this sentiment, 
 in the sane state, is all-pervading. When, therefore, it becomes 
 deranged, we may reasonably expect to witness great, if not 
 frightful results. The derangement here is probably more fre- 
 quently functional than physical in its causes. There is hardly 
 a single event or movement in all life's vicissitudes, that does not 
 make some appeal to the sentiment of fear. The force and power 
 of the appeal must depend upon the natural inherent strength of 
 the sentiment. 
 
 The direction taken by the sentiment, in its manifestation, will 
 be governed by the other faculties with which it may happen to 
 be associated. When united with adhesiveness, it fears the lo^s 
 
MENTAL ALIENATION. 505 
 
 of friends or of friendships ; when with acquisitiveness, that of 
 wealth or worldly possessions ; when with love of approbation, 
 it fears the miseries of a blasted name ; and when with the re- 
 ligious feelings, the terrible and afflictive visitations of the Su- 
 preme Being. 
 
 The melancholic is described as generally thin and emaciated, 
 the hair straight and black, the skin cold and clammy, the look 
 fixed and motionless. He seldom sleeps much, and when occa- 
 sional slumber visits his eyes, a thousand ugly phantoms present 
 themselves to his disturbed imagination, and terrify him into 
 wakefulness. 
 
 So entirely is the mind absorbed in one single idea, that com- 
 mon sensation, to a great extent, seems to have abandoned the 
 bodily organs. They are unsusceptible to impressions, and the 
 intellectual faculties, in extreme cases, suspend the exercise of 
 their functions. 
 
 The mental misery in that state termed despair is truly apall- 
 ing. A clergyman who passed four years and an half in that 
 state in describing his own feelings says, that " he felt the bodily 
 pains and mental anguish of the damned ; that he slumbered 
 only, but never slept soundly during the long period of four and 
 an half years ; that he lost his appetites and passions, so as to 
 desire and relish nothing, and to love and hate no one ; that his 
 feet were constantly cold and the upper part of his body warm ; 
 that he lost all sense of years, months, week", days and nights, 
 and even of morning and evening, and that in this respect time 
 was to him no more. During the whole period of his misery, 
 he kept his hands in constant motion towards his head and thighs, 
 and ceased not constantly to cry out, wretched man that I am ! 
 I am damned ! oh ! I am damned everlastingly ! " Rush on the 
 Mind, 93. 
 
 But the horrors of deranged cautiousness sometimes end not 
 with despair. There are symptoms even beyond this terrible 
 picture. Even the deep seated principle of the love of life is 
 occasionally extinguished, and the ardent wish to die originate? 
 from the severity of mental suffering. In such cases life is some- 
 times destroyed by the frenzied energy to which itself gives birth. 
 
506 MEDICAL JURISPRUDENCE. 
 
 and suicide is actually perpetrated in order to escape from the 
 horrors of existence. 
 
 But there is a state of mind even beyond this, and which is 
 still more distressing. It is where both the desire and the fear 
 of death operate alternately upon the same mind. Dr. Rush says 
 he has seen this state. It was in a lady who wished to be re- 
 lieved from the horror of her thoughts by the complete loss of 
 her reason. v This is beautifully expressed by Shakespeare in his 
 King Lear : 
 
 " Better I were distract ; 
 So should my thoughts be severed from my griefs, 
 And woes, bi/ wrong imaginations, lose 
 
 The knowledge of themselves." 
 
 So almost infinite are the sources of misery in the human 
 1 mind. Who shall say that its sources of enjoyment are not cor- 
 respondingly extensive 1 
 
 Hope is perhaps as strong a sentiment as fear, and as influen- 
 tial in the conduct of life. A derangement of this faculty is 
 sometimes, although not near so frequently met with, in which 
 the torch of the malady may be said to be lit up at the fires of a 
 joyful heart. Those affected with this species of derangement 
 are always happy ; no cloud rests on their horizon, no apprehen- 
 sion dampens their enjoyment. Their eye sees nothing but 
 beauty, their ear hears nothing but music, their tongue talks 
 nothing but rapture. Theirs is a course of light, and whether 
 in their own mansion or a mad-house their present is full of joy, 
 and their future of hope. The mind riots amid its own ruins, 
 and invests even them with the hue of the rainbow. 
 
 There are several other sentiments such as benevolence, vene- 
 ration, self-esteem, &c, that are occasionally met with in a de- 
 ranged state, but they are of such unfrequent occurrence, and so 
 seldom become subjects of medico-legal investigation, that the 
 particular consideration of them here is unnecessary. 
 
 The most interesting, the most fatally destructive, the most 
 frequently met with in courts of justice, and the most difficult 
 of comprehension, is a perversion or derangement of the destruc- 
 tive propensity. There are two forms of this, viz : 
 
 1. Pyromania or destruction by fire. Incendiarism. 
 
MENTAL ALIENATION. 507 
 
 On the European continent considerable attention has been 
 devoted to this particular form of monomania, and several cases 
 have there occurred in illustration of it. It has generally been 
 found either excited by the ordinary causes of insanity, or by 
 that constitutional disturbance which often accompanies the 
 menstrual periods ; or it occurs about the age of puberty, and 
 seems to be connected with retarded evolution of the sexual 
 organs. Ray, 190. One of the first cases noticed was that of 
 Maria Franc, a married woman of intemperate habits, who, from 
 the moment of witnessing a burning building, felt a desire to fire 
 houses which, upon drinking, became an irresistible impulse. 
 This impulse was the only reason she could give. In other re- 
 spects her mind was sound. Within five years she fired twelve 
 houses, and was arrested and executed on the thirteenth attempt. 
 
 In a village near Cologne, a girl of a quiet, inoffensive disposi- 
 tion, and of exemplary character, made seven different attempts 
 at incendiarism. When enquired of as to her motives, she shed 
 tears, confessing that at certain periods she felt her reason for- 
 sake her, and that then she was irresistibly impelled to the com- 
 mission of a deed which, when done, she bitterly repented. She 
 was acquitted of all criminal intentions. Guy's Principles of Fo- 
 rensic Medicine, 312. 
 
 In one instance given, the derangement was connected with 
 imbecility. 
 
 Sometimes this insane propensity has been found coupled with 
 delusions, as in the instance reported by Platner, as quoted by 
 Prichard on the Different Forms of Insanity, 14-1-5. This was 
 a country girl, who twice attempted to set fire to a house. She 
 said she was incited by a voice which continually commanded 
 her to burn, and then destroy herself. The first burning she 
 witnessed with calmness and delight ; the second, she gave an 
 alarm, and attempted to hang herself. She had been subjected 
 to a spasmodic disorder, which degenerated into fits resembling 
 epilepsy. 
 
 Another instance is the case of Jonathan Martin, who set fire 
 to the cathedral church at York, and when accused of having 
 stolen the golden fringe and other ornaments of the choir, de- 
 
508 MEDICAL JURISPRUDENCE. 
 
 clared that he had no design to steal anything, but that an angel 
 from God, having commanded him to set fire to the church, he 
 wished to furnish himself with proof that he alone had commit- 
 ted the act, and that no other person might bear the punish- 
 ment. Prichard, 145 - 6 - 7. 
 
 As this deranged propensity is frequently connected with, or 
 proceeds from, the retarded evolution of the sexual organs, the 
 age of the individual should be noticed, to determine whether it 
 be about the age of puberty. So also the symptoms of irregular 
 developement, and of marked critical movements, suc'.i as rapid 
 increase of stature, small sexual development, uncommon lassi- 
 tude and sense of weight and pain in the limbs, glandular swell- 
 ings, and cutaneous eruptions, should all be carefully observed. 
 Irregularity in the menstrual discharge may exert a strong in- 
 fluence on the mental condition. Symptoms of disturbance in 
 the circulating system, and also in the nervous, may indicate an 
 arrest or delay in the development of the sexual functions. 
 Ray, 195. 
 
 2. The second form of derangement of the destructive pro- 
 pensity, is found where life is the object of it. This has two 
 subdivisions : 
 
 1 . Self-destruction : Suicide, commonly called suicidal mono- 
 mania. This, for legal purposes, is not so necessary to be inves- 
 tigated as it once was. Still, it may occasionally be necessary^o 
 settle the question whether the act of suicide really furnish evi- 
 dence of mental alienation or not. With some, it is regarded as 
 always the effect of insanity ; with others, as never the effect of 
 it. The ancients seem very generally to have arrogated to them- 
 selves the right to destroy their own lives, whenever, in their 
 judgment, it should be proper. Pliny was accustomed to term 
 it the greatest privilege the gods had left in the power of men 
 amid the calamities of human life. Suicide was of very frequent 
 occurrence in Eome ; and in China at the present time, where a 
 mandarin falls into disgrace, he most commonly has recourse to 
 self-destruction. 
 
 Tins is no doubt frequently the result of moral depravity, as, 
 for instance, where men of cultivated intellects and refined pas- 
 
MENTAL ALIENATION. 509 
 
 sions, put a period to their existence when they have derived 
 from it all they can reasonably expect of sensual gratification. 
 
 But in a very great number of cases, and Esquirol thinks in 
 all, the suicidal act is the deed of a monomaniac, and results 
 from a pathological change in the brain, or some part of it. In 
 some cases, a morbid cautiousness may inspire a greater fear of 
 the miseries of life than the evils of death. 
 
 There have also occurred cases, where insane impulse has act- 
 ed in this direction, and the individual has been led, in a man- 
 ner unaccountable to himself, to attempt his own self-destruction. 
 There are many circumstances going to show that it frequently 
 originates from a deranged mind. One is, that although conside- 
 rable forethought and ingenuity may have been evinced in pre- 
 paring the means, yet when the attempt fails, in many cases, the 
 individual, after his recovery, has either no recollection, or a 
 very faint one, of the fact itself, receiving it upon the testimony 
 of others. 
 
 Another fact going to show its connection with insanity, is its 
 hereditary character, and as Falret asserts, it is more hereditary 
 than any other form of insanity. There are certainly many cases 
 on record, showing it hereditary. 
 
 Another feature which it possesses in common with other 
 forms of mental' alienation, is the occasional exacerbations that 
 are witnessed, when its symptoms, for a time, disappear, the 
 clouds of melancholy seeming to vanish, and all appearances in- 
 dicating a return to life and its enjoyments. Again the propen- 
 sity will reappear, and generally in the end accomplish its pur- 
 pose. 
 
 Another fact tending to show its connection with mental de- 
 rangement, is that it sometimes prevails epidemically, and is pro- 
 pagated by sympathy. A soldier at the Hotel de Invalids hung 
 himself on a post. His example was followed in a short time by 
 twelve others, who hung themselves on the same post. On cut- 
 ting down the post, the epidemic ceased. In 1793, no less than 
 1300 are said to have destroyed themselves in Versailles. 
 
 In the French army, a grenadier killed himself. His example 
 was followed by another, and it was feared it was assuming an 
 
510 MEDICAL JURISPRUDENCE. 
 
 epidemic character. Napoleon, then First Consul, issued the fol- 
 lowing order : 
 
 " The grenadier Groblire has committed suicide, from a dis- 
 appointment in love. He was in other respects a worthy man. 
 This is the second event of the kind that has happened in this 
 corps within a month. The First Consul directs that it shall be 
 notified in the order of the day, that a soldier ought to know 
 how to overcome the grief and melancholy of his passions ; that 
 there is as much true courage in bearing mental afflictions man- 
 fully, as in remaining unmoved under the fire of a battery. To 
 abandon one's self to grief without resisting, and to kill one's, self 
 in order to escape from it, is like abandoning the field of battle 
 before being conquered !" 
 
 This proved sufficient to check effectually the growing epi- 
 demic. 2 American Journal of Insanity, 93. 
 
 One additional fact may be mentioned, tending to identify this 
 with insanity or other nervous diseases; and that is, that in 
 many instances, the brain or abdominal viscera have been found, 
 by examination after death, to have suffered organic lesions, the 
 latter having affected the mind by sympathetic irritation. This 
 has been found the fact where no indications of disease preceded 
 the fatal act, or anything that would create a suspicion that any 
 such act was intended. 
 
 2. The second form is homicide, (the destruction of others,) 
 generally termed homicidal mania. This, at the present day, is a 
 subject of immense interest throughout the civilized world. 
 Here, in a most peculiar manner, and with most appaling results, is 
 shown the amazing strength of insane impulse ; which by a pow- 
 er and energy resistless as the fiat of God, impels the wretched 
 bei?ig to destroy life, without a motive to actuate, or an end to 
 be attained, or object to be accomplished. Individuals in the full 
 possession of their usual powers of intellect, whose social and 
 moral organization, to all appearance, remain unaffected, have 
 imbrued their hands in the blood of the innocent, frequently in 
 that of their own wives and children, simply because they felt 
 that they must destroy. The records of insanity are full of such 
 instances, and I am sorry to be compelled to add, that those of 
 
MENTAL ALIENATION 511 
 
 our srlminal courts of justice have too frequently shown, that 
 those who could destroy without motive, and without a sane 
 will, could, as their reward, be murdered under the fori is of 
 law. 
 
 The discovery of this form of partial moral mania, dates back 
 only to the commencement of the present century. It was first 
 distinctly described by Pinel. It is now very universally admit- 
 ted by writers on Medical Jurisprudence. Ray, 198. 
 
 It is remarked by Esquirol, that there are two forms of homi- 
 cidal insanity. In one of these, the monomaniac is actuated by 
 avowed motives, which are more or less irrational, and is gene- 
 rally looked upon as mad. In the other, there are no motives 
 acknowledged or discernible ; the individual being impelled by 
 a blind, irresistible impulse. The first, being complicated with 
 delusions or hallucinations, is only a form of partial intellectual 
 mania. It is the last only that, in strictness, constitutes homici- 
 dal mania ; although both these appear occasionally to be com- 
 bined with each other. 
 
 The recorded instances in which this form of derangement 
 has displayed itself, are very numerous, as may be seen by re- 
 ference to the works of Ray and Prichard on Insanity. All that 
 can be introduced here, is simply sufficient to illustrate, to show 
 the application of the principle. 
 
 A carrier on the route between Untre Cobingen and Hussen- 
 hofen met a woman, whom he struck several times with his 
 hatchet, and left her lying in a ditch by the road-side. Next he 
 encountered a lad thirteen years old, whose head he split open. 
 Shortly after, he split the skull of a man thirty years old, and 
 scattered his brains in the road ; and after hacking the body, left 
 his hatchet and carriage, and proceeded unarmed towards Hus- 
 senhofen. He next met two Jews on the road, whom he attack- 
 ed, but who, after a short struggle, escaped him. Near Hussen- 
 hbfen, he assaulted a peasant, whose cries brought several per- 
 sons to his aid, by whom the maniac was seized and carried to 
 Gemunde. They afterwards led him to the bodies of his victims, 
 when he observed, " It was not I, but my bad spirit, that bas 
 committed these murders." Ray, 200. 
 
512 MEDICAL JURISPRUDENCE. 
 
 William Brown, in 1812, strangled a child whom he acciden- 
 tal met one morning, while walking in the country. He took 
 up the body and laid it on some steps, and then went and told 
 what he had done, requesting to be taken into custody. He said 
 he had never seen the child before ; had no malice against it, and 
 could assign no motive for the dreadful act. He bore an exem- 
 plary character, and had never been suspected of being insane. 
 He was convicted and executed. 
 
 In some cases of homicidal mania, the presence of some physi- 
 cal or moral disorder may be detected j in others, not. Its ex- 
 istence, however, is very possible, in cases where it has not been 
 detected. Sometimes homicidal desires of the intensest kind 
 will Hit through the mind of the perfectly sane, and while in the 
 enjoyment of usual health. 
 
 This form of mania has been known to occur in women, and 
 seems connected with those constitutional changes produced by 
 parturition, menstruation, and lactation. The victim selected is 
 generally a young child. Several instances of this kind are given 
 by Dr.* Ray. 
 
 There are several cases in which the exciting cause is of a 
 moral nature, and the unhappy subject feels under an imperious 
 necessity of destroying life. Instances have not unfrequently 
 occurred, in which were manifested deliberation and design, the 
 act having been perpetrated under the most appalling circum- 
 stances, with the utmost calmness and composure. 
 
 The case of Henriette Cornier, which occurred in France, in 
 1825, is justly regarded as a leading case under this head. She 
 was a female servant, aged twenty-seven years, of a mild and 
 lively disposition, full of gaiety, and fond of children. In June, 
 a change was observed, in her character. She became silent, 
 melancholy, and sank into a kind of stupor. No cause of her 
 dejection could be obtained from her. In September, she at- 
 tempted to commit suicide, but was prevented. In October, she 
 entered into the service of Madame Fournier, but was still melan- 
 choly and desponding. No cause could be ascertained. She 
 would talk only of her misfortune in losing her parents at an 
 euly age, and of having received bad treatment from her 
 
MENTAL ALIENATION. 513 
 
 guardian. On the fourth of November, her mistress went out to 
 walk, having previously told her to prepare dinner at the usual 
 hour, and to go to a neighboring shop, kept by dame Belon, to 
 buy some cheese. She had frequently been there, and maniflst- 
 ed great fondness of Belon's little girl, about nineteen months 
 old. On this occasion, displaying unusual fondness for it, she 
 persuaded its mother to let her take it out with her to walk. She 
 hastened back with the child to her mistress' house, and laying 
 it across her own bed, severed its head from its body with a large 
 kitchen knife. She subsequently declared she felt no particular 
 emotion either of pleasure or of pain. She stated that shortly 
 after, the sight of the horrible spectacle brought her to herself, 
 and she experienced some emotions of fear, but they were of 
 short duration. At the end of two hours, dame Belon came and 
 enquired for her child, from the bottom of the stair-case. " Your 
 child is dead," said Henriette. The mother went up stairs, and 
 pushed forward into the chamber ; and at that moment, Cornier 
 snatched up the head of the murdered child, and threw it into 
 the street, from an open window. An alarm was raised ; the 
 officers of justice, with others, came and found Henriette sitting 
 on a chair near the body of the child, gazing at it, with the 
 bloody knife by her, her hands and clothes covered with blood. 
 She did not attempt to escape, nor did she deny the crime. She 
 confessed all the circumstances, even her premeditated design, 
 and the perfidy of her caresses. She displayed no emotion of 
 remorse or grief, replying with indifference, " I intended to kill 
 the child." She said she had no particular reason for it ; that 
 the idea had taken possession of her mind : and that she was destined 
 to do it. When asked why she threw the head into the street, 
 she answered that it was for the purpose of attracting public at- 
 tention, so that people might come up to her chamber, and see 
 that she alone was guilty. 
 
 This case, attended with these circumstances, presented great 
 difficulty. The jury returned a very singular verdict, viz.: 
 That she was guilty of " committing homicide voluntarily, but 
 not with premeditation ;" and she was sentenced to hard labor 
 for life. Ray, 215, et sea. 
 
 33 
 
514 MEDICAL JURISPRUDENCE. 
 
 This case excited a great sensation in France ; and, what ia 
 very remarkable, Esquirol states that six cases occurred within 
 his own knowledge, immediately after it, showing the strange 
 tendency to imitate acts of this atrocious character. 
 
 Sometimes, as formerly stated, some motive is alleged, which, 
 although well founded, is altogether inadequate. This is illus- 
 trated in the case of Rabello, a Portuguese. He was employed 
 as a mechanic in Litchfield county. His conduct had appeared 
 singular, but inoffensive. One day, a little son of his employer, 
 only twelve years old, accidentally stepped upon his toes; Ra- 
 bello was exceedingly angry, and threatened the boy's life. The 
 next day he appeared sullen, refused his food, and looked wild 
 and malicious. The following morning, he went to the barn- 
 yard with the boy, seized an axe, and killed him on the spot, 
 mangling him in the most shocking manner. He went delibe- 
 rately away from the house, but was soon overtaken by those in 
 pursuit. He acknowledged that he had killed the boy, and gave 
 as a reason, that he had stepped on his toes. 
 
 It was found from the evidence produced at his trial, that this 
 ivas an offence considered most heinous, and not to be forgiven. 
 To test the reality of this, one of the physicians, while counting 
 his pulse, stepped, apparently by accident, upon his toes. The 
 pulse rose immediately forty strokes in a minute ; his counte- 
 nance flushed up, and he appeared instantly in a rage. 
 
 He was acquitted on the ground of insanity, and after the 
 trial, it was ascertained that he had been previously deranged. 
 Ray, 220-21. 
 
 In some cases, religious fanaticism, and excitement of the re- 
 ligious sentiments, have roused into activity the murderous pro- 
 pensity. Pinel gives the instance of a vine-dresser, who thought 
 himself commissioned to procure the eternal salvation of his 
 family by killing them, or by the baptism of blood, as he call- 
 ed it. He killed two of his children, when he was arrested and 
 confined. Fourteen years after, he conceived the project of 
 offering up an expiatory sacrifice, by killing all who might come 
 within his reach, and actually wounded the keeper, and cut the 
 throats of two other lunatics, before he could be arrested. 
 
MENTAL ALIENATION. 515 
 
 Sometimes the insane delusion is that he shall come to want ; 
 and under the influence of that, he kills his family, and general- 
 ly himself. As in the case of James Purington, who, under that 
 apprehension, killed his wife and five of his children. See Ray, 
 '222-3. 
 
 In some cases, the desire to commit an atrocious act was ac- 
 companied by a clear conception of its enormity, and a horror 
 at the idea of its perpetration. The desire has been resisted and 
 overcome, or a warning given to the person to escape. 
 
 A young man, aged twenty-one years, was of a sombre 
 disposition, lost his father at the age of fourteen, and never 
 exhibited much affection towards his mother. At eighteen, his 
 dejection increased; he shunned society, yet worked industri- 
 ously, displaying no other sign of insanity than declaring that he 
 felt a strong inclination to commit murder ; and there were mo- 
 ments when he felt that he could feel pleasure in killing his sis- 
 ter or mother. When the horrible nature of these suggestions 
 were set before him, and their consequences, he exclaimed, " I 
 am no longer master of myself." On several occasions, after hav- 
 ing embraced his mother, his face became red, his eyes sparkled, 
 and he cried out, " Mother, take care of yourself, I am forced to 
 kill you !" 
 
 On one occasion, he met a Swiss soldier in the street, who 
 was a stranger to him ; he seized his sword, and made a sudden 
 effort to take it from him and stab him. On another occasion, 
 he found his mother in the cellar, and attempted to kill her with 
 a bottle. For six months he was agitated with this impulse, slept 
 little, complained of his head, and kept in solitude ; was insen- 
 sible to the grief of his family, but exhibited in his discourse no 
 sign of mental aberration. He was subsequently perfectly re- 
 stored. 
 
 A young lady experienced homicidal desires, for which she 
 could assign no motive. She was rational on every subject, and 
 whenever she felt the approach of this dreadful propensity, she 
 shed tears, entreated to have the straight-waistcoat put on, and 
 to be carefully guarded, till the paroxysm, which sometimes last- 
 ed several days, had passed. Ray, 199 
 
516 MEDICAL JURISPRUDEISXE. 
 
 The numerous eases that have occurred, will, it is thought, 
 justify the following general deductions, most of which are laid 
 down substantially, by Dr. Ray, 224 - 5 : 
 
 1. In general, the criminal act has been preceded by, some 
 physical disturbance, originating in the head, digestive system 
 or uterus ; o£ by an irritable, gloomy, dejected or melancholy 
 state : 
 
 2. The act will also generally be succeeded by the same, or 
 more marked indications of disturbance of function, and having 
 a more direct reference to derangement of mind, either wholly 
 or partially : 
 
 3. The destructive impulse is strongly excited by the sight 
 and proximity of murderous weapons ; by favorable opportuni- 
 ties ; by contradiction, disgust, or some trivial or imaginary cir- 
 cumstance : 
 
 4. The victims selected are either unknown or indifferent, or 
 among his most loved and cherished objects, frequently children 
 and offspring ; 
 
 5. Some deplore the propensity by which they are controlled, 
 and beg to be restrained ; others conceal it ; others openly avow 
 it, declare their murderous designs, and form schemes for 
 their execution : 
 
 6. Some, after gratifying the destructive propensity, confess 
 the act, and give themselves up to the authorities ; a few fly, and 
 persist in denying the act : 
 
 7. Some interpose insanity in defence of their conduct, or as- 
 sert their ignorance of the act ; while others deny that they la- 
 bored under any such condition. 
 
 Delirium. The organs of mind are not here primarily affect- 
 ed They only sympathize with the general system, the state of 
 high febrile excitement being propagated through the entire or- 
 ganization, and affecting the brain in common with other organs. 
 It rarely occurs in long protracted chronic diseases, such as can- 
 cer, dropsy, or pulmonary consumption ; but except these, few 
 diseases terminate in death without the subjects of them being 
 more or less delirious, particularly near their close. 
 
 Delirium may occur suddenly, but more commonly comes on 
 
MENTAL ALIENATION. 517 
 
 gradually, preceded by pain or throbbing in the head, heat, and 
 ilushiDg of the cheeks. The patient at first talks during sleep, 
 and is momentarily forgetful on waking. During the intervening 
 period, his senses are collected. Gradually the delirium becomes 
 more intense. The eyes are open, presenting a dull, listless look. 
 He becomes regardless of persons and things around him, talk- 
 ing to himself in a. low, muttering tone. His mind seems entire- 
 ly occupied with past scenes and events, which occur without 
 order or apparent connection, and to which the tongue gives ut- 
 terance in broken and disjointed sentences. As the delirium 
 becomes more deep and intense, the voice grows more indistinct ; 
 the fingers pick at the bed-clothes, and there is a total incapacity 
 of being roused to any further effort of attention. Sometimes 
 the excitement is much more intense, and a higher degree of 
 nervous symptoms. Ray, 296 - 7 ; Guy, 267. 
 
 Many curious instances have occurred, in which, under the 
 influence of delirium, words and ideas that had long lain dor- 
 mant in the mind, and had become utterly forgotten, are recalled 
 in all their original freshness. 
 
 A patient in St. Thomas' Hospital, after receiving an injury 
 of the head, and becoming delirious, was observed to speak a 
 language that nobody could understand, but which at length was 
 ascertained to be Welch. He was originally a Welshman, but 
 had been from his native country about thirty years, during 
 which he had entirely forgotten his native tongue, and acquired 
 the English language. Ray, 297. Dr. Rush, see Diseases of the 
 Mind, 282-3., mentions the fact that the old Swedes of Phila- 
 delphia, when on their death-beds, would always pray in their 
 naive tongue, although they had not spoken it for fifty or sixty 
 years, and had probably forgotten it before they were sick. He 
 quotes from Dr. Muhlenburgh the further observation that 
 people generally pray, in their last hours, in their native language ; 
 a fact which he had noticed in innumerable cases among his 
 German hearers, although hardly one word of German was spo- 
 ken by them in common life, and in days of health. A physi- 
 cian who, in early life, had renounced the Roman Catholic faith, 
 
518 MEDICAL JURISPRUDENCE. 
 
 in the delirium of a fever which preceded his death, prayed only 
 in the forms of that church. 
 
 These facts would seem to furnish some reason for entertaining 
 the opinion, that nothing acquired by the mind is ever entirely 
 lost, but that all its buried recollections may be rendered avail- 
 able under some of its states or conditions. 
 
 Delirium occasionally disappears a few days or hours before 
 death, leaving the mind much enfeebled by disease, but in pos- 
 session of its natural soundness. 
 
 Delirium more closely resembles mania than any other mental 
 state. Still, to the close observer, there is little danger of their 
 being confounded with each other. Mania is an independent 
 disease, while delirium is only a symptom of another disease, and" 
 as such, is influenced or varied, as the disease diminishes or in 
 creases in severity. The first seldom occurs until after puberty ; 
 the second attacks all ages. In the first, persons and things are 
 clearly recognized ; in the second, little attention is paid to things 
 without. In the first, the patient reasons, although incorrectly ; 
 in the second, there is an entire abolition of the reasoning power. 
 In the first, the muscular power is not diminished, and quite fre-- 
 quently is very much increased ; in the second, there is invaria- 
 bly great muscular debility. In the first, sensation, both general 
 and special, is most frequently unimpaired ; in the second, all 
 these avenues to the understanding seem entirely closed. In the 
 first, many of the bodily functions remain undisturbed ; in the 
 second, every function suffers. Ray, 298 - 9. 
 
 Somnambulism. There is an extensive class of mental manifes- 
 tations hitherto unnoticed, that present many curious and inte- 
 resting phenomena. In it are included spectral illusions, dream- 
 ing, and somnambulism. The two first are unnecessary to be 
 considered in connection with Medical Jurisprudence, and the 
 third may perhaps be looked upon as more curious than useful. 
 
 The power which the mental faculties occasionally manifest, of 
 using, without being conscious of it, the voluntary muscles ; and 
 even of possessing an intimate knowledge of the objects of per- 
 ception around them, while the senses, or channels of sensation, 
 thi ough which they are ordinarily admitted, are locked in slum- 
 
MENTAL ALIENATION. 519 
 
 bers as profound, for the time, as are those of the grave ; are 
 problems in existence, which no eftort of human ingenuity has 
 ever been found entirely capable of solving. 
 
 The peculiarity that seems to pervade this class of cases, is, 
 that a part or all the mental faculties are preternaturally active ; 
 that they are in a state of exaltation, and hence morbid in their 
 displays; and that the senses, or that which is equivalent to 
 them, are in fact so modified as to adapt themselves to the state 
 or condition of mind at the time prevailing. Hence the ear 
 sometimes remains insensible to the loudest sound, and at others 
 will catch, the slightest whisper. Such attention or inattention 
 depends upon whether the sound is in harmony with what 
 happens at the time to be passing within the mind. 
 
 The somnambulist's senses of taste and smell are, at times, 
 acute and accurate ; while at others, they are quite the reverse. 
 
 Negretti, the Italian servant, did not distinguish between sea- 
 soned cabbage and salad. He drank water instead of wine, 
 which he had called for ; and snuffed ground coffee instead of 
 snuff. The occasional greater acuteness of the senses during this 
 state, may be owing to the fact, that the faculties having concen- 
 trated their energies upon one object, are endowed with more 
 and greater strength of perception. 
 
 Another fact going to show that the mind is the all-powerful 
 agent, is, that external objects are often transformed by it into 
 the instruments which it then happens to have occasion for. 
 Thus the somnambulist described by Hoffman, dreaming that he 
 was about going on a journey, strided across the sill of an open 
 window, kicking with his heels, and exerting his voice, as if he 
 supposed himself riding on his horse. 
 
 In some cases, vision, or some power analogous to it, seems to 
 be exercised. Castelli was one night found translating Italian 
 into French, and was observed to look for the words in a dic- 
 tionary. His light having gone out, he found himself in the 
 dark, groped about for a candle, and went into the kitchen to 
 light it. He would also get up and go into his master's shop, 
 and weigh out medicines for supposed customers. 
 
 Another, a priest, would arise from his bed and compose ser 
 
520 MEDICAL JT'RISpnUDEKCE. 
 
 mons, reading over each page -when finished, and erasing and 
 correcting with the utmost accuracy. Ray, 390-91. Another 
 case seems to demonstrate the possession of the power of vision 
 to an almost incredible extent. Jane Ridder was able, in a dark 
 room, to make out the date of coins, the figures of which were 
 nearly obliterated, and to read the motto of a seal, which others 
 had been unable to decipher by the light of a lamp. With her 
 eyes covered by several folds of handkerchief, she could still read 
 and write as if nothing intervened, and play at backgammon 
 understandingly. Ray, 391. 
 
 The senses of hearing and taste are also much modified. But 
 little attention is paid to what is taking place around them, un- 
 less it happen to be connected with what is passing in their own 
 minds. 
 
 There is little doubt but that somnambulism is connected with 
 a morbid condition of the system involving in it the organs of 
 the mental faculties. Like mental alienation it is hereditary, 
 showing its physical origin. As in the active forms of mania, 
 there is sometimes a most remarkable exaltation of some of the 
 faculties. Jane' Ridder would sing correctly, although she had 
 never learned music, nor been known to sing when awake. She 
 would also play at backgammon with considerable skill, though 
 she had never learned the game in the waking state. She also 
 evinced a power of imitation, of which she showed no trace 
 while awake. Ray, 395. 
 
 There are some very striking instances in which the sentiments 
 and propensities of the somnambulist are exhibited in a remark- 
 able degree of activity. A Carthusian monk, although very cor- 
 rect and exemplary in his waking state, yet in his sleeping, was 
 occasionally a thief, a robber, and a plunderer of the dead. A 
 pious clergyman would in his sleep-walking steal, and even 
 plunder his own church. A somnambulist in Maine was strongly 
 disposed to commit suicide. He succeeded one night in escaping 
 from the house, but an outcry being heard from a neighboring 
 pasture, he was found suspended from the limb of a high tree. 
 The rope was fortunately attached to his feet instead of his neck, 
 so that very little injury was experienced, Ray, 395. 
 
MENTAL ALIENATION. 521 
 
 The psychological, as well as physiological facts, 'developed by 
 the somnambulist, are of an exceedingly curious character. Some 
 or all the mental faculties appear, during the paroxysm, to pos- 
 sess an inherent power of acting independent of external in- 
 fluences ; and they also, unconsciously to themselves in a differ- 
 ent state, can bend in subserviency to their own purposes the 
 material organization with which they are connected; and all 
 this, unless we admit two separate and responsible states of being, 
 is without will, motive, or responsibility. 
 
 One of the interesting forms in this class of cases is what is 
 termed ecstasis, or cataleptic somnambulism, in which this ex- 
 altation of the faculties is coupled with a cataleptic affection. 
 Ecstasis is defined to be a state in which certain ideas so com- 
 pletely absorb the mind, that the external sensations are sus- 
 pended, the voluntary movements arrested, and even the vital 
 action retarded. In the paroxysms of cataleptic somnambulism, 
 the patient appears in a deep quiet sleep, conversing with fluency 
 and propriety, and evincing very often extraordinary activity of 
 Litellect. What is the most remarkable fact connected with it 
 i-, that after the paroxysm has passed off, no recollection remains 
 o)' what was either said, done, thought, or felt, during its con- 
 t ii aance ; but on its again recurring, the recollection of all that 
 to( k place in previous paroxysms revives, but the memory of 
 these events that transpired intermediate tiie paroxysms is lost. 
 Thj individual thus has, in a manner, a two-fold existence ; the 
 one being independent of the other ; and the idea of a double 
 consciousness has been suggested, with the view of attempting 
 to explain the strange phenomena presented. We cannot pro- 
 bably expect, in the present state of our knowledge, a perfectly 
 satislactory explanation. 
 
 Drunkenness. This, including its sequel delirium tremens, is 
 a state or condition of mind necessary to be examined on account 
 of its legal consequences. The first effect of a psychological 
 character, noticed after the drinking of alcoholic mixtures, is an 
 increase in the power and activity of the mental faculties. The 
 impulses furnished by the propensities are stronger ;. the emo- 
 tions contributed by the sentiments more vivid ; and the ideas 
 
522 MEDICAL JURISPRUDENCE. 
 
 originating from the intellect more brilliant. The inevitable 
 consequence of this is a rapid expenditure of sensorial power, 
 soon inducing a state of exhaustion. 
 
 The faculties seem at first about equally affected by the stimu- 
 lus. The balance, after a time, becomes lost. The high reflect- 
 ing powers of intellect, together with the higher moral sentiments, 
 become weak, imperfect, vacillating and finally temporarily par- 
 alytic. The exhibitions continue to partake more and more 
 strongly of the peculiar promptings of the propensities, and to 
 become constantly more decidedly animal. This effect is owing 
 not only to an increase in their strength, but also to the dimin- 
 ished power and influence ordinarily exerted over them by the 
 higher sentiments and powers of intellect. 
 
 The effect of habitual and repeated inebriation, is to render 
 the organs of mind continually less and less liable to be influenced 
 by their ordinary, accustomed stimuli. That physical law which 
 graduates organic action in accordance with the ordinary stimuli 
 adapted to elicit it, is violated ; and the consequences of such 
 violation can no more be avoided, than the author of that law 
 can cease to be immutable. 
 
 There is a striking uniformity between the peculiar effects of a 
 single tit of intoxication, and the final results of a course and 
 habit of inebriation, fully carried out. In both, the torpor and 
 exhaustion are first manifested in the reflective faculties and the 
 high moral powers. The intellectual grasp is impaired, and the 
 power of originating moral distinctions, and of appreciating the 
 nature and efficacy of moral forces, is very greatly diminished. 
 The propensities in both cases, released from the restraint of that 
 higher nature, become more energetic in their action. They 
 seem actually improved and invigorated, as if deriving strength 
 and energy by feeding on the corruptions of that moral death 
 which has thrown its oblivious pall over the intellect and higher 
 sentiments — like the worm, increasing from the consumption of 
 its coffined banquet. 
 
 An habitual indulgence in alcoholic drinks, by keeping up a 
 constant irritation of the cerebral organs, results in permanently 
 deranging their structure. The fibres become hardened, and 
 
MENTAL ALIENATION. 523 
 
 stjous effusions sometimes take place. Those pathological 
 changes are effected, which, in turn, react upon the habit, ren- 
 dering its bonds absolutely indissoluble. Hence the inebriate 
 whose case is mentioned by Macnish, replied to the remonstrances 
 of his friend, who painted the distresses of his family, the loss of 
 Ms business and character, and the ruin of his health ; " my good 
 friend, your remarks are just, they are indeed too true ; but / 
 can no longer resist temptation. If a bottle of brandy stood at one 
 hand, and the pit of hell yawned at the other, and I were con- 
 vinced that I would be pushed in as sure as I took one glass, 1 
 could not refrain. You are very kind. I ought to be grateful 
 for so many kind, good friends, but you may spare yourselves 
 the trouble of trying to reform me ; the thing is out of the ques- 
 tion." And the thing probably was out of the question. The 
 habit had so vitiated the organs of mind; and the depraved organs 
 had so reacted on the habit, that each had become bound to the 
 other, by bonds that death only could sunder. 
 
 Drunkenness is often periodical. Individuals are guilty of 
 excesses at particular times, who are perfectly sober during the 
 intermediate periods. Esquirol has noticed this periodicity in 
 drunkenness, and whether continued or periodical, he treats it 
 under the term dipsomania, attributing it to the influence of pa- 
 thological changes in the brain. He, therefore, does not consider 
 its unhappy victims as morally responsible. The craving of the 
 stomach for strong drink he thinks imperious and irresistible. 
 He insists that the unfortunate victims obey an impulse which 
 they have not the power of resisting ; that they are true mono- 
 maniacs ; and that if carefully observed, we should find in them 
 all the characteristic features of partial madness. 
 
 It has been remarked that it sometimes occurs in women at 
 the turn of life, as a result of the important physiological changes 
 which, at that period, take place in the female constitution. 
 Ray, 425. 
 
 There is a singular disease, to which the continued use of in- 
 toxicating drinks very frequently leads, called delirium tremens 
 or mania a potu. The delirium that here supervenes is not at 
 first constant, but becomes so after a few days ; and constitutes 
 
524 MEDICAL JURISPRUDENCE. 
 
 the most prominent feature of the disease. This is not the de- 
 lirium of a fever, because no sufficient febrile symptoms are 
 present. It is distinguished from mania by the previous history 
 of the individual, and the peculiar symptoms of the disorder. 
 The delirium bears a strong resemblance to dreaming. It seems 
 as if dreams were mistaken for realities. 
 
 The patient is suspicious, mistrustful, and subject to constant 
 fears, alarms, and apprehensions. One of the most common hal- 
 lucinations is, that he is constantly seeing devils, snakes, vermin, 
 and all manner of offensive and unclean things around him ; and 
 'peopling every nook and comer of his apartment with these 
 loathsome objects. The extreme terror which these delusions 
 often inspire, produces in the countenance an unutterable expres- 
 sion of anguish, and, in the hope of escaping from his fancied 
 tormentors, the wretched patient often endeavors to cut his own 
 throat, or resort to some other mode of self-destruction. Although 
 generally tractable, and not inclined to be mischievous, yet, under 
 the influence of these terrible apprehensions, he sometimes mur- 
 ders his wife or attendant, whom his disordered imagination 
 identifies with his enemies. After perpetrating an act of this 
 kind, he generally gives some illusive reason for his conduct, re- 
 joicing in his success, and expressing regret at not having done 
 it before. The tremor from which this form of delirium is 
 named, is rarely altogether absent, and where present, is very 
 characteristic. 
 
 Legal Applications ; or the Legal Consequences which at- 
 tach TO THE DIFFERENT FORMS OF MENTAL ALIENATION. 
 
 Having examined the different forms of mental alienation, or 
 unsoundness of mind, and endeavored so to define and describe 
 each form, as to lead to its clear identification whenever it oc- 
 curs, the next object is to make the application to them of the 
 legal principles which human wisdom has devised, and human 
 prudence adopted, with the view both of saving the insane from 
 the consequences of their own actions, at the same time that a 
 sufficient protection is thrown over the community in which they 
 reside. It should here be remarked, however, that the different 
 forms under which mental alienation has been considered, have 
 
MENTAL ALIENATION. 5C5 
 
 been adopted from mere convenience, and as presenting a means 
 of more thoroughly understanding, and clearly explaining, the 
 extremely tangled web of mental alienation. The law seeks only 
 to know whether there exists, in any given case, unsoundness of 
 mind. Whether that unsoundness proceeds from preternatural 
 defect, indicated by idiocy, imbecility, or dementia, or from ex- 
 alted and perverted action of the faculties, as in the active forms 
 of mania, is to it not of the slightest consequence. Whether the 
 unsoundness exists, and is sufficient to absolve from liability, are 
 all it seeks to know. Such, however, is now the extent of know- 
 ledge within the reach of the medical jurist on this subject, that 
 neither courts nor juries could have much confidence in his tes- 
 timony, unless he could designate the forms under which mental 
 alienation presents itself, and describe that then under considera- 
 tion. 
 
 The law, it is true, as we have already seen, does recognize 
 two forms, viz., idiocy and lunacy ; intending, undoubtedly, to 
 include under them the two great divisions of mental alienation, 
 the one originating from preternatural defect, and the other from 
 excess and perverted action of the intellectual and moral powers. 
 , Under the term unsoundness of mind, may be included all that 
 cannot come in under idiocy and lunacy. 
 
 We have already noticed the principle upon which exemption 
 from liability proceeds ; the division recognized by the law ; 
 the occasions in which it interferes ; and the general means or 
 methods by which its interferences are effected. Before proceed- 
 ing to notice the legal consequences which attach to the different 
 forms of unsoundness of mind, it may be proper to direct the 
 attention to a few general considerations. 
 
 The presumption of law is always prima facie in favor of 
 sanity. Whenever, therefore, exemption from liability is claimed, 
 on the ground of mental unsoundness, it devolves on the party 
 claiming to allege and prove it. That allegation and proof being 
 furnished, the legal presumption changes, and the mental un 
 soundness is presumed to continue, until the allegation and proof 
 of a complete restoration, or a lucid interval. This latter is so 
 
526 MEDICAL JURISPRUDENCE. 
 
 frequently made the subject of discussion in courts of law and 
 equity, that some attention should be devoted to it. . 
 
 Lucid Iintervals once formed much more prominent subjects 
 of inquiry than they do at present. Even the term lunacy ori- 
 ginated from a supposed connexion of mania, and its intermis- 
 sions, with the changes of the moon. At the present time, the ' 
 medical profession do not appear to attach so much importance 
 to lucid intervals. Mr. Haslam declares that, "as a constant 
 observer of this disease, for more than twenty-five years, he 
 cannot affirm that the lunatics, with whom he had daily inter- 
 course, have manifested alternations of insanity and reason." 
 On the other hand, Esquirol, who also states facts from personal 
 observation, fully recognizes the existence of insanity with lucid 
 intervals, and identifies it with what others have termed " re- 
 current," and with what he terms "intermittent insanity." 
 The mania, says Fodere, which is accompanied by fury, is very 
 often periodical. Georget speaks of lucid intervals as returns to 
 reason ; but says, that patients in this state have some distur- 
 bance of their ideas, and weakness of mind, impairing their power 
 of attention. Dr. Combe in his Observations on Mental Derange- 
 ment, 2 Vol., insists that the patient, however calm and rational 
 he may appear, is, nevertheless not in as perfect possession of his 
 senses as if he had never been ill. That although in ordinary 
 excitement, and under ordinary circumstances, his perceptions 
 may be accurate, and his judgment sound, yet a degree of irri- 
 tability of brain still remains behind, which renders him unable 
 to withstand any unusual emotion, any sudden provocation, or 
 any unexpected and pressing emergency. This will, probably, ex- 
 press the general views of the medical profession in reference to 
 lucid intervals. 
 
 The next and most important inquiry is what the law regards 
 as a lucid interval. D'Aguesceau, in his pleading in the case of 
 the Abbe d'Orleans, see Evans' Pothier on Obligations, Appendix, 
 579, says, " It must not be a superficial tranquility, a shadow of 
 repose ; but, on the contrary, a profound tranquility, a real re 
 pose. It must be, not a mere ray of reason, which only makes 
 its absence more apparent when it is gone — not a flash of light- 
 
MENTAL ALIENATION. 527 
 
 niag, which pierces through the darkness only to render it more 
 gloomy and dismal — not a glimmering which joins the night to 
 the day — but a perfect light, a lively and continued lustre, a 
 full and entire day, interposed between the two separate nights, 
 of the fury which precedes and follows it. And, to use another 
 image, it is not a deceitful and faithless stillness which follows or 
 forebodes a storm, but a sure and stedfast tranquility for a time, 
 a real calm, a perfect serenity ; in fine, without looking for so 
 many metaphors to represent our idea, it must be, not a mere 
 diminution, a remission of the complaint, but a kind of temporary 
 cure, an intermission so clearly marked, as in every respect to 
 resemble the restoration of health." 
 
 These same views substantially seem to have been early adopted 
 by the Court of Chancery in England. In The Attorney-General 
 vs. Parnthier, 3 Brovm's ch. Cases, 234, Lord Thurlow says, " By 
 a perfect interval, I do not mean a cooler moment, an abatement 
 of pain or violence, or of a higher state of torture — a mind re 
 lieved from excessive pressure; but an interval in which the 
 mind, having thrown off the disease, had recovered its general 
 habit." 
 
 In regard to the continuance of a lucid interval, D. Aguesceau 
 1'urther remarks, that " as it is impossible to judge in a moment 
 of the quality of an interval, it is requisite that there should be 
 a sufficient length of time for giving a perfect assurance of the 
 temporary re-establishment of reason, which it is not possible to 
 define in general, and which depends upon the different kinds of 
 fury ; but, it is certain, there must be a time, and a considerable 
 time, that an action may be sensible in appearance, without the 
 author of it being sensible in fact ; but an interval cannot be per- 
 fect, unless you can conclude from it that the person in whom 
 it appears is in a state of sanity ; the action is only a rapid and 
 momentary effect, the interval continues and supports itself ; the 
 action only marks a single fact, the interval is a state composed 
 of a succession of actions. Its duration must be sufficiently long 
 to admit a judgment of its reality. Nothing can be more distin- 
 guishable than a reasonable action and an interval. The one is 
 an act, the other a state ; the act of reason may subsist with the 
 
528 MEDICAL JUKISPEUDENCE. 
 
 habit of madness ; and, if it were not so, a state of folly cou'd 
 never be proved." 
 
 So, also, in the case before referred to, Lord Thurlow says, 
 " that the evidence in support of a lucid interval, after derange 
 ment at any period has been established, should be as strong and 
 demonstrative of such fact as where the object of the proof is to 
 establish derangement. The evidence, in such a case, applying 
 to stated intervals, ought to go to the sta,te and habit of the per- 
 son, and not to the accidental interview of an individual, or to 
 the degree of self-possession in any particular act." 
 
 The courts of law and equity, in their subsequent decisions, 
 have not essentially modified the rule as above laid down. In 
 the English Ecclesiastical Courts, the rule has, in some instances, 
 been very much relaxed, the disposition having been always 
 strongly manifested to sustain the validity of last wills and testa- 
 ments, when their provisions were reasonable. Perhaps, 
 the strongest case is that of Cartwright vs. Cartwright, 1 Philli- 
 moreJs Rep., 90, in which a will was contested on the ground of 
 insanity in the testatrix. The woman, both before and subse- 
 quent to the making the will, was afflicted with many of the 
 worst symptoms of mania. For some time previous to its date, 
 she was very importunate for the use of pen, ink, and paper, 
 which were withheld from her by the direction of her physician. 
 He at length consented, in order to quiet and pacify her. They 
 were brought to her, and her hands, which had been constantly 
 tied, were unloosed, and she sat down to a bureau to write. She 
 wrote on several pieces of paper in succession, which she tore up 
 and threw into the grate, walking up and down the room in a 
 wild and ferocious manner, and muttering to herself. After 
 spending some time in this manner, she finally wrote a will that 
 suited her, and which occupied but a few lines. Under these 
 circumstances, the court, Sir William Wynne, decided that she 
 had a lucid interval at the time of making the will, which, for 
 that reason, was established as valid. The grounds were, that 
 the will made a natural and consistent distribution of her pro- 
 perty ; that it " was a rational act, rationally done," and hence 
 the inference was, that her mind was visited with a lucid inter- 
 
MENTAL ALIENATION. 529 
 
 val at the moment of making it. The court distinctly took the 
 ground that the act itself afforded the strongest and best proof 
 of the existence of the interval. 
 
 This principle has not been affirmed by subsequent decisions, 
 although a strong tendency has ever existed to infer capacity from 
 the nature and quality of the act done. In White vs. Driver 
 1 Phil., 84, a greater amount of proof was required to establish 
 the fact of a lucid interval ; and in that of Groom and Thomas vs. 
 Thomas and Thomas, 2 Hagg's Eccl. Rep., 433, the court, Sir John 
 Nicholl, laid down the doctrine, that where there is not actual 
 recovery, and a return to the management of himself and his 
 concerns, by the unfortunate individual, the proof of a lucid in- 
 terval is extremely difficult. 
 
 When the sanity is confessedly of a doubtful character, the 
 agent may be inferred rational from the character, broadly taken, 
 of his act. Scruby and Finch vs. Fordham, 1 Addam?s Eccl. Re- 
 port, 74. 
 
 While the law restores to the insane his civil responsibility 
 during a lucid interval, it is much more cautious in restoring his 
 responsibility for crimes. For this caution there are sound phy- 
 siological reasons. Crimes are usually the results of momentary 
 excitement, produced by sudden provocations. These provoca- 
 tions re-produce that pathological condition of the brain called 
 irritation, the essential cause of the mental derangement. The 
 temporary cure, therefore, that constituted the lucid interval, is 
 put an end to, and the diseased condition of the brain is again 
 resumed. 
 
 In the earlier periods of the law, a distinction was made be- 
 tween acts done by those of unsound mind in pais, as it is termed, 
 and those done in courts of record. The latter, such as fines and 
 recoveries, and declarations of their uses, were not voidable, be- 
 cause it was presumed that had they been under these disabilities, 
 the judges would not have admitted them to make these acknow- 
 ledgments. There was, besides, another reason, viz. : The law 
 could allow no averment against the verity of a record ; a record, 
 as Lord Coke observes, importing such absolute verity, that Lt is 
 always proved by the production of itself. 
 
 34 
 
530 MEDICAL JURISPRUDENCE. 
 
 The acts done in pais could be avoided by heirs and personal 
 representatives, but not by the individual himself. The reason 
 assigned was, that " no man should be allowed to disable himself, 
 for the insecurity that may arise in contracts from counterfeit 
 madness and folly. Besides, if the excuse were real, it would be 
 repugnant that the party should know or remember what he did 
 in such a state." 
 
 This doctrine is now entirely exploded. In 3 Bay's Rep., 90, 
 it was held that a man might show he was non compos mentis in 
 avoidance of his deed. Judge Story, in 1 Story's Equity Juris- 
 prudence, § 225, remarks, in reference to the early doctrine, that K it 
 is matter of wonder and humiliation, how so absurd and mis- 
 chievous a maxim could have found its way into any system of 
 jurisprudence professing to act on civilized beings." 
 
 The case of Bagster and Others vs. Portsmouth, 7 Bowling and 
 Ryland, 614, establishes the principle, that, in the absence of all 
 fraud and imposition, and where the goods supplied appear to be 
 suitable to the condition and degree of the party receiving them, 
 and which, in his ordinary habits of life, he would be likely to 
 require, the fact of his being of unsound mind, and legally inca- 
 pable of making his own contracts, would not deprive a trades- 
 man of his right of suing in a court of law for the value of the 
 goods for which he had given him credit. The great difficulty is 
 referred to of being able to discriminate, at first view, between a 
 person of sound and of unsound mind. 
 
 It may be as well to examine, in this connexion, the progress 
 of the law in relation to the criminal responsibility of the insane. 
 There are here two anomalies that strike us in the outset. The 
 one is that a different rule or principle of responsibility should 
 be established between civil and criminal acts; that _ the same 
 degree of incapacity should be exonerated from the civil, and yet 
 held responsible for the criminal conduct. This seems to have 
 been successfully claimed and maintained by^ the Attorney- 
 General of England, in the case of Bellingham, in 1812, and had 
 previously to that been conceded by Lord Erskine, on the trial 
 of Hadfield, in 1800. The concession of Lord Erskine went even 
 beyond what the law requires, as he admitted that a civil act 
 
MENTAL ALIENATION 531 
 
 might be avoided, even although it were not connected with the 
 delusion which constituted the insanity. But to establish the 
 doctrine, that a capacity so diminished or deranged from disease 
 of the organ, as is sufficient to exempt from liability for civil acts, 
 should, nevertheless, be held responsible for those that are crimi- 
 nal, appears strange and unaccountable. Criminal acts, which 
 are usually consequent upon undue excitement, are much more 
 likely to spring from minds just on the verge of derangement, 
 than civil acts, which seem more to follow each other in 
 the ordinary natural course of things. Why, then, should an 
 individual be divested of his property, and absolved from all his 
 civil liabilities incurred while in that state, and yet be held to the 
 utmost degree of accountability for all aggressions upon liberty 
 or life 1 There appears to be no reason, physiological or psycho- 
 logical, for making this distinction. 
 
 Another anomaly is in the character of the evidence adduced 
 to prove capacity or incapacity. When the capacity for the per- 
 formance of a civil act is testing, the nature and character of the 
 act itself is insisted upon as furnishing some proof either of the 
 capacity or incapacity of the person performing it. " A rational 
 act, rationally done," raises, at least, a presumption, that .its 
 source may be rational. So, also, an irrational act, irrationally 
 done, affords a like presumption of incapacity. Does the same 
 rule obtain in acts that are criminal 1 A man imbrues his hands 
 in the blood of his own family, or, as in the case of Freeman, 
 hereafter alluded to, destroys the lives of an entire family that 
 had done him no injury. Instead of its being regarded as an 
 insane act, the individual is more frequently looked upon as a 
 monster of iniquity, who can hardly find a parallel in the records 
 of crime. It cannot, perhaps, be said that the law itself, in direct 
 terms, affixes to these acts these different characters, as it no 
 where lays down distinctly such a principle. The objection is, 
 that causes are generally conducted, and permitted to go to juries, 
 upon these principles. 
 
 The principles that serve as a guide in determining the capa- 
 city or incapacity in relation to civil responsibilities, are either 
 totally inapplicable, or stop far short of exonerating from crimi- 
 
OoZ MEDICAL JURISPRUDENCE. 
 
 rial acts. It becomes then a matter of anxious inquiry what 
 are the tests of capacity or incapacity, and what are the principles 
 that lie at the foundation of irresponsibility for crimes. These 
 have furnished more or less of a puzzle to courts, from the days 
 of Lord Hale to the present time. 
 
 The earliest attempt worthy of notice to define these tests and 
 principles was made by Lord Hale. In his Pleas of the Crevm., 
 39, he says, " There is a partial insanity and a total insanity. 
 The former is either in respect to things quoad hoc vel illud 
 insanize. Some persons that have a competent use of reason, in 
 respect of some subjects, are yet under a peculiar dementia in 
 respect of some particular discourses, subjects, or applications ; 
 or else it is partial, in respect of degrees ; and this is the condi- 
 tion of very many, especially melancholy persons, who, for the 
 most part, discover their defect in excessive fears and griefs, 
 and yet are not wholly destitute of the use of reason ; and this 
 partial insanity seems not to excuse them in the committing of 
 any offence for its matter capital, for, doubtless, most persons 
 that are felons of themselves and others, are under a degree of 
 partial insanity, when they commit these offences. It is very 
 difficult to define the invisible line that divides perfect and partial 
 insanity ; but it must rest upon circumstances, duly to be weighed 
 and considered by the judge and jury, lest, on the one side, there 
 be a kind of inhumanity towards the defects of human nature, 
 or, on the other, too great an indulgence given to great crimes." 
 Again, as a measure of responsibility, he says, " Such a person, 
 as laboring under melancholy distempers, hath yet ordinarily as 
 great understanding as ordinarily a child of fourteen years hath, 
 is such a person as may be guilty of treason or felony." This 
 goes clearly to show that, in the opinion of that learned judge, it 
 is the strength and capacity of the mind only that are affected by 
 insanity ; and hence he attributes to " melancholy distempers," the 
 power of diminishing, instead of perverting and deranging, the 
 action of the mental faculties. It is not strange that such doc- 
 trines should have been laid down in the infancy of knowledge 
 even of the most common forms of mental alienation ; but it is 
 somewhat singular that they should be so long adhered to, either 
 
MEKTAL ALIENATION. 533 
 
 in letter or spirit, amid the constantly increasing lights which 
 have emanated from the medical profession in reference to this 
 dark and mysterious subject. 
 
 This doctrine of Lord Hale has had a prodigious effect upon 
 all subsequent jurisprudence in reference to this condition of 
 mind. It is, perhaps, more in the constructions given to it, than 
 in the doctrine itself, that the objectionable features are to be 
 found. 
 
 The first echo to this doctrine is found in the trial of Arnold, 
 for shooting at Lord Onslow, in 1723; see 8 Margrave's State 
 Trials, 322. Arnold was a weak, idle being, strange, and some- 
 times mad ; leading an irregular, disordered life ; living solitary ; 
 lying about in barns and under hay-ricks ; cursing, swearing, 
 laughing, and throwing tilings about, and disturbed in his sleep 
 by fancied noises. Lord Onslow lived in the neighborhood, and 
 was believed by him to be the cause of all the tumults, distur- 
 bances and wicked devices that happened in the country.' He 
 declared that he sent his devils and imps into his room at night 
 to disturb his rest, and that he constantly plagued and bewitched 
 him, by getting into his belly or bosom, so that he could neither 
 eat, drink, nor sleep for him. He said much about being plagued 
 by the' Bollies or Bolleroys, declaring it was better to die than 
 live so miserably. Under the influence of these delusions, he 
 shot at and wounded Lord Onslow. 
 
 In this case, Mr. Justice Tracy laid down the law to be, " that 
 it is not every kind of frantic humor, or something unaccount- 
 able in a man's actions, that points him out to be such a madman 
 as is exempted from punishment ; it must be a man that is totally 
 deprived of Ms understanding and memory, and doth not know what 
 he is doing no more than an infant, than a brute, or a wild beast. 
 Such an one is never the object of punishment." And I think all 
 would agree that such an one never should be the object of pun- 
 ishment. This would define a state, if possible, below the idiotic. 
 This rule wbuld leave every other but the lowest in the scale 
 of idiocy, fully possessed of all the elements of responsibility. The 
 result was that the jury found him guilty, and he was sentenced 
 to be hung. Lord Onslow, however, was convinced of his ir- 
 
53-1 MEDICAL JURISPRUDENCE. 
 
 responsibility, and on liis application, the sentence was not ex- 
 ecuted, and he was continued in prison during his life. 
 
 On the strength of this case, it might fairly be assumed that the 
 law, in order to exempt the insane from criminal responsibility, 
 required an entire destitution of intellect, an absolute depriva- 
 tion of reason. This ground was met, and completely over- 
 thrown, by Lord Erskine, in the case of Rex vs. Hadf,eld : in the 
 year 1800. He very justly remarks that if a total deprivation of 
 memory was to be taken in its literal sense, then no such mad- 
 ness ever existed in the world. That it is idiocy alone which 
 places a man in this helpless condition ; but that lunatics have 
 not only had memory, in his sense of the expression, — they have 
 not only had the most perfect knowledge and recollection of all 
 the relations they stood in towards others ; and of the acts and 
 circumstances of their lives, — but have, in general, been remark- 
 able for subtlety and acuteness. 
 
 The trial of Hadfield took place in the King's Bench, before 
 Lord Kenyon, in 1800, and is fully reported in 27 Howell's State 
 Trials, 1281. He was indicted for high treason in shooting at 
 the King in Drury Lane Theatre. The defence interposed was 
 insanity. .He had been a soldier, received many severe wounds 
 in the battle near Lisle, and was dismissed from the army on 
 account of insanity, or partial derangement, caused by those 
 wounds. He was afterwards subject to an annual insanity from 
 the beginning of spring to the end of dog days. He had been 
 confined as a lunatic. When affected by the disorder he im- 
 agined himself to hold intercourse with God, sometimes calling 
 himself God, or Jesus Christ, and other blasphemous expressions, 
 committing acts of the greatest extravagance, but at other times 
 appearing rational, and discovering no symptoms of mental in- 
 capacity or disorder. The offence was committed on the 15th 
 of May. On the 1 1th of May next preceding, his mind was very 
 much disordered, and he used many blasphemous expressions. 
 At two o'clock A. M., on the following morning, hcjumped sud- 
 denly out of bed, said he was about to dash out, against the bed- 
 post, the brains of his little son, about eight years old, of whom 
 he was remarkably fond, and that God had ordered him to do so 
 
MENTAL ALIENATION. 535 
 
 On the same and the following day, he used many incoherent and 
 blasphemous expressions. On the morning of the 15th he was 
 worse, went to his master's work-shop, returned to dinner at 
 two, but said he stood in no need of meat and could live without 
 it. In the evening, after repeating his irreligious expressions, 
 he went out and repaired to the theatre. He sat there nearly 
 three-quarters of an hour, when the King entered. As the au- 
 dience rose up to receive him, he got above the rest, and, pre- 
 senting a pistol loaded with slugs, fired it at the King's person, 
 and then let it drop. This situation was favorable, and he took 
 deliberate aim at the King. When apprehended he said he knew 
 perfectly well his life was forfeited, that he was tired of life, and 
 regretted nothing but the fate of a woman who was his wife, and 
 would be his wife a few days longer, he supposed. He spoke 
 calmly, and without any apparent derangement ; said he did not 
 intend any thing against the life of the King, that he knew the 
 attempt only would answer his purpose, repeated that he was 
 tired of life, and that his plan was to get rid of it by other means. 
 These were the most material facts bearing on the subject. 
 
 On this occasion Lord Erskine brought his great talents to bear 
 directly upon the subject of insanity, and with a felicity of ex- 
 pression peculiarly his own, exhibited in bold relief some of its 
 leading and prominent features. The grounds he took and en- 
 forced, and in which the court acquiesced, were substantially — 
 
 1 . That it is the reason of man which makes him accountable 
 for his actions, and that the deprivation of reason acquits hirn of 
 crime : 
 
 2. That it is unnecessary that reason should be entirely sub- 
 verted, or driven from her seat, but that it is sufficient if dis- 
 traction sits down upon it along with her, holds her trembling 
 hand upon it, and frightens her from her propriety : 
 
 3. That the law will not measure the sizes of men's capacities, 
 so as they be compos mentis : 
 
 4. That there is a difference between civil and criminal re 
 sponsibility. That a man affected by insanity is responsible foi 
 his criminal acts where he is not for his civil : 
 
535 MEDICAL JURISPRUDENCE. 
 
 5. That a total deprivation of memory and understanding is 
 not required to constitute insanity : 
 
 6. The then new and all important ground, that the individual 
 is irresponsible where the insanity consists in hallucination ; 
 where the disease springs directly from the delusive sources of 
 thought ; and all their deductions, within the scope of the malady, 
 are founded upon the immoveable assumption of matters as real- 
 ities, either without any foundation whatever, or so distorted 
 and disfigured by fancy, as to be almost nearly the same thing as 
 their creation : 
 
 '7. That the act complained of, and sought to be avoided, must 
 be the immediate unqualified offspring of the disease. 
 
 Although there are some concessions contained in the doctrine 
 that cannot now be admitted as correct, yet, on the whole, the. 
 speech and the case itself was a splendid triumph of reason over 
 prejudice and error. Its great merit consists in showing that 
 insanity is not idiocy ; and in extending the protection of the 
 law, as well to embrace the delusions of the one, as the intellect- 
 ual destitution of the other. The result was the acquittal of the 
 prisoner. 
 
 After this clear, and it would appear, satisfactory exposition 
 and settlement of the law as applicable to insanity, it is painful 
 to advert to the case of Bellingham, 1 Collinson on Lunacy, 650, 
 which occurred only twelve years after. 
 
 He was tried for the murder of the Honorable Spencer Perci- 
 val, in 1812. He appears to have labored under many insane 
 delusions. The principal of these were that his own private 
 grievances were national wrongs ; that his country's diplomatic 
 agents abroad neglected to hear his complaints and assist him in 
 his troubles ; that his losses would be made good by the govern- 
 ment ; that the government would not interfere in his affairs ; 
 and he determined, by assassinating its head, to bring his affairs 
 before the country, supposing then he would have an opportu- 
 nity of making a public statement of his grievances, and of ob- 
 taining a triumph over the attorney-general. These were all 
 delusions, and under their influence he shot the prime minister, 
 Spencer Percival. 
 
MENTAL ALIENATION. 537 
 
 In this case Lord Mansfield charged the jury in substance, 
 that the single question for them to determine was whether, when 
 he committed the offence charged upon him. he had sufficient 
 understanding to distinguish good from evil, right from wrong, 
 and that murder was a crime not only against the law of God, 
 but against the law of his country. He was convicted and exe- 
 cuted. 
 
 In this case the test assumed as the only one, was the power 
 of distinguishing good from evil, right from wrong. And this, or 
 more definitely, the power of distinguishing right from wrong, has 
 ever since been adopted as a test, and sometimes as the only one, 
 that marks the line between sanity and insanity, responsibility 
 and irresponsibility. This test was adopted only twelve years 
 after Lord Erskine's exposure of its entire fallacy as an exclusive 
 test, in his great speech on the trial of Hadfield. He makes the 
 supposition that the character of an insane delusion consisted in 
 the belief that some given person was any brute animal, or an 
 inanimate being, (such cases having existed) ; and that on a 
 trial for murder, it should be made to appear, that he firmly be- 
 lieved the man he had destroyed was a potter's vessel, his mind 
 in every other respect being sane. Then suppose further, that 
 he believed the man whom he destroyed, but whom he destroyed 
 as a potter's vessel, to be the property of another, and that other 
 his enemy, whom he had sought to injure by this destruction of 
 his property. 
 
 As tins may now be regarded as the test best known to the 
 law, it may be important to enquire as to the elements that com- 
 pose it, and what effect they exert upon the insane mind. 
 
 The knowledge of right and wrong implies two tilings : 
 
 1. A perception or recognition, by the mind, of those actions 
 or things, in themselves or others, in regard to which right or 
 wrong may be predicated : and, 
 
 2. The feeling of what is right or wrong, in itself, in reference 
 to such actions or things. 
 
 •The first belongs to the intellectual department, the second to 
 mat of feeling. The first consequently depends upon the action 
 Alt' those perceptive faculties that take cognizance of actions and 
 
538 MEDICAL jrKISPRUDENCE. 
 
 things ; the second upon the faculty of conscientiousness, the 
 moral sense of the metaphysicians. To enable one to judge of 
 the moral qualities of actions and things, both these are neces- 
 sary. Both are susceptible of cultivation and improvement. 
 Both may exist together, or be wanting together, or the one may 
 exist without the other. The one does exist without the other 
 in the brute creation. They perceive actions and things, but 
 feel not their moral relations. They are utterly unable to dis- 
 tinguish, between an injury and a wrong, between a blow that is 
 accidental, and one that is intentional. 
 
 •With us, the one may be so much wanting, from original de- 
 fect, or subsequent occurring disease, as to divest of the elements 
 of responsibility ; or the intellectual faculties may be so warped 
 or perverted by insane delusions, as to deprive the other of all 
 power of exerting its agency in reference to those acts or things 
 involved in the delusion. 
 
 Dr. Eay, whose long experience with the insane enables him 
 to speak from observation, thus eloquently remarks : 
 
 " In no school of logic, in no assembly of the just, can we 
 listen to closer and shrewder argumentations, to warmer exhorta- 
 tions to duty, to more glowing descriptions of the beauty of 
 virtue, or more indignant denunciations of evil doing, than in 
 the hospitals and asylums for the insane. And yet many of these 1 
 very people may make no secret of entertaining notions utterly 
 subversive of all moral propriety, and perhaps are only waiting 
 a favorable opportunity to execute some project of wild and 
 cruel violence. The purest minds cannot express greater horror 
 and loathing of various crimes, than madmen often do, and from 
 precisely the same causes. Their abstract conceptions of crime, 
 not being perverted by the influence of disease, presents its 
 hideous outlines as strongly defined as they ever were in the 
 healthiest condition ; and the disapprobation they express at the 
 sight, arises from sincere and honest convictions. The particular 
 criminal act, however, becomes divorced, in their minds, from 
 its relations to crime in the abstract; and, being regarded only in 
 connexion with some favorite object, which it may help to ob- 
 tain, and which they see no reason to refrain from pursuing, is 
 
MENTAL ALIENATION. 539 
 
 viewed, in fact, as of a highly laudable and meritorious nature. 
 Herein, then, consists their insanity ; not in preferring vice to 
 virtue, in applauding crime and deriding justice, but in being 
 unable to discern the essential identity of nature, between a par- 
 ticular crime and all other crimes, whereby they are led to ap- 
 prove, what, in general terms, they have already condemned." 
 Ray, 289, § 17. 
 
 In confirmation of these views, Baron Hume, a Scotch writer, 
 speaking in reference to this test, says, that " every judgment 
 in the matter of right and wrong, supposes a case, or state of 
 facts to which it applies, and though the person may have that ves- 
 tige of reason, which may enable him to answer in the general, 
 that murder is a crime, yet if he cannot distinguish a friend from 
 an enemy, or a benefit from an injury, but conceives everything 
 about him to be the reverse of what it really is, and mistakes the 
 ideas of his fancy in that respect, for realities, those remains of 
 intellect are of no sort of service to him in the government of 
 his actions, in enabling him to form a judgment as to what is 
 right or wrong on any particular occasion." 
 
 Although there are conflicting decisions upon this point, yet it 
 may on the whole fairly be assumed, that an advance has been 
 made by the law in this respect ; that the enquiry is not limited 
 to the ideas of right and wrong entertained by the prisoner, in 
 the general or abstract, but is to be made in reference to the 
 identical act complained of as criminal. 
 
 Mr. Chitty, in Chitty's Medical Jurisprudence, 354, says : " In 
 practice, to prevent the jury being embarrassed by any techni- 
 calities respecting the import of this term insane, the substantial 
 question presented to the jury in this and all cases, whether of 
 alleged idiocy, lunacy, or insanity, either in general or mono- 
 mania (that is, delusion confined to a particular subject,) is, 
 whether, at the time the alleged criminal act was committed, the 
 prisoner was incapable of judging between right and wrong, and 
 did not then know he was committing an offence against the law of 
 God and of nature 1 " 
 
 In the case of The King vs. Bowler, which occurred in 1S12, 
 (1 Collinson on Lunacy, 673,) the defence interposed was insanity. 
 
540 MEDICAL JURISPRUDENCE. 
 
 Mr. Justice Le Blanc, in that case, charged the" jury, that it was 
 for them to determine whether the prisoner, when he commit- 
 ted the offence with which he stood charged, was incapable of 
 distinguishing right from wrong, and not under the influence of 
 any illusion in respect to the prosecutor, which rendered his 
 mind at the moment insensible to the nature of the act he was 
 about to commit ; since, in that case, he would not be legally re- 
 sponsible for his conduct. But if they should be of opinion that 
 when he committed the offence, he was capable of distinguish- 
 ing right from wrong, and not under the influence of such an 
 illusion as disabled him from discerning that he was doing a 
 wroug act, he would be amenable to the justice of Ms country, 
 and guilty in the eye of the law. 
 
 The late case of The King vs. Orford, (5 Carrington # Payne, 
 ] 68,) was a trial for the murder of a man named Chisnall. The 
 defence was insanity, evidenced by delusion. He labored under 
 the delusion that the inhabitants of Hadleigh, and particularly 
 the deceased, were continually issuing warrants against him, with 
 intent to deprive him of liberty and life. Under the influence 
 of that insane idea, he would frequently abuse persons whom he 
 met in the street, and with whom he never had any dealings 
 or acquaintance of any kind. In his waistcoat pocket a paper 
 was found, headed " List of Hadleigh conspirators against my 
 life." The name of the deceased was among them. There was 
 also found among his papers, an old summons, about a rate, at 
 the foot of which he had written, " This is the beginning of an 
 attempt against my life." 
 
 In this case, Lord Lyndhurst charged the jury, that they must 
 be satisfied, before they could acquit the prisoner on the ground 
 of insanity, that he did not know, when he committed the act, 
 what the effect of it, if fatal, would be, with reference to the 
 crime of murder. The question was, Did he know that he wa? 
 committing an offence against the laws of God and nature ? The 
 prisoner was acquitted on the ground of insanity. 
 
 The language of courts, in reference to this test, is always 
 more or less ambiguous, arising from the fact, that the feeling of 
 right and wrong may, and more generally does, prevail, amid the 
 
MENTAL ALIENATION, i 541 
 
 most unfounded delusions. Whether, therefore, the courts have 
 reference simply to the feelings and the laicwledge consequent upon 
 it, or to its being exercised in reference to things as they actually exist, 
 or as any sane mind would understand them to exist, may make 
 a most material difference. The latter might be a proper test of 
 insanity, but the former would by no means be necessarily so. 
 If the verdicts rendered by juries are to be received as evidence 
 of the construction put upon the charge, they will generally fa- 
 vor the idea that their action has been upon the former. 
 
 Another test proposed, and upon which considerable reliance 
 has at times been placed, is the design or contrivance manifested 
 in the commission of the act. 
 
 Mr. Russell (1 Russell on Crimes and Misdemeanors, 13,) lays 
 this down as one of the established principles that are to guide 
 us in our conclusions on this subject. 
 
 In the case of Arnold, great stress was laid on the fact of his 
 having purchased shot of a much larger size than he usually did 
 when he went out to shoot, with the design, then formed, of 
 committing the murder he afterwards attempted. 
 
 In the case of Bellingham, the Attorney General declared, that 
 " even if insanity in all his other acts had been manifest, yet the 
 systematic correctness with which the prisoner contrived the mur- 
 der, showed that he possessed a mind, at the time, capable of 
 distinguishing right from wrong." It would probably have been 
 very difficult for the Attorney General to have shown how the 
 one was connected with the other; the real connection being 
 about the same as that which exists between the motion of a 
 muscle and the secretion of a gland in the living subject. The 
 sufficiency of this as a test, can be best settled by referring to the 
 opinions of those who have a practical acquaintance with the in- 
 sane. 
 
 " What," says Br. Ray, page 37, § 21, "must be thought of 
 the attainments of those learned authorities in the study of mad- 
 ness, who see in the power of systematic design a disproof of the, 
 existence of insanity, when, from the humblest menial in the 
 service of a lunatic asylum, they might have heard of the in- 
 
542 MEDICAL JURISPRUDENCE. 
 
 genuity of contrivance, and adroitness of execution, that pre- 
 eminently characterize the plans of the insane V 
 
 This power of systematic design is, when analyzed, nothing but 
 the sentiment of cunning developing itself by means of intellectual 
 combinations. The sentiment itself is a primitive power or fa- 
 culty of the mind, and is of a low order, in fact, a mere animal 
 instinct, being found in the brute creation. It is one of those 
 powers that are generally found specially active among the in- 
 sane. Very extraordinary instances are given, in works on in- 
 sanity, going to show the very great extent to which this faculty 
 has developed itself among that unfortunate class of individuals. 
 See iJcM/,39-40, §21. 
 
 Independent of its being generally affected in connection with 
 other powers of the mind, the fact of its being a primitive power 
 or faculty, independent in its function and action, renders it 
 liable itself to deranged manifestation ; and in that case, accord- 
 ing to this doctrine, we should have the actual derangement of 
 one faculty cited as proof of the sanity of the entire mind. So 
 far as relates to its displaying itself through intellectual combi- 
 nations, or the exercise of those faculties that adapt means to 
 ends, we have the instance given by Pinel of the maniac who 
 endeavored to discover perpetual motion, and in his efforts to 
 discover it, constructed some very curious machines. Also in 
 the one mentioned by Esquirol, of the mad general who invent- 
 ed an improvement in the construction of a military weapon, 
 which was subsequently adopted in the army. It may well be 
 doubted whether the plans and proposed arrangements for the 
 management of his kingdom, which are formed in the brains of 
 the maniac who conceives himself a king, might not furnish very 
 useful hints to those who are really such ; or, if their station de- 
 pends on a delusion, it happens to be one very generally prevail- 
 ing among all those who yield them obedience. 
 
 These remarks are not intended to exclude the legitimate in- 
 ference deducible from the resort to design and contrivance by 
 the sane mind. In such, when preceding, and connected with 
 the criminal act, it affords evidence of deliberate intention to 
 commit it, and hence of the evil intent and malice which consti- 
 
MENTAL ALIENATION. 543 
 
 tute the highest elements of crime. The only object is to rescue 
 the really irresponsible from the operation of a test entirely in- 
 applicable to their case, and therefore insufficient to prove any- 
 tliing whatever in relation to their sanity or insanity. 
 
 We now come to another test, that proposed by Lord Erskine, 
 viz., Delusion. The correctness of this test rests not alone on 
 the authority of Lord Erskine, and its approval by Lord Kenyon 
 in the case of Hadfield. It is also sanctioned by Sir John Nicholl, 
 in the case of Dew vs. Clark, (3 Addams, 79,) who says, " The 
 true criterion, the true test, of the absence or presence of in- 
 sanity, I take to be, the absence or presence of what, used in a 
 certain. sense of it, is comprisable in a single term, namely, delu- 
 sion. In short, I look upon delusion, in this sense of it, and in- 
 sanity to be, almost, if not altogether, convertible terms." 
 
 This test, as we shall presently see, has been adopted in this 
 country. To enable us to judge properly of the value and suf- 
 ficiency of it, we should understand both its nature and its 
 sources. As understood by medical jurists, it means the as- 
 sumption, by the mind, of things as realities which have' no ex- 
 istence as such. It is the substitution of the baseless creations 
 of one's own mind, and the action upon them, instead of things 
 as they really exist. 
 
 Such being their nature, their source must be obvious, viz., 
 the intellect. It is alone the province of the intellect to form 
 ideas, and as delusions consist in ideal creations, it is clear they 
 can be referable to no other source but that of the intellect. 
 Their existence, therefore, may be received as evidence of intel- 
 lectual mania, either general or partial. 
 
 Delusion, where it is proved to exist, may fairly be received 
 as a test of insanity ; but is its absence equally a test of sanity 1 
 This would undoubtedly be true, if the human mind consisted 
 of nothing but intellect. But that, as we have already seen, is 
 made up of propensities, sentiments, and emotions, as well as 
 ideas ; or, in other words, it feels as well as thinks.. These pro- 
 pensities and sentiments, as we have already seen, are liable to 
 derangement, giving rise to the phenomena of moral mania. 
 This form of derangement can hardly yet be said to be distinct- 
 
544 MEDICAL JURISPRUDENCE. 
 
 ly recognized by the courts, although its existence may be affirm- 
 ed to be clearly established. That form of it which has the most 
 frequently come up for investigation, and afforded the greatest 
 puzzle to courts, is the derangement of the destructive propen- 
 sity, giving rise to homicidal mania. This will properly arise 
 for more especial investigation in another connection. Although 
 jurists have in many cases acquitted the prisoner, who was 
 shown clearly to have destroyed under the insane impulse, yet 
 the law can hardly yet be said to have framed a principle, under 
 which the exemption from liability can be claimed. 
 
 It will be readily perceived from all this, that the course of 
 decisions has been somewhat vaccinating in reference to the tests 
 of mental alienation. The old test of total deprivation of under- 
 standing, adopted in the case of Arnold, has certainly been laid 
 aside. That of delusion, adopted in the case of Hadfield, was laid 
 aside in that of Bellingham, tried only twelve years afterwards, 
 and the power of distinguishing right from wrong adopted in its 
 place. This latter test was lost sight of in the trial of Martin 
 for setting fire to the York Minster, and that of delusion again 
 adopted. The power of distinguishing right from wrong was 
 again adopted in a somewhat modified form, in the case of The 
 King vs. Orford, and the test of delusion entirely disregarded. 
 Again, in a late case occurring in 1837, that of Greens7nith, (see 
 statement of the case in Taylor, 513,) Mr. Justice Parke told the 
 jury that, as regards the effect of insanity on responsibility for 
 crime, . " it is merely necessary that the party should have suffi- 
 cient knowledge and reason to discriminate between right and 
 wrong," thus rejecting the modification of Lord Lyndhurst, and 
 leaving it simply on the power to discriminate between right and 
 wrong in the abstract, and not as applied to the particular act in 
 question. 
 
 In the case of The King vs. Oxford, for shooting at the Queen, 
 which occurred a short time after the last, and is reported in 
 9 Carrington fy Payne, 525, Chief Justice Denman told the jury 
 " that the question for them to decide was, whether the prisoner 
 was laboring under that species of insanity which satisfied them 
 that he was quite unaware of the nature, character, and conse- 
 
MENTAL ALIENATION 545 
 
 quences of the act he was committing; or, in other words, 
 whethtr he was under the influence of a diseased mind, and was 
 really unconscious at the time he was committing the act, that it 
 was a crime." 
 
 In 1843 occurred the trial of McNaughton for killing Drum- 
 mond, which excited through England a great degree of interest. 
 In this case, it was shown that the prisoner was latterly of a sul- 
 len and reserved character ; that he imagined himself the object 
 and victim of unrelenting persecution ; that he was surrounded 
 by persons who had formed a conspiracy against his comforts, 
 character and life, and that these persons were always in' pursuit 
 of him. The deceased was a stranger to him, but imagined to 
 be one of his persecutors, and that it was necessary to kill him 
 in order to free himself from persecution. In other respects, he 
 appeared sound, and was shrewd in his business transactions, 
 carefully managing his own affairs. The medical witnesses, eight 
 in number, testified that at the time he committed the act, he 
 was laboring under a delusion, and that he was led on by an im- 
 pulse, so irresistible that nothing but a physical impediment 
 could have prevented Ms committing it.. 
 
 Lord Chief Justice Tindal in this case instructed the jury, 
 that before convicting him, they must be satisfied that, when 
 committing the criminal act, he had that competent use of his 
 understanding as that he was doing a wicked and wrong thing ; 
 that he was sensible it was a violation of the law of God and 
 man. The prisoner was acquitted. 
 
 This trial occasioned the submitting of certain questions, by 
 the House of Lords, to the fifteen judges, with the view of elicit- 
 ing their opinions in regard to criminal responsibility. 
 
 As these questions and answers were designed to settle the 
 law in England on this subject, it is proper to notice here those 
 that have reference to the tests to be employed : 
 
 Question I. "Whatsis the law respecting alleged crimes com- 
 mitted by persons afflicted with insane delusions in respect of 
 one or more particular subjects or persons ; as, for instance, when 
 at the time of the commission of the alleged crime, the accused 
 knew he was acting contrary to law, but did the act complained of 
 
 35 
 
546 MEDICAL JURISPRUDENCE. 
 
 with the view, and under the influence of some insane delusion, 
 of redressing or avenging some supposed grievance or injury, or 
 of producing some supposed public benefit 1 
 
 Jlnswer. The opinion of the judges was, thdt, notwithstanding 
 the party committed a wrong act, while laboring under the idea 
 that he was redressing a supposed grievance or injury, or under the 
 impression of obtaining some public or private benefit, he was liable 
 to punishment." 
 
 Question II. " What are the proper questions to be submitted 
 to the jury, when a person alleged to be affected with insane de- 
 lusion, respecting one or more particular subjects or persons, is 
 charged with the commission of a crime — murder, for example — 
 and insanity is set up as a defence 1 
 
 Jlnsvjer. Before a plea of insanity should be allowed, undoubt- 
 ed evidence ought to be adduced, that the accused was of diseased 
 mind, and that at the time he committed the act, he was not conscious 
 of right and wrong. Every person was supposed to lenow what the 
 law was, and therefore nothing could justify a wrong act, except it 
 was clearly proved that the party did not know right from wrong. 
 
 Question IV. If a person, under an insane delusion, as to, ex- 
 isting facts, commits an offence in consequence thereof, is he 
 hereby excused 1 
 
 Jlnswer. If the delusion were only partial, the party accused was 
 equally liable with a person of sane mind. If the accused killed 
 another in self-defence, he would be entitled to an acquittal, but if 
 the crime were committed for any supposed injury, he would then be 
 liable to the punishment awarded by the laws to his crime. 1 '' 
 
 What the judges meant by a delusion that is only partial, is 
 perhaps difficult of explanation. I am not aware of any known 
 instance of general delusion; that is, of delusion universally en- 
 tertained in reference to every thing. If the judges intended 
 that the partial character of it should be understood in reference 
 to the particular delusion entertained ; that is, that the individual 
 alleged to be insane, had some glimpses of truth, and some de- 
 lusive ideas in reference to the particular thing or act done or 
 complained of, then it is apprehended there would be great and 
 insuperable difficulties in ever making any application of it. 
 
MENTAL ALIENATION. 547 
 
 Again, the judges seem to have adopted the right and wrong 
 test, without even annexing to it the qualification proposed by 
 Lord Lyndhurst, unless they use the terms " right and wrong " 
 as synonymous with those of "lawful and unlawful," which 
 there is no sufficient reason for presuming. 
 
 In the trials that have taken place in this country, where the 
 plea of insanity has been interposed, so far as they have become 
 generally known, the tests adopted by the common law of Eng- 
 land, with the exception of the law as recently laid down by the 
 fifteen judges, have in general been adopted. 
 
 In 1835 occurred at Washington the trial of Lawrence, for 
 shooting at General Jackson, then President of the United States. 
 See Vol. 48 of Nile? Register, 119. The delusion under which 
 he was shown to have labored, was that he supposed himself 
 entitled to the English crown, and General Jackson refused to 
 grant him a sufficient sum of money to enable him to assert his 
 right to it, wherefore he supposed himself justified in shooting 
 him. 
 
 The correctness of the doctrine as laid down and asserted by 
 Lord Erskine, and acquiesced in by Lord Kenyon in the case of 
 Hadjield, was admitted by the court, and upon the strength of it 
 Lawrence was acquitted. 
 
 In the case of Theodore Wilson, tried in York county, Maine, 
 in the year 1836, for the murder of his wife in a paroxysm of 
 insanity., the court charged the jury that if they were satisfied 
 the prisoner was not of sound memory and discretion, at the time 
 of committing the act, they were bound to return a verdict of 
 acquittal. Ray, 49, § 27. 
 
 In the trial of Corey for the murder of Mrs. Nash, in New 
 Hampshire, in 1829, the court, Chief Justice Richardson, stated 
 in his charge to the jury, that the only question for them to 
 settle was, whether he was of sane mind when the deed was 
 done. Ray, § 27. 
 
 On the trial of Prescott for the murder of Mrs. Cochran, sub- 
 stantially the same language was made use of. 
 
 On the trial of Rogers, in July 1843, for the murder of Mr 
 Lincoln, in the State Prison of Massachusetts, the court, Chief 
 
548 MEDICAL JURISPRUDENCE. 
 
 Justice Shaw, charged the jury, that insanity or delusion is an 
 excuse for crime, in two ways ; first, where it amounts to a firm 
 belief that one is liable to lose his own life, or suffer some great 
 bodily harm; secondly, where some violent outbreak occurs, 
 which, taken in connexion with former acts, indicates that the 
 will was overborne. The questions for them to decide were, 
 whether such a delusion existed in the mind of the accused ; 
 whether he did the act under an insane, but firm belief, that the 
 deceased was going to shut him up with some dangerous design, 
 or not for a slight punishment ; whether the facts indicate that 
 the deed was done at a moment when the delusion was uncon- 
 trollable, Ray, 49 - 50, § 27. 
 
 On the trial of Abbot by the Superior Court of Connecticut in 
 1841, for the murder of his wife, the jury were instructed to 
 acquit the prisoner, " if they found that, at the time of commit- 
 ting the act, he was insane ; had not sufficient understanding to 
 distinguish right from wrong, and did not know that the murder 
 of his wife was an offence against the laws of God and nature." 
 Ray, 50, §27. 
 
 In this State, the Revised Statutes (2 R. S., 697, § 2,) provide 
 that no insane person can be tried, sentenced to any punishment, 
 or punished, for any crime or offence, while he continues in that 
 state ; and that no act done by a person, in a state of insanity, 
 can be punished as an offence. 
 
 If the last clause were allowed a construction as broad as its 
 terms indicate, it would be only necessary to prove any species 
 of mental alienation, although entirely unconnected with the act 
 complained of, and the exemption from liability would follow of 
 course. 
 
 This part of the section received a construction in the case of 
 Freeman vs. The People, (4 Denio, 9,) in whch Mr. Justice Beards- 
 ley says that the clause is very comprehensive in its terms, and 
 at first blush, might seem to exempt from punishment every act 
 done by a person who is insane upon any subject whatever. The 
 court in that case interpreted the phrase as if it had read " no 
 act done by a person in a state of insanity," in respect to such act, 
 " can be punished as an offence." It required an insane act, and 
 
MENTAL ALIENATION. 549 
 
 not merely the act of an insane person, in order to have applied 
 to it the rule of exemption. 
 
 In the case of Kleim, tried before Judge Edmonds, May 21, 
 1845, (see 2 Vol. American Journal of Insanity, 245,) we find 
 some judicious and sound remarks relative to the rule of law to 
 be applied to the insane condition. The judge begins by stating 
 that the enquiry to be made under the rule of law, as now estab- 
 lished, was as to the prisoner's knowledge of right and wrong, 
 at the time of committing the offence. He takes the clear dis 
 tinction between that knowledge in the abstract, and as applied 
 to the act in question, by stating that the question whether the 
 accused knew the difference between right and wrong is not to 
 be put generally, but in reference to the very act with which he 
 is charged ; and the inquiry therefore is, had the accused a suf- 
 ficient degree of reason to know that he was doing an act that 
 was wrong, or was he laboring under that species of mental ab- 
 erration which satisfied the jury that he was quite unaware of 
 the nature, character, and consequences of the act he was com 
 mittiDg. 
 
 Again he broaches another ground which if not new, has cer- 
 tainly been but little known to the law. " If," says he, " some 
 controlling disease was in truth the acting power within him, 
 which he could not resist, or if he had not a sufficient use of 
 his reason to control the passions which prompted the act com- 
 plained of, he is not responsible ; but we must be sure not to be 
 misled by a mere impulse of passion, an idle frantic humor, or 
 unaccountable mode of action, but enquire whether it is an ab- 
 solute dispossession of the free and natural agency of the human 
 mind." 
 
 Again, he remarks, " It must be borne in mind that the moral 
 as well as the intellectual faculties may be disordered by the disease, 
 so as to deprive the mind of its controlling and directing power. " 
 The first clear legal recognition I have noticed of moral insanity. 
 
 In order, continues the judge, " to constitute crime, a man 
 must have memory and intelligence to know that the act that he 
 is about to commit is wrong — to remember and understand that 
 if he commits the act, he will be subject to punishment j and 
 
55C ' MEDICAL JURISPRUDENCE. 
 
 reason and will, to enable him to compare and choose between the 
 supposed advantage or gratification to be obtained by the crimi- 
 nal act, and the immunity from punishment which he will secure 
 by abstaining from it. If, on the other hand, he have not intel- 
 ligence and capacity enough to have a criminal intent and pur- 
 pose ; and if his moral or intellectual powers are either so 
 deficient that he has not sufficient will, conscience, or controlling 
 mental power ; or if, through the overwhelming violence of mental 
 disease, his intellectual power is, for the time, obliterated, he is ' 
 not a responsible moral agent, and is not punishable for criminal 
 acts." 
 
 He further instructed the jury that they were to consider, as 
 aids to a just conclusion, the extraordinary and unaccountable 
 alteration in his whole mode of fife ; the inadequacy between the 
 slightness of the cause and the magnitude of the offence ; the re- 
 cluse and ascetic life which he had led ; his invincible repugnance 
 to all intercourse with his fellow-creatures ; his behavior and con- 
 duct at the time the act was done, and subsequently during his con- 
 finement in prison ; and the stolid indifference which he alone had 
 manifested during the whole progress of the trial, upon the result 
 of which his life .or death was dependent. 
 
 The prisoner was acquitted, and subsequently confined in the 
 Asylum in Utica, where it was stated, , in 1846, that his bodily 
 health was good, but his mind was nearly gone, quite demented. 
 
 Another criminal trial which, taking the wonderful interest it 
 excited, in connexion with the importance of the principles it 
 involved, has perhaps never been equalled in this State, was that 
 of William Freeman, for the murder of John G. Van Nest, tried in 
 Auburn, July 6, 1846. This has been reported in full by Benja- 
 min F. Hall, Esq., of Auburn. The volume will be found to 
 contain an immense amount of valuable information on the sub- 
 ject of mental alienation, and the application of legal principles 
 to an insane condition of mind. The prisoner had been a convict 
 in the State's Prison at Auburn, for the term of five years, for 
 stealing a horse, of which he was probably innocent. On his 
 liberation, he entertained the idea that as he was sent to the 
 State's prison innocently, and had there labored for five years, he 
 
MENTAL ALIENATION. 551 
 
 was entitled to be paid for that labor, and endeavored to com- 
 mence suits against some individuals to obtain his compensation. 
 Failing to obtain anything in this way, he next seems to have sup- 
 posed he must commence killing for that purpose, and accordingly 
 began with the family of Van Nest, residing about four miles from 
 Auburn, where he killed four and badly wounded another. There 
 were many other facts in the case which cannot here be alluded 
 to. On the arraignment of the prisoner, his counsel, the Hon. 
 William H. Seward, tendered, in behalf of the prisoner, a plea of 
 insanity, upon which the district attorney took issue. The court 
 then proceeded to the trial of that issue, which was preliminary, 
 and to have the effect only of determining whether the prisoner 
 was then insane, or sufficiently sane for the trial to proceed. 
 
 The jury of triers having heard much testimony on the subject, 
 finally returned for a verdict, " We find the prisoner sufficiently 
 sane in mind and memory to distinguish between right and wrong." 
 
 To the sufficiency of this verdict, the prisoner's counsel ob- 
 jected, atad asked the court to instruct the jury to find a verdict 
 upon the issue raised by the plea of insanity, that is, whether the 
 prisoner is " sane or insane." The court refused, and the counsel 
 excepted, and this constituted the most important point raised on 
 the bill of exceptions, and which was presented to the Supreme 
 Court. It was, in fact, no other than the finding whether the 
 capacity to distinguish between right and wrong was a finding of 
 sanity ; or, in other words, whether sanity, and the capacity to 
 distinguish between right and wrong, were equivalent terms. 
 On this point, in the case of The People vs. Freeman, before re- 
 ferred to, the court say, that " in the case at bar, the court profes- 
 sed to furnish a single criterion of sanity, that is, a capacity to 
 distinguish between right and wrong. This, as a test of insanity, is 
 by no means invariably correct ; for while a person has a very just 
 perception of the moral qualities of both actions, he may, at the 
 same time, as to some one in particular, be absolutely insane, and 
 consequently as to this be incapable of judging accurately be- 
 tween right and wrong. If the delusion extends to the alleged 
 crime, on the contemplated trial, the party manifestly is not in a 
 tit condition to make his defence, however sound his mind may 
 
552 MEDICAL JURISPRUDENCE. 
 
 in other respects be." This may certainly be regarded as set- 
 tling the question in this State, that the power of distinguishing 
 between right and wrong, in the abstact, and insanity, are not 
 convertible terms. 
 
 On his trial, under the arraignment, the prisoner's counsel re- 
 lied much on the law as laid down by Judge Edmonds in the 
 case of Kleim. The Attorney-General, Hon. John Van Buren, 
 insisted, that to render a man irresponsible the law required an 
 incapacity to distinguish between right and wrong in regard to the 
 particular act committed, or an inability from disease to resist the 
 commission of the act. A rigid construction of this rule would ex- 
 clude those acts which resulted from delusion. 
 
 Judge Whiting, in his charge to the jury, instructed them to- 
 consider that sanity consists in having a knowledge of right and 
 wrong, as to the particular act charged to have been done by an 
 individual, and in possessing memory, intelligence, reason, and 
 will. The judge further laid down the law to be, " That if the 
 jury find that he was unaware, from insanity, of the nature of 
 the act he committed, the prisoner should be acquitted. If dis- 
 ease was the acting power within him, which he could not resist, 
 he should be acquitted. If he had not sufficient use of his reason, 
 from insanity, to control the passions which prompted the mur- 
 der, he is not responsible. If the jury are satisfied that there was 
 a dispossession, by disease, of the free and natural agency of 
 Ms mind, he is not responsible." 
 
 The judge also instructed the jury to inquire whether the 
 prisoner was laboring under a delusion, and submitted to them 
 whether his acts were the effects of delusion, or of an unsound 
 and erroneous judgment as to his rights, and the way of redres- 
 sing his supposed wrongs. 
 
 The jury found a verdict of guilty, and sentence of death was 
 passed upon him, to be executed on the 18th day of December 
 then next. A writ of error was allowed upon the bill of excep- 
 tions taken, and on review before the Supreme Court, a new 
 trial was granted upon the points raised in reference to the pre- 
 liminary trial or proceeding, the principal one of which I havt' 
 already alluded to. 
 
MENTAL ALIENATION. 553 
 
 While these proceedings were pending, the prisoner was sink- < 
 ing into a lower state of bodily health and mental imbecility, 
 until finally he died in his cell, on the 21st August, 1847. A 
 post-mortem examination was made of his brain, in the presence 
 of a number of highly respectable physicians, the result of which 
 was that the brain was found extensively diseased, and of a 
 character showing very satisfactorily that the disease, in its in- 
 cipient stages, must date back to a period anterior to the sup- 
 posed criminal act for which he was tried and convicted. 
 
 It will be seen, from a careful review of the whole matter, that 
 the legal principles hitherto laid down as applicable to the crimi- 
 nal responsibility of the alleged insane, are either too deficient, or 
 of too vague and indefinite a character, justifying the remark of 
 Judge Edmonds, in the case of Kleim, that " the law, in its slow 
 and cautious progress, still lags far behind the advance of true 
 knowledge." 
 
 One difficulty seems to be the attempt to apply the same prin- 
 ciple to different conditions of deranged mind. Of these, there 
 are at least four different conditions. 
 
 1 . The first of these is where there is a clear mental deficiency ; 
 where the very notion of crimes, laws, and punishments is either 
 confused and imperfect, or not entertained at all ; and where the 
 test of ability to distinguish right from wrong, if it should be ap- 
 plied anywhere, has an application. 
 
 2. The second is where delusion lies at the sources of thought, 
 and where the act itself is directly traceable to it. 
 
 3. The third is where the act results from insane impulse, and 
 is irresistible ; and, as in the first, there is a want of intellect, so 
 
 ' here there is a lack of will. 
 
 4. The fourth is where decided symptoms of derangement 
 have been manifested, but the immediate act is prompted by the 
 receipt of a real injury, as in the case of Lord Ferrers. See 
 Ray's Med. Juris, of Insanity, § 128. 
 
 The three first mentioned have, on different occasions, although 
 not uniformly, been recognized by the law. The last has not yet 
 Deen recogttized. 
 
 Insanity may exonerate from punishment, if it occur after the 
 
854 MEDICAL JURISPRU1/ENCE. 
 
 crime is committed. The law will not permit a man while in aii 
 insane state, whenever it occured, either to be tried, or have judg- 
 ment passed upon him, or to have that judgment executed. 
 
 Legal Consequences or Idiocy, Imbecility, and Dementia- 
 comprising ALL CASES OF DEFECTIVE DEVELOPMENT OR, POWER OF 
 
 Mind. 
 
 The legal consequences attaching to this condition of mind has 
 reference both to criminal and civil responsibility. So far as 
 respects the first, the law always primarily regards the intent to 
 injure, and hence requires that to be first made out to the satis- 
 faction of the court or jury. It also regards the intent to com- 
 mit the kind of injury legitimately deducible from the act. 
 
 What then are the elements of the intent to injure ? They may 
 be summed up in, 
 
 1 . A perception by the intellect, and an appreciation by the 
 moral powers, of the relations in which rational human beings 
 stand towards each other : 
 
 2. Sufficient power of propensity to furnish the impulses 
 necessary to invade the rights of others : 
 
 3. Sufficient intellectual power to perceive the relevancy of 
 means to ends, and the ruinous results to others to which those 
 impulses, if followed, would naturally or necessarily lead ; and 
 
 4. Sufficient strength of moral power, or of the faculty of con- 
 scientiousness, to feel the deviation from right, and to know that 
 the act contemplated is a wrong, and not simply an injury. 
 
 A radical, fatal defect in either one of these should render the 
 being irresponsible. The questions then in any given case to be 
 asked and answered are, 
 
 1 . Are the relations of human beings perceived 1 
 
 2. Are the impulses sufficiently strong that lead to the act 1 
 3.. Are the nature of the means employed, and end accom- 
 plished, understood 1 
 
 4. Are the moral results felt to be wrong 1 
 
 The cases of Schmidt, Delepine, Prescott, Barclay, and Lecouffp 
 are given by Dr. Eay, to which the reader is referred as instances 
 illustrating this branch of enquiry. It was probably in reference 
 to this condition of mind that the test of power to distinguish 
 
MENTAL ALIENATION 555 
 
 between right and wrong was first adopted, and to this only that 
 it can have a proper application. 
 
 In reference to the civil liabilities of the mentally defective, or 
 the principle that divests them of their property, and absolves 
 them from their contracts, some considerable difficulty has been 
 experienced. The issuing, execution, and return of a commis- 
 sion, has already been briefly adverted to. The difficulty mostly 
 arises out of the individual case presented. One very curious 
 in its details is that of Mr. Edward Davies, which may be found 
 in Guy, 320-21. He was a tea dealer in London, and had 
 grown rich in the business. He was of a timid and yielding dis- 
 position, so that although twenty-seven years of age and carrying 
 on an extensive and lucrative business, he was completely sub- 
 ject to the authority of his mother. He neither carried nor 
 spent money without her permission, and dared not quit the 
 house without her leave. He was easily agitated, anxious and 
 fanciful about his complaints, vain of his literary acquirements, 
 abject and timid, but an able and successful tradesman, and 
 thoroughly competent to conduct his business. He became 
 restive under his mother's restraint, and under the influence of 
 it his bodily health and mental tranquility became impaired. 
 He exhibited cccasional incoherence and excitement and antipa- 
 thy to his mother, which was considered by some as a delusion. 
 Proceedings were instituted against him, and it was remarked 
 that the very persons who were trying to confine him as unfit to 
 take care of his business, were themselves consulting him about 
 the management of that very business. After a brief period of 
 confinement his agitation subsided, his incoherence diminished, 
 and nothing but his antipathy to his mother and certain sus- 
 picions, considered as delusions, remained. A commission was 
 granted, but on its execution he was restored to liberty, and the 
 management of his property. The foregoing, if an instance of 
 incapacity at all, must have resulted from the defective develop- 
 ment of some of the mental powers coupled with a tendency to 
 intellectual mania or the entertainment of delusion. 
 
 The legal principle in relation to contracts applicable to this 
 condition of mind is thus laid down by Kent, 2 Kenfs Com., 452. 
 
556 MEDICAL JURISPRUDENCE. 
 
 " Imbecility of mind is not sufficient to set aside a contract, when 
 there is not an essential privation of the reasoning faculties, or 
 an incapacity of understanding and acting in the ordinary affairs 
 of life. This incapacity is now the test of that unsoundness of 
 mind which will avoid a deed at law. The law cannot under- 
 take to measure the validity of contracts by the greater or less 
 strength of the understanding ; and if the party be compos mentis, 
 the mere weakness of his mental powers does not incapacitate 
 him." 
 
 In the case of Jackson ex dem. Cadwell and others vs. King # 
 King, 4 Cowen, 207, the point in controversy was the validity of 
 a deed executed by a grantor, claimed on the one part to have 
 been incompetent, but whose competency was asserted on the 
 other. Many authorities will be found cited in the case. The 
 court there lay down the doctrine that it must be shown that the 
 grantor was non compos, within the legal acceptation of the term ; 
 that it was not a partial, but an entire loss of the understanding. 
 The ground is taken that the common law draws no discrimina- 
 ting line by which to determine how great must be the imbecility 
 of mind to render a contract void, or how much intellect must 
 remain to uphold it. That mere weakness of understanding is 
 not, of itself, any objection in law to the validity of a contract. 
 That if a man be legally compos mentis, he is the disposer of his 
 own property, and his will stands for a reason for his actions. 
 Substantially the same principles were affirmed in the case of 
 Odell vs. Buck, 21 Wend., 142. 
 
 But although. courts of law refuse to interfere and declare void 
 a contract made by an imbecile, unless the imbecility be of such 
 a character, and prevail to such an extent, as to amount to un- 
 soundness of mind, yet courts of equity and even of law, interfere 
 to vacate contracts, and all other acts entered into by a party 
 laboring under a great degree of weakness or imbecility of mind, 
 on the ground of fraud. 1 Story's Equity Jurisprudence,- 227 '. 
 The difference between courts of law and equity in relation to 
 taking cognizance of matters of fraud is, that the former require 
 the fraud to be proved, while the latter will, under certain cir • 
 cumstances, presume it. Jackson vs. King, 4 Cowen, 207 - 220 
 
MENTAL ALIENATION. 557 
 
 It is, therefore, principally in courts of equity that causes of 
 this character come up for investigation, and whenever a case is 
 presented for equitable interference, the whole matter is thorough- 
 ly sifted, all the circumstances examined, all the presumed in 
 fluences inquired into, the consideration of the contract, the in- 
 ducements held out, the nature of the contract, in fine, every 
 thing that can possibly aid in throwing any light upon the act of 
 the parties, and the knowledge, views and motives under which 
 the transaction has occurred. Whenever, from the nature of the 
 transaction, there is not evidence of entire good faith, or the 
 contract or other act is not seen to be just in itself, or for the 
 benefit of these persons, courts of equity will set it aside, or make 
 it subservient to their just rights and interests. 1 Story's Ejuity 
 Jurisprudence, \ 228. 
 
 The doctrine, in general terms, may be stated to be — that the 
 acts and contracts of persons of weak understandings, and who 
 are thereby liable to imposition, will be held void in courts of 
 equity, if the nature of the act or contract justify the conclusion, 
 that the party has not exercised a deliberate judgment, but that 
 he has been imposed upon, circumvented, or overcome by cun- 
 ning, or artifice, or undue influence. 1 Story's Equity Jurispru- 
 dence, 250, §238 ; Gartside vs. hherwood, 1 Bro. Ch. R., 560-61. 
 
 The great rule of the court as announced by Lord Eldon in the 
 case of Gibson vs. Jeyes, 6 Vesey, 266, page 278, is that " he who 
 bargains in a matter of advantage with a person placing confi- 
 dence in him, is bound to show that a reasonable use has been 
 made of that confidence ; a rule applying to trustees, attorneys, 
 or any one else." The same principle is asserted with approval 
 in the case of Whelan vs. Whelan # Whelan, 3 Coweris Rep., 537, 
 in which on page 572, the court say that " a contract obtained 
 from one party, so much in the power of the other, cannot be 
 sanctioned, if confidence has been abused, if there is inadequacy 
 of price, or the inference is plain, that advantage has been taken 
 of age and imbecility." This may justly be considered as a 
 leading case on this subject, and very important in reference to 
 the doctrine discussed and settled by it. 
 
 Inadequacy of consideration alone is not considered as sufficient 
 
558 MEDICAL JURISPRUDENCE. 
 
 to authorise equity to interfere and presume mental weakness 
 sufficient to vacate contracts entered into between parties other- 
 ways competent, unless it is so very great as to demonstrate some 
 gross imposition, or some undue influence ; or, in other words, 
 unless it is made out to such extent as to shock the conscience, 
 and amount, in itself, to evidence of fraud. In such case it 
 would be deemed sufficient. 1 Story's Equity Jurisprudence, 257, 
 ^245-6; Coles vs. Trecothick, 9 Vesey, 246; Under hill vs. Har- 
 wood, 10 Vesey, 219 ; Gwynne vs. Heaton, 1 Bro. Ch. R., 1. ^ 
 
 The case of Portsmouth vs. Portsmouth, 1 Haggard, 359, involves 
 the consideration of the extent of capacity requisite to enable the 
 party to enter into a valid matrimonial contract. A great num- 
 ber of witnesses were examined, from which it appeared, that 
 the Earl of Portsmouth possessed a capacity equal to the ordinary 
 transactions of life ; that he had a good memory when at school, 
 and made progress in arithmetic and the languages ; that he set- 
 tled accounts with agents, attended public meetings and commit 
 tees, prosecuted an offender, and was examined as a witness. 
 
 On the contrary it appeared that he had always been treated 
 by his family as one of feeble capacity ; that his servants were 
 his play-fellows, upon whom he was in the habit of playing all 
 sorts of tricks ; that he was fond of driving a team, and that one 
 was kept for his amusement, as a toy or plaything for him ; that 
 he had a propensity for bell-ringing, was fond of slaughtering 
 cattle, and indulged in wanton cruelty towards man and beast. 
 That a medical man, taken into the family, obtained complete 
 ascendency over him. That he finally delivered him up to the 
 earl's trustees in London, one of whom, within one week after, 
 married him to his own daughter. And it was the validity of 
 this marriage that was called in question. 
 
 The court, Sir John Nicholl, observed that the capacity for 
 instruction and improvement is possessed even by the brute cre- 
 ation, and, therefore, did not, of itself, disprove the fact of im- 
 becility ; that his testifying in a court of justice required little, 
 if anything, more than memory; that his behavior in company, 
 and his few observations on the state of the weather, horses and 
 forming, were not incompatible with great imbecility of mind 
 
MENTAL ALIENATION. 559 
 
 oecause under the restraint produced by formal company, and 
 by the sense of being observed, the more prominent features of 
 imbecility would be shaded, and the individual might pass as 
 possessing a considerable degree of understanding. He declared 
 the marriage null and void. 
 
 Another case in which the marriage contract was annulled on 
 the ground of imbecility in one of the contracting parties, was 
 that of Miss Bagster, reported in 1 Beck's Med. Juris., 579. She 
 was a lady of fortune and had perpetrated a runaway match with 
 a Mr. Newton. Her friends applied for a dissolution on the 
 ground that she was of unsound mind. The facts stated were 
 that she had been a violent, self-willed, and passionate child ; 
 that this continued as she grew up ; that she was totally ignorant 
 of arithmetic, and therefore incapable of taking care of her pro- 
 perty ; that she had manifested a great fondness for matrimony, 
 having engaged herself to several persons, and that, in many re- 
 spects, she evinced little of the delicacy belonging to her sex. 
 She appeared to have memory, but to lack judgment and reason- 
 ing power. Dr. Gordon did not consider her capacity to exceed 
 that of a child of seven years of age. On her examination before 
 the commissioners her answers were pertinent and in a proper 
 manner. Both Drs. Morrison and Haslam had visited her and 
 did not consider her imbecile or idiotic. The jury, however, 
 brought in their verdict that she was of unsound mind since 
 November 1, 1830, and the marriage was consequently dissolved. 
 
 Questions involving the testamentary capacity, or legal com- 
 petency to make a last will and testament, are those which, per- 
 haps, the most frequently arise for investigation in courts of 
 justice. The execution of a will is not unfrequently one of the 
 last acts of life, and its provisions are seldom of a character to 
 meet the views of all the expectants. Hence the disposition, so 
 frequently manifested, of calling in question the legal capacity 
 of the testator. 
 
 A will is the legal declaration of a man's intentions of what he 
 wills to be performed after his death. Nuncupative or unwritten 
 wills, both in this state and in England, are of no validity unless 
 made by a soldier, while in actual military service, or by a mari 
 
560 MEDICAL JURISPRUDENCE. 
 
 ner while at sea. In all other cases wills are required to be in 
 writing. 
 
 No particular form of words is necessary to constitute it. The 
 construction given to it, is that which carries out, the most effect- 
 ually, the intentions of the testator, which are to be gathered 
 from the whole instrument taken altogether. 
 
 In this state, the will is executed by the testator's signing it at 
 the end of it in the presence of two witnesses, declaring it to be 
 his last will and testament, asking them to sign it as attesting 
 witnesses, and they, at his request, signing their names as such 
 witnesses, and also stating their respective places of residence. 
 Many points relative to what constitutes a legal mode of exe- 
 cuting a last will and testament will be found discussed and de- 
 cided in the case of Remsen and another vs. Brinkerhqff and others, 
 26 Wend. Rep., 325. 
 
 A valid will cannot be executed by an infant, an idiot, or a 
 person of insane memory. The diseases which are the most 
 likely to invalidate a will, or to throw a doubt over the testa- 
 mentary capacity of the testator, are all lethargic and comatose 
 affections, whether arising from an internal cause, or an external 
 injury. The effect of these is to suspend the intellectual facul- 
 ties. Apoplexy also produces the same effect, and in case of 
 recovery the patient is often left in a state of imbecility. Phren- 
 itis, delirium tremens, and those inflammations which are accom- 
 panied with delirium, also impair the mind. 1 Beck's Med. Juris., 
 637. 
 
 It is often a point of extreme difficulty to decide where an in- 
 dividual's disposing capacity really terminates. Apoplexy, hemi- 
 plegia, phrenitis, delirium tremens, and all other diseases affect- 
 ing primarily the brain or organs of mind, are, in their nature, 
 disqualifying only so far as they actually impair or destroy the 
 power of manifesting the mental faculties. The fact of their ex- 
 istence, therefore, either previously or at the time a will is exe- 
 cuted, should have no other effect than to induce a suspicion of 
 incapacity, and thus lead to a more strict investigation of the 
 real situation of the party. 
 
 There is another class of diseases not primarily affecting the 
 
MEKTAI. ALIENATION. 5(jl 
 
 Drain, but expending themselves upon other organs, such, for 
 instance, as the pulmonary consumption, which furnish but 
 slight, if any, presumption that the mental powers suffer any 
 degree of diminution. In fact the very reverse frequently occurs, 
 these powers appearing brighter, more active, more energetic, as 
 the sources of life in the organism are wasting away ; as if while 
 the one was returning to its kindred dust, the other was awaking 
 to a higher life. 
 
 Many cases have occurred in which great difficulties were pre- 
 sented. In Bennett's case, cited in 9 Vesey, 186, Shelford on Ln 
 nacy, 179, Lord Chief Justice Eyre stated to the jury that the 
 point was, whether the testator knew perfectly what he was doing, 
 at the time the will was executed. 
 
 In Ingram vs. Wyatt, 1 Haggard's Ecclesiastical Reports, 88-1, 
 the court, Sir John JVicholl, remark that mental imbecility seems 
 to proceed from want of quickness, activity and motion in the 
 intellectual faculties ; that sometimes different faculties are found 
 failing in different persons ; that the memory is sometimes per- 
 fect where higher powers of the understanding are greatly de- 
 fective ; that in an individual of imbecile mind the understand- 
 ing has made little progress with years ; that it has not matured 
 and ripened in the usual manner ; that in such a case, unless the 
 imbecility be extreme, by help of memory, imitation, habit, some 
 improvement may take place, some progress in knowledge made. 
 so that ideas may be acquired, facts, circumstances, places, and 
 hacknied quotations recollected, and the individual will even 
 conduct himself orderly and mannerly, make a few rational re- 
 marks on familiar and trite subjects, retain self-dominion, spend 
 his own little income in providing for his wants, as a boy spends 
 his pocket money, and yet may labor under great infirmity of 
 mind, and be very liable to fraud and imposition. 
 
 Sir John Nicholl appears to have well understood the leading 
 characteristics of the imbecile mind. The principal marks and 
 features of imbecility, he remarks in the same case, are the same 
 which belong to childhood, varying in degree in different indi- 
 viduals. That these are frivolous pursuits; fondness for, and 
 stress upon, trifles ; inertness of mind , paucity of ideas ; shy 
 
 36 
 
•I MEDICAL JURISI'RULENCE. 
 
 ness ; timidity ; submission to control ; acquiescence under in- 
 fluence, and the like. Hence these infantile qualities have ac- 
 quired for this species of deficiency of understanding, the name 
 of childishness. The effect is, that where imbecility exists at all, 
 and in proportion to its degree, it becomes necessary, especially 
 in a case exposed to other adverse presumptions, to ascertain its 
 extent with some accuracy, to see how tar the individual was 
 liable to be controlled by influence, to submit to ascendency, to 
 acquiesce from inertness and confidence in those acts, upon the 
 validity of which the court has to decide. 
 
 In a case in 8 Massachusetts Rep., 372, the court instructed 
 the jury, " that if they should think that the testatrix, at the 
 time of dictating the will, had sufficient discretion for, that pur- 
 pose ; and that, at the time of executing the will, she was able 
 to recollect the particulars she had so dictated, they might ;find 
 her of sound disposing mind and memory at the time of exe- 
 cuting." 
 
 Swinburne says, " if a man be of a mean understanding, neither 
 of the wise sort, nor of the foolish, but indifferent, as it were, 
 betwixt a man and a fool ; yea, though he rather incline to the 
 foolish sort, so that, for his dull capacity, he might worthily be 
 called grossum caput, a dull pate or a dunce ; such an one is not 
 prohibited to make a testament," and again, " it is said that old 
 age is of itself no incapacity, unless it produce mere childishness, 
 or idiocy, as where the testator forgets his own name." 
 
 In Van Alst. vs. Hunter, 5 John. Chan. Rep., 148, the validity 
 of a will made by a person between ninety and one hundred years 
 of age was contested. The chancellor there says, " it is well un- 
 derstood that age alone will not disqualify a person from making 
 a will, provided he has a competent possession of his mental 
 faculties. The law looks only to the competency of the under- 
 standing ; and neither age, nor sickness, nor extreme distress, or 
 debility of body will affect the capacity to make a will, if suffi- 
 cient intelligence remain. The failure of memory is not sufficient 
 to create the incapacity, unless it be quite total, or extend to his 
 immediate family and property. The Roman law seemed to 
 apply the incapacity only to an extreme failure of memory,- as 
 
MENTAL ALIENATION. 563 
 
 for a man to forget his own name. The want of recollection of 
 names, the chancellor observes, is one of the earliest symptoms 
 of a decay of the memory, but this failure may exist to a very 
 great degree, and yet the solid power of understanding remain. 
 
 The case of Clarke vs. Fisher, 1 Paige, 171, is important as in- 
 volving the question of weakness of mind, and also the practice 
 of fraud and imposition. That was the case of a will made by 
 an old man of about eighty years of age, who, for about four 
 years previous to his death, had been paralytic and mostly con- 
 fined to his bed, his speech being much impaired. About three 
 years before his death, he was married to a sister of his first wife, 
 in whose favor, shortly before his death, he made the will in 
 question ; at first giving all his property to his wife, but sub- 
 sequently, in the same will, giving one-fourth after the death of 
 his wife to a supposed daughter of his deceased brother, Law- 
 rence Fisher, who, it was shown, was imposed upon him as his 
 niece, and the other three-fourths to the heirs of Eleanor Clark, 
 Maria Clark, Ann Smith, and Isaac Rapelye. The Chancellor set 
 aside the will, and remarks that " the general principles of law in 
 relation to the capacity of a person to make a will, are well under- 
 stood. He must be of sound and disposing mind and memory, 
 so as to be capable of making a testamentary disposition of his 
 property with sense and judgment, in reference to the situation 
 and amount of such property, and to the relative claims of the 
 different persons who are, or might be, the objects of his bounty." 
 The validity of the same will was also the point in controversy 
 in the case of Clarke et al. vs. Sawyer et al, which was sustained 
 by the Assistant Vice-Chancellor of the first circuit, see 3 Sandf. 
 Rep., 351, but on appeal, was reversed by the Chancellor, from 
 which an appeal was taken to the court of appeals. The same 
 cause there will be found reported in 2 Comstoclc's Reports, 498. 
 in which the decree of the Chancellor is affirmed, and on the 
 same ground, viz., that it was obtained through undue influence. 
 At the same time, the doctrine contained in the cases of Stewart's 
 Executors vs. Lispenard, 26 Wend., 255, and Blanchard vs. JYestle, 
 3 DeniojWl, hereafter mentioned, was referred to and adopted. 
 
 The provisions of the will itself are regarded, as furnishing n* 
 
564 MEDICAL JURISPRUDENCE. 
 
 small amount of evidence in relation to testamentary capacity. 
 Swinburne says, " If a lunatic person, or one that is beside him- 
 self at sometimes, but not continually, make his testament, and it 
 is not known whether the same were made while he was of sound 
 mind and memory or no, then in case the testament be so conceiv- 
 ed, as thereby no argument of phrenzy or folly can be gathered, it is 
 to be presumed that the same was made during the time of his 
 calm and clear intermissions, and so the testament shall be ad- 
 judged good ; yea, although it cannot be proved that the testator 
 useth to have any clear and quiet intermissions at all, yet, never- 
 theless, I suppose that if the testament be wisely and orderly 
 framed, the same ought to be accepted for a lawful testament." 
 This reasoning has always exerted a very strong influence in all 
 adjudications relative to the testamentary capacity — a "rational 
 act, rationally done," presuming its source to be rational. 
 
 Along with the nature of the act, should also be considered its 
 attendant circumstances, such as the situation of the testator at 
 the time ; who were his associates ; by whom he was surrounded ; 
 to what influences he was subject ; whose interests he has 
 favored ; and what have been the relations existing between 
 him and those so favored. 
 
 We have already seen that a will will not be set aside on the 
 ground of imbecility in the testator, if the party knew perfectly 
 what he was doing when it was made. The best evidence of this, 
 is instructions in reference to the provisions of the will, coming 
 from the testator himself. If these cannot be proved, the defect 
 may possibly be remedied by showing that something passed at 
 the execution tantamount to instructions; or, if that be incapable 
 of proof, then to show subsequent recognitions of its provisions 
 of a clear and decided character. The suggestion made by Mr. 
 Taylor in reference to this is worthy of attention, viz., that if a 
 medical practitioner is present at the time the will is executed, 
 he can easily satisfy himself of the state of mind of the testator, 
 by requiring him to repeat from memory the way in which he 
 has disposed of his property. If, upon such request, he repeat 
 the leading provisions of the will correctly, he may be presumed 
 to have understood himself while making, or directing the provi 
 
MENTAL ALIENATION. 5C5 
 
 sions to be made. Taylor's Med. Juris., 512. In case no suspi- 
 cion of fraud exists, a will consistent with previous affection and 
 declarations, and supported by recognition and circumstances 
 showing volition and capacity, is valid, though made in extremis, 
 or at the very termination of life, and though the instructions 
 were conveyed through the party benefited. 1 Hagg. Eccl. Rep., 
 227. 
 
 So, also, it has been held that the clearest and most consistent 
 evidence of capacity and volition is required to support a codicil 
 conveying bequests of such extent as to be irreconcilable with 
 the character of the deceased, and with her intentions, as proved 
 by her affections and former testamentary dispositions ; and where 
 the deceased, at the time of its execution, was in a state of ex- 
 treme weakness and debility, all her confidential friends being 
 excluded or absent, and those only about her who were benefited 
 under, or engaged in, the preparation or execution of the instru- 
 ment. 1 Hagg. Eccl. Rep., 256. 
 
 A case was tried *n Northampton, Massachusetts, in 1848, in 
 which the only question was the capacity of one of the attesting 
 witnesses to a will. It was the case of Oliver SmitKs Will, re- 
 ported in 4 Vol. American Journal of Insanity, 226. The heirs at 
 Jaw claimed that Theophilus P. Phelps, one of the attesting wit- 
 nesses, was in a state of mental alienation at the time of its attes- 
 tation, and, therefore, that there had not been a compliance with 
 the provisions of the statute. The sufficiency of the defence, 
 admitting it to be established, was fully conceded, but the point 
 at issue was whether it was made out. The jury sustained the 
 will, finding the attesting witness competent. 
 
 The law admits a testamentary capacity, where there exists 
 a degree of mental imbecility that would incapacitate for the 
 transaction of ordinary business. In 3 Wash. C. C. R., 587, 
 Judge Washington says, "The capacity may be perfect to dispose 
 of property by will, yet very inadequate for the management of 
 other business ; as, for instance, to make contracts for the pur- 
 chase and sale of property." " It is sufficient, if the testator has 
 such a mind and memory a? enable him to understand the ele- 
 
566 MEDICAL JURISPRUDENCE. 
 
 rnents of which a will is composed, the disposition of his property 
 in its simplest form." 
 
 The question as to what constitutes a legal capacity to make a 
 will, was the most extensively discussed and clearly settled in the 
 great case of Stewart's Executor vs. Lispenard and Others, decided 
 in the Court of Errors of this State, and reported in 26 Wendell, 
 255. The point in controversy in this suit was the validity of 
 the will of Mice Lispenard. The ground upon which it was 
 claimed to be invalid was, that during her whole life, she labored 
 under such a degree of imbecility of mind as to incapacitate her 
 from making a valid will. The surrogate decided against its 
 validity, refusing to admit it to probate. On appeal to the circuit 
 judge of the first circuit, the surrogate's decree was affirmed. 
 The Chancellor on appeal affirmed the same decree ; and from 
 the decree of the Chancellor an appeal was taken to the Court of 
 Errors. The references to authorities, discussions and decisions 
 in this case are all deeply interesting, and it is probably a case 
 that best settles the lowest amount of capacity necessary to the 
 making of a last will and testament. The facts were very numer- 
 ous, and may be found on reference to the case, and also an 
 abridged statement of them in Guy's Principles of Forensic Medi- 
 cine, 291, et seq. 
 
 The doctrines essentially established in this case may be laid 
 down to be the following : 
 
 1. The right of testamentary disposition of property is a 
 natural right, and not a mere institution of positive law. It is 
 subject to the restrictions and regulations of civil legislation, but 
 is not its mere creature. 
 
 2. That a man's capacity may be perfect to dispose of his pro- 
 perty by will, yet inadequate for the management of other busi- 
 ness ; as, for instance, to make contracts for the purchase and 
 sale of property. 
 
 3. That affirmative facts prove the existence of mind ; and, 
 when that is once shown, the negative go to show only its defects 
 and weakness, not its entire deprivation. That a wise man does 
 not always show reason, a fool never. 
 
 4. That imbecility of mind in a testator will not avoid his last 
 
MENTAL ALIENATION. 5C7 
 
 will and testament. That idiots, lunatics, and persons non com- 
 pos mentis, are disabled from disposing of their property by will ; 
 but that every person not embraced within either of these 
 classes, and not laboring under any particular disability, as in- 
 fancy, &c, is competent to make a will, be his understanding 
 ever so weak. That in passing upon the validity of a will, 
 courts do not measure the extent of the understanding of the 
 testator, and that if he be not totally deprived of reason, whether 
 he be wise or unwise, he is the lawful disposer of his property, 
 and his will stands as a reason for his actions. 
 
 5. That the principle upon which the incapacity to make con- 
 tracts and transact ordinary business mainly rests is, that those 
 acts are held to be void, not on account of the general and posi- 
 tive disability of the party to perform all similar acts, but because 
 the whole transaction, with its accompanying circumstances, in- 
 cluding, of course, the fact of mental imbecility, evinced that his 
 consent was wanting to the particular act the subject of adjudica 
 tion. 
 
 6. In the case of the will of a person of imbecile mind, a want 
 of consent by the testator to a particular will may be urged from 
 Ids inability to comprehend its effects and nature ; from the dis- 
 positions of the property being contrary to what naturally might 
 have been expected from the relative situation of the parties ; 
 the preferences, partialities, and former testamentary declarations 
 of the testator ; the absence, at the makirjg of the will, of those 
 to whom he commonly looked for advice ; and generally from the 
 surrounding circumstances, into which the court called upon to 
 pass upon the validity of the will will look with vigilance. And 
 so, on the contrary, evidence of the general knowledge and under- 
 standing of the testator that he is the owner of property, and has 
 the power of disposing of it by will ; of his previous declarations 
 and intent as to its disposition ; of his gratitude and attachment 
 to the donee for long and persevering care and kindness ; and 
 the will itself being in a simple form, intelligible to the plainest 
 mind, will be sufficient to justify the court to pronounce it a 
 genuine and valid instrument. 
 
 Substantially the same doctrine, in regard to the mental capa- 
 
568 MEDICAL JURISPRUDENCE. 
 
 city sufficient to make a will, has since come under the review 
 of the, Supreme court in the case of Blanchard vs. Nestle, 3 Denio, 
 37^ and was adopted and applied by the court in that case. 
 
 Legal Consequences of Mania : 
 
 The principle upon which exemption from legal liability here 
 rests, is entirely diiferent from that we have just 'been consider- 
 ing. There may be here no lack of intelligence ; no want of in- 
 tellectual power to comprehend the law to which obedience is 
 required. The difficulty consists not in the inability to under- 
 stand, but to obey. It toes, not in a deficient intellect, but in an 
 erroneously directed or perverted will. 
 
 Legal Consequences of Intellectual Mania : 
 
 When a maniac commits a trespass upon the person or proper- 
 ty of others, the law renders him amenable in damages to be re- 
 covered in a civil action. Weaver vs. Ward, Hobarfs Rep., 134. 
 
 The same question has recently arisen in this State, in the case 
 of Krorn, vs. Schoonmaker, 3 Barbour's Supreme Court Reports, 
 C47. It is there decided by Harris, Justice, that a lunatic can- 
 not be punished for a crime, but he may be prosecuted for an in- 
 jury done to another ; that he is not a free agent, capable of in- 
 telligent, voluntary action, and therefore is incapable of a guilty 
 intent, which is the very essence of crime ; but that a civil ac- 
 tion, to recover damages for an injury, may be maintained against 
 him, because the intent with which the act was done is not ma- 
 terial. 
 
 The principle upon which this distinction rests, reaches to the 
 measure of damages in a civil action. Where the intent to injure 
 is established, the jury may take that into consideration, and 
 give severe exemplary damages . But a maniac has, in strictness, 
 no will, and hence the only damages that can be properly claim- 
 ed against him, is the mere compensation of the parly injured. 
 
 The legal consequences of general intellectual mania, are easily 
 ascertained and settled. The prevalence of mania, or deranged 
 and perverted action of the intellectual faculties generally, must 
 necessarily be productive of those insane delusions or hallucina- 
 tions, that entirely unfit the individual from basing his conduct 
 upon the ordinary principles of human action. The distorted 
 
MENTAL ALIENATION. 5(j9 
 
 \ if w which the intellect then takes of things ; the intermingling 
 and confounding together of relations ; and the assumption of, 
 and action upon, fancies for facts, all have the effect to disqualify 
 the individual from enforcing his rights, or performing his du- 
 ties, as a citizen or a subject. The commonly received principles 
 of human action affect not him. He is a being by himself, act- 
 ing upon assumptions having no existence except in his own 
 mind, and in accordance with principles unacknowledged by his 
 race. The law, therefore, wisely takes him from his own guid- 
 ance, and while it divests him of his rights, releases him also 
 from his duties. It allows him the use, but not the abuse, of his 
 property ; and holds him irresponsible for any aggression upon 
 life, because he is wanting in those elements of accountability 
 which must be possessed in order to constitute crime. The legal 
 mode of determining incapacity by issuing, executing, and re- 
 turning a commission, has already been considered. 
 
 The cases of difficulty that have presented themselves are 
 those of partial intellectual mania, in which the derangement 
 exists on one or a few topics, leaving the operations of intellect 
 sane upon every other. We apprehend the true principle to be, 
 that whether partial intellectual mania does, or does not, invali- 
 date an act, must depend upon the connection of the act with 
 the peculiar derangement ; that where the act proceeds from, or 
 is intimately connected with, the insane delusion, the actor is ir- 
 responsible, because in respect to such an act, he has ceased be- 
 ing a five moral agent. 
 
 Court; of justice have shown a reluctance to the admission of 
 this principle. It presented itself in the case of Greenwood, 
 Ray's Mtiical Jurisprudence of Insanity, 238 ; White vs. Wilson, 
 13 Vesyh Rep., 88. He was a maniac of intelligence, having 
 been bred to the bar. In the delirium of a fever, he received a 
 draught n om the hand of his brother, and immediately enter- 
 tained the delusion that his brother had given him a potion with 
 a view to destroy him. He recovered from the fever, but never 
 from the delusion. That morbid idea ever afterwards haunted 
 him, and in the will which he subsequently made, he disinherit- 
 ed his brother. The question arose upon the validity of the will. 
 
570 MEDICAL JURISPRUDENCE. 
 
 A verdict had been obtained in the Court of Common Pleas 
 against the will, but the judge strongly advised the jury to find 
 the other way, and they did accordingly find in favor of the will. 
 Subsequently, further proceedings took place, which finally re- 
 sulted in a compromise. 
 
 The same kind of question arose in the case of Johnson vs. 
 Moore's heirs, 1 Little's Rep., 371, in Kentucky. The point in 
 question was the validity of the will of George Moore, which 
 was made by him in 1822, and shortly before his death. About 
 four years previously, he had a dangerous fever, during which 
 he imbibed a strong antipathy against his brothers, imagining 
 they intended to destroy or injure him, which was entirely with- 
 out foundation. This antipathy continued ever afterwards, with 
 the exception that at one time he made a will in their favor, but 
 afterwards cancelled it. The will he left executed, gave all his 
 property to others, he declaring to one of the witnesses that they 
 had endeavored to get his estate before Ms death. 
 
 The court set aside the will, remarking that the testator could 
 not be accounted a free agent, in making his will, so far as his 
 relatives were concerned, although free as to the rest of the 
 world. 
 
 In the case of Dew vs. Clark, 3 Ma'ams' Reports, 79, the ques- 
 tion of partial intellectual mania, or its effect upon the' mind of a 
 testator, was extensively discussed. The testator, a man of in- 
 telligence, a surgeon and medical electrician, left a personal es- 
 tate of nearly ,£40,000, bequeathing to the complainant, a daugh- 
 ter and only child, a life-interest in a small portion of it, bestow- 
 ing the most of it upon his nephews. He had managed his pe- 
 cuniary affairs, and conducted his business, in a rational and suc- 
 cessful manner, but was shown by the daughter, from an early 
 period of her life, to have manifested towards her an insane 
 aversion. The particulars given, leave no room for doubt but 
 that he was laboring under a complete delusion in regard to her 
 character. The court, Sir John Nicholl, considering it fully 
 proved that the will was the direct, unqualified offspring of the 
 morbid delusion concerning the daughter, pronounced it to be 
 null and void in law. 
 
MENTAL ALIENATION. 571 
 
 In 2 FWiier en Obligations, Appendix, 24, is laid down, as we 
 suppose, the true doctrine, by Mr. Evans, the translator: "I 
 cannot but think," says he, " that a mental disorder operating 
 on partial subjects, should, with regard to those subjects, be at- 
 tended with the same effects as a total deprivation of reason ; 
 and that, on the other hand, such a partial disorder, operating 
 only on particular subjects, should not, in its legal effects, have 
 an influence more extensive than the subjects to which it applies, 
 and that every question should be reduced to the point, whether 
 the act under consideration proceeded from a mind fully capable, 
 in respect to that act, of exercising free, sound, and discriminat- 
 ing judgment; but in case the infirmity is established to exist, 
 the tendency of it to direct or fetter the operations of the mind, 
 should be in general regarded as sufficient presumptive evidence, 
 without requiring a direct and positive proof of its actual ope- 
 ration." 
 
 In accordance with these views, the rule or principle to be 
 followed in reference to any act, is — 
 
 1. To establish the delusion, which must be entertained as 
 true, and must be false in fact : 
 
 2. To trace the act in question directly to the delusion, either 
 as being actually produced by it, or so intimately connected with 
 it as to lead to the presumption that it never would have occur- 
 red had not the delusion existed. 
 
 It has been made a question by many, whether the rule should 
 be so restricted ; whether the necessity should exist, of connect- 
 ing the act with the delusion, in order to render it invalid. 
 
 Lord Erskine, in his speech in the case of Hadfield, before re- 
 ferred to, states that when delusion is entertained, it can be set 
 up in avoidance of a civil act, although entirely unconnected 
 with it. So also it has been urged, and with a considerable de- 
 gree of force, that a mind insane upon any subject or topic, is 
 unsound ; that it becomes utterly impossible to know how ex- 
 tensive is the circle embraced within the insane action ; that in 
 many cases, the delusion itself is constantly changing, and hence 
 its character must be undefined, and its influence unascertain- 
 able ; that our knowledge of the insane mind is at best extreme- 
 
572 MEDICAL JURISPRUDENCE. 
 
 ly imperfect, and hence where the sources of thought are delu. 
 sive, our judgment in relation to the sanity of any act may well 
 be doubted. Our experience certainly justifies the conclusion, 
 that a partial insanity, consisting in derangement on one subject 
 or topic, is likely to lead to a more general form of mania ; the 
 circle of insane influence continuing constantly to enlarge, until 
 it comes to embrace the entire mental action. When we consid- 
 er, in addition to all this, that the laws of association are per- 
 verted or annulled through the insane influence; that all the 
 operations of mind, in the least degree tainted with delusion, are 
 withdrawn from the empire of cause and effect, and beyond the 
 limits of all rational estimate or calculation, it is certainly a rea- 
 sonable doctrine that every act of such a mind, whether trace- 
 able to the delusion or not, should be regarded with doubt and 
 suspicion. It may, however, well be doubted, whether in view 
 of our present state of knowledge of the insane mind, a sounder 
 rule can be adopted than the one already mentioned. 
 
 The effect of partial intellectual mania upon the contract of 
 marriage, has been made a question. This kind of contract dif- 
 fers from others, in being vague and undefinable ; in giving rise 
 to rights, duties, and obligations, which can be but little known 
 or appreciated until the occasions occur, out of which they arise. 
 Many harmless delusions may undoubtedly be entertained which 
 might not tend to render the individual less able or competent to 
 perform the duties demanded by the marriage state. Any delu- 
 sion connected directly with the idea of marriage, would proba- 
 bly invalidate the contract. So also would delusions of such a 
 nature or character as to give rise to a course of conduct incon- 
 sistent with the duties and obligations growing out of that rela- 
 tion. 
 
 An anonymous case in 4 Pickering's Rep., 32, consisted in an 
 application for a divorce on the ground of insanity in the wife, 
 at the time of marriage. The proof was, that she was subject to 
 dejection of mind and singularities of conduct. The court said 
 they felt bound to require such evidence of insanity, as in a civil 
 action would justify the jury in finding a party incapable of 
 making a contract, and that the fact of a party's being alle to 
 
MENTAL ALIENATION. 573 
 
 go through the marriage ceremony with propriety, was prima 
 facie evidence of sufficient understanding to make the contract. 
 
 In the case of Browning vs. Reid, 2 Phillimore's Rep., 69, Six 
 John Nicholl lays down the doctrine directly the reverse of this, 
 stating that " going through the ceremony was not sufficient to 
 establish the capacity of the party ; and that foolish, crazy per- 
 sons might be instructed to go through the formality of the cere- 
 mony, though wholly incapable of understanding the marriage 
 contract." 
 
 In a similar case, Lord Stowell (then Sir William Scott,) re- 
 marked, that much stress was not to be laid on the circumstance 
 that the party had manifested perfect propriety of behavior du- 
 ring the ceremony, as persons in that state will nevertheless often 
 pursue a favorite purpose, with the composure and regularity of 
 apparently sound minds. * 
 
 The partially insane should clearly be divested of no right 
 which he can exercise with safety to himself, or those around 
 him. It is not every kind of delusion or hallucination that can 
 justify the law in taking from a man his property, and placing 
 him under the care and custody of a committee. It should be 
 one which, if acted upon, would be likely to prove injurious to 
 himself or others ; or destructive to his property. It must, how- 
 ever, be admitted as true, that no man laboring under any delu- 
 sion, can be considered perfectly safe. It is impossible to pre- 
 dict the course it may take, or the changes to which it may be 
 subject. In all cases, therefore, the individual should be watch- 
 ed, however slight or trivial may be the delusion under which 
 he labors. 
 
 Where the testamentary dispositions are such as indicate that 
 they are founded on motives that might be supposed to govern 
 a sane mind, and no insanity is apparent in them, they ought not 
 to be disturbed, although the mind may be laboring under some 
 degree of derangement. 
 
 The effect of delusion upon criminal responsibility lias already 
 been considered. Hoffbauer has made an ingenious suggestion 
 in relation to the measure of this responsibility. He proposes 
 that the delusive idea shall be considered as true, and that the 
 
&74 MEDICAL JURISPRUDENCE. 
 
 individual shall be regarded and judged, as if he were really 
 placed in the circumstances in which he imagines himself to be. 
 Thus, if he is deluded with the idea that he is commanded by 
 the Supreme Being to destroy the life of a human being, and de- 
 stroys it in obedience to that command, he must be justified, be- 
 cause had he really been so commanded, it would have been his 
 duty to have done so. On the other hand, if, on the receipt of 
 a trivial injury, the individual, under the influence of a delusion 
 originating from, or connected with, the injury, destroys life, he 
 should be held responsible, because the injury, if truly received, 
 would not justify the act. 
 
 It is obvious that such a principle can never be acted upon 
 in criminal jurisprudence without being guilty of monstrous in- 
 justice to the insane. A man really deranged, who, under the 
 influence of delusion, destroys life upon the receipt of a small 
 injury, is no more the master of himself in that act, than if he 
 had done it under a supposed command of the Almighty. The 
 error of those who adopt the reasoning of Hoffbauer, consists in 
 applying to the action of the insane mind, the same tests, and the 
 same rules of judgment, which are applicable to the sane. Those 
 in the slightest degree acquainted with the action of the insane 
 mind, well know, that the practical effect of such a rule would 
 be, in almost every case, to withdraw from the maniac that pro- 
 tection which the law, for wise reasons, has thrown around him. 
 
 Legal Consequences of Moral Mania : 
 
 Irresponsibility in moral mania rests on a different principle 
 from that of intellectual. There is here no delusion, no false 
 assumption of fancies for facts. The intellectual faculties may 
 remain undisturbed in their operations, while the moral are ex- 
 hibiting every variety of derangement. This, it is true, seldom 
 occurs ; as extensive derangement of the moral powers is com- 
 monly accompanied with some perversion of those of the intel- 
 lect. Nevertheless, as the one set of faculties is independent of 
 the other, there exists the possibility of their separate derange- 
 ment. 
 
 As the moral powers embrace the motives, impulses and 
 
MENTAL ALIENATION. 0. o 
 
 promptings to action, the derangement of one or more of tY±em 
 must seriously affect the volition upon which the act depends. 
 
 Actions are volitions carried to their extremest limit. They 
 take place when nothing is wanting to render the volition com- 
 plete, and they are themselves its most perfect evidence. With- 
 out the proof they furnish, there is no accountability to human 
 law ; as man can be accountable to God only for the volitions he 
 forms in his own mind, but leaves unexecuted. The principle 
 of forming volitions, and of carrying them out into acts, must 
 be fully possessed to render a being accountable. When, there- 
 fore, the first is necessarily rendered incomplete, or the last pre- 
 vented by some insurmountable obstacle, all accountability is 
 destroyed. It is in the first only that we witness the agency 
 of moral mania. It is a disturbing element thrown into the 
 very sources whence volitions are derived; and either contri- 
 butes, in large measure, to the formation of those that would 
 otherwise remain unformed, or prevents the formation of others 
 that would otherwise be formed. In either way, it disturbs the 
 ordinary normal operations of mind, and thus absolves it from ac- 
 countability. 
 
 It is not easy to define in what respect this new element modi- 
 fies the volition or the act. The enquiry in relation to the for- 
 mer is unnecessary, except so far as it qualifies the latter. In 
 regard to the manner or respec£ in which it modifies or affects 
 the latter, so as to absolve from its consequences, there can 
 never be expected an entire agreement among writers, or think- 
 ers, or even the decisions of judicial tribunals. 
 
 I have supposed we might find in irresistibility a principle 
 upon which all might agree. That whenever this quality should 
 be found attached to an act, so far as to control it, the actor, in 
 respect to such act, should be deemed irresponsible. 
 
 Without moral liberty, there can be no responsibility for crime. 
 In the normal, sane state of the faculties, this enters as an essen- 
 tial element. In the deranged state of the moral faculties, where 
 the sources of impulse, motive, and feeling are perverted and 
 deranged, this liberty is destroyed, and with it the accountabili- 
 ty for actions 
 
0,> MEDICAL JURISPRUDEICCE. 
 
 Irresistibility, where it arises from deranged or perverted a> 
 tion, should absolve frdm all accountability, because — 
 
 1 . The act is unavoidable, and the actor therefore no more a 
 subject of punishment, than a machine for going wrong when 
 some part of its machinery is out of order. To administer pun- 
 ishment under such circumstances, would shock all the moral 
 sympathies of men. 
 
 2. One of the purposes of punishment could never . be an- 
 swered by it, viz., the reformation of the criminal. If the act 
 be irresistible, the whole effect of punishment upon the indi- 
 vidual must be lost. 
 
 3. Another of the purposes of punishment would remain equal- 
 ly unanswered, viz., the salutary effect to be produced by it upor 
 the minds of others. That effect, instead of being salutar} , 
 would be in a high degree injurious, as it would shock all mond 
 sensibilities, and create a horror of the law itself which could 
 thus needlessly sacrifice life without answering any good end c r 
 purpose. 
 
 But suppose this principle admitted, another grave subject of 
 enquiry presents itself, viz. : How is it to be applied in practice 1 
 What are the tests of irresistibility'? By what indications is it 
 attended, and how is it established in proof 1 Little direct evi- 
 dence can be expected ; and the indirect, is unfortunately less 
 clear and conclusive than it ought to be. It is gathered princi- 
 pally from the nature of the act itself; the circumstances under 
 which it took place ; the things and events that preceded and 
 succeeded it ; the presumed influences that were brought to bear 
 upon the actor ; and the agreement or contrast existing between 
 the act and the entire course of conduct of the individual. 
 
 This question the most frequently arises in cases of homicide, 
 where tne plea of insanity is interposed as a defence. In such, 
 it usually presents great doubt and difficulty, and creates embar- 
 rassments not easily overcome. 
 
 The circumstances under which the act was done will come in 
 for a fair amount of consideration. If it were in open day, in a 
 public place, in sight of witnesses, it would appear more like in- 
 sane impulse, than the secret movements of the criminal. The 
 
MENTAL ALIENATION 577 
 
 impulse, it is true, might act in private as well as in public ; so 
 that the negation of these should not be regarded as conclusive- 
 ly proving it the act of a sane mind. 
 
 If a case of homicide, the relations existing between the par- 
 ties are worthy of much consideration. If the person slain were 
 a parent, a child, a wife, or some near friend or relative, and no 
 particular cause for the act was assigned, it might raise a fair 
 presumption that it was due to insane impulse. If the individu- 
 al slain be an object merely of indifference, towards whom no 
 peculiar feelings either of friendship or enmity can be presumed 
 to be entertained, the presumption, although much less strong, 
 is still in favor of its being an insane act. The mere motiveless 
 destruction of life can with difficulty be regarded as the act of a 
 sane mind. If, on the contrary, a motive exist, or if feelings of 
 enmity, originating in no delusion, be entertained towards the 
 person slain, the presumption will be that it is a sane act. 
 
 It will also be proper and necessary that enquiries should be 
 instituted into the things and events that have preceded, and 
 may succeed the act. There may have been previous derange- 
 ment, or some symptoms of cerebral disease. So also there may 
 be subsequent derangement, the very act itself being an ex- 
 plosion of mania, which may be succeeded by clear evidence of 
 insanity. 
 
 The particular influences that may be brought to bear upon 
 the individual should also be enquired into. The sight and prox- 
 imity of murderous weapons have been known to excite to fear- 
 ful activity the destructive propensity. Favorable opportunities 
 for accomplishing the act, have been at times laid hold of for 
 that purpose. So also contradiction, sudden and unfounded dis- 
 gust, or some trivial, insignificant, and even imaginary circum- 
 stance, has aroused that propensity to terrible activity. 
 
 In some instances, the monomaniac is fully aware of his mala- 
 dy, and begs to be restrained, so as to be rendered incapable of 
 doing an act which he knows to be wrong, but which he feels to 
 be unavoidable. In some cases, after doing it, he makes a volun- 
 tary confession, and gives himself up to the proper authorities. 
 In others, he takes to flight, and if apprehended, denies it. 
 
 37 
 
578 MEDICAL JUMSPItUDEKCE. 
 
 Dr. Ray, in his work on the Medical Jurisprudence of Insanity, 
 pages 225, et seq., § 189-90, lays down some principles that may 
 be adopted in doubtful or difficult cases. The criminal never 
 acts without a motive. It may be the avoidance of some per- 
 sonal inconvenience ; it may be the acquisition of property ; it 
 may be the gratification of revenge. It is always to accomplish 
 some selfish object. The monomaniac acts either without a mo- 
 tive, or upon one so glaringly inadequate, as to be itself evidence 
 of derangement. With the criminal, death is, therefore, simply 
 a means, by which he seeks to accomplish some ulterior end ; 
 with the monomaniac, it is entirely divested of that character, 
 and becomes the end in view, or that which must be so regarded 
 in a sane mind. Hence the criminal never sheds more blood 
 than is necessary for the attainment of his object, while the 
 monomaniac often sacrifices all within his reach, to the cravings 
 of his destructive propensity. 
 
 The criminal always lays plans for the execution of his de- 
 signs. Time, place, and weapons, are all suited to his purpose. 
 The monomaniac may do the same, but seldom or never, unless 
 he is acting under the influence of some delusion. The pure 
 homicidal monomaniac consults none of the usual conveniencies 
 of crime. His act is the act of a moment, regardless of time, 
 place, or witnesses. 
 
 The criminal often has accomplices ; always vicious associates. 
 The monomaniac neither. In the real criminal, there is delibe- 
 ration ; a cool, collected, and often judicious selection of time, 
 place, weapon and circumstance. In the monomaniac, if un- 
 accompanied with delusion, these are all wanting.. 
 
 Another leading line of investigation is the correspondence of 
 the act with all the previous acts and conduct of the individual. 
 Insanity, as generally understood, consists in a perverted faculty, 
 consequent upon a diseased organ. The insane act, therefore, 
 should stand out in strong contrast with all the previous acts 
 done or attempted by the individual. If such prove to be the 
 fact; if, when held up and examined in connection with the 
 great context of existence, it stands alone, unsustained and un- 
 supported by any other of a similar character, it certainly fur- 
 
MENTAL ALIENATION. 579 
 
 nishes strong evidence of derangement. Unfortunately, if found 
 to correspond in character with previous acts, it cannot always 
 be regarded as clear proof of sanity. A propensity may have 
 been originally strong, but the organ healthy; and hence, al- 
 though the calls for gratification may have been clamorous, yet 
 they were controllable. Those calls, however, may have been 
 frequently obeyed; indulgence has only added to the original 
 strength, until the propensity is pushed beyond its normal, 
 healthy state, and becomes perverted, deranged, and irresistible. 
 In such a case, the act will compare well with all the previous acts 
 of life. While, therefore, we might regard the disagreement as 
 affording proof of derangement, yet in case of agreement, we 
 ought not to rest equally clear in a contrary conclusion, but to 
 resort to other indications and sources of proof. 
 
 The subject of moral mania seldom arises for legal investiga- 
 tion except in the administration of criminal law. The tests 
 here adopted, have been already considered, and it is, therefore, 
 unnecessary again to advert to them. 
 
 The Legal Consequences of Delirium : 
 
 Questions of doubt and difficulty often arise in regard to the 
 legality of acts, contracts, and wills, done, made, and executed 
 in a delirious state. Febrile delirium incapacitates, not so much 
 by weakening the powers of mind generally, as by deranging 
 their regular functional operations. Delirium, as we have al- 
 ready seen, is usually but a symptom of some other disease, and 
 almost universally, an acute one. The establishment of its ex- 
 istence, during any part of the disease, throws a doubt over all 
 the contracts entered into subsequently, and during its continu- 
 ance. That doubt may be dissipated by clearly showing the fact 
 of a lucid interval at the time the contract was made. The same 
 strength of proof will not here be required to establish the fact of 
 a lucid interval, as the law renders necessary in the case of mania. 
 The character of the delirium, in reference to its being tempo- 
 rary or permanent, will be a materia] subject of inquiry. When 
 merely temporary, and only of occasional occurrence, a less 
 amount of proof will be required. 
 
 Thus in the case of Brogden vs. Brawn, 2 Jlddams' Rep., 441, 
 
580 MEDICAL JURISPRUDENCE. 
 
 the last will and testament of a widow which was executed on 
 the evening of the day previous to her death, her disease being 
 acute, and of ten days continuance, on the last two or three of 
 which, she was more or less delirious, was contested on the ground 
 of a want of testamentary capacity. The medical testimony was 
 divided on die subject, but the attending physician attributed 
 the delirium to the paroxysms of severe pain suffered by the 
 deceased, it being scarcely perceptible when these were absent, 
 and he believed that in the intervals she had perfect capacity. 
 It also appeared that the will had been prepared from instruc- 
 tions received from her ; that it was read over to her, and was 
 subscribed by her in the usual form, with a dash below. 
 
 Its validity was established ; Sir John Nicholl very justly ob- 
 serving, that " in cases of permanent, proper insanity, the proof 
 of a lucid interval is a matter of extreme difficulty, and for this 
 among other reasons, namely : that the patient so affected is not 
 unfrequently rational to all outward appearance, without any renl 
 abatement of his malady ; so that in truth and substance, he is 
 just as insane in his apparently rational, as he is in his visible 
 raving fits. But the apparently rational intervals of persons 
 merely delirious, for the most part, are really such. Delirium is 
 a fluctuating state of mind, created by temporary excitement, 
 in the absence of which, to be ascertained by the appearance of 
 the patient, the patient is, most commonly, really sane. Hence, 
 as also indeed, from their greater presumed frequency in most 
 instances in cases of delirium, the probabilities, a priori, in favor 
 of a lucid interval, are infinitely stronger in a case of delirium, 
 than in one of permanent, proper insanity ; and the difficulty of 
 proving a lucid interval is less, in the same exact proportion, in 
 the former, than it is in the latter case, and has always been so 
 held by this court." 
 
 Questions involving the legal consequences of delirium seldom, 
 if ever, arise in the administration of criminal justice. Neither 
 can they be said to be frequent in matters of contract or other 
 common business transactions. The muscular debility, and great 
 reduction of physical energy, which usually accompany the 
 disease, of which the delirium is a symptom, place the patient 
 
MENTAL ALIENATION. 581 
 
 in a position extremely unfavorable for the performance of 
 any action. It is in the execution of last wills and testaments 
 that questions of this character generally arise, and here very 
 puzzling questions frequently present themselves. 
 
 In the decision of these questions, involving the testamentary 
 capacity, the nature of the act itself, together with its attendant 
 circumstances, are to be principally regarded. " If it be agreeable 
 to instructions or declarations previously expressed, when un- 
 questionably sound in mind ; if it be consonant to the general 
 tenor of his affections ; if it be consistent and coherent, one part 
 with another ; and if it have been obtained by the exercise of 
 no improper influence, it will be established, even though the 
 medical evidence may throw strong doubts on the capacity of 
 the testator. On the contrary, when these conditions are absent, 
 or are replaced by others of an opposite description, it will as 
 generally be annulled, however plain and positive m;iy be the 
 evidence in favor of his capacity." Ray's Med. Juris, of Insanity, 
 305,^261. 
 
 In the case of Evans vs. Knight and Moore, 1 Jlddams, 229, the 
 testator made his will on the 21st, and died on the 24th of April, 
 of an attack of pneumonia, during the latter stages of which he 
 had considerable delirium. A physician who saw him on the 
 21st testified that he was not in a state of sound mind, memory, 
 and understanding, or capable of doing any act requiring the ex- 
 ercise of thought, judgment, and reflection. Another who saw 
 him on the 23d thought it extremely improbable that he should 
 have been free from wandering and mental affection on a day so 
 shortly before he saw him as the 21st. He, however, gave in- 
 structions for a will, without any suggestions from the legal 
 adviser who reduced them to writing, and approved and sub- 
 scribed them after they were read to him. He also, while giving 
 instructions, appeared rational, and conducted with propriety. 
 The testamentary capacity was held to have been sufficiently 
 made out. 
 
 Those interested in looking at authorities on this subject may 
 refer to Cook vs. Goude and Bennett, 1 Haggard, 577 ; King and 
 Thwaits vs. Farley, lb., 502 ; Waters vs. Howlett, 3 Haggard, 79'' ; 
 
582 MEDICAL JURISPRUDENCE. 
 
 Bird vs. Bird 2 Haggard, 142 ; Martin vs. Wotton, 1 Lee's Ecel 
 Rep., 130 ; Bittleston vs. Clark, 2 iee, 229 ; Marsh vs. Ti/rre/, 2 
 Haggard's Eccl. Rep,, 84 ; Holy vs. iMy, 1 Haggard, 146. 
 
 In some head affections, the patient isin a comatose state, from 
 which he may be roused to apparent consciousness for a short 
 time, so as to recognize persons and answer questions ; but he 
 soon subsides into a state of sleep. In such cases, the testamen- 
 tary capacity does not exist. So, also, in case of an injury to the 
 head, the patient, after rallying from its immediate effects, may 
 answer questions rationally, appear collected and intelligent, and 
 yet, at the same time, remain so utterly unconscious, that in 
 subsequent times he recollects nothing of it. 
 
 A case is mentioned by Dr. Ray, page 301, § 257, quoting it 
 from Dr. Woodward, of a legal gentleman who, in the course oi 
 an acute pneumonic affection, began to have slight delirium on 
 awaking in the morning, but it was observed at no other time. 
 At this period of time, he requested his physicians to apprise 
 him if they considered his case dangerous, as he wished to alter 
 his will which had been previously made by him. They did not 
 consider him in much danger, but it was thought advisable that 
 he should make the alteration, and he did so. He recovered, 
 and some months after, found this altered will among his papers, 
 and had not the slightest recollection of ever having made it, and 
 was much dissatisfied with its dispositions, as great injustice was 
 done by them to two of his sons. This should certainly induce 
 a caution against deciding too hastily in favor of the testamentary 
 capacity. 
 
 Legal Consequences of Suicide : 
 
 The English common law appears, by its provisions, to have 
 entertained a great horror of suicide. The man who had per- 
 petrated self-murder was deemed a felon, and his goods were 
 forfeited to the crown. He was denied christian burial ; but, 
 without any funeral ceremony, was interred in a four-road-way, 
 with a stake passed through the body. These severities induced 
 juries very generally to regard the act as itself evidence of mental 
 derangement. 
 
 The law of England still treats suicide as a felony, unless the 
 
MENTAL ALIENATION. 583 
 
 fact of derangement is established. Those, therefore, who have 
 attempted its commission and failed, are treated as sane and res- 
 ponsible agents. Insanity, as in any other case, may be inter 
 posed as a defence, but is not to be presumed. 
 
 In the case of the Queen vs. Rumball, see Taylor's Med. Juris., 
 520, the prisoner was charged with attempting to drown her 
 child. She had fastened the child to her dress, and threw herself 
 into a canal, with the intention of committing suicide. She was 
 rescued, and tried and convicted of attempting to murder her 
 child by drowning. 
 
 In the case of the Queen vs. Gathercole, same reference as 
 above, a man was charged with manslaughter under the follow- 
 ing circumstances. The prisoner threw himself into a canal, for 
 the purpose of drowning himself. The deceased, who was pass- 
 ing, jumped in and rescued him, but was himself drowned in the 
 humane attempt. The defence was that the prisoner was insane, 
 and therefore irresponsible. This was negatived, and he was 
 convicted. So a man attempting to shoot himself, accidentally 
 shoots another, is held responsible for it, unless insanity is shown. 
 
 Suicide, in its medico-legal relations, possesses, at the present 
 day, but little interest beyond the bearing it may be deemed to 
 have on mental alienation. It may be either a sane or an insane 
 act, and the difficulty lies in distinguishing the one from the other. 
 It may be resorted to in order to escape disgrace or ruin, and a 
 lesser evil of the two, in which case it would be the act of a sane 
 mind ; or it may proceed from delusion, or from a sudden irresis- 
 tible impulse, in either of which cases it would be the result of 
 insanity. 
 
 Under the head of suicidal monomania, many circumstances 
 are mentioned going to show that there are many things in com- 
 mon between the suicidal tendency and mental alienation, lead 
 ing to the conclusion, that very frequently the one was only a 
 form of the other. A fact is mentioned in the 18th Report of 
 the Superintendent of the Hartford Asylum, see Guy's Principles 
 'of Forensic Medicine, 315, which further shows its connexion 
 with general mania. Of the fifty-six discharged cured, eleven 
 strongly manifested the suicidal propensity, scarcely a moment, 
 
584 MEDICAL JURISrRUDEKCE. 
 
 day or night, passing, but they seemed intent upon killing them- 
 selves ; and some did not refrain from attempting it even in the 
 presence of their attendants. The means resorted to were 
 strangling, wounding, starving, throwing themselves from win- 
 dows, and endeavoring to obtain poisons. Yet these all finally 
 recovered, and were among the most perfect recoveries ever 
 witnessed. 
 
 The cases which have presented the greatest difficulty have 
 been those in which a will was made a short time prior to the 
 commission of the act ; and where, therefore, the effect of the act 
 upon the will became necessarily involved in the decision. In 
 such, if the act was the result of insanity, then it would still re- 
 nain to be investigated whether that insanity was of such a cha- 
 racter as to destroy the testamentary capacity. The possession 
 and exercise of that capacity is perfectly consistent with the ex- 
 istence, at the time, of some forms of mental alienation. If no 
 delusion clogs or misguides the judgment, and no frenzy controls 
 the will, a mind possessing ordinary power, or even less, may 
 exercise the testamentary capacity. 
 
 The course which courts have deemed it the safest to take, in 
 cases of this character, is to inquire into the previous conduct of 
 the testator, and to examine the provisions of the will. If those 
 provisions are such as to indicate the exercise of sense and judg- 
 ment, the will will be sustained. 
 
 In the case of Burrows vs. Burrows, 1 HaggaroVs Eccl. Reports, 
 109, the act of suicide was committed three days after the ex- 
 ecution of the will. As no insanity was shown at the -time the 
 instructions for drawing the will were given, Sir John Nicholl 
 decided in favor of its validity. 
 
 In the case of Brooks and Others vs. Barret and Others, 7 Pick- 
 ering's Reports, 94, Chief Justice Parker held that suicide, com- 
 mitted fifteen days before the execution of the will, was not 
 sufficient, in the absense of other evidence, to prove him insane, 
 and thus invalidate the will. 
 
 If the provisions of the will are unreasonable, or inconsistent 
 with the previoiis declarations of the testator in reference to 
 them, the commission of suicide shortly after its execution will 
 
MENTAL ALIENATION. 585 
 
 bo regarded as one of the evidences of a want of testamentary 
 capacity. 
 
 Legal Consequences of Somnambulism: 
 
 It must be seldom that this condition of mind comes up foi 
 investigation in courts of law. It may incapacitate an individual 
 from the performance of the duties required by his situation, and 
 thus impair the validity of contracts to which he may be a party. 
 It may, if concealed at the time of entering into them, annul con- 
 tracts of service, as it may render the individual troublesome, 
 mischievous, and even dangerous. 
 
 As the acts, while in that state, are done unconsciously, none 
 can properly be imputed as crimes ; although for wrongs done 
 to others, the individual would probably be held accountable, to 
 the same extent, and on the same principle, as in the case of the 
 lunatic. 
 
 Legal Consequences of Drunkenness : 
 
 As there are different degrees of drunkenness, it is obvious 
 that the same legal rule should not have an equal application to 
 all cases that may arise. In the first stage, where there is merely 
 excitement and preternatural activity of the faculties, although 
 the rapidity of their movements may prevent all deliberate 
 thought, and produce a confusion of ideas, yet the law cannot 
 exempt the individual either from civil or criminal responsibility. 
 
 In the second stage, the senses are retained, although in an 
 enfeebled state, but the judgment and memory, if exercised at 
 all, are so only in the slightest possible degree. He has no idea 
 of the consequences of his actions ; realizes little, if at all, the re- 
 lations in which he stands to others ; and is awakened to un- 
 bounded rage on the slightest provocation. In such a state, it 
 is obvious he can no more be responsible for his acts than he is 
 for his drunkenness. In the last stage, he is entirely divested of 
 reason, and no longer conscious of his external relations. 
 
 In settling the extent of legal liability which attaches to these 
 lower degrees of drunkenness, it becomes necessary to decide 
 the important question, how far an individual is answerable for 
 acts done in such a state or condition as must excuse the acts 
 themselves, but which state or condition has been voluntarily 
 
586 MEDICAL JURISPRUDENCE. 
 
 induced. This question has been very differently settled among 
 different nations. The Grecian law awarded a double punish- 
 ment for a crime committed under the influence of inebriation, 
 not only punishing the crime, but also the drunkenness that gave 
 rise to it. 
 
 The Roman law allowed the plea of drunkenness in exculpa- 
 tion for acts committed under its influence, except in the case of 
 women, and those it punished capitally. In the French penal 
 code no mention is made of drunkenness, but the highest French 
 tribunal has decided that drunkenness being both voluntary and 
 reprehensible, could never constitute a legal or moral excuse. 
 
 In Austria, under the code of 1803, drunkenness is made a 
 ground of exculpation from responsibility when not voluntarily 
 induced for the purpose of committing the crime. The German 
 jurisprudence takes substantially the same view. In France, 
 England and Scotland, a different principle has prevailed. 
 
 In France, as early as the reign of Francis I., an ordinance 
 was made declaring that drunkenness shall, in no case, absolve 
 from the ordinary punishment of crime. The present penal code 
 is silent on the subject, but the court of cassation, the highest 
 judicial tribunal in the kingdom, has decided that drunkenness, 
 being a voluntary and reprehensible state, could never constitute 
 a legal or moral excuse. Ray's Med. Juris, of Insan., § 392-3. 
 
 The common law of England, in early periods, regarded un- 
 favorably all attempts to set up drunkenness in exculpation or 
 avoidance of any act. " A drunkard, who is, voluntarius demo, 
 hath no privilege thereby, whatever ill or hurt he doth, Lis 
 drunkenness doth aggravate it." Thomas' Coke's Littleton, 46. 
 The principle proceeded upon, and which many regard as un- 
 sound, is that because the act of drinking is voluntary, therefore 
 the person is responsible for whatever actions it may lead him to 
 commit. An act, therefore, which is entirely unintentional, is 
 visited with the same consequences with one that is intentional. 
 But the law, it should not be forgotten, regards the act of drink- 
 ing as in itself reprehensible, and purely voluntary. It, there- 
 fore, lends the weight of its sanctions against the act, by refusing 
 to permit its consequences to be mitigated or modified by it. 
 
MENTAL ALIENATION. 587 
 
 The rule of law, however, varies according to the nature of 
 the act. A civil act is visited with different consequences from 
 a criminal one. Courts of equity early interfered to relieve 
 against acts done, and contracts entered into, while in the drunken 
 state, where they were procured by the fraud or imposition of 
 the other party. 1 Story's Equity Jurisprudence, §230; 3 Pier. 
 Will., 130, note (Jl.) In order to lay a foundation for affording 
 «uch relief, it was long required that the contrivance of the other 
 party, in effecting the intoxication, should be a necessary element. 
 This would be evidence of fraud and imposition, and hence would 
 avoid it on the application of him upon whom it was practiced. 
 
 It may now, however, be regarded as settled, that drunkenness 
 itself, however induced, when so excessive and absolute as to 
 suspend the reason, is a complete defence to a contract entered 
 into while in that state. The parties do not contract on equal 
 terms. The one has no consenting mind. It can, however, be 
 ratified in the sober state, being voidable, and not absolutely void. 
 Story on Contracts, § 27 ; Kent's Com., 2, p. 451 ; Pitt vs. Smith, 
 3 Camp., 33 ; Burratt vs. Buxton, 2 Aiken's Vermont Rep., 167 ; 
 Dorr vs. Munsell, 13 John. Rep., 430. 
 
 A criminal act is regarded differently. To such, the law will 
 never allow drunkenness to be interposed as a defence. It may 
 possibly in mitigation of sentence, and perhaps reduce the class 
 of the particular offence. Story ,on Contracts, § 28 ; Pennsylvania 
 vs. McFall, Addison's R., 257; 1 Russell on Crimes, 11. 
 
 Under this head comes also to be considered the legal respon- 
 sibility for criminal acts done while laboring under delirium tre- 
 mens. This is a remote result of drunkenness, but characterised 
 by most of the elements that constitute the active forms of mania. 
 This question arose in the case of Brew, tried for the murder of 
 Clark ; see 3 American Jurist, 7-9; 5 Mason's Rep., 28 ; Ray's 
 Med. Juris, of Insan., §403-4. Mr. Justice Story in that case 
 says : " The question made at the bar is whether insanity, whose 
 remote cause is habitual drunkenness, is, or is not, an excuse in 
 a court of law, for a homicide committed by the party while so 
 insane, but not at the time intoxicated or under the influence of 
 liquor. We are clearly of opinion that insanity is a competent 
 
588 MEDICAL JURISPRUDENCE. 
 
 excuse in such a case. In general, insanity is an excuse for any 
 crime, because the party has not the possession of his reason, 
 which includes responsibility. An exception is, when the crime 
 is committed while the party is in a fit of intoxication, and while 
 it lasts ; and not, as in this case, a remote consequence, super- 
 induced by the antecedent exhaustion of the party arising from 
 gross and habitual drunkenness. Had the crime been committed 
 when Drew was in a fit of intoxication, he would have been lia- 
 ble to be convicted of murder. As he was not then intoxicated, 
 but merely insane from abstinence from liquor, he cannot be 
 pronounced guilty of the offence. The law looks to the imme- 
 diate, and not to the remote cause, to the actual state of the 
 party, and not to the cause which remotely produced it." The 
 jury acquitted the prisoner. 
 
 Another instance in which this condition of mind became a 
 subject of medico-legal enquiry was in the case of Theodore Wil- 
 son, who was tried for the murder of his wife, in York county, 
 Maine, in 1835. The facts are reported in Ray's Medical Juris- 
 prudence of Insanity, §405. He was acquitted on the ground of 
 insanity. 
 
 In another case, that of John Birdsell, see Ray's Med. Juris, oj 
 Insanity, §406, this condition of mind came up for adjudication 
 in the supreme court of Ohio. The prisoner had delirium tre- 
 mens several times, and on this occasion had been drinking so 
 freely as to become intoxicated some three days before the act 
 was committed. He labored under several hallucinations, one 
 of which was that his wife was in combination with three of his 
 neighbors, and that they had conspired to take his life. He 
 fancied that these were in the loft manufacturing ropes to hang 
 him, and would go up, and come back pretending to have in his 
 hands their fragments, having cut the ropes to pieces. He killed 
 his wife in the evening, by striking her on the head with an axe. 
 When taken he manifested no compunction for the act ; said he 
 knew he should be hanged for it ; that he ought to have done it 
 nine months sooner, and evinced no dread of punishment for his 
 crime, but still continued to be in great apprehensions from the 
 peisons who, he believed, had intended to kill him. The question 
 
MENTAL ALIENATION. 589 
 
 submitted to the jury was, whether the prisoner was capable of 
 discriminating between right and wrong. They found that he 
 was, and accordingly returned a verdict of guilty. The punish- 
 ment was commuted by the governor to that of imprisonment, 
 but previous to the commutation, he became permanently in- 
 sane. 
 
 The general principle extracted from these cases, and which 
 may now'be considered as forming a part of American jurispru- 
 dence, is, that where the jury are satisfied that the criminal act 
 was committed in a state of insanity, that is to exempt from its 
 legal consequences, whatever may have been the cause that pro- 
 duced it : That the legal consequences of insanity are the same, 
 whatever causes may have been in operation contributing to its 
 production. 
 
 Cases of great difficulty sometimes occur, in which an indi- 
 vidual has formerly received some injury, as a blow on the head, 
 or has been afflicted with some disease of the brain, which has 
 left that organ in a very irritable condition, and liable to be se- 
 riously affected by very slight causes. Under such circumstances, 
 drunkenness will often produce a temporary madness, which will 
 continue only during the drunken fit, leaving the mind in the 
 possession of its usual sanity. It is asked whether insanity is 
 here to be urged as an excuse, the act being perpetrated while 
 under the immediate effect of intoxicating liquor. There are 
 instances of soldiers, who have received wounds in the head, and 
 who well know from experience that excesses in drinking will 
 render them mad. What shall be the rule adopted in such cases 1 
 The high authority of Judge Story sustains the position, that in- 
 sanity is not a competent excuse for crime, if it be committed 
 while the party is in a fit of intoxication, and while it lasts. 
 
 This principle is illustrated in the case of McDonough , who 
 was indicted and tried for the murder of his wife, before the su- 
 preme court of Massachusetts, in 1817. Ray's Medical Jurispru- 
 dence of Insanity, §398. Some years previous to the commission 
 of the act, he had received a severe injury of the head, in conse- 
 quence of which there occurred occasional paroxysms of insanity, 
 although his mind was generally sane and clear. These were 
 
690 MEDICAL JURISPRUDENCE. 
 
 often produced by intoxication, although they sometimes took 
 place without any apparent exciting cause. In one of these fits 
 of insanity, induced by drinking, and while actually under the 
 influence of liquor, he murdered his wife. 
 
 The court, in charging the jury, observed, " that if they be- 
 lieved the prisoner was in a fit of lunacy when he committed the 
 act, he should be acquitted ; but if they believed he was of sound 
 mind, or, if his reason were impaired, that it was caused by in- 
 toxication only, the fact being proved, and no palliating circum- 
 stances existing, he must be convicted." The prisoner was 
 found guilty. 
 
 This seems to have been a case in which the act was very 
 clearly traced to a pathological condition of the brain, and this 
 should have formed " a palliating circumstance " in exoneration. 
 The very thirst for liquor itself may have been the result of 
 morbid action in the brain, induced by this pathological condition. 
 Alison, in his Principles of the Criminal Law of Scotland, page 
 654, makes the following sensible remarks: "If either the in- 
 sanity has supervened from drinking, without the panel's (the 
 prisoner's) having been aware that such an indulgence in his 
 case leads to such a consequence ; or if it has arisen from the 
 combination of drinking with a half crazy or infirm state of mind, 
 or a previous wound or illness which rendered spirits fatal to his 
 intellect, to a degree unusual in other men, or which could not 
 have been anticipated, it seems inhuman to visit him with the 
 extreme punishment which was suitable in the other case. In 
 such case the proper course is to convict ; but in consideration 
 of the degree of infirmity proved, recommend to the royal mercy." 
 
 The laws of New- York, and several other states, provide for 
 the care and custody of the person and estate of an habitual 
 drunkard in the same manner as in case of lunatics. Nor is the 
 committee discharged, and the property restored, without proof 
 of a permanent reformation. The amount of proof required 
 must be in a great measure dependent on circumstances, but as 
 a general rule a voluntary refraining from the use of intoxicating 
 drinks for at least one year immediately preceding the a; plica- 
 tion will be required. 3 Edward's Rep., 380. 
 
FEIGNED DISEASES. ^91 
 
 CLASS IV. 
 
 This class includes all questions arising out of deceptive 
 practices, and these may all be summed up in the general topic 
 of 
 
 FEIGNED DISEASES. 
 
 This subject presents certainly a matter of curious enquiry. 
 It is curious to observe the power achieved by some individuals 
 over their own organization. It is no less curious to notice the 
 agents and instrumentalities they have discovered, or become 
 possessed of, having the power to produce in their material sys- 
 tems the appearances or indications of disease ; their ingenuity 
 and adroitness in turning to the best account all such agents and 
 instrumentalities ; and the extent of change they are capable of 
 effecting in different parts, or in their entire systems, by a simple 
 effort of volition. 
 
 The utility of occupying much time or space in the discussion 
 of this subject may well be doubted, as, with a few exceptions, 
 the medical profession are seldom called upon in this country to 
 decide upon the feigned or real character of the disease. In 
 Europe it is much more necessary to understand this subject. 
 The great source which furnishes the occasion from which far 
 the greatest number of feigned diseases have arisen is the military 
 service. 
 
 The large standing armies constantly kept on foot by the dif- 
 ferent powers of Europe have done a violence to human nature 
 by merging the man into the soldier. We might naturally ex- 
 pect that all the possible means which art could invent, or inge- 
 nuity devise, would be here put in requisition to effect an escape 
 from so unnatural a bondage. Accordingly we find Fodere ob- 
 serving of his own nation, at the time when conscription was in 
 full force there, that the art of feigning diseases was then brought 
 to such perfection as to " render it as difficult to detect a feigned 
 disease, as to cure a real one." Fortunately we are almost en 
 
592 MEDICAL JURISPRUDENCE. 
 
 tirely exempt from this great political evil, which brings in its 
 train so many moral and physical evils. There are nevertheless 
 occasions in which diseases are and will continue to be feigned 
 among us, although they are fewer in number and less frequently 
 resorted to. One instance is the mendicant, who hopes to be 
 enabled by means of it to live on in habits of idleness, and to 
 have his necessary wants supplied by an appeal to the benevolent 
 feelings of the liberal. Another is the criminal, who resorts to 
 them with the view of avoiding all liability for crime. So also 
 the desire of gratifying revenge has sometimes furnished the 
 motive for feigning, and injuries actually received maybe greatly 
 aggravated in appearance for the purpose of recovering heavier 
 damages. 
 
 Zacchias has laid down five general rules which are extremely 
 judicious, and<are some or all useful in detecting all feigned dis- 
 eases whatever be their kind or character. 
 
 1 . The first rule is, that the physician must in all suspected 
 cases, ascertain from himself or his relatives and friends what 
 are his physical and moral habits ; what the state of his affairs ; 
 what the peculiar nature of his connexions with others, whether 
 he is in danger of the infliction of some punishment, or of being 
 tried for the commission of some crime ; in fine he should cau 
 tiously make all those enquiries likely to throw any light upon 
 the motive by which he is actuated. 
 
 2. The second rule is, to compare the disease suspected to be 
 feigned, with the causes capable of producing it ; such as the 
 age, temperament, and mode of life of the individual. Many, 
 probably most, diseases do not supervene without having fur- 
 nished some previous indications. Great changes in the system 
 are almost always gradual. The occurrence, for instance, of a 
 dropsy immediately succeeding a state of excellent health, would 
 be an anomaly never witnessed. In all cases, therefore, where 
 a disease is suddenly induced without any previous change or 
 preparation of the system, there should be strong suspicion en- 
 tertained that the will of the individual has had more or less 
 agency in its production. 
 
 3. The third general rule is founded upon the aversion of per 
 
FEIGNED DISEASES. 593 
 
 sons who are feigning diseases from resorting to the proper 
 remedies. This may arise not alone from a dislike of the medi- 
 cines themselves, but from a desire to delay the using of any 
 means which would create in others an expectation that a cure 
 would be effected by them. Aversion to medicines may be ex- 
 perienced in cases of real disease, but it never will be likely to 
 be, to any great extent, where a severe pain is present. 
 
 4. The symptoms should be closely scrutinized, with the view 
 of determining whether they are, in reality, such as should pro- 
 perly belong to the disease. Patients are not supposed to be as 
 thoroughly cognizant with all the symptoms that attend upon, 
 and indicate a particular disease as physicians are. Hence where 
 artifice is suspected, an ingenious physician may often lead the 
 patient into a detail of symptoms, many or even most of which 
 are entirely inconsistent with the disease he is attempting to 
 feign. 
 
 5. The fifth, and last direction is, to follow the course of the 
 complaint, and attend to the circumstances which successively 
 occur. Thus no case of local inflammation can very long exist 
 without affecting the general system, inducing a preternatural 
 action in all its parts, and resulting in a more or less severe state 
 of feverish excitement. It requires a much more profound 
 knowledge than that ordinarily possessed to enable an individual 
 to exhibit the symptoms of a disease as they should successively 
 occur, even admitting they possessed the power. This remark, 
 however, applies more particularly to those diseases that have 
 successive steps or stages, each one following another in regular 
 gradation. 
 
 All diseases are not feigned with equal ease and facility. In 
 some the symptoms are established with a great degree of cer- 
 tainty. These can rarely all be exhibited, certainly not in their 
 natural order of succession, either from lack of knowledge or lack 
 of power or both. There are some also in which it is the nature 
 of the disease to work great changes in the system, in which the 
 excretions and secretions are affected in a very perceptible man- 
 ner, and such it is hardly possible to imitate. There are others 
 variable and uncertain in their symptoms, and attended with 
 
 38 
 
594 MEDICAL JURISPRUDENCE. 
 
 little or no change in the external appearance, such, for example, 
 as insanity and epilepsy. In these cases, and in all such as make 
 the physician dependent for the results he arrives at, on the 
 statement given him by the patient, the difficulty in detecting is 
 much greater, and the result arrived at less certain. 
 
 In some works treating extensively on this subject, there is a 
 classification of diseases the most generally imitated. I shall 
 content myself with citing a few instances of the diseases the 
 most commonly imitated with the means of imitating them, and 
 the methods of detection, which, with the exception of insanity, 
 are taken mostly from Dr. Beck. 
 
 Fever may be induced by the use of various stimulants, such 
 as wine, brandy, cantharides, &c. A feverish state of the sys- 
 tem may be created by violent exercise, and then the cold fit 
 imitated. Dr. Cheney mentions that he once found a soldier 
 apparently in the chill of an intermittent, shaking violently, but 
 on throwing oif the bed clothes he found him not in the cold, but 
 in the sweating stage, caused by his exertions. 
 
 No feigning of fever can be sustained for any length of time, 
 as a continued resort to the stimulants for that purpose would, 
 of itself, result in the production of real disease. As fevers are 
 usually produced by some active stimulating agent taken into 
 the system, it can often be detected in the secretions, or in the 
 contents of the stomach or rectum, evacuated by emetics or 
 cathartics A case is mentioned by Dr. Hutchinson, where the 
 vomiting, by its smell, disclosed that tobacco had been taken. In 
 the same case, the pulse was extremely small and rapid, and the 
 tongue was covered with a brown coating the eighth of an inch 
 thick, which, on being removed, was found to be common brown 
 soap. In another case, the tongue was made to exhibit a dry 
 white appearance, by rubbing it with whiting obtained from the 
 wall. Chalk, pipe-clay, brick-dust, and flour have all been used 
 to give the tongue an appearance indicating fever. 
 
 The appearances and symptoms of Consumption are sometimes 
 attempted to be produced by creating emaciation by abstinence 
 and drinking vinegar, and by mixing up expectoration with pus 
 ootained from others, tinging it with blood from the gums. A 
 
FEIGNED DISEASES. 595 
 
 discriminating prolonged examination of the case will generally 
 detect it. 
 
 Diseases of the Heart are sometimes feigned, and their fre- 
 quently attending symptom, interruption or derangement of the 
 pulse, is produced by the application of ligatures for that pur- 
 pose. So, also, the pulse may sometimes be suspended by pres- 
 sure on the artery. In one case, the physician was equally 
 unsuccessful in finding his patient's pulse at the right or left 
 wrist, but finally detected him, whenever "his pulse was to be 
 examined, suspending it by pressing Ms finger on the artery 
 under the arm-pit. 
 
 The appearance of aneurism, or of some other serious derange- 
 ment of the circulating system, has been produced by ligatures. 
 In one case, a ligature was bound tightly round the neck, and so 
 very fine as to be almost entirely hid by the folds of the skin. 
 The countenance was much swollen and livid, but on the remov- 
 ing of the ligature, the alarming symptoms were soon found to 
 disappear. 
 
 The functions of the heart have also been deranged by a resort 
 to agents taken internally. The powder of white hellebore taken 
 in large quantities, causes vomiting, purging, syncope, tremors, 
 and great nervous irritability, followed by great and inordinate 
 action of the heart and arteries, and which, in its turn, is sue- • 
 ceeded by great debility, or a disposition to paralysis. In smaller 
 doses, it is usually productive of disorder of the stomach and 
 violent and continued palpitations. ' 
 
 Pain, under some one or more of its numerous forms, is very 
 frequently feigned. The natural language of pain is so easily 
 learned, that it may be often feigned with tolerable success. The 
 forms under which it is very frequently simulated are those of 
 rheumatism, lumbago and sciatica. 
 
 Pain in the external parts is less frequently feigned than in 
 the internal. In the former, it is also usually accompanied with 
 heat, redness, change of color or tumor, which renders its Simula 
 tion difficult. Gout and rheumatism are sometimes feigned, but 
 their regular symptoms, such as redness in the one, and tumefac- 
 
596 MEDICAL JURISPRUDENCE. 
 
 tion or diminution of size, with retraction or loss of motion in 
 the other, render detection often easy. 
 
 There are, however, some kinds of pain, such, for instance, as 
 the scorbutic, in which no external appearances indicate its ex- 
 istence. In all such cases, the difficulty of detection is much 
 greater. Although the natural language of pain may, for a time, 
 be imitated with tolerable success, -yet a close and careful obser- 
 vation, and that particularly at times when the individuai is 
 not apprised of it, will generally succeed in detecting the imposi- 
 tion. The internal pain of any large organ or viscus is almost 
 uniformly accompanied by symptoms which unequivocally denote 
 its existence. Thus, severe pain in the head, thorax or abdomen, 
 is attended with a set of symptoms peculiar to each case, all of 
 which it may be difficult or impossible to imitate. Pain in the 
 head is accompanied with a loss of sleep, a fever, and, if it be 
 very severe, with delirium. These complicated results cannot 
 be easily imitated. 
 
 Inquiry should be made into the nature of the pain, whether 
 it is throbbing, darting, or constant ; what has been its duration, 
 and what is its alleged cause. It is hardly possible for severe 
 pain to be of long continuance without effecting a derangement, 
 more or less permanent, in the system. It is advised-, by Dr. 
 Beck, if there is much suspicion of the reality of the pain, to mix 
 a little opium with the patient's food, and observe whether sleep 
 be readily induced by it. As opium has not the same effect upon 
 every constitution, its operation cannot be assumed as an infalli- 
 ble test. The state or condition of the patient during sleep, 
 however induced, should furnish some indications as to the reality 
 of the complaint. The presence of violent pain is not consistent 
 with a calm, quiet, long continued slumber. Satisfactory experi- 
 ments may often be made during sleep to test the actual existence 
 of pain, more especially that which is internal. A soldier com- 
 plained of a severe pain in the abdomen, and screamed on the 
 slightest approach of anything to that part. About midnight, 
 the medical attendant found him fast asleep. It required consid- 
 erable pressure and even kneading of the abdomen before his 
 slumber could be disturbed. 
 
FEIGNED DISEASES. 597 
 
 An appeal to a strong mental aversion has sometimes proved 
 successful in effecting sudden cures. Dr. A. T. Thompson men- 
 tions a case in which a feigned tic doloureux was suddenly cured 
 by recommending to rub the part affected over the back of a 
 dog, an animal against which the patient entertained an inveterate 
 antipathy. This, at the time, was supposed to be owing to the 
 strong influence of the mind over the action of the nervous sys- 
 tem, but was, eight years afterwards, admitted by the patient to 
 have been a deception. 
 
 Haemoptysis may be feigned by pretending to cough and then 
 spitting out the blood created by pricking the gums ; or red paint 
 may be held under the tongue that would tinge the saliva of a 
 red color. The patient should be made to spit without coughing, 
 in which case the saliva would still retain its red color. 
 
 A vomiting of blood has been sometimes feigned, to effect 
 which the blood of some animal has been drunk, or some colored 
 liquid used, and then thrown up in the presence of spectators. 
 
 Bloody Urine has been feigned by adding blood to the excre- 
 tion, or by using substances that have the quality of reddening 
 it, such as the prickly pear, the beet root, madder, &c. A very 
 good test is to subject the bloody urine to the action of heat, and 
 in real cases a brown coagulum will be formed. 
 
 Great Weakness is feigned by using substances to make the 
 face appear pale and livid. In such case, the state of the appetite 
 should be inquired into, and the pulse and skin examined. Great 
 emaciation has been produced in a short time, by sucking a 
 copper cent in the mouth and swallowing the saliva. 
 
 Diarrhoea may be excited by a mixture of vinegar and burnt 
 cork, or a solution of sulphate of iron. Vomiting may be pro- 
 duced at will by some persons, simply by pressure on the abdo- 
 men. Others produce it by swallowing air. The vomiting of 
 undigested food is suspicious. It may be induced by a diseased 
 stomach ; but the continuance of a good appetite, and the absence 
 of emaciation, afford good evidence of the health of that organ. 
 
 Paralysis of the superior and inferior extremities is often 
 feigned. A single limb is sometimes pretended to be affected by 
 it. A swelling of the extremity, in cases of pretended paralysis, 
 
598 MEDICAL JURISPRUDENCE. 
 
 is sometimes produced by ligatures. Electricity and the actual 
 cautery will generally be found effectual in their application to 
 pretended cases. 
 
 Epilepsy is a disease often feigned. In suspected cases, it 
 should be observed whether the symptoms that usually ac- 
 company real epilepsy, such as a livid face, a fixed pupil, a pale 
 lip, a distorted and frothy mouth, an altered pulse, dullness of 
 sensation, vertigo, and great weakness, are all or most of them 
 present. The symptom altogether the most available in detecting 
 deception, is the obtuseness and almost entire want of feeling 
 that characterizes it. Fodere relates the case of an artillerist, 
 who was such an adept in deceiving as to elude all his means of 
 detecting except the application of fire, and this always recovered 
 him. One curious fact is connected with his confession, which 
 is, that he never counterfeited a paroxysm without feeling, for 
 several days afterwards, a violent pain in the head. De Haen, 
 in a case submitted to him, suspected deceit, and as it subse- 
 quently appeared truly so, from the following circumstances. 
 During the paroxysm, the eyes were opened in a natural manner, 
 and not with a wink ; the pulse was natural ; when the curtains 
 were drawn, the pupil of the eye was dilated, and when opened, 
 contracted, and the contraction occurred very violently when a 
 candle was presented. The following means have been resorted 
 to for the purpose of detection, viz. : 
 
 To blow snuff into the nostrils : 
 
 To dip flannel into hot water, and apply it to the side : 
 
 To pour a drop of alcohol into the eye : 
 
 To pour a small stream of water on the face : 
 
 To insinuate aloes and salt into the mouth. 
 
 The following circumstances are noticed under this head : 
 
 1. In real epilepsy, if the hands be forced open, they will re- 
 main expanded ; in the feigned, they will immediately close 
 again. 
 
 2. In real epilepsy, the contractions of various parts of the 
 body always come on simultaneously. There is no regular period 
 in the return of the fits. 
 
FEIGNED DISEASES. 599 
 
 3. In real epilepsy, warmth and perspiration are present dur- 
 ing the fit ; in the feigned, they succeed it. 
 
 4. In real epilepsy, there is concealment of situation ; in the 
 feigned, rather a desire of publicity. 
 
 The Convulsions that are feigned are not attended with that 
 stiffness and rigidity of the muscles with those that are real. 
 Convulsions are difficult of imitation for any considerable length 
 of time, because the antagonist muscles will soon come to exert 
 a force which all the efforts of the imposter are unable to bear 
 up against. 
 
 Catalepsy is sometimes feigned. The following ludicrous 
 anecdote will serve to explain something of the nature of it, and 
 of the means of detecting it : 
 
 " A patient in the hospital feigned to be afflicted with catalepsy ; 
 in which disorder, it is said, a person loses all consciousness and 
 volition, yet remains in the very attitude in which they were 
 suddenly seized with this temporary suspension of the intellec- 
 tual faculties. Mr. John Hunter began to comment before the 
 surrounding students on the strangeness of the latter circum- 
 stance ; and as the man stood with his hand a little elevated and 
 extended, he said, you see, gentlemen, that the hand is supported 
 merely in consequence of the muscles persevering in that condi- 
 tion to which volition had excited them, prior to the cataleptic 
 seizure. I wonder, continued he, what additional weight they 
 would support, and so saying, he slipped the noose of a cord 
 round the wrist and hung to the other end a small weight, which 
 produced no alteration in the position of the hand. Then, after 
 a short time, with a pair of scissors, he imperceptibly snipped 
 the cord. The weight fell to the ground, and the hand was as 
 suddenly raised in the air by the increased effort which volition 
 had excited for the support of the increased weight. Thus was 
 it manifested that the man possessed consciousness and volition, 
 and the imposture stood revealed." 1 Beck, 2-3. 
 
 Syncope and Hysteria have sometimes been attempted to be 
 feigned, but they cannot resist the action of sternutatories. The 
 symptoms attending them are not easily dissembled. A small, 
 feeble and languishing pulse, an almost suppressed respiration, 
 
600 MEDICAL JURISPRUDENCE. 
 
 cold sweats, coldness of the extremities, and paleness of the 
 countenance, cannot generally be commanded at will. 
 
 There are on record some very extraordinary cases of Somno- 
 lency, in which there is the appearance of total insensibility for 
 a long period of time. In this state, the application of the most 
 powerful agents has been resisted for months. A very extra- 
 ordinary case illustrating this is quoted by Dr. Beck from the 
 Edinburgh Annual Register, 1 Beck. 24-5, which goes to show 
 the very great power which the mind is capable of exercising 
 over the sufferings of the body. 
 
 One Phineas Adams, a deserter, aged eighteen years, lay from 
 the 26th of April, to the 8th of July, 1811, in a state of insen- 
 sibility, resisting the action of every agent, as electric shocks, 
 powerful medicines, &c. His eyes were closed, his countenance 
 pale, his sustenance sucked in through his teeth ; but his respi- 
 ration was free, and his pulse of a healthy tone. Snuff was thrust 
 up his nostrils, and pins under his finger-nails, to excite sensa- 
 tion, but all in vain. He even underwent the operation of 
 scalping, to ascertain whether there was not some injury of the 
 brain, and gave no sign of sensibility whatever during the ope- 
 ration, except the utterance once only of a groan, when the in- 
 strument was applied to scrape the head ; and yet, after his dis- 
 charge, the whole turned out to be an imposition. 
 
 The Scrofula has been attempted to be imitated, by exciting 
 ulcers in the neck and lips with euphorbium, or other acrid sub- 
 stances. It is not, however, possible to imitate the true scrofu- 
 lous ulcer. 
 
 Scurvy has been feigned, by inducing a bleeding state of the 
 gums by means of potash. 
 
 Opthalmia has been very extensively imitated. It may be 
 artificially excited by the application of various stimulants. 
 The rapidity of its progress generally detects it, as the acme is 
 arrived at within a few hours after the application of the acrid 
 substance. The substances so used have been principally salt, 
 sulphate of copper, corrosive sublimate, cantharides, alum, to- 
 bacco juice, lime, and nitric acid. Deception in this disease has 
 prevailed so alarmingly as to render it necessary to proclaim an 
 
FEIGNED DISEASES. 601 
 
 ordinance declaring that no soldier should be discharged for the 
 loss of one eye only. 
 
 The blindness produced by amaurosis has been often imitat- 
 ed. The pupils in this case are usually dilated and fixed. There 
 are, however, some cases in which they retain their contractile 
 power after the sight is lost. The patient should always be watch- 
 ed to see whether he does not avoid obstacles. Extract of bella- 
 donna or hyoscyamus, applied to the skin around the eye, give 
 a dilated pupil and inactive iris. The eye, however, is always 
 rendered more or less red from local applications ; besides, the 
 effects in such cases are always temporary. 
 
 Deafness has sometimes been pretended, but this can general- 
 ly be detected by close observation. Ordinary persons can never 
 be expected to be always on their guard, and opportunities will, 
 therefore, generally occur of detecting imposition. One con- 
 script was detected by the general letting fall, intentionally, a 
 small piece of silver behind him. He turned his head in the 
 direction of the sound, and thus disclosed the fraud he was 
 practicing. The sensation created by hearing an unexpected 
 sound, can very rarely be successfully concealed. 
 
 There have been very extraordinary instances of those who 
 have pretended to be deaf and dumb, and have successfully car- 
 ried through, for a long period, the practice of the fraud. Fo- 
 dere has found women more successful than men in the feigning 
 of deafness and dumbness. A remarkable case of one Victor 
 Foy is cited, who, for the space of four years, succeeded in 
 eluding all that ingenuity could contrive, or artifice invent, with 
 a view to his detection. So perfect had he become, that to use 
 his own expression, when the fraud was detected, he had un- 
 learned how to hear. After passing through every ordeal, and 
 being found and announced in the public journals as actually 
 deaf and dumb, he was guilty of the imprudence of stating in 
 writing that he had been under the charge of the Abbe Sicard. 
 That ingenious and penetrating individual immediately pro- 
 nounced, from the writing itself, that the writer was not born 
 deaf and dumb, for the reason that he wrote from sound, while 
 the deaf and dumb write only from sight. A course of experi- 
 
602 MEDICAL JURISPRUDENCE. 
 
 ments subsequently adopted ana followed up, resulted in a com- 
 plete disclosure of the imposition. 
 
 If the tongue retains its muscular power, the pretension to 
 dumbness is, in all probability, without any foundation. 
 
 Tumors and enlargements have furnished many occasions for 
 feigning. In one case, a female had an abdominal enlargement 
 which continued to increase for thirty-nine years, and excited so 
 much commisseration and charity as to enable her to lead a very 
 comfortable life. Great curiosity existed as to the cause of so 
 singular a phenomenon. After her death, the tumor was found, 
 not on her body, but in her wardrobe, in the shape of an im- 
 mensely large sack or cushion, so made as to exactly fit the shape 
 of the abdomen. From excessive modesty, she would suffer no 
 medical man to examine her during life. 
 
 All the appearances of hydrocephalus have been caused by 
 opening the integuments of the head near the vertex, and then 
 introducing air between them and the muscles. Similar infla- 
 tions, together with the appearance of the most hideous deform- 
 ity, has been produced in a child by means of introducing air, 
 and the application of 'Ugatures to different parts of the body. 
 So also the resemblance to a dropsy has been caused by inflating 
 the parietes of the abdomen. Swollen appearances may also be 
 produced very easily by the introduction of air into the cellular 
 tissue, as that tissue is spread over the whole surface of the body, 
 and a very small aperture serves for the introduction of the air. 
 Ligaments applied to the lower extremities have produced the 
 appearance of anasarca of those extremities. Ascites has been 
 apparently caused by the injection of water into the cavity of 
 the abdomen. Tympanites of the stomach, and great distention 
 of the abdomen, have been produced by swallowing air. 
 
 Hydrocele has been imitated by means of injected fluids, or 
 by the introduction of air through a small incision. 
 
 The appearance of Hernia has also been produced by infla- 
 tion, and that so frequently, that a receipt for its production 
 seems to have been current in the British army. Some men have 
 been enabled to produce swellings resembling hernia, by retain- 
 
FEIGNED DISEASES. 603 
 
 Ing the testes in the groin, through the power they could exer- 
 cise over the cremaster muscles. 
 
 An individual mentioned by Mr. Hutchison, possessed such 
 perfect control over the testicles, that he could pull both together 
 from the bottom of the scrotum up to the external abdominal 
 rings, and again let them both drop together, or he could pull 
 each separately, letting each separately drop ; or one could be 
 ascending while the other was descending, and that about as 
 rapidly as the eye could follow them. 1 Beck, 38. 
 
 CoNTRACTiONSvand deformity, and consequent lameness, have 
 been often feigned, to effect some purpose, sometimes to increase 
 the damages sustained from a trifling injury. Inaction, and the 
 use of ligatures, may render the parts thin ; or an effect is some- 
 times produced by maintaining particular joints for a long time 
 in one position. The real nature of the case may sometimes be 
 detected by close watching, without any appearance of suspicion. 
 A resort may also be had to remedies. Electricity has often been 
 found successful. An emetic, causiDg sickness, has resulted in 
 the contracted limb's being found to yield to a very slight force. 
 Those complaining of the contraction of one of the lower ex- 
 tremities, should be compelled to support themselves for some 
 time on the healthy leg alone. The trembling and elongation of 
 the other soon manifest the deceit. Feigned cases have also been 
 detected by examination during sleep, by engaging them in inte- 
 resting conversation, or by resorting to any means, so calculated 
 to make them forget their situation as to let their limbs fall into 
 a natural mode of action. There are, however, some extraordi- 
 nary cases of deception mentioned ; one particularly, of a con- 
 vict who succeeded in convincing everybody that he had a bent 
 knee, that disabled him from doing hard labor, for the period of 
 seven years. But upon being discharged, one knee was found to 
 be equally sound with the other. 
 
 Ulcers have been frequently feigned ; or rather, an appear- 
 ance resembling ulcers has been produced, by resorting to divers 
 expedients for that purpose. Acetate of copper, quick-lime, the 
 juice of euphorbium, or other acrid plants, have been made use 
 of for the purpose of creating the appearance of ulcers, or of 
 
604 MEDICAL JURISPRUDENCE. 
 
 preventing real ones from healing. Irritation has been some- 
 times caused or kept up by rubbing the part, and thrusting pins 
 through the bandages. False ulcers may generally be detected — 
 
 1 . By examining their borders. They will be found to be less 
 callous. 
 
 2. By examining their surfaces. They -will generally be found 
 more superficial than real ones. 
 
 3. They are less painful than real ones. 
 
 4. The nature of the discharge must be observed, whether it 
 be pus or sanies. 
 
 5. The general habit of the patient must be attended to. If 
 all the indications of health are present, ulcerous appearances may 
 be suspected : And, 
 
 6. False ulcers may be easily healed, because there is no radi- 
 cal vice in the system, which has caused their production. 
 
 One singular mode of practicing deception by inducing disease, 
 has been to insert a copper half-penny, or some copper substance, 
 into a cut made for that purpose in the flesh, and leave it imbed- 
 ded there. The penalty paid has been often severe, as it has re- 
 sulted in the loss of the limb. 
 
 Even cancer has been sought to be imitated, but its detection 
 will depend mainly upon the same principles as those that test 
 the real or feigned existence of ulcers. 
 
 Wounds of many different kinds have been frequently feigned 
 or resorted to for various purposes. Needles have been thrust 
 into various parts of the body. In one case, no less than four 
 hundred were removed from different abscesses in about three 
 years. 
 
 Mutilations have been voluntarily made, and their detection 
 has been a matter of great difficulty. The kind of mutilation 
 the most common among the Roman soldiery was the cutting off 
 the thumb ; and the cutting off that, or some one or more of the 
 fingers, has been often resorted to among the English and French 
 soldiers, to obtain their discharge. The French soldiers, in some 
 instances, even caused their teeth to be filed off or extracted, so 
 as to render themselves unable to bite off the end of the car- 
 tridge. 
 
FEIGf»ED DISEASES. 605 
 
 In the case of voluntary mutilation, a close attention to the 
 circumstances will frequently disclose the truth. Those who re- 
 sort to it are not always observed to act upon the close connec- 
 tion subsisting between the cause and its effects. One, for in- 
 stance, alleged that the amputation of two of his fingers was ef- 
 fected by the collision of water casks. The cuts, on examina- 
 tion, were found to be clean, and the amputation complete. 
 Another complained of having lost his thumb by falling on bro- 
 ken glass, but there was no mark of abrasion whatever. 
 
 Insanity, or Mental Alienation, in all its varied forms, may 
 be feigned, and this it is most important for the American medi- 
 cal jurist to understand. One reason of the reluctance with 
 which courts of law entertain the plea of insanity in a criminal 
 prosecution, is undoubtedly some apprehension lest it should 
 prove to be feigned, and thus an imposition be practiced upon 
 them. The entire immunity from punishment which Insanity 
 carries along with it, creates a strong motive on the part of the 
 criminal to feign it. Besides, the symptoms of real insanity are 
 of so indefinite and equivocal a character, and some of them 
 withal so marked, that according to the popular understanding 
 of it, there is little difficulty in successfully imitating it. All 
 these require that a very attentive consideration should be given 
 to this very important subject. 
 
 The great mass of the people, including even those of very 
 respectable intelligence, know no other kind of mental alienation 
 than idiocy, the lower degrees of imbecility, and the active forms 
 of mania, and more generally of intellectual mania only. They 
 mostly regard it as consisting in general and indiscriminate ra- 
 ving, without any reference to object or end ; as a letting loose 
 of every faculty, in order that it might display its most intense 
 and utmost workings. If this were really the fact, madness 
 might be imitated by working up the mind into a state of intole- 
 rable frenzy, and thus exhibiting at will the extreme action of 
 the faculties. But in the real disease, there is a certain method 
 in madness, which without close observation remains unperceiv- 
 ed, and which, therefore, the similator would fail to imitate. 
 This method consists in the reference which all the ravings of 
 
606 MEDICAL JURISPRUDENCE. 
 
 the maniac have to some leading idea, which is predominant 
 throughout, constituting usually the delusion or hallucination in 
 which the disease consists. 
 
 Those who have had the amplest opportunities for observing 
 the insane, unite in testifying that it is extremely difficult to 
 feign insanity successfully, and that no attempts at such imposi- 
 tion can long be sustained. Georget, Haslam, and Conolly, all 
 concur in this statement. All the different forms of insanity 
 have their own peculiar characteristics, which are known and 
 easily recognized by the experienced observer. Those who un- 
 dertake to feign it are, in almost all cases, ignorant of these, and 
 hence incapable of displaying it in its true colors. 
 
 In suspected cases, it would be well first to have reference to 
 the motive that may have influenced the attempt at deception. 
 Is there any good to be obtained, of evil to be avoided, by being 
 insane at that particular time 1 Inquiry should be strictly made 
 as to the time when the first insane indications appeared, and 
 what were the circumstances that preceded or accompanied 
 them 1 If a criminal act, were the indications prior or subse- 
 quent to its commission 1 The act may itself have been a con- 
 sequence of insanity, or by its action upon the mind, it may so 
 have unhinged its faculties, as to have produced the derange-, 
 ment. In either case, the insanity will probably have borrowed 
 its hue from the crime, and allusion will frequently be made to 
 it. This would probably be far from the case with the simu- 
 lator. 
 
 It is a remark in which there is undoubtedly much truth, that 
 imposters in almost all cases over act. Their opportunities for 
 observing really insane exhibitions have probably been small, 
 and hence their attempts at imitation will be defective. They 
 act under the general impression that insanity is only another 
 name fbr indefinite wildness, and that the greater the irregulari- 
 ty, strangeness, and utter singularity of their conduct and men- 
 tal manifestations, the more likely they will be to accomplish the 
 deception. The fact is generally overlooked, that it often re- 
 quires much discrimination to detect the insanity, and that even 
 in the case of the most raving mania, there are periods of time 
 
FEIGNED DISEASES. 607 
 
 intervening between the paroxysms, in which there is little if 
 any insane manifestation. During these intervening periods, the 
 maniac remembers his friends and acquaintances ; also has a re- 
 collection of places, dates, and events. There may be strange 
 combinations of ideas, but they will generally have reference to 
 the particular delusion present. This delusion may aiford the 
 clue by which their peculiar mental anomalies are explain- 
 able. 
 
 In simulated insanity, all these things are apt to be overlooked. 
 The imposter is likely to take it for granted, that if he is inco- 
 herent, his perceptions erroneous, and his ideas regardless of 
 truth, propriety, or proportion, he is thoroughly acting out in- 
 sanity. Hence he will not perceive common qualities or ordinary 
 relations ; forgets friends and acquaintances ; confounds names 
 and places ; jumbles together events ; misremembers dates ; in 
 fact, trains his perceptive faculties to make false returns, in order 
 that he may display greater wildness and irregularity. An in- 
 stance of this occurred in the case of Jean Pierre, a; given by 
 Dr. Ray, page 337, et seq., § 292-3. 
 
 It has been remarked, that in those cases that were simulated, 
 there is a certain hesitation, and appearance of premeditation in 
 the succession of ideas, however incoherent, very different from 
 the abruptness and rapidity with which in real madness the train 
 of thought is changed. This, to a practiced observer, is a strong 
 source of proof. 
 
 Another great point towards which the attention should be 
 directed, is the moral displays of the patient, and particularly 
 such as are exemplified in the character of the feelings manifest- 
 ed towards those to whom he sustains the nearest and dearest 
 relations. The effect of moral mania, either singly, or in com- 
 bination with intellectual, is to create such a perversion of the 
 moral feelings, as to implant enmity and hate in the very sources 
 of love and affection ; so that those objects which, in the sane 
 state, are the most loved and cherished, become in the insane, 
 the most hated and abhorred. This fact the imposter will not 
 probably be aware of. 
 
 The plots and schemes of the really insane, so far ss the in- 
 
608 MEDICAL JUE.ISPRUDEKCE. 
 
 tent to injure others is developed by .them, almost uniformly have 
 a direct reference to their nearest and dearest friends; while 
 those of the imposter regard rather the persons with whom he is 
 at enmity, or, at least, towards whom he is indifferent. 
 
 Another test is furnished in the almost entire disregard paid 
 by the really insane to the decencies and proprieties of life. The 
 perversion in the moral feelings naturally leads to a perversion 
 in conduct, which results in outraging all the forms and fashions 
 usually observed, and held almost sacred in the ordinary inter- 
 course of society. This trait the imposter may fail to imitate, 
 and his conduct in that particular should be closely observed. 
 
 Nor should the disturbance in the physical organization be 
 overlooked. The wildness, and unsettled character of the eye ; 
 the peculiar cast of the countenance, and expression of the fea- 
 tures; the evidences of febrile excitement, manifested by in- 
 creased heat, and accelerated pulse, are all circumstances which, 
 although not controlling, are nevertheless by no means to be lost 
 sight of, in the determination of doubtful cases. 
 
 Another point of considerable importance to be noticed, is the 
 sleeplessness that accompanies the disease. In cases of actual 
 raving mania, this usually prevails to an astonishing extent; 
 days, and sometimes whole weeks, passing on without the pa- 
 tient's experiencing any sleep whatever. The faculties being 
 under the guidance of insane impulse, seem to be exempt from 
 the ordinary laws to which, in a healthy state, they are subject. 
 Action, intense and unceasing, impairs not their ability to act. 
 They seem rather to gather fresh strength from exertion, and to 
 be invigorated by the means that ordinarily exhausts. Not so, 
 however, with the imposter. From the ordinary laws of mind, 
 he can claim no exemption. To him, as to the rest of man- 
 kind, repose is necessary to gather the means for renewed effort. 
 The extraordinary exertions rendered necessary to keep up a 
 simulation of raving mania, cannot fail soon to exhaust the re- 
 sources of the individual, and to render rest necessary to recruit 
 his wasting energies. If carefully watched, he will not be found 
 to prolong his sleeplessness and continued exertion beyond two 
 or three days. 
 
FEIGNED DISEASES. C09 
 
 The really insane are far less susceptible than others to the 
 operation of many medicines, such as purgatives, emetics, and 
 opium. The last is frequently used in suspected cases. The 
 simulator cannot resist the action of a strong dose of opium ; 
 while, on the maniac, it will have little or no effect. 
 
 Another point to which observation may be directed, is the 
 causes and appearances that preceded the first occurrence of 
 any well marked symptoms of the disease. Real insanity sel- 
 dom if ever comes on suddenly. The outbreak or explosion may 
 be sudden, but that is almost invariably preceded by what is 
 termed the incubation of madness. There are a great variety of 
 symptoms, such as singularities in ideas and conduct, that almost 
 invariably precede the explosion. Few real cases occur without 
 some previous indications having been furnished. 
 
 The simulator, on the contrary, is not apt to resort to previous 
 training. His insanity is generally sudden — instantaneous. He 
 takes by surprise. The faculties all at once jump from their 
 regular modes of acting, into unlimited extravagance of mani- 
 festation. 
 
 Nor should the peculiarities and habits of the individual be 
 overlooked. Habits of intoxication immediately succeeded by 
 complete abstinence, may have given rise to something resem- 
 bling the delirium tremens. A great degree of nervous irrita- 
 bility may possibly be sufficient to explain the phenomena pre- 
 sented. Careful enquiry should be made whether the ancestors 
 of the individual have ever been afflicted with any form of men- 
 tal alienation ; or whether the individual himself, at any previous 
 period of his life, had a similar affliction. 
 
 Another point towards which the attention should be directed, 
 is the morbid irritability and sudden displays of violent passion, 
 without any adequate cause, which characterize the really insane. 
 There is an impatience of contradiction, and strong ebullition of 
 passion occurring upon the most trivial circumstance, which are 
 extremely difficult of imitation. The imposter cannot so easily 
 vary his conduct. He cannot readily divorce the act from its 
 motive, or reverse the ordinary relations existing between the 
 force of the motive and the performance of the act. 
 
 39 
 
610 MEDICAL JURISPRUDENCE. 
 
 Considerable stress is laid upon the bold, unflinching look of 
 real maniacs, and the extreme difficulty attending its successful 
 imitation. The imposter almost invariably shrinks from a keen, 
 searching glance, and may also betray some emotion on being 
 directly charged with the deception. 
 
 The observations thus far made, are more particularly appli- 
 cable to general mania, as this is the form the most universally' 
 known, and the most generally imitated. Many of the tests al- 
 ready mentioned, apply to partial, as well as general mania.' 
 
 As to partial mania, " its simulators," says Haslam, " are de- 
 ficient in the presiding principle, the ruling delusion, the un- 
 founded aversions, and causeless attachments which characterize 
 insanity. They are unable to mimic the solemn dignity of 
 characteristic madness, nor recur to those associations which 
 mark this disorder, and they will want the peculiarity of look, 
 which so strongly impresses the experienced observer." 
 
 With the simulator, there is an obvious anxiety to produce an 
 impression, which contrasts strongly with the reserve and indif- 
 ference of the real monomaniac. 
 
 The real monomaniac is extremely prejucided in favor of his 
 own opinions, and impatient of the slightest contradiction ; 
 while the simulator readily overlooks this essential point, if the 
 contradiction is skilfully managed. 
 
 Another point essential to be attended to, especially with those 
 of naturally excitable temperaments, is to introduce the topic 
 which embraces his delusion, and if the case be a real one, ac- 
 celerated pulse, a flushed countenance, and evidence of excite- 
 ment will be the result ; while the simulator will remain un- 
 affected. 
 
 Idiocy is sometimes attempted to be imitated, especially by 
 those whose experience may have furnished them with opportu- 
 nities of observing that form of alienation. The past history 
 of the individual must here be referred to. Idiocy is either con- 
 genital, or has been produced by very obvious causes. If the 
 history can be traced back to a period of intelligence, the case 
 is not congenital, and enquiry must be made as to the causes 
 that produced it. In cases of simulation, it will be difficult to 
 
FEIGNED DISEASES. 611 
 
 find real causes adequate to the production of the effect, existing 
 at the precise period of time when their agency would be re- 
 quired for that production. 
 
 There would be a serious difficulty with the most perfect imi 
 tator, in assuming the appearance, look, and bearing of an idiot. 
 The stamp of genuine idiotism, no effort of mind can reach. 
 The expressionless features; the vacant look; the unutterably 
 stupid cast of countenance, characterizing simple idiotism, can 
 proceed only from the absence, not the presence, of mind; 
 
 Imbecility is more easily feigned than idiocy. In real imbe- 
 cility, there is a singular mixture of stupidity and shrewdness, 
 which is difficult of imitation. The shrewdness of the simulator 
 is generally displayed in those cases in which his own interest is 
 concerned, and his stupidity, in things that do not concern him. 
 When, therefore, his answers and statements are of such a cha- 
 racter as to criminate himself, the case is probably a genuine one. 
 But the conclusion should not be too hastily drawn that it is not 
 such an one, if they have not that effect. 
 
 Senile dementia may be sometimes feigned. This, it must be 
 recollected, proceeds from a deficiency of mental power and ex- 
 citement. The simulator will be found to base his manifesta- 
 tions on excess of mental excitement. His delusions and hallu- 
 cinations, and all his mental exhibitions, will indicate power and 
 energy, and not the weakness that is attendant on senile de- 
 mentia. They will partake more of the character of partial 
 mania, than of this form of dementia. Instead of being charac- 
 terized by weakness and childishness, they will be found to pos- 
 sess the elements of strength and energy. 
 
 It is suggested by Dr. Ray, to mention in the hearing of a per- 
 son supposed to be feigning insanity, some symptom of madness 
 which is easily imitated, as not being present. At a subsequent 
 examination, if the derangement is feigned, this symptom will 
 be very sure to be observed, whether it is or is not a symptom 
 of madness. 
 
612 MEDICAL JURISPB.UDENIE. 
 
 CLASS V- 
 
 This Class includes a brief consideration of the following 
 topics, viz : 
 
 age; identity; presumption of survivorship; life 
 assurance; and medical evidence. 
 
 I. AGE. 
 
 The only point of view in which I shall consider Age, is as af ■ 
 fecting the question of Identity. The action of organic forces is 
 so different in different individuals, and is dependent also upon 
 so many different circumstances, that the changes which are 
 common to all, cannot be relied upon as occurring at the same 
 age. The period of puberty, for instance, depends upon climate, 
 food, manner of life, and probably much upon the constitution 
 itself. 
 
 As has been heretofore stated, the centre of the body, at birth, 
 is at the umbilicus. In the adult, it is generally at the pubes ; 
 and for the intermediate ages, at intermediate points — nearer to 
 the umbilicus in the infant, and to the pubes in those approach- 
 ing the adult age. In the female, the lower extremities being 
 shorter than those of the male, especially the thigh bones, the 
 centre of the body will be found above the pubes. 
 
 The following generally mark the times of the appearance of 
 the first set or milk teeth, those of the lower jaw preceding those 
 of the upper : 
 The central incisors, in from five to seven months : 
 The lateral incisors, in from six to nine months : 
 The first molars, in from eight to fifteen months : 
 The canine teeth, in from fifteen to eighteen months : 
 The second molars, in from eighteen to twenty-four months. 
 The above can only be stated as general results. There is 
 groat diversity in individual cases. 
 
A.GR. 613 
 
 The permanent set are very irregular in the time of their ap- 
 pearance They are not complete till the dentes sapientitB appear. 
 This generally happens from the eighteenth to the twenty-fifth 
 year, but it is occasionally deferred to a much later period. One 
 remarkable case is mentioned of a man of eighty, who died from 
 the irritation produced by cutting his wisdom tooth. - 
 
 As one of the signs of old age, the arcus senilis, or white line 
 around the margin of the iris, has been mentioned; but the 
 times of its appearance in different individuals are very various. 
 All the other indications of age in the living, are more or less de- 
 ceptive. 
 
 In the dead subject, age will be found to work many changes 
 upon the osseous system. As old age increases the internal cavi- 
 ties of the bones increase, from the absorption of the osseous 
 matter, and the bones will, therefore, become lighter. Those of 
 the head are more solidly united, but the absorption of their 
 diplce renders them thin. The lower jaw becomes shallow ; the 
 alveolar processes are absorbed, and the angle again becomes ob- 
 tuse as in childhood. The spinal column is also curved. The 
 cartilages of the larynx and ribs are ossified. In children, the 
 gelatine greatly preponderates in the composition of the bones. 
 In youth, the gelatine and earthy matter are found united in 
 about equal proportions. In old age, the phosphate of lime 
 greatly predominates. Hence the osseous tissue is more dense, 
 dry and fragile, abounding as it does in earthy materials. The 
 heart and arteries are generally found to some extent ossified, 
 in old age. 
 
 II. IDENTITY. 
 
 Questions of identity, relative to the living and the dead, are 
 frequently occurring in courts of justice. There is one instance 
 in which a jury may be empanelled to try the question of identity 
 only, and that is where a prisoner after his conviction makes his 
 escape and is re-taken. In the inquest of the coroner, the first 
 step taken is to identify the body, or such remains of it as may 
 be found. 
 
 In identifying the living, the testimony of medical witnesses is 
 
61-1 MEDICAL JURISPRUDENCE. 
 
 not often required, unless to explain the nature of deformities, or 
 injuries, or some particular changes, designed to alter the exter- 
 nal appearance. The following may be enumerated as some of 
 the means by which, in a disputed case, the identity may be 
 established or disproved : 
 
 1 . Congenital marks or malconfbrmations. These are of a per- 
 manent character, and, when well established, may always be 
 relied upon. 
 
 2. Wounds, or injuries of the hard parts, as the bones. These, 
 where the injuries are severe, will be likely to remain for long 
 periods of time. 
 
 3. Wounds, or injuries on the soft parts. These leave behind 
 them scars, the presence or absence of which may decide th * 
 question in controversy. In a case of bigamy, which came o'i 
 for trial before Judge Livingston, in New-York, in 1804, the only 
 question was one of identity : whether Joseph Parker, as be 
 called himself, was really Thomas Hoag, under which name he 
 was being tried. It was stated that Hoag had a scar on his fore- 
 head, a small mark on his neck, and that his speech was quick 
 and lispiDg. All these peculiarities were found on the prisoner. 
 It was, however, testified that Hoag had a scar under his foot, 
 occasioned by treading upon a drawing knife. On examining his 
 feet, mo scar was to be found en either of them. 1 Beck, 516 ; 
 Guy, 22. 
 
 4. Scrofulous ulcers leave behind them cicatrices, which are 
 almost as permanent as scars. Small-pox and burns also leave 
 their marks behind them. 
 
 5. The effect produced on the system by working at particular 
 trades or professions, should also be carefully examined. 
 
 6. Form of face, cast of countenance, make of body, physiog- 
 nomy, pathognomy, the consideration of all those many things 
 that make up the idea of an individual. These are the most 
 subject to change ; but they offer the most obvious and easily 
 accessible means of judgment. 
 
 Long continued exposure to fatigue and hardship, and the 
 action of depressing passions, will produce great changes in the 
 individual. This was illustrated in the case of the Italian, Casali, 
 
IDENTITY. 610 
 
 who left his country at an early age, and returned after an ab- 
 sence of thirty years, and laid claim to his property which his 
 heirs had appropriated to themselves. The judges were much 
 perplexed and embarrassed, and finally consulted Zacchias as to 
 whether the human countenance could be so changed as to 
 render it impossible to recognize the person. He.assigned several 
 causes which might produce such an alteration ; as age, change 
 of air, aliments, the manner of life, and the diseases to which we 
 are liable. The decision was finally given in his favor, the heirs 
 failing to prove his death. 
 
 There are cases on record in which the hair has been suddenly 
 changed from black to white in the course of a few hours. Mary, 
 Queen of Scotland, is said to have afforded one instance, several 
 other are also mentioned. Guy, 24. Violent and sudden emotion 
 has also had the same effect. The hair may be changed by va- 
 rious agents. Charcoal and grease will change it from a light to 
 a dark color. It may be detected by its soiling the fingers, or 
 by putting a lock into boiling water. Litharge, chalk, and fresh 
 lime, composing the Tinctura Pompeiana, changes the color from 
 light to various shades of brown and black. So, also, black hair 
 may be changed to various lighter shades, as to chestnut, blond 
 and yellow, by being steeped or washed in solutions of chlorine, 
 of different strengths, and during a longer or shorter time. In 
 such cases, the chlorine is readily detected by its smell. These 
 deceits are always easily detected by allowing the hair to grow 
 for a short time, the individual not having access to these means. 
 In identifying the dead, the physician may be called upon to 
 determine the age, sex, and probable stature of the party to whom 
 the fragments belong ; and also to notice any particular deformity 
 that may serve as a means of identifying. Dupuytren identified 
 the body of a murdered man chiefly by a malformation of the 
 hip joint. A case in Edinburgh was decided by a dentist, who 
 produced a cast of the gums which he had taken during life. In 
 the late trial of Dr. Webster, in Boston, for the murder of Dr. 
 George Parkman, the only evidence of any importance bearing 
 on the subject of identity, was the testimony of the dentist, Dr. 
 Keep. A block of teeth was found in Dr. Webster's laboratory, 
 
616 MEDICAL JURISPRUDENCE. 
 
 which, on being shown to Dr. Keep, he recognized as a set of 
 teeth he had made for Dr. Parkman in 1846, between three or 
 four years previous to the trial. There was great irregularity in 
 the left side of the lower jaw of Dr. Parkman, which occasioned 
 much trouble in filling. On this left side was the largest block.. 
 After being set, the Dr. complained that he had not room enough 
 for his tongue, to obviate which, the witness ground off the lower 
 jaw, which, from want of space, he was compelled to do on a 
 very small wheel. The effect of this was to remove the pink 
 color which was to represent gums and enamel. The shape left 
 by the grinding was peculiar, because of its being ground on a 
 small wheel. He was enabled, as he stated, to recognize the 
 shape of the outline as being the same that he had labored on so 
 long. On finding and comparing the model with the left lower 
 block, the resemblance was very striking. The remains of the 
 Marchioness of Salisbury were identified by the jaw-bone having 
 gold appendages for artificial teeth. There is great danger that 
 on such occasions public opinion, feeling, or passion, may warp 
 the judgment, and sometimes even pervert the facts. The 
 celebrated case of the body of Timothy Monroe being identified 
 as that of William Morgan, the murdered freemason, in 1827, 
 will present a case fully in point. The proof from the testimony 
 of Mrs. Morgan, the family physician, and others, seemed to 
 leave scarcely any doubt on the subject. The bald head, gray 
 beard, much hair on the breast, long white hairs in the ears, 
 mark of innoculation on the left arm, the teeth double all round, 
 two of them extracted from the same side of the face, the dentist 
 having the very teeth which fitted exactly, the marks of a sur 
 gical operation upon the' large toe of the left foot, all seemed to 
 be proof of a character that could leave little doubt remaining, 
 notwithstanding the clothes found on the body were differ- 
 ent from any Morgan had ever worn, and his pocket was found 
 to be full of tracts published by the British Tract Society. The 
 verdict was that the body was that of William Morgan. Soon 
 afterwards, a Canadian advertisement for the body of Timothy 
 Monroe caused the remains to be disinterred, when, on the hold- 
 ing of a second inquest, it was discovered that the teeth were not 
 
IDENTITY. 617 
 
 double all round in front, and that five had been extracted from 
 this body, whereas Morgan had lost but two. The jury, fourteen 
 days after the other inquest, found the body to be that of Timothy 
 Monroe. 
 
 It is an important inquiry what proofs, in relation to identity, 
 can be derived from the skeleton itself ; and, in the first place, 
 it is inquired whether any results as to the probable stature of 
 the party can be arrived at from the examination of an extremity 
 or a bone. M. Sue has attempted to answer this inquiry so far 
 as concerns the extremities. He has embodied the results of 
 his measurements in a table ; but it appears, from subsequent 
 examination, that these results are to be received with caution. 
 It has been remarked that from the twentieth to the twenty-fifth 
 year, the superior border of the symphysis pubis forms the centre 
 of the body, and this continues through the more advanced ages, 
 the only change taking place in old age being the curving of the 
 spine. Previous to adult age, the centre of the body varies ac- 
 cording to the age. Guy, 33. 
 
 The skeletons of the two sexes bear to each other a much 
 f reater resemblance prior to puberty than subsequently. The 
 bones in the female are lighter, more cellular, and less marked 
 either by asperities, or by being curved by muscular action, or 
 by processes, than those of the male. The female skull is smaller, 
 more oblong, and less depressed at the sides. The jaws and 
 teeth are also smaller, and the chin less prominent. The ster 
 num is shorter, and more convex ; the ensiform cartilage thinner 
 and later ossified ; the ribs more delicate, and their cartilages 
 longer ; and the antero-posterior diameter longer than the lateral. 
 Guy, 47-8. 
 
 The stature of the female is, on the average, considerably less 
 than that of the male. The great relative differences between 
 the two are to be found in the width of each at the hips and 
 shoulders. In the former, the female skeleton exceeds the male ; 
 in the latter, it is just the reverse. 
 
 The most marked point of difference is to be found in the pel- 
 vis. The following are the principal points of difference : 
 
 1 . In the male, there is a certain roughness, bulkiness and 
 
618 MEDICAL JURISPRUDENCE. 
 
 weight ; in the female, more lightness, smoothness and elegance. 
 
 2. In the male, the ilia are more erect ; in the female more ex - 
 panded. 
 
 3. In the male, the brim is more rounded, the longest diameter 
 stretching from before backward ; in the female, more oval, the 
 long diameter lying between the sides. 
 
 4. In the male, the pelvis is deep ; in the female, shallow. 
 
 5. In the male, the outlet is small ; in the female, capacious. 
 
 6. In the male, the arch of the pubis is contracted ; in the 
 female, capacious, in order to make room for the ready passage 
 of the head. 2 Beck, 24-5. 
 
 III. SURVIVORSHIP. 
 
 There are often important rights attached to survivorship. 
 The descent of property is frequently made dependent upon it. A 
 mother and her child both die during delivery. Which one sur- 
 vived the other 1 If the mother survived the child, then her 
 heirs are entitled to her property. If the child the mother, 
 then its heirs are entitled to it. The rights of' the claimants all 
 depend upon the simple fact of survivorship. In the absence of 
 all direct proof, therefore, how is a question of this kind to be 
 settled! 
 
 Our law has laid down no rules on the subject. The evidence, 
 at best, can amount to probabilities, and these must be derived 
 from the medical profession. These probabilities may arise in 
 two classes of cases.' The first of these relates to the survivorship 
 of mother and child, when both die during delivery. 
 
 The presumption here is somewhat dependent on circum- 
 stances. There are several causes that go to favor the survivor- 
 ship of the mother. The iniant may die, 
 
 1 . From a difficult or slow delivery : 
 
 2. From pressure on the umbilical cord : 
 
 3. From partial detachment of the placenta, giving rise to 
 haemorrhage : 
 
 4. From the parturitions being complicated with convulsions 
 
 5. From the infant being very large, or prematurely born. 
 There are, however, certain causes that may destroy the life 
 
hturvivORSHip. 619 
 
 of the mother first. Sudden accidents, such as drowning, a blow 
 on the head, or violent hemorrhage, may have this effect. The 
 child may also survive if the death of the mother be owing to a 
 severe acute disease. But if the mother die of a lingering wasting 
 disease, the probabilities are in favor of her survivorship. 
 
 The second class of cases relates to the question of survivor- 
 ship where two or more are destroyed by a common accident, such, 
 for instance, as a shipwreck. Questions of this kind generally 
 arise in those cases where father and son, or husband and wifo 
 perish by a common accident, and no direct proof can be obtained 
 as to which of the two survived. The Koman law in such cases 
 adjudged the survivorship to the husband ; and in case of lather 
 and son, to the son, if he had arrived at his majority ; and, in 
 case of two individuals, the one not having arrived at the age of 
 puberty, to the one who had passed that period. 
 
 The code Napoleon makes the following provisions : 
 
 " If several persons, naturally heirs of each other, perish by 
 the same event, without the possibility of knowing which died 
 first, the presumption as to survivorship shall be determined by 
 the circumstances of the case, and in default thereof, by strength 
 of age and sex : 
 
 If those who perished together, were under fifteen years, the 
 oldest shall be presumed the survivor : 
 
 If they were all above sixty, the youngest shall be presumed 
 the survivor : 
 
 If some were under fifteen, and others above sixty, the former 
 shall be presumed the survivors : 
 
 If those who have perished together, had completed the age of 
 fifteen, and were under sixty, the male shall be presumed the 
 survivor, where ages are equal, or the difference does not exceed 
 one year : 
 
 If they were of the same sex, that presumption shall be admit 
 ted which opens the succession in the order of nature, of course 
 the younger shall be considered to have survived the elder." 1 
 Beck, 494. 
 
 These are cited as being generally founded on correct physio 
 logical principles, except that where those under fifteen are ad 
 
620 MEDICAL JURISPRUDENCE. 
 
 judged to survive those over sixty, there is thought to be an 
 error ; as that would embrace infants who would probably perish 
 much sooner than those over sixty. 
 
 It may be stated, in general terms, that the body arrives at its 
 maximum of strength and vigor at from twenty-five to thirty 
 years of age, and continues in possession of that strength up to 
 about fifty years. Before and after these periods the power of 
 endurance will become very gradually less. 
 
 There have been but few decisions upon this point, too few to 
 settle many principles in reference to it. In the case of Satter- 
 thwaite vs. Powell, 1 Curtis' Eccl. Reports, Major Arrnett, his wife 
 and four children, all perished together by shipwreck. In this 
 case the court decided that the parties must be presumed to have 
 died at the same time, and the fact of the husband's survivorship 
 not being affirmatively made out, administration must pass to 
 the next of kin. 
 
 In the case of General Stanwix, who perished with his daughter, 
 by shipwreck, the court could not come to any decision, but ad- 
 vised a compromise, to which the claimants agreed. Guy, 403 ; 
 1 Beck, 495, fyc. 
 
 In the case of Taylor who, with his wife, perished by ship- 
 wreck, the court presumed the survivorship of the husband, and 
 granted administration to his next of kin. 1 Beck, 496, et seq. 
 
 The same decision was made in the case of Selwyn and his wife 
 in 1831. 
 
 In the case of The King vs. Hay, 1 Blackstone , s Reports, 640, 
 where a father and his only daughter perished at sea in the same 
 vessel, the court did not decide the question of inheritance, but 
 Lord Mansfield recommended a compromise, and said there was 
 no legal principle on which he could decide it. 
 
 In Wright vs. Sarmuda, 2 Phillmore, 266, where the husband 
 with his whole family perished together by shipwreck, the court 
 held that they all died together and that none could transmit 
 rights to others. 
 
 In Taylor vs. Diplock, 2 Phillmore, 261, the court held to the 
 same doctrine as applicable to husband and wife under the same 
 circumstances. 
 
LIFE ASSURANCE. 621 
 
 IV. LIFE ASSURANCE. 
 
 " Life assurance is a contract by which the underwriter, for a 
 certain sura, proportioned to the age, health, profession, and 
 other circumstances of that person whose life is the object of in- 
 surance, engages that the person shall not die within the time 
 limited in the policy; or if he do, that he will pay a sum of money 
 to him in whose favor the policy was granted." 2 Park on Insu 
 ranee, 571 . The period of time insured may be limited to a cer- 
 tain number of years, or it may be during the life of the indi- 
 vidual. 
 
 The policy expresses the terms of the contract between the 
 parties. It usually excepts the case of death by suicide or by 
 the hands of justice. It may also be rendered void by any fraud- 
 ulent concealment on the part of the assured. 
 
 The business of life assurance is now carried on very exten- 
 sively, and the general 1 mode of proceeding is so well understood 
 as to require but slight notice. The offices generally have in 
 their employ a physician, whose duty it is to examine and report 
 upon the condition, and state of health of the applicant. They 
 also generally present a list of questions which the medical at- 
 tendant of the applicant is required to answer in writing. These 
 relate principally to present and past states of health, hereditary 
 predispositions, habits of life, and diseases with which he may 
 have been attacked. The general object to be accomplished is to 
 determine the degree of risk attending the proposed insurance. 
 
 The more precise and definite the questions proposed, and the 
 more fully they are made to cover the whole ground of risk, the 
 less occasion will be likely to arise for litigation. Still some 
 questions submitted may be answered in perfect good faith, and 
 yet give rise to disputes. Thus the applicant may be suffering 
 from indigestion, or some trifling disorder which the physician 
 says nothing about, as he does not look upon it as having a ten- 
 dency to shorten life. All such, therefore, may become questions 
 in courts of law, to be decided on medical testimony. 
 
 In the case of Sir James Ross, who was warranted in good 
 health at the time of making the policy, it was decided that the 
 
G22 MEDICAL JURISPRUDENCE. 
 
 omission to state the receipt of a wound, having no connexion 
 with the fever of which he died, did not avoid the policy. That 
 the only question was " whether he was in a reasonable good 
 state of health, and such a life as ought to be insured on common 
 terms.' 1 
 
 In the case of Breasted vs. The Farmers' 1 Loan and Trust Com- 
 pany, 4 Hill, 75, the question came up for decision whether an 
 act of suicide can be perpetrated by an insane person. An action 
 was brought on the policy. The plea interposed was that the 
 policy excepted death by his own hand, and that the assured had 
 committed suicide. Replication that when he committed it he 
 was mentally deranged. Demurrer to the replication. The 
 court sustained the demurrer j thus settling the principle, that 
 the suicide excluded by the policy was such as could not be in- 
 flicted by an insane mind. This is in accordance with the prin- 
 ciple laid down by Blackstone in 4 Blackstoneh' Com., 184, that 
 suicide involves the deliberate termination of one's existence, 
 while in the possession and enjoyment of his mental faculties, 
 and that self slaughter, by an insane man or a lunatic, is not an 
 act of suicide within the meaning of the law. 
 
 In another case which occurred in England, the policy was 
 contested on the ground that no mention was made of spasms 
 and cramps from fits of the gout, but the court decided that a 
 warranty can never mean that a man has not the seeds of a dis- 
 order, for we are all born with the seeds of mortality in us ; and 
 that a man subject to the gout, is alike capable of being insured, 
 if he has no sickness at the time to make it an unequal contract. 
 
 In the case of Swete vs. Fairlie, 6 Carrington §• Payne, \ , it was 
 decided that a policy of insurance on the life of another person, 
 who at the time of the insurance, is in a good state of health, is 
 not vitiated by the non-communication by such person of the 
 feet of his having, a few years before, been afflicted with a dis- 
 order tending to shorten life, if it appears that the disorder was 
 of such a character as to prevent the party from being conscious 
 of what had happened to him while suffering under it. 
 
 In the case of Watson vs. Mainwaring and others, 4 Tauntc^ 
 7C3, the recovery was resisted on the ground that he stated In 
 
LIFE ASSURANCE. 623 
 
 his declaration that he labored under no disorder which tended 
 to shorten life, whereas he had been afflicted with symptoms of 
 dyspepsy. As it was proved to have been neither " organic nor 
 excessive " the recovery was allowed. 
 
 In 1 Carrington # Payne's Nisi Prius Reports, 360, a recovery 
 was successfully resisted, on the ground that -the individual omit- 
 ted to name his actual medical attendant, but named one who 
 had formerly attended him, but had not for the three years next 
 preceding the date of the application, and during which time he 
 had labored under serious illness. 
 
 It was proved in a case tried at York, in 1835, that the indi- 
 vidual labored under insanity at the time the policy was effected ; 
 but as all the medical witnesses, except one, testified that they 
 did not think this disease had a tendency to shorten life, a ver- 
 dict was given to the plaintiff. 
 
 If the applicant is addicted to habits of intemperance, that fact 
 should not be concealed from the insurers. In two cases the 
 actions were defeated upon the ground that the knowledge of 
 such habits had been withheld, although the health of the indi- 
 viduals was at the time, apparently good. 6 Easfs Rep., 188 ; 5 
 Bingham, 503. 
 
 In the case of the Earl of Mar, related by Professor Christison, 
 Lie question arose whether the habit of taking opium to excess 
 for many years was one tending to shorten life. The case was 
 decided chiefly on a technical ground, and was finally compro- 
 mised. 
 
 In the matter of life assurance there is much yet to be learned : 
 
 1 . As to the effect of alcoholic liquors on the duration of human 
 life : 
 
 2. As to the effect of certain habits of living, and of certain 
 arts, trades, and professions on longevity : and, 
 
 3. What extent of influence certain diseases, such as inflam- 
 mations, apoplexy, &c, have in shortening life, although the in- 
 dividual has apparently entirely recovered from their effects 
 
624 MEDICAL JURISPRUDENCE. 
 
 MEDICAL EVIDENCE. 
 
 The great object of the science of Medical Jurisprudence is io 
 qualify medical men for testifying understandingly in courts of 
 justice. The general rules bearing on this subject are essentially 
 the same in whatever court the physician may be called upon to 
 testify. The court in which he is the most frequently and con- 
 stantly called upon is the coroner's. The great object here is to 
 enquire into all cases of death attended by circumstances of an 
 unusual or suspicious nature. 
 
 In this state, whenever a coroner receives notice that any per- 
 son has been slain, or has suddenly died, or has been dangerously 
 wounded, a jury must be summoned of not less than sixteer, 
 nor more than twenty-three. The jury's first duty, after bein 5 
 sworn, is to view the body, without doing which the inquest j * 
 void. They next hear evidence as to the cause of death. Th e 
 inquest is generally held in a public house nearest to the spct 
 where the body was found. The coroner has the power of sum- 
 moning witnesses and of compelling their attendance. The wit- 
 nesses are sworn previously to being examined, their testimony 
 is reduced to writing, and returned, together with the inquisition 
 of the jury, to the next criminal court of record that shall be held 
 in the county. 
 
 The necessity that is almost always found to exist of having 
 the attendance of a medical witness has led, in many instances, 
 to the selection of physicians to fill the office of the coroner. 
 This, in the common run of cases, might save the necessity of 
 the attendance of a medical witness. In England a provision has 
 been made to remunerate the medical witness for his 'time and 
 attendance upon this court, but hitherto none has been made in 
 this state. He may be compelled to attend all criminal trials in 
 the different courts of this state without any pecuniary compen- 
 sation. This operates as a peculiar hardship, especially as he is 
 often called upon to make post-mortem examinations with a view 
 to ascertain the cause of death, and sometimes to analyze sus- 
 pected fluids. His duties as a witness, however, do not require 
 him to make this examination or to analyze those fluids. The 
 
MEDICAL EVIDENCE. 625 
 
 law demands of him only what lie actually knows, and cannot 
 compel him to acquire additional knowledge. It is, therefore, at 
 his own option whether he will make post-mortem examinations, 
 or analyze suspected fluids. 
 
 The coroner's court is the only tribunal that can originate en- 
 quiries into the cause of death where no suspicion attaches to 
 any party as guilty. Its finding is never final either as to the 
 cause of death or the party that occasioned it. As the same 
 matter is generally destined to undergo other and much more 
 searching investigation in higher courts, it becomes very neces- 
 sary that the medical witness should be extremely cautious in 
 giving his testimony, because if he is not, he will be embarrassed 
 in his second examination, as his previous .deposition may be 
 brought up and compared with what he is giving on the trial. 
 
 Witnesses in all courts are either common or skilled. The duty 
 of the first is simply to state facts ; that of the second, to state 
 opinions. The medical witness may be required to do either, 
 but when regarded purely as a medical witness, he is a skilled 
 one, or as is more commonly termed, an expert. 
 
 The principle upon which the skilled witness gives his testi- 
 mony is by no means confined to the medical witness. It em- 
 ■ braces all matters of science, and all questions of skill and judg 
 ment. In all such, men of knowledge and experience may be 
 required to give their opinions. These opinions are presumed 
 to be grounded upon such a knowledge of facts and principles as 
 to entitle them to great weight and consideration. A medical 
 witness need not even be acquainted with the case in relation to 
 which his testimony is required. He may hear the evidence of 
 others, and then be called upon to prove the general effect of the 
 disease they describe, and its probable consequences in the par- 
 ticular case. So in regard to the effects of wounds, medical wit- 
 nesses may be always required to show whether they were of 
 such a character as to result in death. 
 
 The duties of a witness when called on to the stand, are to 
 answer as clearly and intelligibly as possible, the questions asked 
 him by counsel, court, or' jury. If the precise answer will not 
 elicit the whole truth, whatever is wanting to do thait should be 
 
 40 
 
626 MEDICAL JURISPRUDENCE. 
 
 supplied. The witness, however, should understand that it js 
 no part of his duty to volunteer statements not required of him, 
 and not , directly connected with the matter in controversy. 
 Whenever he undertakes to do that, he is very likely to furnish 
 points upon which he can be more or less embarrassed in his 
 cross-examination. The language made use of should be plain, 
 simple, and, if possible, devoid of all technical terms. 
 
 The first examination is made by the counsel calling him, 
 which is termed his direct examination. The object of this is to 
 elicit the opinion of the witness on the point in controversy. 
 This opinion every medical man, every skilled witness, is entitled 
 to give. The value of it will depend upon the knowledge on 
 which it is based. , It is, therefore, important that the opinion 
 thus given should be thoroughly sifted, to get at the foundation 
 on which it rests. This is usually done by the opposing counsel, 
 in what is called his cross-examination. Here all the possible 
 grounds may be examined, and all the knowledge in relation to 
 the particular subject, together with the means and facilities of 
 acquiring it, inquired into. This sometimes takes a great length 
 of time, and is extremely tedious and embarrassing. The result 
 of this cross-examination tends either to establish or weaken, and 
 sometimes entirely invalidate, the opinion given. 
 
 It should be constantly borne in mind by the medical witness, 
 that -so far as he speaks in the character of an expert or skilled 
 witness, he has nothing to do with collateral circumstances. This 
 opinion should be based entirely upon the. medical facts which 
 are made to appear in the case, and the medical principles that 
 are applicable to them. The intermingling of common with 
 medical facts, and the statement of opinions founded on both, 
 will effectually destroy all confidence in any opinions thus formed 
 and declared. 
 
 A question has been raised whether a medical witness, while 
 testifying on the stand, is at liberty to cite medical authorities, 
 and to refer to and read them, for the purpose of fortifying his 
 own opinion. This he is not in form permitted to do. He may 
 refer to authorities, and state from recollection what they con- 
 tain in reference to the point in controversy ; but he is presumed 
 
MEDICAL EVIDENCE. 627 
 
 to embody in his own opinion the views and ideas of the leading 
 authorities of his profession. 
 
 Whenever a medical practitioner becomes acquainted with a 
 case which he either knows, or has good reason to believe, will 
 be made a matter of legal investigation, he should avail himself 
 of the earliest opportunity to reduce his observations to writing, 
 in which form they should be preserved. From notes, or written 
 memoranda thus made at the time, or as soon after as is practi- 
 cable, he will be permitted to refresh his memory, while testify- 
 ing, and thus be enabled to be much more full, complete and 
 satisfactory in his testimony than he could possibly be without 
 their assistance. 
 
 Another thing of great importance for a medical witness to 
 understand is how far the law will protect him in refusing to 
 state confessions which the patient may have made to him in 
 confidence. All facts communicated by a client to his legal ad- 
 viser, which are essential or necessary to enable him to advise or 
 act upon, in a matter of business, or which the client has good 
 reason for believing to be thus essential or necessary, are within 
 the rule of protection, and the counsel has no right to give them 
 in evidence in a court of law. Jlnneshy vs. Lord Anglesia, 17 
 Haw. St. Tr., 1239 to 1244. 
 
 In relation to the clergy, a case is reported in 2 City Hall 
 Recorder, 80, in which the point came up before the mayor, the 
 late De Witt Clinton, whether confessions made to a Catholic 
 priest, in accordance with the discipline of the church, could be 
 given in evidence in a court of justice. The rule established in 
 England was to compel the production in evidence of cbnfessions 
 made under such circumstances. In the case above referred to, 
 it was held that the confessions were within the rule, and, there- 
 fore, could not be given in evidence. In regard to the clergy of 
 other denominations, in which confession forms no part of church 
 discipline, they are not within the rule of protection, and hence 
 they may be compelled to disclose all confessions made, however 
 secret or confidential they may have been. 
 
 In regard to physicians, in all the States of the Union except 
 New- York and Missouri, the physician may be compelled to 
 
628 MEDICAL JURISPRUDENCE. < 
 
 testify what his patient may have admitted to him, however 
 secret or confidential may have been the communication. This 
 was also the law in this state, until the Revised Statutes of 1830, 
 see 2 R. S., 406, § 73, enacted that "no person duly authorized 
 to practice physic or surgery shall be allowed to disclose any in- 
 formation which he may have acquired in attending any patient 
 in a professional character, and which information was necessary 
 to enable him to prescribe for such patient as a physician, or to 
 do any act for him as a surgeon." This affords complete pro- 
 tection so far as the communication made is of such a character 
 as the act requires. Beyond that, the principle of protection 
 does not extend. Within the principle of protection, the party 
 may, if he choose, waive the privilege, in which case the facts 
 may be disclosed. 
 
 The refusal of a witness to testify what may legally be requi- 
 red of him, will subject him to imprisonment for a contempt of 
 court, until he is willing to comply with what the law demands. 
 
 It may become important to know what are the legal requisi- 
 tions of a confession, or what qualities it must possess before it 
 can be given in evidence : " A confession, in order to be ad- 
 missible, must be free and voluntary; that is, it must not be ex- 
 tracted by any sort of threats or violence, nor obtained by any 
 direct or implied promises, however slight, nor by the exertion 
 of any improper influence." No confession made to a physician 
 can be given in evidence, unless received with the qualifications 
 above mentioned. The physician should also be enabled to tes- 
 tify as to the state of the 'mind of the party making the confes- 
 sion. 
 
 One other topic remains to be adverted to under this head, 
 and that is the subject of Dying Declarations. These the physi- 
 cian will be the most likely to hear, and hence they become the 
 most important for him to understand. In the admission of 
 these declarations in evidence, the law, from the necessity of the 
 case, is compelled to dispense with a test which it deems all- 
 important in eliciting the truth, and that is, the cross-examination 
 of the witness. It permits the dying man to speak without be- 
 ing subjected to this test. As an equivalent for this, no declara- 
 
MEDICAL EVIDENCE. 629 
 
 tions of that kind can be admitted unless under very peculiar 
 circumstances. The law requires two things to render them 
 admissible. The one is, that the party making them shall be 
 in a dying state at the time they are made ; and the other is, 
 that he shall himself be fully aware that he is in that state. It is 
 necessary that he should be placed under the most solemn cir- 
 cumstances, as he is allowed to speak without the sanction of 
 an oath. The physician will be expected to state what his real 
 situation and condition were, and probably also what he thought 
 his situation to be at the time he made the admission. 
 
 It is further necessary, to entitle them to admission, that the 
 death of the deceased should be the subject of the charge, and 
 the circumstances of the death, the subject of the dying decla- 
 ration. " As the declarations of a dying man are admitted on a 
 supposition that in his awful situation, on the confines of a future 
 world, he had no motives to misrepresent, but on the contrary 
 the strongest motives to speak without disguise and without 
 malice, it necessarily follows, that the party against whom they 
 are produced as evidence, may enter into the particulars of his 
 state of mind, and of his behavior in his last moments; or may 
 be allowed to show that the deceased was not of such a charac- 
 ter as was likely to be impressed with a religious sense of his 
 approaching dissolution." 
 
INDEX 
 
 ABBOT, 
 
 case of, 548. 
 ABDOMINAL ENLARGEMENT, 
 
 sign of pregnancy, 52. 
 
 when commences, 52. 
 
 when ceases, 52. 
 
 when owing to other causes, 53. 
 ABDOMEN, 
 
 wounds of the, 231. 
 ABORTION, 
 
 statutes of New-York concerning, 126. 
 
 by what means produced, 130. 
 
 natural causes productive of, 130. 
 
 practiced in the city of New-York, 138. 
 
 principal points to be attended to in case of, 1JS 1 
 ABSORPTION OF POISONS, 
 
 facts going to show, 295. 
 ACCESS, 
 
 legal presumption of, 80. 
 ACIDS, MINERAL, 
 
 their properties, 330. 
 
 the symptoms they produce, 330. 
 
 treatment in case of poisoning with, 333. 
 
 three principal acids, what, 333. 
 ACID, NITRIC OR SULPHURIC, 
 
 evidence of administration of, 331. 
 
 morbid appearances caused by, 332. 
 ACID, SULPHURIC, 
 
 how distinguished from others, 333. 
 ACTS 
 
 indicating volition after wounds, 260. 
 ACONITUM NAPELLUS, 
 
 monkshood, 406. 
 ADAMS, PHINEAS, 
 
 remarkable case of, 600. 
 ADIPOCERE, 
 
 how appearing and from what formed, 424. 
 
632 INDEX. 
 
 AGE, 
 
 modifying character of wound, 270. 
 
 a physical cause of impotence, o. 
 
 or period within which conception may occur, 70. 
 
 considered as affecting the question of identity, 612. 
 
 centre of ths body, means of distinguishing, 612. 
 
 times at which the first set of teeth appear, 612. 
 
 times at which the dentes sapientiee appear, 613. 
 
 what effect It has upbn the bony systems, 613. 
 AGGREGATION, 
 
 state of, a modifying circumstance, 299. 
 AIR, 
 
 an element essential to putrefaction, 422. 
 ALCOHOL, 
 
 through what medium it acts, 409. 
 
 effect of in small doses, 410. 
 
 symptoms of poisoning by, 410. 
 
 morbid appearances caused by, 410. 
 
 treatment in case of poisoning by, 410. 
 ALDEN, I/XDIA, 
 
 case of, 274. 
 ALKALIES AND THEIR SALTS, 337. 
 
 mode of action of, 337. 
 
 symptoms of poisoning by, 337. 
 
 post-mortem appearances caused by, 338. 
 AMMONIA, 
 
 what, 339. 
 
 symptoms of poisoning by, 339. 
 
 morbid appearances caused by, 339. 
 
 remedies in case of poisoning by, 340. 
 ANDROGYNE, 
 
 what, 19. 
 ANDROGYNI, 
 
 what, 18. 
 ANIMALS, 
 
 experiments on, as evidence of poisoning, 314. 
 ANIMAL HEAT, 
 
 extinction of as a cause of death, 419. 
 ANIMALCULE 
 
 in semen, 30. 
 ANIMAL MATTER DECAYED, 
 
 poisonous, 384. 
 ANNESLEY, RICHARD, 
 
 case of, 245. 
 ANTIDOTES TO POISON, 
 
 with what view given, 304. 
 ANTIMONY, 
 
 salts of, 380. 
 APOPLEXY, 
 
 what it arises from, 385. 
 
INDKX. 633 
 
 A.POPLEXY— (Continued.) 
 
 how distinguished from narcotic poisoning, 3S6. 
 
 of the congestive kind, 387. 
 
 of the serous kind, 387. 
 
 from extravasation, 387. 
 
 how it occurs, 428. 
 
 what to have reference to in cases of, 428. 
 
 of the simple kind, 428. 
 
 as a cause of death by hanging, 441. 
 APPEARANCES 
 
 not always produced by contused wounds, 209. 
 
 case of, 210. 
 
 from post-mortem examination, proof of poisoning, 309. 
 AQUA TOFFANIA, 
 
 account of, 289. 
 AECUS SENILIS, 
 
 what, and how a mark of age, 613. 
 AREOLA, 
 
 what, 48. 
 
 its dimensions and color, 48. 
 
 its raised appearance, turgescenee, and glandular follicles, 49. 
 
 when it appears, 50. 
 ARISTOTLE S 
 
 theory of functions of the testicles, 8. 
 ARNOLD, 
 
 case of, 533. 
 .ARSENIC, 
 
 a metallic compound, 340. 
 
 its difl2rent preparations, 340. 
 
 its properties, 341. 
 
 its solubility, 341. 
 
 its taste, 341. 
 
 its chemical tests, 341. 
 
 tests of in liquids containing organic matter, 344. 
 
 its action on the living system, 345. 
 
 quantity necessary to produce fatal effects, 345. 
 
 time within which its effects begin to be developed, 345. 
 
 course and character of symptoms, 346. 
 
 medium through which it acts, 346. 
 
 first variety of symptoms, 347. 
 
 second variety of symptoms, 348, 
 
 third variety of symptoms, 350. 
 
 when introduced into the system through oilier channels than the 
 stomach, 351. 
 
 points to be observed in reference to symptoms, 352. 
 
 treatment in case of poisoning by, 353. 
 
 post-mortem appearances in case of death by, 353. 
 
 force of evidence derived from post-mortem appearances, 356. 
 
 ASCITES, 
 
 how distinguished from pregnancy, 53. 
 
634 INDEX 
 
 ASPHYXIA, 
 
 what, and how produced, 429. 
 
 symptoms of, 429. 
 
 appearances in dead body indicative of, 430, 
 
 cause of, 430. 
 
 nervous or syncopal, 433. 
 
 from cerebral congestion, 433. 
 ATROPA BELLADONNA, 
 
 deadly nightshade, 405. 
 AUDLEY, LORD, 
 
 case of, 6()1. 
 AUSCULTATION, 
 
 for what purpose used, 60. 
 AVENZOAR, 
 
 case of, 12. 
 
 B. 
 
 BAGSTER, MISS, 
 
 case of, 559. 
 BAGSTER et al. vs. PORTSMOUTH, 
 
 case of, 530. 
 BALLOTEMENT, 
 
 what, and how done, 59. 
 BANBURY PEERAGE 
 
 case, 5. 
 BELLINGHAM, 
 
 case of, 536. 
 BELL, J., 
 
 case of, 281. 
 B1RDSELL, 
 
 case of, 588. 
 BIRTH, 
 
 premature, 83. 
 
 how long did child survive, 171. 
 BLADDER, 
 
 state of before and after birth, 171. 
 
 wounds of the, 233. 
 BLAKE, 
 
 experiments by as to poisons acting by absorption, 29k. 
 BLINDNESS, 
 
 how imitated, 601. 
 BLIGHT, 
 
 case of, 256. 
 BLOOD, 
 
 character of foetal and adult, 141. 
 
 difference between total and ad-ilt, 142 
 
 its distribution in different organs of the body, 141. 
 
 ecchymosis or extravasation, proof of life, 147. 
 
 changes in, indicating pregnam y, 43. 
 
index. 635 
 
 spots of, how identified, 217. 
 
 why poisons are not detected in, 296. 
 
 fluid state of, in death from drowning, 436'. 
 BLOODY URINE, 
 
 how feigned and detected, 597. 
 
 marks as signs of rape, 30. 
 
 marks, difference between and menstrual discharge, 30. 
 BOWLER, KING vs., 
 
 case of, 539. 
 BORN ALIVE, 
 
 what constitutes, 112. 
 BOUGHTON, SIR THEODOSIUS, 
 
 case of, 308. 
 BRAIN, 
 
 foetal, changes in, 108. 
 
 state of in death from drowning, 436. 
 BREASTED vs. FARMERS' LOAN & TRUST COMPAN I, 
 
 case of, 622. 
 BREASTS, 
 
 enlargement of indicating pregnancy, 47. 
 
 what enlargement may proceed fi am, 47. 
 BRINVILLIER, DE MARCHIONESS, 
 
 account of, 290. 
 BROGDEN vs. BROWN, 
 
 case of. 579. 
 3R0WN, 
 
 case of, 260. 
 BROWN, WILLIAM, 
 
 case of, 512. 
 BURKE & HARE, 
 
 how they accomplished death, 44. 
 BURNING, 
 
 whether it occurred before or alter death, 450. 
 
 inflicted during life, what the appearances, 452, 
 
 CAESARIAN OPERATION, 
 
 what, 11J» 
 
 effect of, tlV. 
 
 case of, 119. 
 CALDERHEAD, MRS., 
 
 case of, 239. 
 CAMPHOR, 
 
 symptoms of poisoning by, 409. 
 CAMPBELL, MARGERY, 
 
 case of, 449. 
 C&NTHARIDES, 
 
 its symptoms, 383. 
 
036 INDEX. 
 
 C A.NTHA RIDES— (Continued.) 
 
 post mortem appearances caused by, 384. 
 
 treatment in case of poisoning by, 384. 
 CARBONIC ACID GAS, 
 
 whence derived, 403. 
 
 its effects when respired, 403. 
 
 post-mortem appearances caused by, 403. 
 
 treatment in case of poisoning by, 403. 
 CARBURETTED HYDROGEN GAS, 404. 
 CARTWRIGHT vs. CARTWRIGHT, 
 
 case of, 528. 
 CARUNCUL.S3 MYRTIFORMES, 
 
 what, 27. 
 
 appearance of, 28. 
 CASALI, 
 
 case of, 614. 
 CASES 
 
 illustrating law applicable to wounds, 272. 
 CASTLEHAVEN, LORD, 
 
 case of, 24. 
 CASTELL1, (Somnambulist,) 
 
 case of, 519. 
 CATALEPSY, 
 
 how feigned, curious instance of, 59. 
 CATALEPTIC SOMNAMBULISM, 
 
 what, 521. 
 CAUTIOUSNESS, 
 
 derangement of, 504. 
 
 direction of derangement, how governed, 504. 
 
 remarkable cases of derangement of, 505. 
 CATHARTICS, 
 
 as cause of abortion, 132. 
 CHASTITY, 
 
 its effect on impotence, 11. 
 CHITTY'S TEST OF MENTAL ALIENATION, 539. 
 CHEMICAL COMBINATION, 
 
 a modifying circumstance, 299. 
 CHEMICAL ANALYSIS, 
 
 evidence from in proof of poisoning, 310. 
 CHILD, 
 
 how long been dead, 177. 
 CHILDREN, 
 
 possible number of at one birth, 101. 
 CHRISTISON, 
 
 ease of supposed poisoning related by, 313. 
 CHOLERA, 
 
 simp ; e, distinction between and irritant poisoning, 322. 
 
 Asiatic or malignant, distinction between and irritant poisoning, 323 
 CICATRIX, 
 
 form of, 205 
 
index. 637 
 
 cicatrization, 
 
 stage of, 264. 
 CIRCULATION, 
 
 cessation of, sign of death, 418. 
 CIRCUMSTANCES PROCLAIMING MOTIVE OF INFLICTOR 257 
 CIRCUMSTANTIAL EVIDENCE, 255. ' 
 
 CLASSIFICATION OF POISOMS, 320. 
 CLEAVELAND, NORMAN, 
 
 case of, 137. 
 CIVIL AND CRIMINAL RESPONSIBILITY, 
 
 difference between, 530. i 
 
 differenr-e in evidence of each, 531. 
 CLARK vs. FISHER, 
 
 ca?e of, 563. 
 CLEPTOMANIA, 502. 
 COLD, 
 
 a means of destroying- life of new born child, 181. 
 
 effects of on system ami surface, 450. 
 
 by what means these effects have varied, 451. 
 
 morbid appearances caused by, 451. 
 COLCHICUM, 406. 
 COLICA PICTONUM, 
 
 lead colic, 376. 
 COMPOUND POISONING, 
 
 wVa% 411. - 
 
 with arsenic suid alcohol, 411. 
 CONDE, PRINCE DE, 
 
 case of, 431. 
 COMPRESSION, 
 
 how arising, 221. 
 
 symptoms of, 224. 
 CONCEPTION, 
 
 first change which follows, 40. 
 
 subsequent changes following, 41. 
 
 constitution changes, 41. 
 
 change in features, 42. 
 
 change in appetites, 42. 
 
 while in a state of unconsciousness, 73. 
 
 means of ascertaining, 81. 
 CONIUM MACULATUM, 
 
 htmlock, 406. 
 CONSTITUTIONAL PECULIARITIES 
 
 modifying wounds 270. 
 CONSTITUTIONAL DISEASE AND DEBILITY, 
 
 cause of Impotence, 10. 
 CONSTITUTIONAL PECULIARITIES WHICH INDICATE SEX, 20, 
 COMBUSTION, SPONTANEOUS HUMAN, 
 
 its possibility, 452. 
 
 phenomena attending it, 453. 
 
 pas ■ of, 454. 
 
638 INDEX. 
 
 COMMISSIONS IN CASK OF ALLEGED LUNACY, 
 
 and law in relation to, 468. 
 
 proceedings had under same, 469. 
 
 legal questions arising under sam?, 470. 
 CONDITIONS Of DERANGED MIND 
 
 leading to irresponsible acts, 553. 
 CONCUSSION OR COMMOTION, 
 
 what, 213. 
 
 how arising, 222. 
 
 cases of, 223. 
 
 symptoms of, 224. 
 CONSIDERATION, 
 
 inadequacy of, as evidence of mental weakness, 558. 
 CONSUMPTION, 
 
 how feigned, 594. 
 CONTRACTIONS AND DEFORMITY, 
 
 how feigned and detected, 603. 
 CONTUSION, 
 
 what, 200. 
 CONVULSIONS, 
 
 how imitated, 599. 
 CONTUSED WOUNDS, 
 
 how inflicted, 237. 
 COOPER, SIR ASTLEY, 
 
 case by, loss of testicle, 8. 
 COPPER, SALTS OF, 
 
 for what purpose used, 369. 
 
 its different compounds, 370. 
 
 its tests, 370. 
 
 its symptoms, 371.. 
 
 the post-mortem appearances it causes, 372. 
 
 treatment in case of poisoning by, 372. 
 
 its use for culinary and domestic purposes, 373. 
 CORD, 
 
 mark of in case of death from hanging, 443. 
 
 depends probably on the manner of death, 444. 
 CORONER, 
 
 his duties, &c, 624. 
 
 court, and duties, 624. 
 CORNIER, HENRIETTA, 
 
 case of, 512. 
 COREY, 
 
 case of, 547. 
 CORPUS LUTEUM, 
 
 what, 66. 
 
 how distinguishable, 67. 
 
 when it changes and disappears, 68. 
 
 points of difference between true and false, 69. 
 CORPORA LUTEA, 
 
 false, how formed, 69. 
 
index. 639 
 
 CORROSION, 
 
 what, 293. 
 COUNTENANCE, 
 
 evidence from, in case of death by hanging, 442. 
 COURVOISIER, 
 
 case of, 256. 
 CRANIUM, 
 
 preternatural thinness of, 271. 
 CRETINISM, 474. 
 CRIMINAL ACTS, 
 
 how distinguished from insane, 578. 
 CRICHTON, Dr., 
 
 extraordinary case related by, 417. 
 CROIX, SAINTE. 
 
 account of, 291. 
 CROWN PRINCE OF SWEDEN, 
 
 case of, 308. 
 CURTESY, 
 
 tenant by, 112. ' 
 
 DATURA STRAMONIUM, 
 
 thorn-apple, 406. 
 DAUTUN, 
 
 remarkable case of, 250. 
 DA VIES, EDWARD, 
 
 ca',<? of, 555. 
 DEAFNESS, 
 
 how feigned, 601. 
 DEATH, 
 
 natural or accidental, made of in child, 190. 
 
 whether occasioned by injury or previous disease, 27 1 
 
 sudden, what it arises from, 426. 
 
 by drowning, at what period it takes place, 437. 
 
 what it is, 413. 
 
 whether real or apparent, 415. 
 
 signs of, what they are, 418. 
 DELIRIUM, 
 
 what, 516. 
 
 singular case of, 517. 
 
 difference between and mania, 518. 
 
 legal consequences of, 579. 
 DELIRIUM TREMENS, 523. 
 
 its characteristics, 524. 
 
 legal consequences of, 587. 
 DELIVERY, 92. 
 
 when concealed, to what points to refer, 92. 
 
 deceptive, how detected, 93. 
 
 can a woman be delivered, and remain unconscious, 94. 
 
*540 INDEX, 
 
 DELI VEE Y— ( Continued.') 
 
 signs and indications of recent, 96. 
 
 within what time examination should be made, 98. 
 
 wiiat diseases may produce effects that may be mistaken for, 90 
 
 dops not always follow pregnancy, 100. 
 
 permanent indications of, 101. 
 
 signs of life or death of child before or during, 116. 
 
 signs of death during, 1 18. 
 
 signs of life during, 117. 
 
 signs of in case of death of mother, 120. 
 
 summary of things connected with, 121. 
 DELUSION AS A TEST OF INSANITY, 583. 
 DEMENTIA, 
 
 what, and how distinguished from idiocy and imbecility, 481. 
 
 how distinguished from mania, 482. 
 
 when arising from sudden shock, 482. 
 
 incoherence, feature of, what, 483. x 
 
 senile; what, and how characterized, 484. 
 
 second degree of, 485. 
 
 third and fourth degrees of, 485. 
 DESHA, 
 
 case of, 423. 
 DESIGN OR CONTRIVANCE, 
 
 as a test of insanity, 541. 
 
 analysis of, 542. 
 DESPAIR, ( 
 
 remarkable case of, 505. 
 DESTRUCTIVE PROPENSITY, 
 
 two forms of derangement of, 506. 
 
 two subdivisions of, 508. 
 DEVANEAGH vs. DEVANBAGH, 
 
 case of, 4 
 DEW vs. CLARK 
 
 case of, 570. 
 DIAPHRAGM, 
 
 indications of life from, 1<0. 
 
 wounds of the, 230. 
 DIATHESIS, 
 
 preternaturally hemorrhagic, 271. 
 DIARRHCEA, 
 
 how produced, 597. 
 DIFFERENCE OF TISSUE AND ORGAN, 
 
 modifying circumstance in case of poisoning, 300. 
 DIGITALIS, 
 
 fox -glove, 407. 
 DISEASE, PREVIOUS, 
 
 did it preexist, or was it a consequence of injury, 274. 
 
 or injury su'obscquent, as a modifying circumstance, 276. 
 
 h.iw modifying, 303. 
 
 of heart, how feigned, 595. 
 
INDEX it 
 
 DISCHARGES FROM VAGINA, 
 
 not gonorrhoeal, 32. 
 DISLOCA1ION, 
 
 what, 214. 
 DIURETICS, 
 
 as abortives, 133. 
 DROWNING, 
 
 means of destroying life of new oojn child by, 18t. 
 
 causes of death by, 432. 
 
 appearances presented in ease of death by, 433. 
 
 signs and indications of death by, 434. 
 
 whether result of accident, suicide, or homicide, 439. 
 D1EW, 
 
 case of, 587. 
 DRUNKENNESS, 521. 
 
 progress of, 522 
 
 effects of on brain, 522. 
 
 periodical, 523. 
 
 legal consequences of, 58J 
 
 laws of different countries in relation to, 586. 
 
 common law of England in relation to, 586. 
 
 effects of on civil contracts, 587. 
 
 effect of on criminal acts, 587. 
 
 acts committed in, after injuries of the head, &c. 589. 
 DRUNKARD, HABITUAL, 
 
 provided for by laws of New-York, 590. 
 DUCTUS ARTERIOSUS, 
 
 what, 143. 
 
 changes in after birth, 172. 
 DUCTUS VENOSUS, 
 
 what, 143. 
 
 changes in after birth, 172. 
 DUNCANS, 
 
 case of, 258. 
 DYING DECLARATIONS, 
 
 under what limitation received in evidence, 620. 
 DYSMENORRHEA, 
 
 membranes expelled in, 65. 
 
 E. 
 
 EARL OF ESSEX, 
 
 case of, 256. 
 EA.RLY OVUM, 
 
 when expelled, how examined and identified 61. 
 ECCHYMOS1S, 
 
 what, 200. 
 
 its cause, 200. 
 
 its seat, 201 . 
 
 its form, 202. 
 
 41 
 
6 12 INDEX. 
 
 ECCHYMOSIS— (Continued.) 
 
 its history, 202. 
 
 its diagnosis, 204. 
 
 before and after death. 207. 
 ECSTASIS, 
 
 definition of, 521. 
 EDMONDS', JUDGE, 
 
 charge in the case of Kleim, 549. 
 ELLENBOROUGH ACT, 
 
 what, 125. 
 EMETICS, 
 
 as cause of abortion, 132. 
 EMMENAGOGUES, 
 
 as abortive agents, 133. 
 EPILEPSY, 
 
 liable to be confounded with narcotic poisoning, 388. 
 
 means of distinguishing between, 388. 
 
 how feigned and detected, 598. 
 
 distinctions between real and pretended, 598. 
 ERETHYSM, 
 
 mercurial, symptoms of, 363. 
 
 whether intermittent or not, 364. 
 ERGOT, 
 
 as an abortive agent, 134. 
 EROTIC MANIA, 5U0. 
 ERSKINE'S 
 
 grounds in the case of Hadfield, 535. 
 EVANS' POTHIER ON OBLIGATIONS, 
 
 principles laid down in, 571. 
 EVANS vs. KNIGHT & MOORE, 
 
 case of, 581. 
 EVIDENCE, 
 
 general sources of in reference to poisoning, 306 
 
 from post-mortem examination, 309. 
 
 from chemical analysis, 310. 
 EXCORIATION OF FINGEKa, 
 
 as proof of death by drowning, 436. 
 EYE, 
 
 state of, as a sign of death, 419. 
 
 F. 
 
 FACE, 
 
 wounds of the, 2C7. 
 FEMALE, 
 
 violated without her knowledge, 30. 
 FEVER, 
 
 how feigned, 594. 
 FEIGNED DISEASES, 591. 
 
 effect on, of standing armies, 591. 
 
INDEX. 643 
 
 FEIGNED DISEASES— (Continued.) 
 
 rules laid down by Zacchias for detecting, 592. 
 
 not all diseases feigned with equal ease, 593. 
 FISH vs. PALMER, 
 
 case of, 112. 
 FISH, 
 
 some kinds of, poisonous, 384. 
 
 treatment in case of poisoning by, 384. 
 F(ETAL MOVEMENTS, 
 
 in utero, how excited, 56. 
 
 two species of, 56. 
 FCETAL LIFE, 
 
 progress of, 1U4. 
 FCETAL STATE, 
 
 changes in and signs of maturity and immaturity, 104. 
 FCETAL CIRCULATION, 
 
 peculiarities of, 143. 
 FCETUS, 
 
 weight and length of, 109. 
 
 maturity of how characterised 111. 
 
 immaturity of how characterised, 111. 
 FOY, VICTOR, 
 
 case of, 601. 
 FORAMEN OVALE, 
 
 what, 143. 
 
 changes in after birth, 173. 
 FRACTURE, 
 
 what, 213. 
 FRANC MARIA, 
 
 case of, 507. 
 FRANCIS, Dr., 
 
 case mentioned by, 116. 
 FREEMAN, 
 
 case of, 548, 550. 
 
 report of trial of, 550. 
 FROTH, 
 
 in larynx, &c, in death from drowning, 434. 
 
 in mouth and nostrils, evidence of death from drowning, 437. 
 
 G 
 
 GANGRENE 
 
 stage, 266. 
 GANGRENE AND LIVIDITY, 327. 
 GARDNER PEERAGE CASE, 87. 
 
 questious involved in, 88. 
 GASES, 
 
 certain of them irritant poisons, 385 
 GERAN, COUNTESS DE SAINT, 
 
 ease of, 94. 
 
6t4 INDEX. 
 
 GENITALS, 
 
 wounds of the, 234. 
 GESTATION, 
 
 period of, variable in animals, 82. 
 
 protracted, 84. 
 
 protracted, reasons against, 84. 
 
 reasons answered, So. 
 
 protracted, authorities for, 86. 
 
 protracted, laws favoring, 86. 
 
 protracted, case3 of, 86. 
 GODFREY, SIR EDMUNDBURY, 
 
 case of, 4-17. 
 GUNSHOT WOUNDS, 
 
 consideration of, 240. 
 
 before or after death, 240. 
 
 near or from distance, 241. 
 GRAAFIAN VESICLE, * 
 
 how surrounded and formed, 66. 
 GRAHAM'S LECTURE, 
 
 extract from, 501. 
 GREENACRE, 
 
 case of, 217. 
 GREENWOOD, 
 
 case of, 569. 
 
 H. 
 
 HAEMOPTYSIS, 
 
 how feigned and detected, 597. 
 HABIT, 
 
 a modifying circumstance in cases of poisoning, 301. 
 HADFIELD, 
 
 case of, 534. 
 HANGING, 
 
 several signs and indications of death by, 443. 
 
 whether it occurred during life or after death, 443. 
 
 whether, accidental, suicidal, or homicidal, 445. 
 
 cause of death from, 440. 
 
 signs and indications of death by, 442. 
 HALE, LORD, 
 
 law applicable to insanity, 532. 
 HEADACHE, 
 
 indicating pregnancy, 43. 
 HEAD, 
 
 wounds of the, 221. 
 HEART, 
 
 injuries of the, 229. 
 HERNIA, 
 
 how imitated, 602. 
 
INDEX. 645 
 
 HERMAPHRODITISM, 
 
 what, 17. 
 HERMAPHRODITES, 
 
 classification of, 18. 
 HILAIRE, M. GEOFFRY ST., 
 
 work on hermaphroditism, 20. 
 HIPPOCRATICA FACIES, 
 
 as a sign of death, 418. 
 HOAG OR PARKER, 
 
 case of, 614. 
 HODGSON, 
 
 case of, 317. 
 HOFFBAUER'S PRINCIPLE OF CRIMINAL RESPONSIBILITY, 573. 
 HOMICIDAL MANIA, 510. 
 
 its discovery, 511. 
 
 two forms of it, 511. 
 
 cause of, 511. 
 
 various causes of, 512. 
 
 cases of, 515. 
 
 general deductions from, 516. 
 HOPE, 
 
 derangement of, 506. 
 HUME BARON'S, 
 
 statement of test of insanity, 539. 
 HUNTER, 
 
 case of impregnation related by, 8. 
 HYDROCEPHALUS, 
 
 how imitated, 602. 
 HYDROCYANIC ACID, OR PRUSSIC ACID, 396. 
 
 under what form found, 396. 
 
 its tests, 397. 
 
 its power as a poison, 397. 
 
 on what it acts, 398. 
 
 what dose required, 398. 
 
 what time it begins, 398. 
 
 how quickly it operates, 398. 
 
 its symptoms, 400. 
 
 how soon it proves fatal, 401. 
 
 post mortem appearances caused by, 401. 
 
 treatment in case of poisoning by, 402. 
 HYDROSTATIC TEST, 
 
 on what principle dependent, 154. 
 
 what when applied to the lungs, 154, 
 
 objections to, 155. 
 
 body lighter by putrefactive process, 155. 
 
 answer to objection of putrefactive process, 156. 
 
 float from artificial inflation, 158. 
 
 answer to objection of floating from artificial inflation, 15S. 
 
 float from emphysematous condition, 161. 
 
 answer to that objection, 162. 
 
fi-16 INDEX. 
 
 HYDROSTATIC TEST— (Continued.) 
 
 other objections, 162. 
 
 another class of objections, 164. 
 
 value of' test, 167, 
 
 how application made of it, 168. 
 HYMEN, 
 
 what, 26. 
 HYPOSPADIA, 
 
 what, 7. 
 
 I. 
 
 IDENTITY, 
 
 one instance in which it alone is tried, 613. 
 
 the various marks and indications proving, 614. 
 
 proofs of derivable from the skeleton itself, 617. 
 
 difference between skeletons of ma^e and female, 617. 
 IDIOCY, 
 
 definition of, 473. 
 
 how distinguished, 473. 
 
 varieties of, 474. 
 
 where most frequently found, 474. 
 
 when feigned, racourse had to past history, 610. 
 IDIOSYNCRASY, 
 
 a modifying circumstance in case of poisoning, 202. 
 IDIOT, 
 
 how legally defined, 466. 
 IMBECILITY, 
 
 how defined, 475. 
 
 how distinguished from idiocy, 470. 
 
 susceptible of some education, 475. 
 
 systematised by Hoffbauer, 476. 
 
 diSerent degrees of, 477. 
 
 as affecting the moral nature, 478. 
 
 instance of moral, 480. 
 IMMERSION, 
 
 effects of, on dead body, 439. 
 IMPOTENCE AND STERILITY. 2. 
 IMPOTENCE, 
 
 what, 2. 
 
 when questions of, arise, 3. 
 
 kinds of, 4. 
 
 physical causes of, 5. 
 
 caused by what injuries and diseases, II. 
 
 constitutional indications of, 12. 
 
 moral causes of, 12. 
 
 curable causes of, 14. 
 
 causes of, in female, 14. 
 IMPOTENCE AND STERILITY, 
 
 arrangement of causes of, 15. 
 I 
 
INDEX. 647 
 
 INCUBATION OF MANIA, 
 
 what, 486. 
 INCISED WOUNDS INFLICTED DURING LIFE, 
 
 characteristics of, 215. 
 
 on dead body, 215. 
 INCISED WOUNDS AND PUNCTURED, 238. 
 INDULGENCE, 
 
 its effect on impotence 11. 
 INFANTICIDE, 
 
 questions discussed in, 123. 
 
 legal provisions bearing on, 124. 
 
 laws of different states concerning, 127. 
 
 points to which attention should be directed, 194. 
 INFLAMMATION, 
 
 how arising, 225. 
 
 proceeding from irritation, 293. 
 INFLAMMATORY STAGE, 
 
 what, 264. 
 INGRAM vs. WYATT, 
 
 case of, 561. 
 INJURY, 
 
 sufficiency of to cause mischief in healthy person, 273. 
 INQUEST, 
 
 object of, where held, 425. 
 INQUISITION OF CORONER'S JURY, 
 
 what, 425. 
 INSANITY, 
 
 most frequently feigned, 605. 
 
 popular impression as to what >t consists in, 605. 
 
 difficult of imitation, 606. 
 
 have reference to motive, 606. 
 
 feigned cases over act, 606. 
 
 observe the moral displays, 607. 
 
 really insane disregard the decencies and proprieties of life, 608. 
 
 sleeplessness accompanies real insanity, 608. 
 
 morbid irritability characterizes the really insane, 609. 
 INTELLECTUAL MANIA, 
 
 how characterized, 492. 
 
 how described, 492. 
 INTENT TO INJURE, ELEMENTS OF, 554. 
 INTESTINES, 
 
 wounds of the, 232. 
 
 inflammation of; distinction between arid irritant poisoning, 323. 
 IRRESISTIBILITY 
 
 absolves from accountability, 575. 
 
 why it so absolves, 576. 
 how this test applied in practice, 576. 
 IRRITANT CLASS OF POISONS, 
 
 what included under, 320. 
 
 what substances it embraces, 320. 
 
61S INDEX. 
 
 IRRITANT CLASS OF POISONS— (ContUned.) 
 
 what symptoms it develops, 321. 
 
 orders divisible into, 330. 
 IRRITANTS, 
 
 morbid appearances caused by, 325. 
 
 vegetable, 381. 
 
 vegetable, what they are, 381. 
 
 where poisonous property resides, 381. 
 
 symptoms developed by, 381 . 
 
 morbid appearances caused by, 382. 
 
 treatment in case of poisoning by, 382. 
 IRRITANTS, ANIMAL, 383. 
 IRRITATION, 
 
 what, 293. 
 
 J. K., 
 
 case of instance of moral mania, 499. 
 JACKSON vs. KING, 
 
 case of, 556. 
 JARDINE, REV. FERGUS, 
 
 case of, 82. 
 JOHNSON vs. MOORE'S HEIRS, 
 
 case of, 570. 
 JURY, CORONER'S, 
 
 their duties, 425, 624. 
 
 K. 
 
 KENNOWAY, DAVID, 
 case of, 275. 
 
 li fcjK.£V j J ., 
 
 rase of, 225. 
 KIDNEYS, 
 
 wounas of the, 233. 
 KLEIM, 
 
 case of, 549. 
 
 LABOR, 
 
 when it may be prematurely induced, 101. 
 LACERATED WOUNDS, 
 
 what, 220. 
 LANARGAN, 
 
 case of, 317. 
 LA VIGOREAUX AND LA VOISON. 
 
 account of, 291. 
 
INDEX. 649 
 
 LAW, 
 
 applicable to wounds, 272. 
 
 cases illustrating its application, 272. 
 
 On what occasion interferes, in cases of non compos mentis, 467 
 
 presumption of, 525. 
 LAWRENCE, 
 
 case of, for shooting at President Jackson, 547. 
 LEGAL APPLICATIONS, 524. 
 LEGAL CONSEQUENCES, 
 
 of mental deficiency, 554. 
 
 of mania, 568. 
 
 of intellectual mania, 568. 
 
 of moral mania, 574. 
 
 of delirium, 579. 
 
 of suicide, 582. 
 
 of somnambulism, 585. 
 
 of drunkenness, 585. 
 LEAD, 
 
 why interesting, 373. 
 
 its compounds, 374. 
 
 its tests, 374. 
 
 the symptoms it developes, 376. 
 
 effects of constant use of, 378. 
 
 post mortem appearances caused by, 378. 
 
 treatment in case of poisoning by, 379. 
 
 its use for culinary and domestic purposes, 379. 
 LEGITIMACY, 
 
 consequences of illegitimacy, 79. 
 
 who are legitimate, 80. 
 
 legal rule relative to, 80. 
 
 questions in, when and how arising, 80. 
 
 what questions involved in, 81. 
 
 legal rule governing, 81. 
 LEMON JUICE, 
 
 spots of, mistaken for blood, 218. 
 LIFE, 
 
 the orders of functions necessary to, 413. 
 
 at what period of gestation fostus endowed with, 129. 
 
 of child, by what modes destroyed, 179. 
 LIFE ASSURANCE, 
 
 how defined, 621. 
 
 void from neglect to state name of actual medical attendant, 623 
 
 void from neglect to state intemperate habits of assured, 623. 
 LIGHTNING, 
 
 persons found dead by, 454. 
 
 how it operates, 451. 
 
 post-mortem appearances caused by, 455. 
 LIQUID TESTS OF ARSENIC, 343. 
 LIVE BIRTH, 
 
 meaning of term, 140. ' " 
 
650 INDEX. 
 
 LIVE BIRTH— (Continued.) 
 
 proofs of from circulating S}stcm, 141. 
 LIVER, 
 
 wounds of the, 233. 
 LOBELIA, 
 
 cases of poisoning by, 382. 
 LOCHIA, 
 
 what and how known, 98. 
 LOCUSTA, 
 
 account of, 289. 
 LUCID INTERVALS, 
 
 what, 526. 
 
 D'Aguesceau's statement of, 526. 
 
 their continuance, 527. 
 
 evidence in support of, 528. 
 LUNACY, 
 
 how derived, and what signifies, 466. 
 LUNGS, 
 
 how 1 prior and subsequent to birth, 145. 
 
 what changes in their volume by raspira'.ion, 150. 
 
 what changes in their situation by respiration, 151. 
 
 what changes in their shape by respiration, 151. 
 
 what changes in their color by respiration, 151. 
 
 what changes in their consistence and density by respiration, 152. 
 
 what changes in their specific gravity by respiration, 154 
 
 injuries of the, 229. 
 LYING, 
 
 species of insane manifestation, 504. 
 LYNDHURST, LORD, 
 
 charge in case of King vs. Orford, 540. 
 
 M. 
 
 MACKENZIE, 
 
 case of, 278. 
 MALFORMATION OR TRANSFORMATION OF PARTS, 270. 
 MALUM-REGIMEN, 
 
 a modifying circumstance, 279. 
 MANIA, 
 
 active forms of, 486. 
 
 its incubation, what, 486. 
 
 its physical indications, 487. 
 
 its divisions, 488. 
 
 general intellectual, what it consists in, 489. 
 " " how characterized, 492. 
 
 legal consequences of, 568. 
 
 intellectual, legal consequences of, 568. 
 
 moral, legal consequences of, 574. 
 irfAR, EARL, 
 
 case of, 623. 
 
INDEX 651 
 
 MARRIAGE, 
 
 eii ct of partial intellectual mania on contract of, 572. 
 MARSELIS vs. THALHIMER, 
 
 case of, 114. I 
 
 MARSH'S HYDROGEN TEST FOR ARSENIC, 343. 
 MARTIN, JONATHAN, 
 
 case of, 507. 
 MATURITY, 
 
 has child arrived at, 140. 
 
 evidence of, 140. 
 MAYHEM, 
 
 questions arising in, 283. 
 
 statute law concerning, 283. 
 
 Mcdonough, 
 
 case of, 589. 
 McNAUGHTON, 
 
 case of, 545. 
 McLAREN, JANET, 
 
 case of, 277. 
 MECHANICAL MEANS OF PROCURING ABORTION, 135. 
 MECONIUM, 
 
 what, 171. 
 MEDICAL EVIDENCE, 624. 
 MEDICAL JURISPRUDENCE, 
 
 definition of, 1. 
 
 classification of subjects in, 1. 
 MEDICO-LEGAL EXAMINATION OF WOUNDS, 
 
 how made, 284. 
 MEMBRANES RUPTURED BY INSTRUMENTS, 136. 
 MENINGITIS, 
 
 what, 389. 
 
 liable to be confounded with narcotic poisoning, 389. 
 MENSES, 
 
 what, 44. 
 
 suppressed during pregnancy, 45. 
 MENTAL ALIENATION, 
 
 subjects discussed under, 457. , 
 
 its definition, 457. 
 
 its seat, 459. 
 
 its history, 460. 
 
 its causes, 461 . 
 
 organic or physical causes of, 462. 
 
 moral causes of, 463. 
 
 principle on which legal exemption proceeds, 465 
 
 forms of recognized by law, and division, 466. 
 
 classification of subjects embraced in, 472. 
 MERCURY, 
 
 general consideration of, 357. 
 
 its preparations, 357. 
 
 its tests, 357. 
 
6*>2 INDEX. 
 
 U 42RCU RY— ( Continued.) 
 
 the symptoms it develops, 359. 
 
 the three varieties of symptoms of poisoning by, 360. 
 
 difference between symptoms of poisoning with arsenic and mer- 
 cury, 360. 
 
 second variety of poisoning with, 361. 
 
 third variety of poisoning with, 362. 
 
 symptoms characterizing mercurial erethysm, 363. 
 
 secondary effects of, 365. 
 
 inertness of, in metallic state, 366. 
 
 strength of evidence resulting from symptoms, 367. 
 
 post-mortem appearances caused by, 367. 
 
 treatment in case of poisoning by, 369. 
 MILK IN THE BREASTS, 
 
 a sign of pregnancy, 51. 
 MISCARRIAGE, 
 
 exciting or immediate causes of, 131. 
 MIXTURE, 
 
 a. modifying circumstance in case of poisoning, 300. 
 MOIR, CAPT., 
 
 case of, 278. 
 MOISTURE, 
 
 essential to putrefaction, 422. 
 MOLES, 
 
 what, 63. 
 
 when proof of pregnancy, 64. 
 MONROE, TIMOTHY, 
 
 case of, 616. 
 MONSTERS, 
 
 what the law regards such, 20. 
 MORAL CIRCUMSTANCES, 
 
 as evidence of poisoning, 315. 
 MORAL MANIA, 495. 
 
 how defined, 496. 
 
 its division, 496. 
 
 general, in what it consists, 496. 
 
 change in the moral powers, 497. 
 
 most observable in conduct, 498. 
 MORGAGNI, 
 
 interesting case of poisoning, related by, 317. 
 MURDOCK, MISS SOPHIA, 
 
 case of, 74. 
 MUSCULAR FUNCTION, 
 
 necessary to life, 413. 
 MUSCULAR IRRITABILITY, 
 
 extinction of, a sign of death, 419. 
 MUTILATIONS, 
 
 singular instances of, 604. 
 
INDEX. 553 
 
 N. 
 
 NAPOLEON, 
 
 his order to stop suicidal mania, 510. 
 NARCOTIC CLASS OF POISONS, 
 
 what included under, 320. 
 NARCOTIC POISONS, 
 
 on what act, 385. 
 
 usual symptoms of, 385. 
 
 morbid appearances caused by, 385. 
 
 chemical analysis of little use, 3t0. 
 NARCOTIC GASES, 
 
 what, 402. 
 NARCOTICO-ACRID POISONS, 404 
 
 whence derived, and how act, 404. 
 NARCOTICO ACRIDS, 
 
 the symptoms caused by them, 405. 
 
 post-mortem appearances caused by, 405. 
 
 Orflla's division of them, 405. 
 NARCOTICO IRRITANTS OR ACRIDS, 
 
 what included under, 320. 
 NAUSEA AND VOMITING, 
 
 a sign of pregnancy, 46. 
 NEGRETTI, 
 
 somnambulist, case cf, 519. 
 NERVES OF NECK, 
 
 compression of, a cause of death by hanging, 44s. 
 NERVOUS FUNCTION, 
 
 necessary to life, 413. 
 NERVOUS IMPRESSIONS, 294. 
 NICOT1ANA TOBACCUM 
 
 tobacco, 406. 
 NORKOTT, 
 
 case of, 257. 
 NUX VOMICA, 
 
 how exhibited, 408. 
 
 its symptoms, what it acts on, 408. 
 
 morbid appearances caused by, 409. 
 
 treatment in case of poisoning by, 409. 
 
 0. 
 
 OPIUM, 
 
 head of narcotic class of poisons, 390. 
 
 where obtained, and its preparations, 390. 
 
 chemical tests unable to discover, 391. 
 
 how detected, 391. 
 
 how it acts, 391. 
 
 how it affects animals, 392. 
 
6."1 INDEX. 
 
 OPIUM— ( Continued.) 
 
 how it affects man, 392. ^ 
 
 how soon it begins to operate, 393. 
 
 symptoms of poisoning by, 394. 
 
 quantity required for fatal dose, 394. 
 
 morbid appearances caused by, 394. 
 
 treatment in case of poisoning by, 395. 
 OPTHALMIA, 
 
 how imitated, 600. 
 ORFORD, KING vs., 
 
 case of, 540. 
 ORGANS, 
 
 malformations of so as to cause death at birth, 192. 
 
 diseases of same, 193. 
 ORGANS, GENITAL, 
 
 state of indicating death from hanging, 445. 
 OS AND CERVIX UTERr, 
 
 state of in virgin, 56. 
 
 changes in consequent «n conception, 57. 
 " from what other causes, 57. 
 " proofs of progress from, 57. 
 OXALIC ACID, 334. 
 
 how it acts, 335. 
 
 symptoms of poisoning by, 335. 
 
 post-mortem appearances caused by, 336. 
 
 treatment in case of poisoning by, 337. 
 OXFORD, KING vs., 
 
 case of, 544 
 
 PAIN, 
 
 under what forms feigned, 595. 
 
 means of detecting when feigned, 59b. 
 PALLOR OF FACE, 
 
 sign of death by drowning, 434. 
 PARALYSIS, 
 
 how feigned and detected, 597. 
 PARTIAL INTELLECTUAL MANIA, 
 
 its peculiarities, 493. 
 
 delusive ideas entertained in, 494. 
 PARTIAL MORAL MANIA, 
 
 what it consists in, 500. 
 TARTIE3, 
 
 strength and situation of, in case of rape, 3S. 
 PENIS, 
 
 malformation or defect of, 6. 
 PEOPLE vs. HULSE, 
 
 reference to, 24. 
 
INDEX. 65S 
 
 PERINEUM, 
 
 laceration of in delivery, 98. 
 PERFORATION, 328. 
 
 from corrosives, 328. 
 
 from ulceration, 328. 
 
 from softening (luring life or after death, 328. 
 PERSONS FOUND DEAD, 
 
 questions arising in, 412. 
 PLACE WHERE BODY IS FOUND, 431. 
 PLOTT, Dr., 
 
 case of suspension mentioned "oy, 440. 
 PLOUQUET'S TEST, 
 
 what, 146. 
 
 objections to, 146. 
 POINTS 
 
 to be attended to in case of suspected poisoning, 318. 
 POISON, 
 
 mode of administration in experiments on animals, 31.' 
 POISONING, 
 
 . as a means of destroying life of new born child, 189. 
 
 art of secret, 289. 
 
 history of art of secret poisoning, 289. 
 POISONS, 
 
 questions discussed in, 286. 
 
 definition of, 287. 
 
 the law applicable to, 287. 
 
 statute of New-York applicable to, 288. 
 
 how introduced into the system, 292. 
 
 their mode of action, 293. 
 
 how conveyed from one organ to another, 294. 
 
 circumstances which modify action of, 299. 
 
 their arrangement and classification, 320 
 POLLOCK, Mrs., 
 
 case of, 239. 
 PORTSMOUTH, vs. PORTSMOUTH, 
 
 case of, 558. 
 POSITION, 
 
 in which body is found, to be noted, 431. 
 POST-MORTEM APPEARANCES, 
 
 produced by mercury, 367. 
 
 produced by copper, 372. 
 POWER OF DISCRIMINATING RIGHT FROM WRONG, 
 
 a test of insanity, 537. ■ 
 
 analysis of, 537. 
 PREGNANCY, 
 
 occasions for investigating, 37. 
 
 may be feigned, 39. 
 
 may be concealed, 40. 
 
 sources of signs, and indications of, 40. 
 
 spurious, when and how occurring, 71. 
 
libfa INDEX. 
 
 PREGN ANCY— ( Continued.) 
 
 when complicated with disease, 72. 
 
 ignorance up to time of delivery, 74. 
 
 signs of death during, 117. 
 PREMATURE BIRTH, 83. 
 PRKSSURE, 
 
 its effect on artificial inflation, 159. 
 PRESUMPTION UF ACCESS, 
 
 and that husband is father, 80. 
 PREVIOUS INJURY OR DISEASE, 
 
 modifying medico-legal character of wounds, 27t. 
 PiYALISM MERCURIAL, 
 
 duration of, 364. 
 PULSATION OF FCETAL HEART, 
 
 its characlers, 61. 
 PULSE, 
 
 changes in, indicative of pregnancy, 44. 
 PUNCTURED WOUNDS, 
 
 what, 220. 
 PURULENT STAGE, 
 
 what and when, 264. 
 PUTREFACTION, 
 
 as a sign of death, 421. 
 
 how distinguished from gangrene, 421. 
 
 several circumstances that modify it, 423. 
 PUTREFACTIVE PROCESS, 
 
 objections to hydrostatic test, 156. 
 PYROMANIA, 
 
 incendiarism, 506. 
 
 cases of, 5U7. 
 
 Q. 
 
 QUALITIES TRANSMISSIBLE, 90. 
 QUANTITY ADMINISTERED, 
 
 a modifying circumstance, 299. 
 QUEEN vs. RUMBALL, 
 
 case of, 583. 
 QUEEN vs. GATHERCOLE, 
 
 case of, 583 
 QUESTIONS AND ANSWERS OF THE FIFTEEN JUDGES, 
 
 in regard to law governing insanity, 545. 
 QUICKENING, 
 
 what, 128. 
 
 why important, 54 
 
 definition of, 51. 
 
 what may be mistaken for, 55. 
 
 time of, 55. 
 
INDEX. 657 
 
 R 
 
 RABELLO, 
 
 case of, 514. 
 ft APE, 
 
 what, 22. 
 
 laws relating to, 22. 
 
 laws of New-York relating to, 23. 
 
 upon whom may be committed, 25. 
 
 what to be made out on indictment of, 25. 
 
 points to which attention should be directed, 25. 
 
 may be followeu ny pregnancy, 35. 
 
 summation of points to which to direct attention, 36 
 RAYNOR, 
 
 cas-? of, 264. 
 RECTOR, HENRY, 
 
 case or, 236. 
 REDLION vs. WOOLVERTON, 
 
 case of, 89. 
 REDNESS OF STOMACH AND INTESTINES, 
 
 pseudo-morbid, described, 326. 
 REINSCH'S TEST OF ARSENIC, oiJ. 
 RELATIONS OF BODY 
 
 with surrounding objects, 431. 
 REMOTE ACTION OF POISONS, 
 
 what, 294. 
 REPERCUSSION, 
 
 what, and how done, 59. 
 RESEMBLANCE TO PARENT, 
 
 as proof of paternity, 90. 
 RESPIRATION, 
 
 prior to birth, 162. 
 
 while in womb, 163. 
 
 a voluntary act, 414. 
 
 connecting link between sensorial, nervous and muscular functions, 41* 
 
 cessation of as a sign of death, 418. 
 RESPIRATORY SYSTEM, 
 
 proving life or death at birth, 149. 
 RESPONSIBILITY, 
 
 difference between civil and criminal, 53(1. 
 REX vs. PHILIPS 
 
 case of, 128- 
 REX vs. HAINES, 
 
 case of, 245. 
 RIDDER, JANE, 
 
 case of, 520. 
 RIGIDITY OF MUSCLES, 
 a sign of death, 420. 
 
 42 
 
C 58 INDEX. 
 
 RODMAN, Dr., 
 
 remarkable case mentione ! by, 1 .6. 
 ROGERS, 
 
 case of, 547. 
 ROSS, SIR JAMES, 
 
 case of, 621. 
 RUST, 
 
 spots of mistaken for blood, 218. 
 
 SALIVATION, 
 
 mercurial, in what manner it proves fatal, MHB. 
 SAUNDERS, 
 
 case of, 288. 
 SAVINE, 
 
 as an abortive agent, 133. 
 SATTERTHAITE vs. POWELL, 
 
 case of, 620. 
 SCROFULA, 
 
 how imitated, 600. 
 SENSATIONS, 
 
 in case of death from hanging, 412. 
 SECRET POISONING, 
 
 art of, 289 
 SENSORIAL FUNCTION, 
 
 necessary to life, 414. 
 SEMEN, 
 
 how distinguishable, 30. 
 SEMINAL SPOTS, 
 
 how appearing and distinguishable, 31. 
 SENILE DEMENTIA, 
 
 when feigned, what proceeds fro n, 611. 
 SEPARATION 
 
 of the umbilical cord, 175 
 SEX, 
 
 questions arising ont of relations of, it. 
 SEXUAL ORGANS, 
 
 blending or mingling of, 19. 
 SHAPE OF LUNGS 
 
 affected by respiration, 150. 
 SHOT, 
 
 distance between, indicates distance fired from, 24£ 
 SYPHILIS, 
 
 as proof of rape, 31. 
 SIMPLE CHOLERA, 
 
 distinction between and hritant poisoning, 322. 
 SITUATION OF LUNGS, 
 
 affeclcd by respiration, 150. 
 
INDEX. (559 
 
 SUN, 
 
 state of as a sign of death, 419. 
 
 changes in, after birth, 176. 
 SKELETON, FCETAL, 
 
 progress of, 108. 
 SOFTENING, 327. 
 SOMNOLENCY, 
 
 how feigned and detected, 600. 
 SMOTHERING, 
 
 death by, how accomplished, 449. 
 
 signs or indications of death by, 450. 
 SOMNAMBULISM, 518. 
 
 rases of, 520. 
 
 legal consequences of, 585. 
 SPECIFIC GRAVITY, 
 
 of lungs increased by disease, 164. 
 SPLEEN, 
 
 wounds of the, 233. 
 SPARA HIERONYMA, 
 
 account of, 290. 
 SOUFFLE, OR PLACENTAL SOUND, 
 
 what, 60. 
 
 its seat and characters, 6!. 
 
 how imitated, 61 
 STARVATION, 
 
 persons found dead from, 455. 
 
 symptoms attending death by, 455. 
 
 time in which death is produced by, 456. 
 
 post-mortem appearances caused by, 456. 
 
 a means of destroying new-born child, 181. 
 SPINAL CORD, 
 
 injuries to, 226. 
 SPRAIN, 
 
 what, 214. 
 SPRAGUE, CHARLES, 
 
 remarkable case of, 503. 
 STANWIX, GENERAL, 
 
 case of, 620. 
 
 STEWART'S, EXECUTOR, vs. LISPENARD 
 
 case of, 566. 
 
 STATIC TEST, 
 
 what, 145. 
 STERILITY, 
 
 what, 3. 
 
 generally confined to female, 16. 
 
 causes of, 16. 
 
 STOMACH, 
 
 inflammation of, distinction between, and irritant poisoning, 323. 
 
 distention of, distinction between, and irritpnt poisoning, 324. 
 
 rupture of, distinction between, and irritan poisoning, 324. 
 
 water in, in death from drowning, 435. 
 
66 1 INDEX. 
 
 STOMACH AND INTESTINES, 
 
 redness of, how caused, 325. 
 STRANGULATION, 
 
 differences observable between, and death from hanging, 446. 
 
 whether cause of death, or resorted to afterwards, 447. 
 
 whether accidental, suicidal or homicidal, 448. 
 
 means of destroying life of new-born child, 186. / 
 
 STRYCHNIA, 
 
 a destructive poison, 407. 
 SUICIDE, 
 
 legal consequences of, 582. 
 
 facts showing it insane, 509. 
 SUICIDAL MONOMANIA, 508. 
 SULPHURETTED HYDROGEN GAS, 403. 
 
 symptoms, and post-mortem appearances caused by, 404. 
 SUFFOCATION, 
 
 a means of destroying life of new-born child, 179. 
 SUGILLATION, 
 
 a cadaverous lividity, 205. 
 
 how distinguished from ecchymosis, 206. 
 SUPERFCETATION, 
 
 possibility of, 76. 
 
 reasons against, 76. 
 
 answers to same, 77. 
 
 cases of, 77 - 78. 
 
 explanation of, 79. 
 SURVIVORSHIP, 
 
 when necessary to be enquired into, 618. 
 
 when between mother and child, 618. 
 
 when two or more destroyed by common accident, 619. 
 
 provisions of Code Napoleon in relation to, 619. 
 
 cases illustrating, 620. 
 SUSPENSION OF RESPIRATION, 
 
 a cause of death by hanging, 440. 
 SWETE vs. FAIRLIE, 
 
 case of, 622. 
 SYMPATHY, 
 
 action of poisons by, 296. 
 
 reasons for, 297. 
 
 answer to reasons, 298. 
 SYMPTOMS, 
 
 one source of evidence in case of poisoning, 305. 
 
 suddenness of their occurrence, 305 
 
 regularity in their increase, 306. 
 
 uniformity in their nature, 306. 
 
 beginning soon after a meal, 306. 
 
 appearing during a state of health, 307. 
 
 comparing them with those of natural disease, 307. 
 
 developed through irritant class of poisons, 321. 
 
 of poisoning with arsenic, arranged under three heads, 34" 
 
INDEX. , 661 
 
 SYMPTOMS— (Continued.) 
 
 of poisoning with copper, 371. 
 
 of poisoning with lead, 376. 
 SYNCOPE, 
 
 what, 426. 
 
 what it arises from, 427. 
 SYNCOPE AND HYSTERIA, 
 
 how feigned and detected, 59.4. 
 
 TAYLOR, 
 
 case of, 620. 
 TEMPERATURE, 
 
 high, essential to putrefaction, 422. 
 TENANT, Rev. WILLIAM, 
 
 extraordinary case of, 416. 
 TENANT BY THE CURTESY, 
 
 what, 112. 
 TESTICLE, 
 
 defect or disease of, 8. 
 
 one sufficient for impregnation, 9. 
 TESTICLES, 
 
 when not found in scrotum, 9. 
 
 diseases to which they are subject, 9. 
 
 connection between and cereuelitim, 10. 
 
 structure of, defective, 10. 
 TESTS OF COPPER, 370. 
 THECAR, 
 
 case of, 89. 
 THOM, 
 
 case of, 311. 
 THOMPSON ADS. COMMONWEALTH OF MASSACHUSETTS, 
 
 case of, 382. 
 THORAX, 
 
 changes effected in by respiration, 149. 
 
 wounds of the, 228. 
 THROAT AND NECK, 
 
 wounds of the, 227. 
 THURLOW, LORD, 
 
 his definition of lucid interval, 527. 
 TIME, 
 
 interval of, a circumstance modifying the medicolegal character ol 
 wounds, 268. 
 TISSUES 
 
 differ in their power of absorption, 301. 
 TOFFANIA, 
 
 account of, 28i 
 TONGUE, 
 
 position of in persons drowned, 434. 
 
662 INDEX. 
 
 TOWNSEXD, Col., 
 
 extraordinary ease of simulating death, 116. 
 TRACHEA, 
 
 water found in, in case of death from drowning, 435. 
 
 or larynx, laceration of, cause of death by hanging, 44k. 
 TRANCE, 
 
 state resembling death, 416. 
 TREATMENT 
 
 in case of poisoning by mercury, 369. 
 
 in case of poisoning with copper, 372. 
 TUMORS AND ENLARGEMENTS, 
 
 how feigned, 602. 
 TURNER, 
 
 case of, 280.- 
 
 u. 
 
 ULCERATION, 328. 
 ULCERS, 
 
 how feigned, 603. 
 
 false, how detected from the real, 604. 
 UMBILICAL VESSEL, 
 
 what, 144. 
 
 changes in, 171. 
 UMBILICAL CORD, 
 
 successive changes in, after birtn, 174, 
 
 witheiing of, 174. 
 
 dessication, or drying of, 175. 
 • separation of, 175. 
 
 neglect of tying, 189. 
 UMBILICUS, 
 
 state of during pregnancy, 54. 
 
 cicatrization of, 176. 
 URETHRA, 
 
 unnatural situation of, 7. 
 URINE, 
 
 changes in, indicating pregnancy, 43. 
 UTERINE, 
 
 a sensible sign of pregnancy, 52. 
 UTERINE HYDATIDS, 
 
 how occurring, 64. 
 
 how long retained, 64. 
 UTERUS, 
 
 changes in, on conception, 40. 
 
 continuation of changes, 41. 
 
 ordsr of changes in, 58. 
 
 changes, how produced, 58. 
 
 how appearing when examined after death, 6t 
 
 morbid growths in, 72. 
 
I.NI5EX Ci** 
 
 V. 
 
 V A (JIN A, 
 
 narrowness of, in virgin state, 15. 
 same as connected with rape, 27. 
 bluish tint of evidence of pregnancy, b'2. 
 VAN ALST., vs. HUNTER, 
 
 case of, 562. 
 VENESECTION, 
 
 as a cause of abortion, 131. 
 VIABILITY, 
 
 what, 115. 
 VINE DRESSER, 
 
 case of, 514. 
 VIOLENCE, 
 
 marks of, in bodies found in water, 43S. 
 VIRGINITY, 
 
 signs of, when most perfect, 28. 
 
 inferences from, 28. 
 VOLITIONS AND ACTIONS, 
 
 what, 575. 
 VOLUME OF LUNGS, 
 
 affected by respiration, 150. 
 VOMITING, 
 
 how feigned, and detected, 51/7. 
 
 w. 
 
 WAGNER, Dr., 
 
 remarkable case related by, 137. 
 WALLACE, Dr., 
 
 case reported by, 261. 
 WATSON, V3. MAINWARiNG, 
 
 case of, 622. 
 WEAKNESS, 
 
 how caused and feigned, 597. 
 WEAPON, 
 
 with which wound was inflicted. '•'-«•- 
 
 employed, nature of it, 259. 
 WEBSTER, Dr., 
 
 case of, 615. * 
 
 WEIGHT, 
 
 of the foetus at birth, 109. 
 WHELAN, vs. WHELAN, 
 
 case of, 557, 
 WHISTELO, 
 
 case of, 91. 
 WHITING, JUDGE, 
 
 charge to the jury in the case of Freeman, 5o2. 
 
6'H INDfcX. 
 
 WILDBERGH, 
 
 case related by, 311. 
 WILLIAMS, LUCY, 
 
 case of. 91. 
 WILL, 
 
 what, 559. 
 
 how to be executed, 560. 
 
 what diseases disqualify, 660. 
 WILSON, 
 
 case of impotence related bv 7 
 
 WILSON, THEODORE, 
 
 case of, 547, 5R8 
 WITHERING, 
 
 of the cord, when, 174. 
 WITNESSES, 
 
 either common or skilled, 625. 
 
 duties of, when called on to the stand, 625. 
 
 direct examination, object of, 626. 
 " " value of, 626. 
 
 cross-examination, object of, 626. 
 
 duties as to citing medical authorities, 626. 
 
 confessions to lawyers, clergymen and physicians, 627. 
 
 duties as to confessions of parties, 627. 
 
 refusing to testify, consequence of, 628. 
 
 testifying to confession, 628. 
 
 testifying to dying declarations, 628. 
 
 before coroner; duties and compensation, 426 
 WOUND, 
 
 was it the direct cause of death? 
 
 its nature and situation, 247. 
 
 its direction, 248. 
 WOUNDS OF THE HEAD, 221. 
 WOUNDS, 
 
 what circumstances modify their medico-legal character, 267 
 
 general consideration of, 198. 
 
 definition of, 199. 
 
 division of, 199. 
 
 medico-legal questions arising in, 235. 
 
 whether self-inflicted or pnt. ?46. 
 
 incised, different stages ot, zo4 - 
 
 inflammatory stage, 264. 
 
 puru'ent stage, 264. 
 
 cicatrization stage, 264. 
 
 gangrene stage, 266. 
 
 a means of destroying life of new born child, 181. 
 
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