INFANTICIDE
According to the present state of English law, infanticide--murder of a
_new-born_ child--is not regarded as a specific crime, but is treated
and tried by those rules of evidence which are applicable in cases of
felonious homicide, but with this difference, that the law requires
proof that the child was born alive. An old Statute (21 Jac. I. c.
27) made the concealment of the birth of a bastard child conclusive
evidence of murder. As far as the legal estimation of the crime is
concerned, it matters not whether the child was killed immediately
on its entrance into the world, or within a few days afterwards. A
fœtus not bigger than a man‘s finger, but having the shape of a child,
is a child within the Statute (R. _v._ Colmer, 9 Cox, 506; R. _v._
Hewitt, 4 F. & F. 1101). An English judge, at a late trial, stated
that if the jury were of the opinion that the prisoner had strangled
her child before being wholly born, she must be acquitted of murder.
The law also, on the score of humanity, presumes that every child is
born dead until direct evidence to the contrary, from medical or other
sources, is given. The onus of the proof of live birth, therefore,
devolves on the prosecution. It may also be difficult to decide as to
the maternity, and the woman accused will have to be examined as to the
possibility of her recent delivery.
Here let me repeat the advice given on page 148 as to the examination
of a woman. Your duty is to request the woman to allow of the necessary
examination, giving her the warning which every magistrate or coroner
is bound to give to any person charged with a crime, before requiring
an answer to a question which may be used in evidence against her at
the subsequent trial. The innocent and the guilty may alike object to
an examination, but the presumption is against the party declining,
if several have voluntarily submitted. A young lady committed suicide
rather than submit to an examination by two medical men under an order
from the coroner. The medical men were guilty of a grave indiscretion,
and both they and the coroner were acting _ultra vires_ in attempting
to force a woman to obtain evidence against herself (Taylor, vol. ii.
p. 431).
The decision as to recent delivery will, to a great extent, rest on the
condition of the mother, and the apparent age of the child found dead.
The discovery of the body of the child is not necessary to conviction,
but the medical evidence as to the signs of respiration, of course,
depends on the body being found and examined. In most cases of alleged
infanticide tried in England, juries appear more inclined to fall back
on the minor offence--_concealment of birth_--than to convict of the
capital offence; and this appears to be the only alternative if the
body cannot be found, for, as we have just said, in law every child is
held to be born dead. It must of course be shown that the woman has
been recently delivered. In case of failure to prove the murder of the
child, the Act (24 and 25 Vict. c. 100, sec. 60) enacts that “if any
woman shall be delivered of a child, every person who shall, by any
secret disposition of the dead body of the said child, whether such
child died before, at, or after its birth, endeavour to conceal the
birth thereof, shall be guilty of a misdemeanour.” The mere avowal of
the birth is not sufficient to convict her; she must be proved to have
done some act of disposal of the body after the child was dead (R. _v._
Turner, 8 C. & P. 755).
In Scotland, _concealment of pregnancy_ is a statutory crime,
chargeable when the child born is found dead or is not found at all,
and there is no proof of its having been murdered. Pregnancy, up to
a period when a child might be born alive, must be proved, and the
words “during the whole period of her pregnancy” do not imply that the
pregnancy must have continued for the full period of nine months. All
that is necessary is that there should be such proof of duration of
pregnancy as made a living birth possible. If the accused can bring
forward a witness to whom she communicated her pregnancy, or called for
assistance at the birth, or (it is believed) can prove that the child
was born dead, she is entitled to an acquittal.
It has also been said that a woman ought not to be convicted of
“concealment of pregnancy,” if at the time of delivery the fœtus
do not appear to have reached the seventh month of intra-uterine
existence. The birth of a “child,” whether dead or alive, is essential;
therefore, if the woman accused “can prove that that which she brought
forth was not a ‘child,’ but an abortion, or a _fœtus_, which, from
some accident, was in such a condition that, though there had been
assistance, it could not have been in a condition to be called ‘a
child,’ then the case is out of the Statute.” The Scotch Statute
differs from the English on the “concealment of birth” in this, that so
long as the woman makes known her pregnancy, the motive for doing so is
not considered. Thus, if she make arrangements with anyone to conceal
the birth, “the Statute is eluded by that very circumstance” (Alison).
The Statute applies to married as well as to single women; but, in
the former case, the penalty is seldom enforced unless foul play is
suspected.
DEFINITION OF THE TERM “LIVE BIRTH” IN CRIMINAL CASES
“The entire delivery of a child.” There must be an independent
circulation in the child before it can be accounted alive (R. _v._
Enoch, 5 C. & P. 539). The entire child must be actually born into the
world in a living state (R. _v._ Poulton, 5 C. & P. 329). But the fact
of the child being still connected with the mother by the umbilical
cord will not prevent the killing from being murder (R. _v._ Reeves, 9
C. & P. 25). To kill a child in its mother‘s womb is no murder, because
the person killed must be “a reasonable creature in being, and under
the King‘s peace.” But if the child be injured in the womb, and yet be
born alive, and then die as a result of such injuries, it may be murder
in the person who inflicted them (R. _v._ Senior, 1 Mood. C. C. 346).
A distinction must be drawn between _medical_ or _physiological life_
and _legal life_. A child may have breathed, as it not infrequently
does, _before_ it is completely born into the world; and this might, in
a medical point of view, be considered as a live child, but it is not
one legally. The entire delivery of the child is necessary in law; and
“it must also be proved that the entire child has actually been born
into the world in a living state, and the fact of its having breathed
is not a conclusive proof thereof.” The inference unfortunately follows
from this ruling, that a mother may kill her child without fear of
punishment, if she do so before the entire body has slipped from her.
DEFINITION OF THE TERM “LIVE BIRTH” IN CIVIL CASES
The evidence of live birth in civil is somewhat different from that
required in criminal cases. The viability of the child is determined in
Scotland by its _crying_; in France, by its respiration; in Germany,
“the LIVE BIRTH of a child is to be held proven when it has been
heard to cry by witnesses of unimpeachable veracity present at its
birth”; but in England, the pulsation of the child‘s heart, or any
tremulous motion of the muscles, however slight, has been considered as
satisfactory proof of live birth.[15]
[15] Fyshe or Fisher _v._ Palmer, in 1806.
According to Blackstone, “crying, indeed, is the strongest evidence,
but it is not the _only_ evidence”; and Coke remarks, “If it be born
alive, it is sufficient though it be not heard to cry, for peradventure
it may be born dumb.”
=Signs of Live Birth prior to Respiration, and independent of it.=--(1)
Negative.--Signs of intra-uterine death, _i.e._ putrefaction, or
“intra-uterine maceration,” or of such imperfect development that it
could not have been born alive. (2) Positive.--Injuries to the child
showing that it must have been born alive.
1. Negative.--_Intra-uterine Putrefaction._--This condition differs in
some remarkable points from putrefaction in air.
The body is extremely flaccid and flattened, the bones of the cranium
moving easily on one another. The skin of the hands and other parts of
the body bear the evidence of prolonged soaking in fluid. In parts,
the skin is whitish, or of a reddish-brown or coppery-red colour,
without any trace of green, which is always present when putrefaction
takes place in the air. The cuticle may be raised in blisters, and be
easily detached from the true skin. The denuded patches are moist and
greasy, and exude a stinking, reddish-coloured serous fluid. The face
is flattened, and the features distorted. In one case that Husband
attended of intra-uterine death of the fœtus in a primipara, and where
putrefaction was far advanced, the scalp burst during delivery, and
the brain was poured out. Should, however, the child be exposed to
the air, it may soon acquire the appearances proper to putrefaction
in that medium. If the child, immediately after birth, be thrown into
water, the putrefactive changes would be like those of intra-uterine
decomposition. In this case the lungs must be examined for the evidence
of death by drowning.
2. Positive.--Evidence that injuries found on the body could not have
been inflicted during birth, or accidentally after birth. On this
subject it is scarcely possible to give an opinion one way or the
other. All the medical witness can fairly state is, that, from the
condition of the lungs, respiration has or has not taken place; that,
in the former case, it is not easy to state whether the injuries were
the cause of death or inflicted after death.
=Appearances showing that a New-Born Child has breathed.=--1. Walls
of the Chest.--“The vaulting of the thorax is not of the slightest
diagnostic value.” Casper quotes from Elsässer the following remarks:
“It is irrefutable that the variations in the circumference of the
thorax (and, of course, in its diameters) are so considerable that no
certain normal mean for a thorax that has breathed, and for one that
has not breathed, can be laid down. In most cases the measurements
of the thorax are incapable of determining whether the lungs contain
air or not. The reasons for these variations is, without doubt, to be
referred to the congenital differences in the volume of the osseous
thorax; partly, also, to the thickness of the soft parts, particularly
of the subcutaneous fat and the thoracic muscles; partly, also, to the
differences in the degree and amount of the dilatation of the thorax by
respiration, with which the distension of the lungs also corresponds,”
&c.
2. Diaphragm.--The position of the diaphragm may be considered as a
good diagnostic sign; for it is found that, in children born dead,
the highest point of the concavity is between the fourth and fifth
ribs, whereas in those born alive it is between the fifth and sixth.
The position of the diaphragm may be affected by the gases produced
during putrefaction, and also, in children who have _breathed_, from
distension of the stomach and intestines with gas.
3. Stomach and Intestines.--With regard to the stomach, Tardieu has
suggested that the presence of air-bubbles in the glairy mucus usually
found in that organ is a sign of live birth, as it can only have arisen
from the swallowing of saliva and mucus, aerated by repeated attempts
at respiration, probably lasting from five to fifteen minutes. Air
in the duodenum is strong evidence of live birth. Breslau of Prague,
who has further investigated this subject, states that, in children
born dead, or who have undergone prolonged intra-uterine putrefaction,
there is never any accumulation of gas in the stomach or intestines,
and that the presence of gas in these organs is contemporaneous
with respiration, and is independent of the ingestion of food.
The intestines of newly-born children do not float in water, but
rapidly sink in that fluid. As respiration proceeds, the coils of the
intestines become distended with gas.
4. Kidneys and Bladder.--The presence of crystals of uric acid in the
pelvis of the kidneys and even in the bladder has been suggested as
a sign of live birth. Uric acid infarction, as it has been called,
usually occurs in from two to ten days after birth, at a period when
there are more important signs of live birth than this, even if
infarction did not occur, as it does, in still-born infants.
5. Lungs.
(_a_) _Size._--In the fœtus, prior to respiration, the lungs do not
fill the cavity of the chest, and the left lung is never found even
partially covering the heart.
After respiration they fill the thorax more or less completely, the
amount of distension depending, of course, upon the completeness of the
respiratory acts on the part of the child.
(_b_) _Consistence._--Before respiration has taken place, the lungs
feel firm, compact, and resistant, and are of the consistency of liver.
After respiration they are spongy, crepitant, and yielding when pressed
between the fingers. They also present a marbled appearance. These
signs of respiration are more or less modified by disease, and the
_atelectasis pulmonum_ of Jörg, jun.
Casper denies the existence of _atelectasis pulmonum_ as a distinct
disease of newly-born children, and considers that “it is nothing
else than the original fœtal condition, from which it differs in no
anatomical respect”--an opinion supported by Meigs, who says “it, in
fact, resembles exactly the fœtal lung.” It is simply the result of the
child dying from some cause before respiration has had time to become
fully established, and has possibly been confounded with hepatisation.
It must also be remembered that cases are on record of infants having
lived for some hours, and then died, yet the lungs sank as a whole, and
when cut in pieces.
(_c_) _Colour._--The colour of the fœtal lungs is “exceedingly
various,” and it is by no means easy to convey the idea of colour by
words. Speaking in general terms, the lungs of children who have _not_
breathed are of a reddish-brown liver colour, this colour changing
to a brighter red at their margins. In children who _have_ breathed,
the lungs are of a slaty-blue colour, more or less mottled with
circumscribed red patches. This circumscribed mottling is _never_ found
in perfectly fœtal lungs. When the lungs are inflated artificially,
they swell up and present a uniform cinnabar-red colour, destitute of
insular marbling. The insular marbling of the lungs is characteristic
of lungs that have breathed, and is due to the presence of blood in the
arteries and veins surrounding the inflated lung tissue.
(_d_) _Buoyancy in Water._--Lungs which have respired float in water.
But the objection may be raised that lungs that have _not_ respired may
yet float from--
1. The result of artificial respiration.
2. The result of putrefaction.
The value of these objections will be discussed in the following pages.
The following table is given by Tidy:
--------------------------------+-----------------------------------
Lungs that have not Breathed. | Lungs that have Breathed.
--------------------------------+-----------------------------------
1. Dark in colour (black-blue,| 1. Light in colour (rose-pink,
maroon, or purple), resembling | pale pink, light red, or crimson),
liver. No mottling. | mottled.
|
2. Air-vesicles not visible | 2. Air-vesicles distinctly
to the naked eye. | visible to the naked eye, or a
| lens of low power (say a two-inch,
| or even a common reading-glass).
|
3. When squeezed or cut, do | 3. Crepitate or crackle freely.
not crepitate or crackle. |
|
4. Contain but little blood, | 4. Contain a good deal of blood,
therefore little escapes on | which escapes freely on section.
section. |
|
5. The blood present is not | 5. The blood present is freely
frothy, unless there be | mixed with air, and therefore
putrefaction. | appears frothy.
|
6. Sink in water, unless | 6. Float in water; or, at all
putrid, and often not then. | events, the parts which have been
| expanded, or have breathed, float.
| If fully expanded, they will buoy
| up the heart.
|
7. Bubbles of gas arising | 7. The air cannot be squeezed
from putrefaction may be | out by pressure.
squeezed out, and as they |
escape are usually noted to |
be of large size. |
--------------------------------+-----------------------------------
Hydrostatic Lung Test
(_Docimasia pulmonum hydrostatica_)
The value of this test, which is a test of respiration and not of live
birth, is founded on the supposition that a lung in which respiration
has taken place will float if placed in water, and that when this has
not occurred it will sink. Admitting that a lung floats as a result of
respiration, it has been objected that this is no proof of live birth,
for respiration may take place in:
1. The womb, _vagitus uterinus_.
2. The maternal passages, _vagitus vaginalis_.
3. Cases when the head protrudes, the body not yet being born.
With regard to the two first objections, it will be sufficient to say
that, in all the cases of so-called intra-uterine respiration, the
respiratory acts have occurred in difficult or instrumental labours,
where it is justifiable to suppose that, in the endeavour to remove the
child, a certain amount of air may have been unavoidably admitted into
the maternal passages. But the cases with which the medical jurist has
to deal cannot be classed with these, for in all those brought under
his notice delivery has been more or less rapid and unassisted.
To the last objection the same reply may be given, that rapid delivery
in doubtful cases must be considered as the rule, and that the time
which elapses between the birth of the head of the child and its
complete delivery is so short as not to lead to any great error in
diagnosis. It is true that the woman may faint with the child half
born, and that respiration may thus take place; and it has not yet been
decided how many inspirations a child must make to entirely inflate its
lungs, or the length of time required to do so.
_N.B._--Any pressure exerted on the umbilical cord during the process
of delivery gives rise to respiratory acts on the part of the fœtus.
The presence of what Casper calls _petechial ecchymoses_ beneath the
pleuræ, upon the aorta, and even on the heart, are, as a rule, a proof
that attempts at respiration have been made. These petechial ecchymoses
are sometimes found on the same parts in the drowned. (See “Drowning.”)
How is the Hydrostatic Lung Test performed? and What are the Objections
to its Use?
As this test was first used, it consisted in placing the lungs, with
or without the heart, in water, and then noting whether they sank or
floated. A glass vessel, eighteen inches high and twelve in diameter,
half filled with distilled water at 60° F., should be used. In summer,
water at the ordinary temperature of the room will answer the purpose.
To this rough test pressure is now added; the lung, or portions of it,
are greatly compressed in a linen cloth, and then thrown into water as
before. If the lungs thus compressed float, respiration is held to have
taken place; should they sink, the contrary is presumed.
Pressure is used for the following reason: The air generated by
putrefaction, and which may cause the lungs to float, is removed by
pressure, but no amount of pressure, short of entirely destroying
the lung tissue, will remove that which is the result of respiration
or inflation; and between these the medical expert must decide from
collateral evidence.
In performing the test: (1) Try if the lungs will float with the heart
and thymus gland attached to them. (2) If they will float without the
heart, &c. (3) Try if portions will float with or without pressure.
The following are the Objections to this Test:
1. The lungs may sink as a result of disease.
2. Respiration, even in healthy lungs, may be so
imperfect that they may sink.
3. Emphysema pulmonum neonatorum.
4. Putrefaction.
5. Artificial inflation.
1. That in consequence of disease the entire lungs, or portions of
them, may sink, and yet respiration may have taken place. Disease of
the lung may occur previously to birth or soon afterwards, but it is
scarcely probable that the disease would attack every portion of the
lung. Parts, doubtless, small in proportion to the diseased part, may
yet have been sufficiently inflated to float. The presence of disease
is also not difficult of detection.
2. That respiration, even in healthy lungs, may be so imperfect that
they may sink. This objection can scarcely be considered valid against
the general application of the test, for in these cases there is no
known test by which respiration or its absence can be determined. They
are, therefore, out of the pale of the test, as they are out of every
other mode of investigation.
3. _Emphysema pulmonum neonatorum._--Emphysema is generally the result
of excessive dilatation of the air cells of the lung, rupture of the
cell walls, and infiltration of the intra-lobular areola tissue. This
condition may be brought about by:
(_a_) Respiration. (_b_) Inflation.
The fact of the matter is simply this, that the so-called _emphysema
pulmonum neonatorum_, or emphysema of new-born children, is nothing
more or less than incipient putrefaction, induced by certain
unascertained conditions.
Casper sums up his conclusions on this subject in the following words:
“That not one single well-observed and incontestable case of emphysema,
developing itself spontaneously within the lungs of a fœtus born
without artificial assistance, is known; and it is not, therefore,
permissible in forensic practice to ascribe the buoyancy of the lungs
of new-born children, brought forth in secrecy and without artificial
assistance, to this cause.”
4. _Putrefaction._--It must be admitted as proved that the lungs of
new-born children in a state of decomposition will float in water.
But this admission does not render the test valueless, for it must be
remembered:
(_a_) That air generated by putrefaction is found in bubbles
_under_ the pleuræ, or in the fissures between the
_lobuli_ of the lungs, and _not in the air cells_ of
the lungs.
(_b_) That gas as a result of putrefaction can easily be
removed by compressing the lungs, or portions of them.
(_c_) That crepitation in putrefied lungs is absent, owing
to the fact stated under (_a_).
(_d_) That the lungs are among those organs which putrefy
late.
(_e_) That negative evidence may be obtained, if the lungs,
in a highly putrescent body, sink in water. The
tendency of putrefaction, as above stated, is to cause
them to float.
5. _Inflation._--In the first place, it is to be remarked that to
inflate the lungs is by no means an easy task. Elsässer states “that
in forty-five experiments performed on children born dead, without
opening their thorax and abdomen, only _one_ was attended with complete
success, thirty-four with partial success, and ten with none whatever;
and it must also be remembered that these experiments were conducted
without disturbance, and with the greatest care.” Professor Gross
states his opinion on this subject thus: “We are decidedly of opinion
that artificial inflation of the lungs is a very difficult matter; and
we believe that the complete distension of these organs can only be
effected where a tube is introduced into the mouth of the larynx.” In
the cases that come before the medical expert, the question naturally
arises, Who would inflate the lungs? Surely not the mother. If not the
mother, who else? It has been suggested that some malicious person
might inflate them to sustain a charge of infanticide. Is this probable?
The following points may be noticed on this subject:
(_a_) Known difficulty in inflating the lungs.
(_b_) Absence on the part of the mother of any preparation to
save the life of her child.
(_c_) Presence of air in the stomach and intestines, the result
of attempted inflation.
(_d_) Bright cinnabar-red colour of the lungs, without trace
of mottling.
(_e_) Absence of frothy blood when the lungs are cut into.
(_f_) When, therefore, we observe the following
phenomena, a sound of crepitation without any escape
of blood-froth on incision, _laceration_ of the
pulmonary cells with hyperæmia, bright cinnabar-red
colour of the lungs _without any marbling_, and
perhaps _air_ in the (artificially inflated)
stomach and intestines, we may with certainty conclude
that the _lungs have been artificially inflated_.
It may be further noted that natural respiration is accompanied with,
first, the distension of the air cells of the lungs with air; and,
second, with an increased flow of blood into the organs, beyond that
necessary for their nourishment and growth. They thus increase in
absolute weight, while their specific gravity is lessened.
The objections just mentioned apply to the hydrostatic test as
originally employed. It will now be necessary to notice those against
the same test when modified by pressure. These are two in number:
1. That no amount of pressure, short of entirely destroying the lung
tissue, can expel the air from a lung that has been inflated, or from
one in which respiration has taken place.
2. Pressure is, therefore, no test of natural respiration or of
artificial inflation.
In answer to the above, it will only be necessary to refer to what has
been already said with regard to the difficulty of inflation, and the
more probable event of the condition of the lungs being the result of
respiration.
Casper thus sums up the result of his views with regard to the
probative value of the _docimasia pulmonaris_:
“=That a child has certainly lived during and after its birth=--
“1. When the diaphragm stands between the fifth and sixth ribs.
“2. When the lungs more or less completely occupy the thorax, or at
least do not require to be sought for by artificial separation of the
walls when cut through.
“3. When the ground colour of the lungs is broken by insular marblings.
“4. When the lungs are found by careful experiment to be capable of
floating.
“5. When a bloody froth flows from the cut surface of the lung on
slight pressure.”
=The Lung Test is unnecessary when=--
1. The umbilical cord has dropped off, and cicatrisation has followed.
2. Where food is found in the stomach.
3. Where there are evident signs of putrefaction _in utero_.
4. Also in the case of the birth of monsters, or where, from congenital
malformation, the possibility of live birth is excluded.
Besides the hydrostatic test, the following have been proposed:
Ploucquet‘s Test.--This test is based on the relative weight of the
lungs, before and after respiration, to that of the entire body of the
child. The variations found in practice between the relative weights
render the test worse than useless.
Absolute Weight of the Lungs.--This test consists in a comparison
of the weight of the lungs before and after respiration, and it may
be stated here that the lungs, prior to respiration, vary in weight
from about 400 to 650 grains; but so much depends on the maturity or
immaturity of the child, and degree of respiration, that, like the
last, the test is unworthy of confidence.
Wredin‘s Test.--Dr. Wredin, of Petrograd, states that the gelatinous
substance found in the middle ear of infants before birth, gradually
disappears, to be replaced by air on the subsequent establishment of
respiration. Wendt, of Leipzig, from an examination of 300 cases,
declares that the gelatinous substance can only be expelled by the
establishment of full respiration. The value of this test has been
questioned, as some observers have found that in different cases
intervals of from a few hours to five weeks have occurred, before the
replacement of the gelatinous material by air.
Table Showing the Signs of Maturity of Child At Birth
As regards:
1. _Average Length of Body._--Nineteen inches.
2. _Average Weight of Body._--About seven pounds.
3. _Eyes._--The pupillary membrane is not found in the
mature child.
4. _Navel._--Said to be exactly midway between the
pubes and the ensiform cartilage.
5. _External Genitals._--Testicles found in the
scrotum, and the labia majora cover the vagina and
clitoris.
6. _Os Femoris._--Ossification of the inferior
femoral epiphysis. The osseous nucleus measures from
three-quarters of a line to three lines in diameter.
CAUSE OF DEATH TO THE FŒTUS
Death may be due to--
I. Immaturity on the part of the fœtus.
II. Complications occurring during or immediately after birth.
III. Congenital disease in one or more of the fœtal organs.
IV. Neglect or exposure, constituting “Infanticide by Omission.”
I. Immaturity on the part of Fœtus.-From some cause or another, the
child may die immediately after birth, in spite of every attempt to
save it. In many of these cases no disease adequate to account for
death can be detected.
II. Complications occurring during or immediately after Birth.--(1)
Unavoidable or inherent in the process of parturition. (2) Induced with
criminal intent, constituting “infanticide by commission.”
1. _Unavoidable or Inherent in the Process of Parturition._--The
immediate cause of death may be either maternal or fœtal. In the
former, the presence of tumours in the pelvic passages, or disease
of the bones, causing a narrowing of the canal, may lead to fatal
compression of the head of the child. Death may also be due to
protracted labour from debility on the part of the mother, or she may
suddenly faint after delivery. A congested state of the brain may
be present in these cases. In the latter (fœtal), pressure on the
umbilical cord from malposition of the child during labour, or an
abnormal increase in the size of the head, may cause death. There is
also a greater mortality, both during and after delivery, among male
than female children. The child may be also accidentally suffocated in
the fæces of the mother, or in the fold of her dress; or it may be born
while the woman is straining at stool, and be drowned in the contents
of the pan. Husband once met with a case of accidental death of a
child from suffocation in the drawers of the mother, who persisted,
from motives of delicacy, in wearing those articles of dress during
her confinement. Death may also result from strangulation, occasioned
by the pressure of the funis round the child‘s neck. The death in this
case can scarcely be considered as due to strangulation, as the child
had never breathed, but it is probably the result of the arrest of the
flow of blood along the cord, from the tightness of the folds round the
neck. Some congestion of the brain may, however, be found resulting
from the pressure on the vessels of the neck. Lastly, death may
ensue from a fall on the floor in cases of sudden and quick labours,
especially if the woman be in the erect posture at the time of delivery.
2. _Induced with Criminal Intent._--Infanticide by commission: was
the death due to violence? The answer to this question is by no means
easy. In all doubtful cases the attendant circumstances must be taken
into consideration. A woman may unintentionally injure her child in her
efforts to drag it from her. The presence of respiration, more or less
complete, is strongly presumptive against the death being the result
of accident. But even here considerable caution is necessary, for the
injury may not be immediately fatal, although accidentally inflicted,
sufficient time elapsing between its infliction and the death of the
child to allow of respiration. Foreign bodies found in the mouth and
fauces are also corroborative of death by violence. A case is recorded
in which the child‘s fauces, upper portion of the œsophagus, the
larynx, and the trachea were closely packed with a coarse green sand,
and yet the lungs sank when the hydrostatic test was applied to them.
There was nothing to show when the packing of the fauces was effected.
Strangulation may be produced by the constriction of the umbilical
cord round the neck, and for this reason marks round the child‘s
neck cannot always be ascribed to intentional violence. Of 327 cases
collected by Elsässer, in which the cord was from one to four times
round the children‘s necks, there was not in a single instance any
mark of the cord perceptible, even though in some cases the cord had
to be cut to permit the completion of labour. With regard to marks
round the neck of a new-born child, Casper remarks that it is possible
“to mistake the folds of the skin, produced by the movements of the
head, and which remain strongly marked in the solidified fat, and are
very prominent, particularly in short necks, for the marks of the
cord.” The _mark_ left by the _funis_ is broad, corresponds with the
breadth of the cord, runs without interruption round the neck, and is
everywhere quite soft, and never excoriated. Ecchymoses may be present,
irregularly following the line made by the cord. On the other hand,
“a mummified, parchment-like, unecchymosed depression points in every
case to strangulation by a hard, rough body,” and this more especially
if there be any abrasion of the cuticle or laceration of the skin.
Death, sometimes ascribed to strangulation, is probably the result
of suffocation, and happens thus: any pressure exerted on the cord
cuts off the blood from the placenta to the fœtus, and gives rise to
respiratory attempts on the part of the child, the child dying from
suffocation, or from the engorgement of the lungs with liquor amnii
drawn into them at every effort to breathe. An infant may be poisoned.
This cause of death is very rare, but deaths have resulted from the
use of poisonous gases. While on this subject it may be advisable
to state here that ulcerations have been found in the stomach and
intestines more or less accompanied with a collection of dark brown or
black bloody fluid, which have given rise to suspicions of poisoning
in infants to all outward appearances quite healthy. An infant may be
thrown into water and drowned. No traces of this mode of death would
be discoverable in the infant unless respiration had taken place prior
to its immersion. The plea of accidental drowning in a cesspool or
water-closet pan may be put forward; it is therefore well to examine
the cord. Has a ligature been placed upon it? Has it been cut by a
sharp instrument? The nature and character of the fluid found in the
stomach should be noted.
Fractures of the skull may happen--
1. _In the Womb._--The parturient female may fall from a considerable
height, and thus cause injury to her child. These cases are of no
judicial importance, as the presence of intra-uterine putrefaction or
an examination of the lungs will at once show that the child has not
breathed. It must be borne in mind, however, that dislocations may take
place in the womb, and this fact may be brought forward in defence. The
history of the case, and the absence of any other signs of violence,
will decide the truth or falsity of the plea.
2. _During Labour._--Fracture of the cranial bones during labour
generally occurs in difficult and protracted labours, which, from
this very cause, seldom become the subject of judicial inquiry. In
some cases the defective ossification of the bones of the skull may
give rise to fractures, which may lead to dangerous mistakes. This
deficiency, in the process of ossification is thus described by Casper:
“If the bone in question is held up to the light, this is seen to shine
through the opening, which is closed only by the pericranium. When the
periosteal membrane is removed, the deficiency in the ossification
is seen in the form of a round or irregularly circular opening, not
often more than three lines in diameter, though frequently less; its
edges are irregular and serrated: these edges are _never depressed,
as is the case in fractures_; and neither they nor the parts in their
neighbourhood are ever observed to be ecchymosed.” The child in these
cases may breathe for a short time, and then die without any apparent
cause.
[Illustration: Fig. 26.--Photo-micrograph of human milk, × 250.
(R. J. M. Buchanan.)]
3. _By Falls._--It is beyond doubt possible for a child to be born so
precipitately as to fall on the floor and be severely injured, and that
even fatally. In cases of alleged precipitate birth, to account for
injuries found on the child, the following points should be remembered,
and will assist in forming a diagnosis:
1. In Favour of Precipitate Birth and Accidental Injury
(_a_) Rupture of the umbilical cord. In all cases it would be advisable
to measure the length of the cord, and then the distance of the vulva
from the ground, allowing of course for the woman not being quite
erect at the time of delivery owing to a separation of the legs. A
disproportion between the two measurements may or may not account for
the rupture of the cord. The following measurements may be taken: usual
length of cord, eighteen to twenty inches; distance of vulva from the
ground, twenty-six inches, but allowing for stooping, two-thirds of the
above. To the length of the cord must be added about nine inches, the
distance from the navel to the top of the head of the child. Thus, a
fall of about thirty inches will put no strain on the cord. A case is
on record of a rupture of the cord taking place while the woman was in
a _recumbent_ position, but in that case the labour was precipitate,
and the cord very short and small.
(_b_) Placenta not detached from the child.
(_c_) Fracture of the parietal bones; the fracture radiating into the
frontal and squamous portion of the temporal bone. In experiments
on twenty-five children dropped from a height of thirty inches, one
parietal bone was found fractured in sixteen of the cases; both
parietals, in six cases. The fractures in most cases occurred about the
parietal protuberances. It must be remembered that the children were
dead, and that it is easier to fracture the skull of a live infant than
that of a dead one.
(_d_) Imperfect ossification of the bones of the skull.
(_e_) Absence of other injuries.
2. In Favour of Criminal Violence
(_a_) The fact of the umbilical cord being divided by some sharp
instrument and not torn. A caution must be here inserted, for Taylor
mentions a case where rupture of the cord occurred in such a manner
that it could not be decided whether it had been intentionally cut or
torn.
(_b_) Extensive fracture of one or more of the bones of the cranium.
(_c_) Fracture and dislocation of the neck.
(_d_) Presence of incised wounds, and other evidence of violence.
_N.B._--In all doubtful cases, a guarded opinion should
be given, stating simply that the dissection does not
reveal anything contrary to the statements offered as to
the cause of death.
III. Congenital Disease in one or more of the Fœtal Organs.--In all
cases the presence of congenital disease must be sought for.
IV. Neglect or Exposure, constituting “Infanticide by Omission.”--Under
this head may be mentioned the following:
(_a_) Neglecting to place the child in such a position that it may
breathe freely.
(_b_) Neglecting to protect the child from extremes of cold or heat.
(_c_) Neglecting to feed it with the food appropriate to its age. (See
Signs of Death from Starvation, pp. 132 _et seq._)
(_d_) Neglecting to tie the umbilical cord.
To give answers to these questions will in many cases be impossible,
and each must be decided by such circumstances as present themselves
in each individual case. For instance, if the body be found stiff,
blanched, naked or nearly so, lying on the ground, the vessels of
the interior gorged with blood, whilst the superficial vessels are
contracted and can be seen only with difficulty; at the same time,
the hydrostatic test shows that respiration has taken place, and in
the absence of all external or internal causes--the probability is in
favour of death by cold. In close relation with the present subject is
the question--
=Has the Infant bled to Death?=--Fatal hæmorrhage from the cord may
occur, especially if it be divided by a sharp instrument close to the
body of the child. As a rule, hæmorrhage does not occur from a ruptured
cord. (The signs of death from hæmorrhage have been noticed, page 81.)
=How Long did the Child survive its Birth?=--The answer to this
question is by no means easy, and the data on which a decision can
be based are not very reliable. The presence or absence of the
_vernix caseosa_ should be noticed. In still-born children the closed
eyelids, when raised, do not remain open; in the live-born, on the
other hand, the eyes remain half open even after repeated attempts to
close them. Another guide to the determination of the length of time
the child survived its birth may be found in the absence or presence
of the meconium in the intestines. The meconium--so-called from its
resemblance to inspissated poppy juice--is found in the large intestine
as a dark-greenish pasty mass, more or less filling that portion of
the bowel. In the upper portions of the intestines it varies from a
light-yellowish or greyish to a greenish-brown colour, till in the
large intestine it assumes the colour and consistence above mentioned.
It is generally discharged by the infant in from four or five to
forty-eight hours after birth. In breech presentations it may be passed
during the process of delivery, although the child be still-born; but
its entire absence from the intestines is presumptive of existence for
some days after birth.
[Illustration: Fig. 27.--Photo-micrograph of starch granules, × 250
(potato). (R. J. M. Buchanan.)]
The following are some of the points to be considered in forming a
diagnosis: (1) Changes in the skin. (2) Changes in the umbilical cord.
(3) Changes in the circulatory system.
Table showing how long a New-born Child has Lived.
---------+-----------------+----------------+-------------------
| At Birth, | |
| but before | From | From
| Respiration. | 1 to 24 Hours. | 2 to 3 Days.
---------+-----------------+----------------+-------------------
_Skin_. |As a rule, |The skin is |The skin assumes
| very red, soft, |firmer and rosy,|a yellowish
|smooth, and |and the vernix |tint. Sometimes
|covered with |caseosa not so |on the
|a whitish, fatty,|white. |abdomen and
|sticky coat | |base of the chest,
|(vernix caseosa).| |the epidermis
| | |shows signs of
| | |approaching
| | |exfoliation.
---------+-----------------+----------------+-------------------
_Head_. |Presence of caput| |The caput
|succedaneum. | |succedaneum has
| | |disappeared,
| | |leaving only a
| | |slight ecchymosis.
---------+-----------------+----------------+-------------------
_Umbilical_|Is fresh, firm, |The umbilical |The cord is
_Cord_. |bluish, roundish,|cord is |brown from its
|more or less |withering, and |extremity to its
|spongy. |the calibre of |base, is less
|The ductus |the arteries is |moist, and already
|arteriosus is |beginning to |shows signs of
|four to six |diminish from |mummification. The
|long. Its |the thickening |vessels are not
|lines diameter |of their walls. |easily made out,
|is double | |being flattened,
|that of each of | |and contain a
|the branches of | |fine clot more or
|the pulmonory | |less contracted.
|artery. | |
---------+-----------------+----------------+-------------------
_The_ |The large |The meconium |The green mucus
_Large_ |intestine |is discharged, |which covered the
_Intestine_.|contains |but the large |intestine is
|meconium. |intestine still |detached in
| |contains thick |places.
| |greenish mucus. |
---------+-----------------+----------------+-------------------
---------+--------------------+------------------+---------------
| From | From | From
| 3 to 4 Days. | 4 to 6 Days. | 6 to 12 Days.
---------+--------------------+------------------+---------------
_Skin_. |The icteric |The exfoliation |The exfoliation
|colour of the |of the skin |of the skin
|skin is more |extends from the |has extended to
|marked. Exfoliation |groins to the |the extremities.
|of the skin |axillæ and between|
|has begun over |the shoulders. |
|belly and base of |The epidermis |
|the chest. |is detached in |
| |strips, in scales,|
| |or as a firm |
| |powder. |
---------+--------------------+------------------+---------------
_Head_. | | |
---------+--------------------+------------------+---------------
_Umbilical_|The cord is of |The cord is |If the cord was
_Cord_. |a brownish-red |detached from |thin, cicatris-
|colour, flattened |the abdomen, the |ation is complete
|and distorted. |membranes first, |before the
|The vessels are |then the arteries,|tenth day. The
|twisted like a |and last, the |arteries, the
|gimlet. The arteries|vein. The arteries|vein, and other
|are in great |and the vein are |fœtal canals are
|part obliterated, |quite obliterated.|obliterated. If
|the calibre of the |The ductus |the cord was
|vein and ductus |arteriosus and |thick, a
|venosus is |foramen ovale |sero-purulent
|diminished, but they|diminished in size|discharge may
|and the foramen |are still open. |continue to the
|ovale are still | |twenty-fifth or
|open. The | |thirtieth day.
|circumference of | |
|the ring is injected| |
|and begins | |
|to show signs | |
|of inflammation, | |
|with the discharge | |
|of a sero-purulent | |
|fluid at | |
|the base of the | |
|cord. | |
---------+--------------------+------------------+---------------
_The_ |The green |The green mucus |
_Large_ |mucus almost |quite absent. |
_Intestine_.|absent. | |
---------+--------------------+------------------+---------------
1. _Changes in the Skin._--Exfoliation of the cuticle. The time
at which this occurs is so variable as to be of little value in a
medico-legal inquiry.
2. _Changes in the Umbilical Cord._--Mummification of the cord is
not of the slightest value as a proof of extra-uterine life; but the
separation of the cord which occurs between the fourth and seventh day,
especially when cicatrisation has taken place, is a sure sign that the
child must have lived four or five days at least. Two other appearances
of some value may also be noted, namely:
(_a_) In fresh bodies, the appearance of a bright red ring about a line
in breadth, which surrounds the insertion of the cord, and which is
formed within the uterus.
(_b_) A similar red ring, about two lines broad, around the insertion
of the cord, accompanied with “_thickening, inflammatory swelling of
the portion of the skin affected, and slight purulent secretion from
the umbilical ring itself_.” This latter condition Casper considers as
affording “_irrefragable proof of the extra-uterine life of the child_.”
3. _Changes in the Circulatory System._
(_a_) Ductus Arteriosus.--Arterial duct. A contracted condition of this
duct is of no value as a proof that a child has survived its birth; for
the duct is liable to become contracted, and even obliterated, before
the birth of the child.
(_b_) Ductus Venosus.--Nothing certain is known as to the exact time
when this duct closes; the condition of the vessel is, therefore, of no
assistance in determining the possibility of the child having survived
its birth. The duct has been found closed in a still-born child; and
in one child, which lived for a quarter of an hour, both the _ductus
arteriosus_ and the _foramen ovale_ were found closed. Cases are also
on record in which these fœtal channels were found open after thirty
days of extra-uterine life.
(_c_) Foramen Ovale.--What has been said of the preceding may be said
with regard to the foramen ovale.
_N.B._--To sum up, therefore, in the fewest words,
any attempt at forming an opinion on the _docimasia
circulationis_ may result in a fatal error on the
part of the medical witness, as it is impossible to
determine with any accuracy by days the period of their
closure. As a general statement, however, the following,
according to Bernt and Orfila, is the order in which
obliteration of the fœtal vessels takes place: (1) The
umbilical arteries. (2) Ductus venosus. (3) Ductus
arteriosus. (4) Foramen ovale.
Synopsis
1. Infanticide is not regarded as a specific crime.
2. To be tried by the same rules of evidence as apply to murder.
3. The law presumes that every child is born dead, till proof to the
contrary is given.
4. Onus of proving live birth devolves on the prosecution.
5. The body need not be found in order to obtain conviction of the
suspected party, if not of infanticide, at least of concealment of
birth.
The medical evidence, however, depends on the body being found and
examined.
The medical witness may be examined on one or more of the following
points:
(1) The recent delivery of the accused.
(For “Signs of Recent Delivery,” see page 155 et seq.)
(2) Maturity of the child found.
(3) Was the child still-born or live-born?
(4) Cause of death.
(5) Lastly, as to the mental condition of the mother.
Puerperal mania, &c.
6. In absence of proof of infanticide, the woman, in England, may be
tried for _concealment of birth_, that is, disposing secretly of the
body, whether the child be born dead or alive.
7. In Scotland, a woman may be tried for _concealment of pregnancy_
when the child is dead or missing, if she do not call for or make use
of help or assistance in the birth; but the case is quashed, if the
child be shown alive by the mother to others.