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MEDICAL See also:JURISPRUDENCE, or FORENSIC See also:MEDICINE , that See also:branch of See also:state medicine which treats of the application of medical knowledge to certain questions of See also:civil and criminal See also:law. The See also:term " medical jurisprudence," though sanctioned by See also:long usage, is not really appropriate, since the subject is strictly a branch of medicine rather than of jurisprudence; it does not properly include sanitation or See also:hygiene, both this and medical jurisprudence proper being distinct branches of state medicine. The connexion between medicine and the law was perceived long before medical jurisprudence was recognized, or had obtained a distinct appellation. It first took its rise in See also:Germany, and more tardily received recognition in See also:Great See also:Britain. Forensic medicine, or medical jurisprudence proper as distinguished from hygiene, embraces all questions which bring the medical See also:man into contact with the law, and embraces (1) questions affecting the civil rights individuals, and (2) injuries to the See also:person. I.—QUESTIONS AFFECTING THE CIVIL OR SOCIAL RIGHTS OF INDIVIDUALS 1. Development of the Human See also:Frame.—The development of the See also:physical and See also:mental See also:powers of the human being is a See also:factor of great consequence in determining criminal responsibility, civil responsibility, or the See also:power of giving validity to civil contracts, and in determining the See also:personal identity of a living person or of a See also:corpse. Human See also:life is usually divided into the five periods of See also:infancy, childhood, youth, manhood and old See also:age. Some writers increase the number of these unnecessarily to seven periods. Infancy is the See also:period from See also:birth till the first or See also:milk set of See also:teeth begin to be See also:shed—usually about the seventh See also:year. During this period the See also:body increases in See also:size and stature more, relatively, than at any other period of existence; and the mental faculties undergo great development. The milk teeth, twenty in number, are evolved in a definite See also:order, beginning with the central incisors at about six months, and ending with the second molars about the termination of the second year. From the size and stature of the body, the development of the teeth, and the more or less advanced state of ossification or solidification of the bony See also:skeleton, conclusions may be See also:drawn as to the probable age of the See also:infant. Childhood extends from the commencement of the shedding of the milk teeth to the age of See also:puberty—usually from the seventh to the fourteenth or fifteenth year. During this period the body expands, as well as the bony structures, without any clearly marked difference in structure being observable between the sexes except as regards the genitals, so that it is impossible to distinguish absolutely between the male and the See also:female skeleton during this period. The milk teeth are shed, and are replaced by the second or permanent set, See also:thirty-two in number, though these do not usually all make their See also:appearance during childhood. Marked See also:differences between the proclivities of the sexes are noticeable even at an See also:early period of childhood, and long before the characteristic functions begin to be See also:developed. Youth is marked at its commencement by the changes which occur at puberty—the development of the genitals in both sexes, the appearance of See also:hair on the genitals, the appearance of a See also:beard in the male, the development of the. breasts in the female, the appearance of the monthly flow in the female, and the ability to secrete semen in the male. Marked mental changes now occur, and the generative functions are perfected. Youth terminates at the age of legal See also:majority, twenty-one years, or perhaps the period ought to be extended to twenty-five years of age, as it is with some nations. Manhood (or Womanhood) is the period of perfection of all the bodily and mental powers. It ceases in woman with the cessation of the monthly flow at about See also:forty-five years of age; but in man it often extends to a much later period of life. Old Age begins with the decay of the bodily and mental faculties, and is characterized by wrinkling of the skin, loss of the teeth, whitening of the hair, and feebleness of the limbs. In its later stages decay of the mental faculties, deafness, obscurity or loss of See also:vision, and bowing of the spine are added. 2. Duration of Human Life.—The chances of human life See also:form an important subject of inquiry, and on deductions from comparisons of birth and See also:death rates is founded the See also:system of annuities, See also:insurance against loss in sickness, and the insurance of lives. Since the See also:establishment of compulsory See also:registration of deaths, our knowledge of the See also:ordinary and extraordinary chances of human life has been extended, and surer data are available for calculations of probabilities of life, of survivorships, and of the payments which ought to be made in benefit clubs (see INSURANCE). 3. Personal Identity: Where the identity has to be established or disproved after long See also:absence, exposure to See also:foreign climates and hardships, wounds, &c., the problem has often been extremely difficult. The data for identifying a person are individual and See also:family likeness, stature, the See also:colour of the eyes, peculiarities of garb and manner, recollection of antecedent events, but more especially marks on the persons either congenital or acquired. Such are naevi or See also:mother's marks, scars, and disunited or badly See also:united fractures, known to have existed upon the missing person (see See also:IDENTIFICATION). In the See also:case of the living, identification is more often a See also:matter for the See also:police officer than for the medical man. See also:Bertillon and See also:Galton have each devised methods for the identification of criminals (see See also:ANTHROPOMETRY, and See also:FINGER-PRINTS). 4. See also:Marriage.—Under this See also:head the medical jurist has to See also:deal principally with the nubile age, viewed in the See also:light of nature and according to legislative enactments, and with such physical circumstances as affect the legality of marriages, or justify See also:divorce. In Great Britain the age at which the sexes are first capable of propagating the See also:species is later than in more See also:southern climes. Ordinarily it does not occur before fifteen years of age for the male and fourteen for the female; exceptionally it occurs at the ages of thirteen and of twelve (or even less) respectively in the male and female. By law, nevertheless, parents and guardians may, in See also:England at all events, forbid the marriage of See also:young See also:people till the age of legal majority. The only physical circumstances which in Great Britain form a See also:bar to marriage are physical inability to consummate, and the See also:insanity of one of the parties at the See also:time of marriage. Both those circumstances have been pleaded and sustained in the law courts. In other countries See also:minor physical circumstances, as disease, are held to invalidate marriage. s. See also:Impotence and Sterility.—These are of importance in connexion with See also:legitimacy, divorce and criminal assaults. Impotence and sterility may arise from organic or from functional causes, and may be curable or incurable. Impotence (q.v.) is taken cognisance of by the law courts as a ground of divorce, and might, of course, be urged as a See also:defence in a case of See also:rape. Sterility is not a ground of divorce, but might be a question of importance in cases of legitimacy. 6. Pregnancy.—This subject presents one of the widest See also:fields for medico-legal See also:evidence. The limits of age between which it is possible, the limits of utero-gestation, and the signs of pregnancy may all in turn be the subjects of investigation. The limits of age between which pregnancy is possible are usually fixed by the appearance and cessation of the monthly flow; and these ordinarily begin about fourteen and cease at forty-five years of age. Exceptionally they appear as early as the tenth year, and may not cease till the end of the fifth See also:decade of life. Cases, however, have occurred where a woman has conceived before menstruating; and a few doubtful cases of conception are recorded in See also:women upwardsof fifty or even sixty years of age. The See also:general fact of pregnancy being limited by the age of puberty on the one See also:hand and the cessation of the monthly flow—or fifty-three or fifty-four years as the extreme limit of age—must be accepted as the safest See also:guide in practice. The limits of utero-gestation are not in England fixed by legislation. The See also:French See also:code fixes the extreme limit of three See also:hundred days. The ordinary period is forty See also:weeks and a See also:half, or two hundred and eighty-three days from the cessation of the last monthly See also:flux. The limit of three hundred days, as fixed by the French code, is perhaps never exceeded, if ever reached. The uncertainty of See also:females in fixing the exact date of conception has given rise to the discrepant opinions of physiologists on the subject. It is well known, however, that among the higher animals the period is not precise; and impregnation and conception need not necessarily be coincident. The signs of pregnancy are of the utmost importance to the medical jurist. He may be called upon to pronounce upon the virtue of a female, to sustain or rebut a plea for divorce, to determine whether a See also:capital See also:sentence shall be carried out, or to determine whether it is probable that an See also:heir will be See also:born to an See also:estate. Medical jurists classify the signs of pregnancy as uncertain or certain; it is the former which are most regarded by the public, but the latter are alone of probative value to the jurist. The usual and uncertain signs are the cessation of the monthly flow, See also:nausea, sickness, a darkening of the areola and the formation of a secondary areola around the nipple, enlargement of the breasts, increased size of the See also:abdomen, the formation of a See also:tumour in the womb, quickening, and the motions of the foetus. Also uncertain are the uterine souffle, which is a See also:peculiar soft See also:sound heard over the abdomen and synchronous with the maternal See also:pulse and ballottement or the examination for a floating tumour in the abdomen between the fifth and eighth months of pregnancy. The certain signs of pregnancy are the foetal limbs palpated through the abdomen by the physician, the pulsations of the foetal See also:heart heard by means of the See also:stethoscope, the pulsations being much quicker and not synchronous with the maternal pulse. This latter is inapplicable before the See also:fourth See also:month of gestation. 7. Parturition.—The imminence of the See also:process of parturition is of comparatively little See also:interest to the medical jurist; but the signs of See also:recent delivery are all-important. These signs are the bruised, swollen, and lacerated state of the See also:external genitals, relaxation and See also:dilatation of the vagina and womb, the existence of a peculiar vaginal See also:discharge known as the lochia, a relaxed and fissured See also:condition of the abdominal walls, a peculiar aspect of the countenance, and the distended state of the breasts due to the secretion of milk. The lochial discharge is the most characteristic sign. All the signs may disappear within ten days of delivery, though this is not usual. Connected with parturition, the question of viability (potentiality for life) of the See also:child is not unimportant. After the See also:intra-uterine age of seven months is reached a child is certainly viable. The period at which the foetus becomes viable cannot be stated with certainty; but five See also:calendar months, or one hundred and fifty days, is perhaps the nearest approximation. The viability of a child is judged by its size and See also:weight, its general state of development; the state of the skin, hair, and nails; its strength or feebleness,the ability to cry, and its power of taking maternal nourishment. The question of viability has important See also:bearings upon the See also:crime of See also:infanticide. In the case of See also:succession to See also:property the meaning of " born alive " is different from the meaning of the same expression as used respecting infanticide. In questions of tenancy by the See also:curtesy (q.v.) it has been decided that any See also:kind of See also:motion of the child, as a twitching and tremulous motion of the lips, is sufficient evidence of live-birth. By the French code, however, no child that is born alive can inherit, unless it is born viable. As regards infanticide, See also:proof of a conclusive See also:separate existence of the child is demanded before live-birth is admitted. The subject of superfoetation and superfecundation, or the possibility of two conceptions having occurred resulting in the birth of twins with a considerable intervening See also:interval, is obscure and has given rise to much controversy. There is much, however (e.g. the existence of a See also:double or bifid uterus), to countenance the view that a double conception is possible. 8. Monsters and Hermaphrodites.—To destroy any living human birth, however unlike a human creature it may be, is to commit a crime. See also:Blackstone states that a See also:monster which hath not the shape of mankind hath no inheritable See also:blood; but the law has not defined a monster, nor what constitutes a human form. The same author states that if, in spite of deformity, the product of birth has human shape, it may be an heir. Hermaphrodites are beings with malformations of the sexual See also:organs, simulating a double See also:sex. Physiologists do not admit, however, the existence of true hermaphrodites with double perfect organs, capable of performing the functions of both sexes. 9. Paternity and See also:Affiliation.—These are often matters of great doubt. A considerable time may elapse between the absence or death of a See also:father and the birth of his reputed child. As has already been said, three hundred days is the utmost limit to which physiologists would extend the period of utero-gestation. This subject involves questions respecting See also:children born during a second marriage of the mother, See also:posthumous children, bastardy, and alleged cases of posthumous children. ro. Presumption of Survivorship.—When two or more persons perish by a See also:common See also:accident, when a mother and her new-born child are found dead, and in a few analogous cases, important civil rights may depend upon the question which lived the longest; and great ingenuity has been displayed in elucidating the disputes which have arisen in the law courts in such cases. I r. Maladies exempting from Discharge of Public Duties frequently demand the See also:attention of the medical man. He may be called upon to decide whether a man is able to undertake military or See also:naval service, to See also:act as a juryman without serious See also:risk to life or See also:health, or to attend as a See also:witness at a trial. 12. Feigned and Simulated Diseases often require much skill and caution in order to detect the imposture. 13. The Signs of Death.—The determination of the actual existence of death assumes a certain importance in tropical countries, where the See also:necessity for speedy interment may involve a risk of See also:burial alive. Such an accident cannot well occur where a medical man confirms the existence of death, and in the United See also:Kingdom, where burial rarely takes See also:place before the See also:lapse of forty-eight See also:hours, such changes usually occur in the body as to render any See also:error practically impossible. Within a varying period, usually not more than twelve hours, the body becomes rigid, owing to the development of rigor mortis or See also:post mortem rigidity. The blood, which during life is equally distributed throughout the body, gravitates to the most dependent parts and develops a discoloration of the skin which is known as post mortem lividity or post mortem staining. At a variable period of time, dependent on the cause of death, also the temperature and moisture of the See also:air to which the body is exposed, de-See also:composition or putrefaction sets in. These changes after death are of great importance, not only as affording certain proof of death, but also because they furnish valuable See also:information as to the probable time at which it occurred, and from the fact that they may alter or destroy evidence as to the cause of death.' 14. Insanity or Mental See also:Alienation.—A medical man may be required to give evidence in any of the law courts, civil, criminal or ecclesiastical, before commissions de lunatico inquirendo, or before a See also:magistrate, as to the sanity or insanity of an individual; and he may have to sign certificates of unsoundness of mind with the view of providing for the safe custody and proper treatment of a lunatic. Hence he must be See also:familiar with the See also:chief forms of insanity (see INSANITY), and be able to distinguish and treat each of these. He will also be required to detect feigned insanity, and to examine persons charged with crime with the view of preventing real lunatics from being treated as criminals. II.—INJURIES TO THE PERSON r. Deftoration.—The signs of defloration are obscure and uncertain; and it is rather by the coexistence of several of the usual marks than the existence of any one sign, that any just conclusion can be arrived at. . 2. Rape.—This crime consists in the carnal knowledge of a woman forcibly and against her will. The proofs of rape apart from the consistency of the woman's See also:story, mainly depend on the presence of marks of violence, stains, &c. In all charges of rape, the woman and her assailant should be examined as soon as possible by a medical man, but such examination, it is important to remember, can only be carried out with the See also:free consent of the party to be examined. It is to be noted that according to See also:English law the slightest degree of penetration is sufficient to constitute the crime of rape. 3. See also:Mutilation.—This may consist in the cutting or See also:maiming of any member; castration is the most important, and perhaps butmedical jurist in the first place to ascertain the fact of death, and to distinguish between real and apparent death; and then to determine, if possible, the period at which death took place. Infanticide, or child See also:murder, is by the See also:British law treated with the same severity as the murder of an adult. Indeed infanticide as a crime distinct from murder has no legal recognition. Practi. cally this severity defeats itself, and hence an alternative See also:charge of concealment of birth in England, or concealment of pregnancy in See also:Scotland, is usually preferred in such cases. The iniquity of the old law which threw the onus of proof of still. birth on the mother now no longer exists, and the law demands. strict proof of live-birth at the hands of the See also:prosecution. Hence the subject involves See also:nice points of forensic medicine. The child must be proved to have arrived at the period when there was a See also:probability of its living (proof of viability) ; and as the establishment of respiration is necessary to prove live-birth the evidences of this act must be carefully investigated. The size and position of the lungs, and the state of the vessels concerned in foetal circulation, must be carefully noted. The foetal lungs are dark, dense and See also:liver-like in appearance and consistence, and sink when immersed in See also:water; whilst the fully respired lungs are rosy, marbled, and soft and crepitant when handled. Minor degrees of respiration are recognized by the appearance of little See also:groups of dilated air-vesicles, and by the fact that, although the lungs as a whole may sink in water, certain portions of them, into which respired air has penetrated, See also:float in water even after subjection to See also:firm pressure in the hand. Care must be taken, nevertheless, to exclude buoyancy of the See also:lung due to putrefaction; in this case the air may be expelled by See also:gentle pressure, and the previously buoyant portion of lung now sinks in water. It is impossible, however, to distinguish certainly between a lung naturally inflated and one artificially insufflated. It must be See also:borne in mind that, although live-birth cannot be affirmed in the absence of signs of respiration, the presence of these signs is not proof of live-birth in the legal sense of the term. The law demands for live-birth a separate existence of the child after delivery ; and breathing may take place whilst the child is still either wholly or partially within the maternal passages, and in some See also:special cases whilst still within the uterus itself. When proofs of respiration—it may be to such an extent as to leave no doubt as to live-birth—have been found, the cause of death is then to be investigated. Wounds, and other forms of injury, must be sought for. There may be signs of strangulation, suffocation, puncture of the fontanelles and consequent injury to the See also:brain, the See also:administration of a See also:poison, or other means of procuring death. It must be borne in mind that some of these causes may be brought about by omission, or even by accident. Thus strangulation may arise from natural and unrelieved pressure of the See also:navel-See also:string on the See also:neck of the child; suffocation from See also:immersion of the See also:face of the child in the maternal discharges, or by pressure of clothes on the mouth. Death may result from See also:haemorrhage through neglect to tie the navel-string, or the infant may perish from exposure to See also:cold. In the case of exposed infants it is important to ascertain the real mother. As such exposure usually takes place soon after birth, comparison of the age of the infant with the signs of recent delivery in the suspected mother is the best method of proving the relation. rarely effected as a crime. Self-mutilation, giving rise to false accusations, is occasionally resorted to. 4. Criminal See also:Abortion.—This crime consists in unlawfully procuring the See also:expulsion of the contents of the gravid uterus at any period See also:short of full term. It must be noted that while this See also:definition may be held to recognize the See also:induction of premature labour by medical men in certain circumstances, yet, when the operation is necessary, a medical man should always protect himself from possible misconstruction of his See also:action (i.e. criminal See also:intent) by having a consultation with another practitioner. The means employed in criminal abortion to procure the desired result may be classed under three heads: (r) general violence to the body, (2) administration of drugs supposed to have abortifacient qualities, (3) instrumental interference with the contents of the uterus. Among the drugs frequently employed for the purpose, although by no means always successfully, are See also:ergot, strong purgatives, See also:iron, See also:rue, See also:pennyroyal, savin. 5. See also:Homicide.—The legal sense of the term homicide excludes such injuries as are the result of either accident or of See also:suicide. It embraces murder or wilful homicide, See also:manslaughter or culpable homicide, casual homicide, and justifiable homicide. Ordinary homicide may be accomplished by several modes that may sometimes be ascertained by examination of the body, e.g. poison. As a preliminary in all cases of homicide, it is the See also:duty of the Death from See also:Asphyxia.—Among the forms of violent death due to this cause are drowning, See also:hanging, strangulation, garotting, smothering, suffocation from choking, See also:mechanical interference with the expansion of the See also:chest walls, as when persons are crushed together during a panic in a See also:fire, breathing poisonous gases, such as carbonic See also:acid or carbonic See also:oxide. Suicide and accidental death from these causes are still more common. Drowning is thought to produce death occasionally by the suddenness of the See also:shock causing suspension of the functions of circulation and respiration—by shock without a struggle. The usual mode of death appears, however, to be by the circulation of unoxygenated blood through the brain acting as a poison upon that See also:organ; and this is attended with all the phenomena of asphyxia, as in suffocation. The phenomena attending asphyxia are as follows. As soon as the See also:oxygen in the arterial blood, through exclusion of air, sinks below the normal, the See also:respiratory movements grow deeper and at the same time more frequent; both the inspiratory and expiratory phases are exaggerated, the supplementary respiratory muscles are brought into See also:play, and the breathing becomes hurried. As the blood becomes more and more venous, the respiratory movements continue to increase both in force and frequency. Very soon the expiratory movements become more marked than the inspiratory, and every muscle which can in any way assist in expiration is brought into play. The orderly expiratory movements culminate in expiratory See also:convulsions; these violent efforts speedily exhaust the See also:nervous system, and the convulsions suddenly cease and are followed by a period of See also:calm. The calm is one of exhaustion; all expiratory active movements have ceased, and all the muscles of the body are flaccid and quiet. But at long intervals lengthened deep inspiratory movements take place; then these movements become less frequent; the See also:rhythm becomes irregular, so that each breath becomes a more and more prolonged gasp, which becomes at last a convulsive stretching of the whole body; and with extended limbs and a straightened See also:trunk, with the head thrown back, the mouth widely open, the face drawn and the nostrils dilated, the last breath is taken. The above phenomena are not all observed except in cases of sudden and entire exclusion of air fmm the lungs. In slow asphyxia, where the See also:supply of air is gradually diminished (e.g. in drowning), the phenomena are fundamentally the same, but with minor differences. The appearances of the body after death from drowning are various. There may be pallor of the countenance, or this may be livid and swollen. The air passages are filled with frothy mucus, and there may be water in the See also:stomach. The ends of the fingers are often excoriated from grasping at See also:objects; and weeds, &c., are sometimes found grasped in the hands. The distinction between murder and suicide by drowning can rarely be made out by examination of the body alone, and is usually decided from See also:collateral circumstances or marks of a struggle. Attention must also be paid to the existence of wounds on the body, marks of strangulation on the neck, and the like. Hanging may result in death from asphyxia, or, as is more particularly the case in judicial hanging, some injury is inflicted on the upper portion of the See also:spinal See also:cord, resulting in instant death. The ordinary appearances of.death from asphyxia may be found: dark fluid blood, congestion of the brain, intensely congested lungs, the right cavities of the heart full, and the See also:left comparatively empty of blood, and general engorgement of the viscera. Ecchymosis may be found beneath the site of the cord, or a See also:mere parchmenty appearance. There may even be no See also:mark of the cord visible. The mark, when See also:present, usually follows an oblique course, and is high up the neck. The fact that a body may be suspended after death, and that if this be done speedily whilst the body is still warm there may be a post-mortem mark undistinguishable from the mark observed in death from hanging, must not be forgotten. Suffocation may occur from the impaction of any substance in the glottis, or by covering up the mouth and See also:nose. It is frequently of accidental origin, as when substances become accidentally impacted in the See also:throat, and when infants are overlaid. The phenomena are those of pure asphyxia, which have already been detailed. On post-mortem examination the See also:surface of the lungs is found covered with See also:minute extravasations of blood, known as punctated ecchymosis. Strangulation may be accomplished by See also:drawing a cord tightly See also:round the neck, or by forcibly compressing the See also:windpipe (throttling). Hence there may be either a circular mark round the neck, not so oblique as after hanging, or the marks of the fingers may be found about the region of the larynx. The cartilaginous structures of the larynx and windpipe may be broken. The mark of the ligature is often See also:low down in the neck. The signs of asphyxia are present in a marked degree. Mephitism.—In the United Kingdom this last form of death usually results accidentally from an See also:escape of See also:lighting See also:gas, the danger has been much increased in many towns owing to the addition of carburetted water-gas to the ordinary supply. Carbonic oxide gas is contained in ordinary lighting gas to the extent of about 6 to 8 %, and is extremely fatal when inhaled. Carburetted water-gas contains about 28%, and when mixed with ordinary lighting gas the percentage of carbonic oxide is thus very much increased. As a mode of assassination it is seldom employed, but is frequentlyresorted to on the See also:continent of See also:Europe by suicides, See also:charcoal fumes being commonly used for the purpose. 6. Death from See also:Starvation.—Cases occur in which it is important to distinguish this from other modes of death. In such cases the skin becomes harsh and dry, and may acquire a peculiar odour; the subcutaneous See also:fat disappears; the gums shrink away from the teeth; the See also:tongue and mouth become dark-coloured and dry; the eyes are bloodshot; the intestines become thin and their coats translucent; the See also:gall-See also:bladder is distended. The period of See also:total See also:abstinence from See also:food required to kill an adult is unknown, and greatly depends upon whether there be See also:access to liquid. In some cases persons have been able to subsist on little or no nourishment for long periods, the body being in a state of quasi-See also:hibernation. 7. Death from Extremes of Temperature.—(r) Death from cold is not often observed in the British Isles. A portion only of the body, as the extremity of a See also:limb, may perish from extreme cold. After the first sensation of tingling experienced on exposure to severe cold, loss of sensation supervenes, with languor and an irresistible propensity to See also:sleep. The tendency to this forms an extreme danger in such cases. (2) Death from extreme See also:heat usually occurs in the form of burning and scalding, attended with destruction of a large portion of the cutaneous structures. Here the cause of death is obvious. The human body is capable of exposure to very hot air—as is seen in See also:Turkish See also:baths-for a considerable period with impunity. See also:Sunstroke is a cerebral See also:affection brought on by too great exposure to a ,hot See also:atmosphere, especially whilst undergoing fatigue. 8. Death by See also:Lightning.—Lightning or an electric current may cause instant death. No visible marks of the effects of the electric current may be left, or the body may be singed or discoloured, or the skin may be perforated at one or two spots. 9. Injuries or Wounds.—These include in a medico-legal sense not only those characterized as incised, punctured, contused, lacerated, stab wounds, but also See also:burns, injuries produced by firearms, fractures, dislocations, &c. One of the chief questions which have to be decided in all forms of violent death is whether it was the result of accident, suicide or murder. In cases of fatal wounding, among the points to be noted, which will help to decide the question, are the situation, direction and extent of the See also:wound, the position in which the body and any weapon may be found, together with the presence and See also:distribution of any blood marks and the signs of a struggle. In wounds caused by fire-arms the injury, if suicidal, is usually situated in a vital and accessible See also:part of the body, the See also:temple, mouth, and chest being the favourite situations; but such an injury also presents, as a See also:rule, the characteristic appearances resulting from the discharge of the weapon See also:close to the body, viz. besides the wound of entrance of the See also:bullet, there are singeing of the cuticle and hair, and blackening of the See also:area immediately surrounding the wound, from particles of unconsumed See also:powder being driven into the skin and from the See also:smoke of the discharge. These effects are naturally not produced when the weapon is discharged at a distance exceeding 2 or 3 ft., as usually happens in cases of homicidal See also:shooting. They may also be wanting in undoubted suicidal wounds produced by revolvers and cartridges filled with amberite or other smokeless powders. Death from burning is generally accidental, very rarely suicidal, and when homicidal is usually employed to conceal traces of other violence inflicted upon the body. In large conflagrations death is not always due to burning. Charred bodies may be found presenting various injuries due to the fall of beams, crushing, the trampling of others tryibg„ to escape, &c., or fractures and lacerations may be due simply to the action of the heat. Death may result from such injuries, or from suffocation by the gases of See also:combustion, before the victim is affected by the actual fire. Spontaneous combustion of the body has been stated to occur, but the evidence upon which the cases See also:rest is not well authenticated. Punctured wounds or stabs require minute attention; for there have been instances in which death has been produced by an See also:instrument so small as a See also:pin thrust into a vital part. Wounds of the head are always dangerous, especially if the See also:blow has been severe. The person so wounded may See also:die without See also:division of the skin, or fracture of the bones, as' happens in what is known as concussion of the brain. duced by the blood of other animals, more especially domestic Contusions which ddo not See also:divide the skin may fracture the See also:skull; d or the inner table of the skull may be fractured without the See also:outer being broken or depressed. Even wounds of the See also:scalp may prove fatal, from inflammation extending towards the brain. Punctured wounds of the head are more dangerous than cuts, as more likely to excite fatal inflammation. When the brain and its membranes are injured, all such wounds are generally fatal. Wounds of the face or organs of sense are often dangerous, always disfiguring, and productive of serious inconvenience. Wounds of the neck are always serious whenever more than the skin is divided. The danger of opening large blood-vessels, or wounding important nerves, is imminent; even the division of a large vein in the neck has proved immediately fatal, from the entrance of air into the See also:vessel, and its speedy See also:conveyance to the heart. A blow on the neck has instantly proved fatal, from injury to an important See also:nerve, generally the pneumogastric or the sympathetic. Dislocations and fractures of the bones of the neck prove instantly fatal. Wounds of the chest are always serious when the cavity is penetrated, though persons may recover from wounds of the lungs, and have even survived for some time considerable wounds of the heart. This last is an important fact ; because we are not always to consider the spot where the body of a person killed by a wound of the heart, and apparently remaining where he See also:fell, is found as that in which the fatal wound was inflicted. Instances have occurred of persons surviving severe wounds of the heart for several days. Broken ribs are never without danger; and the same may be said of severe contusions of the chest, from the See also:chance of inflammation extending inwards. Wounds penetrating both sides of the chest are generally considered as fatal; but possibly there may be recovery from such. Wounds of the abdomen, when they do not completely penetrate, may be considered as See also:simple wounds, unless when inflicted with great force, so as to bruise the contents of the abdominal cavity; in that case they may produce death without See also:breach of surface, from rupture of some viscus, as sometimes happens from blows or kicks upon the belly. Wounds injuring the peritoneum are highly perilous, from the risk of severe inflammation. Wounds of the stomach or intestines, or of the gall-bladder, generally prove mortal, from the effusion of their contents into the peritoneal cavity producing fatal inflammation: Wounds of the liver, See also:spleen or kidneys are generally soon mortal, from the great vascularity of those organs. Wounds of the extremities, when fatal, may generally be considered so from excessive haemorrhage, from the consequences of inflammation and See also:gangrene, or from the shock to the system when large portions of the limb are forcibly removed, as in accidents from machinery, and in wounds from firearms. Blood Stains.—The examination of blood stains is a frequent and important operation in criminal charges. Blood stains when fresh and abundant can be recognized without difficulty, but when old, or after being acted upon by certain substances, their identity is not readily determined. The tests which may be applied to a suspected stain consist of: (t) The microscopic test. A portion of the stain is soaked in a drop of some fluid which will soften and cause separation of the dried blood corpuscles without altering their characteristic appearance. Such fluids are solutions of glycerine and water of a specific gravity of Io28 or 30 % See also:caustic potash. The recognition of blood corpuscles affords evidence of the nature of the stain. (2) Chemical tests. (a) Heat applied to a See also:solution obtained by soaking some of the stained fabric' in cold water. A blood solution is red, and loses its red colour on application of heat, while at the same time a See also:buff-coloured precipitate is formed. (b) On applying a drop of freshly prepared See also:tincture of See also:guaiacum and then some ozonic See also:ether or peroxide of h drogen to the stain, a See also:blue colour is obtained if blood be present. Many other substances, however, give the same reaction. (c) If, even to the smallest particle of dried blood, a fragment of common See also:salt and some glacial acetic acid be added, and the latter is then heated to ebulhtionitnd allowed to evaporate away, small See also: On adding ammonium sulphide to the solution the haemoglobin is reduced and only one broad dark See also:band is seen (reduced haemoglobin). On adding caustic potash to a solution of blood, alkaline haematin is formed, and this again is transformed on the further addition of ammonium sulphide into reduced haematin or haemochromogen, which gives a very characteristic spectrum of two dark bands situated in the yellow part of the spectrum. The See also:production of these three different spectra from a red-coloured solution is characteristic of blood. Old blood stains are insoluble in water, whereas recent stains are readily soluble in cold water, yielding a red solution. The application of hot water or washing with See also:soap tends to See also:fix or render blood stains insoluble. See also:Vegetable dyes may likewise give red solutions, but they may be distinguished from blood by the addition of See also:ammonia, which alters the colour of the former, but rather intensifies the red colour of a blood solution. The differentiation between human blood stains and those See also:pro- animals, is a matter of great importance to the me 'cal jurist. When the blood stain is fresh, measurement of the corpuscles may decide the question, but in the case of dry and old stains it is impossible to make the distinction. A method has been discovered, however, which enables the distinction to be made not only between human blood and that of other animals (with the exception of Simiidae), but also between the bloods of different animals. The method depends upon the fact that if an See also:animal (A), such as a See also:dog or See also:rabbit, is inoculated with the blood or serum of another animal (B), then the blood or serum of A is found to produce a specific reaction (namely, the production of a cloudiness or precipitate) when added to a solution of the blood of a similar animal to B, and that species of animal only. If, therefore, human blood serum is injected into an animal, its blood after a time affords an " See also:anti-serum " which produces the specific reaction only in human blood solutions and not in those formed from the blood of other animals. ro. Poisoning.—There is no exact definition of a poison (q.v.). Popularly, substances which destroy or endanger life when swallowed in small quantity are called poisons, but a scientific definition would also include many substances which are injurious to health in large doses or only after repeated administration, and which act not only when swallowed, but also when taken into the system through other channels, e.g. the skin or the lungs. The branch of See also:science which relates to poisons, their nature, methods of detection, the symptoms produced by them, and treatment of poisoning, is called See also:Toxicology, and is one of the most important subjects included under the term Medical Jurisprudence. The medical evidence in cases of poisoning rests upon—(r) the symptoms produced during life; (2) the post mortem appearances; (3) the chemical See also:analysis and detection of the substance in the body, or in the excretions and vomited matters, or in articles of food; (4) experiments on animals in the case of certain poisons where other conclusive evidence is difficult to obtain. The treatment of cases of poisoning will vary according to the substance taken, but the general principles which should be followed are: (a) to get rid of the poison by means of the stomach-See also:pump, or by washing out the stomach with water through a soft See also:rubber See also:tube, or by giving an emetic such as See also:mustard, sulphate of See also:zinc, See also:ipecacuanha; (b) to neutralize the poison by giving a substance which will form with it an innocuous See also:compound (e.g. in the case of the strong acids by administering See also:magnesia or common See also:whiting), or which has an opposite physiological action (e.g. atropine in See also:opium poisoning); (c) to promote the elimination from the body of the poison which has been already absorbed; (d) general treatment of any dangerous symptoms which appear, as by stimulation in collapse or artificial respiration in asphyxia. Food Poisoning (see also See also:ADULTERATION).—Foods may prove noxious from a variety of causes: (I) The presence of metallic poisons, as in peas artificially coloured with See also:copper salts, in tinned foods from dissolved See also:tin salts, &c. (2) The contamination of any food with the specific germs of disease, as for example, milk infected with the germ of enteric See also:fever. (3) The presence in See also:meat of parasites, such as the Trichina spiralis, or of disease in animals, capable of transmission to man, such as See also:tuberculosis, or the presence of poison in the flesh of animals which have fed on substances harmless to them but poisonous to human beings. See also:Grain may be infected with parasitic See also:fungi of a poisonous See also:character, as for example Claviceps purpurea, causing epidemics of ergotism. (4) Foods of various kinds may contain saprophytic bacteria which elaborate certain poisons, either before or after the food is taken. It is chiefly in relation to food-poisoning from the last-mentioned cause that our knowledge has been increased in recent years. Many cases of food-poisoning, previously of mysterious origin, can now be explained by the action of bacteria and the products which they give rise to—tox-albumoses, ptomaines, 'toxins—by splitting up proteid substances. It is not necessary that the food should show evident signs of putrefaction. It may not do so, and yet on' being eaten produce violent symptoms of gastro-intestinal irritation almost immediately, followed by various nervous symptoms. In such cases a chemical poison, developed by putrefactive bacteria before the food was eaten, quickly acts upon the system. On the other hand, symptoms may not appear for many hours after ingestion of the food, and then come on suddenly and with great severity—there has been a period of See also:incubation. In such cases the food when swallowed has contained the bacteria, but the poisonous toxin has been elaborated by them afterwards in the system during the period preceding the onset of symptoms. In both varieties of poisoning the symptoms are similar, consisting of gastro-intestinal irritation—vomiting, purging and See also:pain in the abdomen—together with great prostration, fever, See also:muscular twitchings, disturbances of vision, See also:delirium and See also:coma. The varieties of meat which have most frequently given rise to poisoning (Botulismus) are pork, See also:ham, veal, sausages, brawn, various kinds of meat pies and potted meats. See also:Pig flesh appears to be specially liable to become infected. A point of considerable interest, which has sometimes given rise to doubt as to the poisonous character of meat in certain instances, is, that the same food may be poisonous at one time and not at another. Thus it may be harmless when freshly prepared, cause fatal effects if eaten a See also:day or two afterwards, and shortly after that again prove perfectly innocuous. This is explained by the fact that the toxic substances take some time to develop, and after development are still further split up by the bacteria into other bodies of a harmless nature. In some See also:fish—e.g. Trachinus See also:draco, or See also:sea See also:weaver—the poison is a physiological product of certain glands. In others the poison is not known, as in the family Scombridae, to which the disease Kakke has been attributed. in the United Kingdom the poisonous effects produced by fish are due to bacterial agency after death, and instances have occurred from the eating of See also:herrings, See also:mackerel, dried salt codfish, See also:caviare, tinned See also:salmon and tinned sardines. Shellfish may produce poisonous 'effects from putrefactive changes or from the development in them (oysters and mussels) of ptomaines. Brieger discovered a ptomaine in poisonous mussels to which he gave the name mytilotoxin. It is now fully proved that oysters and mussels may become contaminated with the organism of typhoid fever if placed in specifically polluted water, and thus transmit the disease to human beings. Milk, as already stated, may be contaminated and convey the infection of See also:scarlet fever and other diseases. It may also contain substances of bacterial origin, which are possibly the cause of infantile See also:diarrhoea, and others, having a fatal effect upon adults. See also:Cheese has frequently caused poisoning. See also:Vaughan discovered a toxic substance in milk and cheese—tyrotoxicon—but there are other toxic substances of bacterial origin sometimes present in cheese to which poisonous effects have probably been due. See also:Mushroom-poisoning results from the eating of poisonous fungi in See also:mistake for the edible mushroom. The poisonous See also:element in most cases is either muscarin contained in the fungus See also:Amanita muscaria, or phallin in Amanita phalloides. Additional information and CommentsThere are no comments yet for this article.
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