room.

SUICIDE THROUGH STABBING (HOFMANN).

The body was found lying upon the left side, behind and across the doorway of the The body was almost entirely covered with freshly coagulated blood, and clothed only with a shirt, which was saturated with blood. Extensive blood-marks reached from the body to the bed, the covering of which latter was likewise saturated with blood, and beside which lay a large, open pocket-knife.

After cleansing the body six stab-wounds were recognized. Of these, one was situated in the right side of the neck, the other five on the anterior surface of the chest. All the wounds had a slit-like form, and showed throughout sharp, arched, separated edges, between which there was a collection of coagulated blood. This latter was continued to the left beyond the wound as a dried streak, in which direction the blood had probably flowed at the first turning of the body.

The wound of the right side of the neck continued into the depths of the neck as a wedge-shaped canal gradually decreasing in size. It opened in its course the outer wall of the right carotid artery, and cut the jugular vein transversely.

Of the wounds of the chest, the uppermost one was situated two inches below the middle of the left clavicle. It penetrated the second intercostal space and ended in the lung, which was tuberculous, and which at this point was partly adherent to the pleura.

The four other wounds were confined to the region of the left nipple, and were almost transverse. They ended in the antero-external part of the upper lobe of the left lung, into which, as six slit-like openings 4-7 mm. in length, they penetrated a distance of 1-3 cm. In the left pleural cavity there were about 300 c.c. of partly fluid, partly coagulated blood. Closer investigation revealed that the external openings of two of the wounds showed notches in their edges, and that one of them corresponded with a double slit-like opening in the pleura. It follows, therefore, that these openings were punctured twice; and, further, that with five punctured openings in the skin, seven were found in the lung.

That it was a case of suicide was demonstrated by the external circumstances and all the postmortem findings. It was clear that the deceased had produced the wounds while in bed, and that he had then attempted to arise and go to the door, where he fell. Excluding these facts, the opened and uninjured shirt, the symmetric disposition of the openings of the stab-wounds and of the course of the canal of the wounds, and the proximity of the wounds of the chest, as likewise the fact that into two of the wounds punctures were made twice, were more indicative of suicide than of murder.

The course of the puncture-canals, especially that of the neck, permits the supposition that the stabs were done with the left hand, and inquiries revealed that the deceased was left-handed.

The clot may be in the brain-that is, coming from the rupture of an artery supplying the brain tissue. The question then arises whether this blood-clot was the result of contusion or of disease. Not only do the circumstances of the case need to be inquired into, but careful examination of the brain and vessels must be made before an opinion can be

FIG. 24.-Fracture of the skull caused by the kick of a horse.

reached. In 1880 two policemen in Albany, N. Y., were called to arrest a man who was creating a breach of peace. The man was getting over a debauch, and was ugly and riotous. He refused to submit quietly to arrest, but fought the officers to the station-house, nearly a mile distant.

To bring him into submission the officers used their

FIG. 25.-Fracture of the skull caused by a blow from a long, angular bar of iron.

clubs. He was hit but once, on the right temple, a fairly severe blow, which did not rupture the skin, but raised quite a lump. Reaching the station-house he again fought the officers, and was finally pushed into a cell and left. The man was a little over thirty years of age, and was arrested late in the afternoon. In the evening the watchman spoke to

the prisoner, getting curses for an answer. man reported the man asleep and snoring. in the morning, the prisoner was dead.

About midnight the watch-
When the cell was opened

The coroner's physician held the autopsy, and reported that he found this bruise on the right temple, with a clot in the temporal muscle under it. There was no fracture of the skull. In the right lobe of the cerebrum was a clot, evidently from a rupture of the right anterior cerebral artery or one of its branches. The doctor did not find anything of note in the remainder of the autopsy, and he reported death to have been caused by the apoplexy described, and further stated he considered the cause of the apoplexy the blow struck by the policeman. This led to the arrest of the officers implicated. Their counsel, not being satisfied with the examination of the coroner's physician, obtained an order to have the body exhumed, and asked me to make further examination. This I did. Of course, the first autopsy prevented any very extended research, but evidences of atheroma about the aorta were noted, and pieces of the cranial arteries were taken for microscopic examination. The liver and kidneys were found to be fatty. Under the microscope, fatty degeneration of the vessels was clearly demonstrated. Talking the case over with the doctor who held the first autopsy, and receiving from him some statements which did not appear in his written report; 'adding these to the results of the examination by the microscope, I gave the opinion that apoplexy was due to disease and not to the blow.

There is no question but that the death was from the apoplexy, but in persons under forty years of age apoplexy is rare. It is true the drinking-habit is a predisposing cause to this condition, and cases occur in young life where the vessels of the brain, diseased from constant intoxication, give way under sudden acceleration of the blood, and the patient dies from apoplectic effusion. And it is again found that blows, severe ones to the head, especially in a person in whom the skull is very thin, or who is suffering from heart or kidney disease, are productive of hemorrhage into the brain, generally into the soft membrane, the arachnoid, or at the base of the brain, around the medulla. Unless the force of the blow is sufficient to cause rupture of the brain tissue, the effusion is found somewhere on the surface and not in the substance of the brain itself. It may be in the lateral ventricles also, but the bleeding here. would be from the velum interpositum, and might almost be said to be on the surface. The case of Near, who was jumped upon by Morgan, previously quoted, bears on this subject. Here there was extensive hemorrhage in the arachnoid, at the base, in the lateral ventricles, and around the spinal cord. But nowhere was there an effusion into the brain substance-nowhere was the brain lacerated. Near was a drinking man, and was drunk at the time of the assault, but it could not be said that such extensive hemorrhage was due to his habits, to the division of the arteries, especially after such violence had been sustained.

In this case there was but one blow upon the right temple, causing bruising of the temporal muscle and extravasation of blood in it. There was no testimony that the blow knocked the man down, ren

dered him insensible, or but for a short time made him stop his fighting and struggling, for these he resumed as soon as he reached the station-house. The coroner's physician stated that there was no rupture of the brain-substance, and the clot which caused the death was in the

FIG. 26.-Fracture of the skull caused by a blow from a hammer. The circular form of the fracture, despite the four-cornered shape of the hammer, is accounted for by the fact that the edges and corners of the hammer were rounded from long use, and by the fact that the deceased had a thick growth of hair, and at the time of injury was wearing a cap.

tissue of the right cerebral lobe. There was no fracture and no effusion of blood over the surface of the brain. The question properly arose, Was the blow on the temple one that would do injury-and dangerous injury-to an ordinary man-one not diseased? Careful examination

FIG. 27.-Fracture of the skull caused by the kick of a horse. On the inner surface of the skull the vitreous table is detached and the dura lacerated by a sharp splinter of bone.

into the character and force of the blow led to the conclusion that the answer must be in the negative.

"If, on these occasions,' a medical witness is unable to state posi1 Taylor, Principles and Practice of Medical Jurisprudence, 624.