Evidence of Life Before Respiration.-Putrefaction in Utero.-Evidence of Life After Respiration.-Color, Volume, Consistency.-Presence of Developed Air-cells, and Absolute Weight of the Lungs.-Static Test.-Weight Increased by Respiration The Hydrostatic Test.-Sinking of the Lungs from Disease or Atelectasis.-Life with Perfect Atelectasis or Entire Absence of Air from the Lungs.-Erroneous Medical Inference from Sinking of the Lungs.-Floating of the Lungs from Putrefaction.— Floating of the Lungs from Artificial Inflation.-Inflation not Distinguishable from Imperfect Respiration.-Results of Compression.-Improper Objections to the Hydrostatic Test.-Respiration Before Birth.-Respiration a Sign of Life, not of On the Proofs of a Child Having Been Born Alive.-Evidence from Respiration.- From Marks of Violence.-From Natural Changes in the Foetal Vessels.-From the Discovery of Air and Food in the Stomach and Bowels.-Ear-test.-General Causes of Death in Newborn Children.-Proportion of Children Born Dead.-Natural Causes of Death.-A Protracted Delivery.-Debility.-Bleeding from Laceration of the Navel-string.-Compression of the Navel-string.-Malformation.-Destruction Violent Causes of Death.-Suffocation.-Drowning.-Death of the Child from Cold and Exposure.-Starvation.-Death from Immaturity.-Wounds in Newborn Chil- dren.-Fractures of the Skull, Accidental and Criminal.-Twisting of the Neck.- Violence in Self-delivery.-Power of Locomotion and Exertion in Females After Death of the Child from Strangulation.-Strangulation by the Navel-string.-Acci- dental Marks Resembling those of Strangulation.-Constriction Before and After Death. Before and After Breathing.-Before and After the Severance of the Navel- Live Birth in Civil Cases.-Date of Birth.-Signs of Live Birth Independently of Re- spiration or Crying.-Vagitus Uterinus.-Tenancy by Curtesy.-Legal Birth.- Post-mortem Births.-Minority and Majority.-Plural Monstrous Births Presumption of Legitimacy.-Natural Period of Gestation.-Duration of Pregnancy from One Intercourse.-Premature Births.-Short Periods of Gestation.-Via- bility. Earliest Period at which a Child may be Born Living.-Evidence from the State of the Child.-Protracted Births.-The Period of Gestation not Fixed by Disputed Paternity.-Parental Likeness.-Affiliation.-Posthumous Children.-Super- fœtation in Relation to Legitimacy.-Supposititious Children.-Sexual Malforma- Impotency.-Causes.-Procreative Power in the Male.-Puberty.-Age for Virility.- Virility of Crypsorchides and Monorchides.-Sterility.-Procreative Power in the Female. Earliest and Latest Periods for Childbearing.—Legal Relations Sources of Medical Evidence.-Rape on Infants and Children.-Marks of Violence.- Purulent Discharges from the Vagina.-Evidence from Gonorrhea and Syphilis.- Rape on Girls After Puberty.-Defloration.-Signs of Virginity Rape on Married and Adult Women.-Circumstances Under which it may be Perpe- trated on Adult Women.-Loss of Physical Evidence.-Pregnancy Following Rape. Varieties of Insanity.-Mania.-Abstinence from Food.-Delusions Regarding Poison. -Delirium Distinguished from Mania.-Primary Delusional Insanity.-Dementia.— Idiocy.-Imbecility.-Hereditary Transmission.-Feigned Insanity.-Appearances The Lunacy Laws.-Medical Certificates.-Regulation of Lunatics and Idiots.-Ap- plication of Restraint.-Illegal Imposition of Restraint.-Violence of Temper.- Lunatics as Witnesses.-Interdiction.-Commissions in Lunacy.-Examination of Alleged Lunatics.-Medical and Legal Tests of Competency.-Conflict of Evidence The Plea or Defence of Insanity.-Circumstances under which it is Admissible.- Homicidal Insanity.-Moral Insanity.-Symptoms.-Legal Tests.-Medical Tests. Puerperal Mania. Pyromania. - Kleptomania. - Dipsomania. - Responsibility of Drunkards.-Delirium Tremens.-Somnambulism.-The Deaf and Dumb Principles of Life Insurance.-Medical Responsibility.-What Diseases Have and What Have Not a Tendency to Shorten Life?-Concealment of Diseases.-Concealment of Habits. Material Concealment.-What is Intemperance?-Proximate and Re- mote Effects.-Opium-eating.-Inveterate Smoking.-Insanity.-Voidance of Poli- MEDICAL JURISPRUDENCE. MEDICAL EVIDENCE. CHAPTER I. THE PRACTICE OF MEDICAL JURISPRUDENCE.-MEDICAL AND MEDICO-LEGAL DUTIES.-INSPECTION OF BODIES IN DEATH FROM WOUNDS OR POISONING.-USE OF NOTES.-MEDICO-LEGAL REPORTS.-DYING DECLARATIONS. MEDICAL JURISPRUDENCE-or, as it is sometimes called, FORENSIC, LEGAL, or STATE MEDICINE-may be defined to be that science which teaches the application of every branch of medical knowledge to the purposes of the law; hence its limits are, on the one hand, the requirements of the law, and on the other, the whole range of medicine. Anatomy, physiology, medicine, surgery, chemistry, physics, and botany lend their aid as necessity arises; and in some cases all these branches of science are required to enable a court of law to arrive at a proper conclusion on a contested question affecting life or property. The purpose of this work is to bring as far as possible within a small compass those subjects that especially demand inquiry, and which more particularly concern the duties of the educated physician and surgeon. The definition above given necessarily implies that a medical jurist should have a theoretical and practical knowledge of all branches of the profession, a large range of experience, and the rare power of adapting his knowledge and experience to emergencies. He should be able to elucidate any difficult medico-legal question that may arise, and be prepared at all times to make a cautious selection of such medical facts, and a proper application of such medical principles, as may be necessary to enable a judge to place the subject in an intelligible light before a jury, and to enable a jury to arrive at a just conclusion. The variety of subjects of which a medical jurist is required to have a knowledge, may well alarm a student and lead him to suppose that, as he cannot make himself perfectly acquainted with all, he may well forego the labor of preparing himself in any. But this would be taking an erroneous view of his position. This description of the qualifications necessary to constitute a normal witness in a court of law must not deter him from entering on the study. It is assuredly beyond the mental power of any individual that he should be at the same time profoundly versed in all the principles of medicine and jurisprudence, and that he should be able to answer all possible questions, and encounter and remove all medical difficulties, that may occur during the trial of a civil or criminal case. All that the law expects from a medical man is a fair average knowledge, not 2 (17) 18 DUTIES OF PHYSICIANS AND merely of his profession, but of that which falls more peculiarly under the province of a medical witness. There can be no doubt that the more perfectly a man has made himself master of his profession, the better will he be fitted to follow the principles and apply himself to the practice of medical jurisprudence; but he must divest himself of the notion that these principles can be spontaneously acquired, or that they are necessarily derived from the study of those isolated branches of medicine upon which medical jurisprudence is based. The materials for the medical jurist undoubtedly exist in these collateral sciences; but they require to be assorted, selected, and moulded into shape before they can be applied to any useful or practical purpose. The duties of a medical jurist are distinct from those of a mere physician or surgeon. The latter looks only to the treatment of disease or accident, and the saving of life; but the object of the former, in a large proportion of cases, is, whether in reference to the living or dead, to aid the law in fixing on the perpetrator of a crime, or to rescue an innocent person from a falsely imputed crime. Thus he may be required to determine whether, in a particular case, the cause of death was natural or violent; and for this purpose it will be necessary for him to make an entirely new application of his professional knowledge. He has now the difficult task of making a selection from those parts of the medical sciences which bear upon the legal proof of crime. Some members of the profession have been inclined to look upon medicolegal practice as an unnecessary addition to their ordinary duties; but there are few that have been long engaged in medical practice who have not found themselves occasionally placed in situations of difficulty from the occurrence of cases demanding medico-legal investigation. A medical man is summoned to attend a person laboring under the effects of poison criminally administered; but at the time he may have no knowledge, or even suspicion, that poison is the cause of the symptoms. In spite of the best treatment, death ensues: here the functions of the medical man end, and those of a medical witness begin. It is impossible that he can now avoid giving evidence, or shift the responsibility on another-the law will insist on his appearance, first in the court of the coroner, next before the magistrates, and afterwards at the assizes. It will here be assumed that, as a registered member of the profession, he is fully competent to answer every question put to him by judge and counsel relative to the general effects of poisons; the quantity required to destroy life; and the time within which a poison may prove fatal. It may be objected to his evidence, that the deceased had died from the effects of disease and not from poison; in which case the cross-examination will lead to a searching inquiry into all of those diseases which resemble the effects of poison in their symptoms and post-mortem appearances, as well as the means of making an unfailing distinction between them and the fallacies to which the chemical processes for the detection of poison are liable. On another occasion a medical man may be called to render assistance to one stabbed in a quarrel and speedily dying from the wound. The office of the surgeon here ceases, whilst that of the medical jurist begins. He must now be prepared to answer numerous questions, all bearing upon the legal proof of crime, all necessary in law, although apparently superfluous in surgery. Thus he may be asked to state the precise characters of a wound inflicted upon the body of a man soon after death; and by what means a particular wound was inflicted. Was it homicidal or accidental? The amount of blood lost? Whether the person could have moved or performed any act after receiving the wound? Are |