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The post-mortem examination having been concluded, the calvaria should be replaced in position, the parts of the scalp inverted, and the latter as well as the abdominal walls brought together and securely sewed.'
Identification.-Ordinarily the dead body submitted for medical examination is either entire or almost so. Not infrequently, however, the body has been purposely mutilated after death, by a murderer, for example, with the view of escaping detection, or as in cases of death from fire, explosions, railroad accidents. Under such circumstances, when often only parts of the body or bodies can be recovered for examination, the highest anatomical skill may be requisite for the identification of the remains or the determination of the cause of death. But little difficulty, however, should be experienced in determining, for example, whether the bones recovered be human or not, if the greater part of the skeleton, especially if parts of the skull, be submitted for examination. It is only when a bone or a fragment of a bone has been obtained, as from the ruins of a fire, that mistakes as to their true nature are likely to be made by the medical examiner. Inasmuch as the bones of the domestic animals have been
1 In this connection it should be mentioned that in cases involving life or death the post-mortem examination should be thorough, lest the defence urge that the true cause of death be other than that alleged. In more than one case through such neglect has the prosecution failed to convict, owing to some organ not having been examined (Taylor, Alfred Swayne: Manual of Medical Jurisprudence, eleventh American edition, by Clark Bell, Esq., Philadelphia, 1892, p. 23).
frequently mistaken for those of man, even by physicians, if the examiner be in doubt as to the nature of a bone, it would be better for him to submit it to a comparative osteologist for determination, rather than to trust to his own judgment, unless specially qualified by previous osteological studies to give an opinion on the subject.
As regards the skull more especially, there is usually no difficulty in determining whether a skull be a human one. The particular race, however, cannot always be indicated, for while there is no difficulty, for example, in distinguishing a Caucasian skull (Fig. 1) from that of a typical negro
(Fig. 2), it is not only difficult, but often impossible to exactly identify the many forms of skull intermediate in character between the two. In the identification of human remains the sex, age, and stature are usually to be determined. Inasmuch as the skeleton of the male differs from that of the female as regards the size, weight, strength of the bones, in the relative development of the ridges and prominences serving for the attachment of the muscles, and more particularly in the size and shape of the pelvis (Figs. 3, 4), all of which peculiarities are fully described in works on anatomy, there is usually no difficulty if the skeleton is
entire in determining whether it be that of a male or a female. If, however, a single bone or a fragment of a bone be sub
mitted for an examination it is often so difficult to determine the sex that no positive opinion should be expressed.
The age of a body can be approximately at least inferred from the development of the teeth and the extent of the ossification of the bones. It is important, therefore, that the medical examiner should be familiar with the period and order in which the teeth appear and the bones ossify. In the jaws of a child at full term there are usually found the rudiments of twenty primary and four secondary or permanent teeth, twenty-four teeth in all. The average date of the eruption or cutting of the primary or milk teeth is as follows: The four central incisors appear from five to eight months after birth, the four lateral incisors from seven to ten months, the four anterior molars from twelve to sixteen months, the four canines from fourteen to twenty months, and the four posterior molars from eighteen months to three years.1 At a period of life varying between six and seven years the
1 Bell, T.: Anatomy, Physiology, and Diseases of the Teeth, 1837, pp. 66, 79.
jaws contain forty-eight teeth-twenty milk teeth and twenty-eight permanent teeth situated behind the milk teeth, which they will replace as the former are shed. The order in which the permanent teeth appear is as follows: The four anterior molars appear at seven years, the four central incisors at eight years, the four lateral incisors at nine years, the four anterior premolars at ten years, the four posterior premolars at eleven years, the four canines at about twelve years, the four second molars at about fourteen years,' the four posterior molars at from eighteen to twenty-one years of age. As a general rule, the teeth of the lower jaw appear first, but in this respect there are exceptions, as also in the order of the appearance of the teeth. It should be mentioned in this connection, also, that in cases of rickets the cutting of teeth is often delayed, while in syphilis it is premature. In the latter case the teeth have a notched appearance, and often crumble away. With the loss of the teeth and progressive absorption of the alveolar processes due to age, the lower jaw undergoes a marked change in the widening of the angle of its neck, and in the diminution of the width of its body, imparting to the mouth that expression so characteristic of the aged.
The degree of ossification of the lower epiphysis of the femur (Fig. 5) is one of the most certain signs of the age of the foetus and of the new-born child.3 Thus if no ossific deposit be found in the cartilaginous epiphysis of the
1 Saunders, Edwin: "The Teeth a Test of Age, considered with Reference to the Factory Children," addressed to the members of both houses of Parliament, London, 1837, p. 42.
2 Woodman and Tidy: Handy Book of Forensic Medicine and Toxicology, London, 1877, p. 623.
3 Béclard: Nouvelle Journal de Médecine, Chirurgie et Pharmacie, tome iv., 1819, p. 113; Casper: op. cit., vol. iii. p. 23.
femur it may be stated that the foetus has not yet reached the eighth month of intrauterine life. If the ossific deposit has attained a diameter of about one line the foetus has reached full term. If the ossific deposit measures more
From a child at birth, showing a nucleus in the lower epiphysis.
The natural skeleton of a child about two years old.
than one-quarter of an inch the child has lived after birth for some little time. The length of the skeleton. of the child at birth is usually about sixteen inches. Ossification begins at the extremities of most of the long