Introduction 399
Arson 402
1. Spontaneous Combustion by friction 403
2. Spontaneous Combustion by the fermentation of Vegetable
and Animal substances 404
3. Spontaneous Combustion by Chemical action 406
Human Combustion 412
Rape 416
Of Homicide generally VOL. II.—1
Of Real and Apparent Death 3
Of the Physiological causes and Phenomena of Sudden Death 16
Syncope 25
Suffocation 32
1. By Drowning 35
2. By Hanging 42
1. By pressure on the Vessels 43
2. By pressure on the Nerves of the Neck 44
3. By pressure on the Fracture of the Spine, and
Dislocation of the Neck 44
3. By Manual Strangulation 46
4. By Smothering 48
5. By the Inhalation of Air deprived of Oxygen 48
6. By other modes 55
Death by Exposure to Cold 59
Death by the Agency of Heat 63
Death by Lightning 63
Death by Starvation 67
Application of the physiological facts established in the
preceding Chapters, to the general treatment of Asphyxia 75
On the manner of producing Artificial Respiration 78
By the Application of Heat 81
By the Internal Exhibition of Stimulants 82
By Electricity 82
Treatment of particular cases of Asphyxia 84
Case 1. Wherein the action of the heart fails before that
of the respiratory organs 84
Case 2. Wherein the function of respiration ceases, while
the heart continues to circulate black blood 86
Of the Coroner’s Inquest 93
Suicide 104
Of Murder generally 110
1. By exposing a sick or weak person, or infant, to the
cold 110
2. By exposing an impotent person abroad, so that he may
receive mortal harm 110
3. By Imprisoning a man so strictly that he dies 111
4. By Wounding or Blows 116
_a._ Incised wounds, or cuts 119
_b._ Punctures 120
_c._ Bruises 121
_d._ Lacerations 123
_e._ Gun-shot wounds 124
5. By Poisoning 128
Of Poisons, chemically, physiologically, and pathologically
considered 131
Their literary history 131
Of slow, consecutive, and accumulative Poisons 143
1. Of slow Poisons 143
2. Of consecutive Poisons 147
3. Of accumulative Poisoning 148
General remarks on the Medical Evidence required to
substantiate an accusation of Poisoning 153
1. Whether all, or most of the symptoms, characteristic of
the action of Corrosive and Narcotic Poisons, may not
arise from morbid causes of spontaneous origin? 155
2. Whether organic lesions similar to those produced by
poisoning, may not occasionally result from natural
causes? 162
3. Whether the rapid progress of putrefaction in the body,
generally, or in any particular part, is to be considered
as affording presumptive evidence, in support of an
accusation of poisoning? 182
4. How far the absence of poison, or the inability of the
Chemist to detect it, in the body, or in the fluid ejected
from it, is to be received as a negative to an accusation
of poisoning 182
5. What degree of information can be derived from
administering the contents of the stomach of a person
supposed to have been poisoned, to dogs, or other animals? 193
On the Classification of Poisons 199
A classification of the different modes by which Poisons
produce their effects 207
Mineral Poisons 209
Class I. CORROSIVE POISONS 210
_Arsenic_ 210
Arsenious acid, or white oxide of arsenic 212
1. Symptoms of poisoning by the Arsenious acid 216
Symptoms of the first degree 216
Symptoms of the second degree 217
Different modes of poisoning by the Arsenious acid 220
Physiological action of Arsenious acid 223
Organic lesions discovered on dissection 225
Of the Chemical processes by which the presence of
Arsenious acid may be detected 232
1. The Arsenic is in a solid form 232
A. By its reduction to the metallic state 233
B. By the application of certain re-agents, or
tests, to its solution 240
2. The arsenious acid is mixed with various
alimentary and other substances 252
Arsenic acid, and its salts 256
The sulphurets of arsenic 257
_Mercury_ 257
Corrosive sublimate 257
Symptoms of poisoning by corrosive sublimate 259
1. Symptoms which follow a large dose 260
2. Symptoms which are produced by the repetition of
small doses 260
Physiological action of Corrosive Sublimate 262
Antidotes to Corrosive Sublimate 263
Organic lesions discovered on dissection 266
Of the Chemical processes for its detection 267
_a._ By its metallization through the agency of
Galvanism 268
_b._ By precipitating metallic mercury from its
solution, by the contact of a single metal 269
3. It is dissolved in various coloured liquids 272
4. It is mixed or combined with some medicinal body
in a solid form 273
5. It is united with alimentary substances which
have effected its decomposition 274
6. It is decomposed, and a part exists in intimate
combination with the membranes of the alimentary canal 274
Red Oxide of Mercury 275
Red Precipitate 276
Other preparations of Mercury 276
_Antimony_ 277
Emetic Tartar, Tartarized Antimony 279
Symptoms of poisoning by it 280
Antidotes 280
Physiological action of Emetic Tartar 282
Organic lesions discovered by dissection 283
Tests for the detection of Emetic Tartar 284
1. The poison is in a solid form 284
2. It is mixed with various alimentary
substances 285
_Copper_ 285
Oxide of Copper 287
Green Carbonate of Copper, Natural Verdegris 288
Verdegris 290
Blue Vitriol 291
Symptoms of poisoning by the Salts of Copper 291
Organic lesions discovered on dissection 291
Chemical detection of their presence 291
A. By their reduction to a metallic state 292
B. By the application of certain tests to their
solutions 293
The suspected poison is mixed with alimentary
substances 294
_Tin, and its Muriates_ 295
_Zinc_ 296
White Vitriol, Sulphate of Zinc 297
Symptoms of poisoning by it 297
Organic lesions 298
Chemical processes for its detection 297
_Silver_ 299
Lunar Caustic, Nitrate of Silver 299
Chemical processes for its detection 300
_The Concentrated Acids_ 301
Oil of Vitriol, Sulphuric Acid 302
Symptoms of poisoning by it 303
Organic lesions 304
Antidotes 304
Chemical processes for its detection 305
Nitric Acid 305
Symptoms of poisoning by it 306
Organic lesions 309
Chemical processes for its detection 312
Spirit of Salt, Muriatic Acid 313
Symptoms of poisoning by it 313
Chemical processes for its detection 314
Oxalic Acid 315
Symptoms of poisoning by it 316
Antidotes 316
Chemical tests for its detection 316
_Boiling Water_ 316
_Melted Lead_ 317
_The Caustic Alkalies_ 318
Potass or Potash 319
Liquor Potassæ 320
Chemical tests for its detection 320
Potassa Fusa, or Kali Causticum 321
Potassa eum Calce 321
Sub-carbonate of Potash, Pearl Ash 322
Symptoms of poisoning by any of the above 322
Preparations 322
Antidotes 323
Organic lesions 323
Soda 323
Ammonia and its Carbonate 323
Symptoms of poisoning by Ammonia 324
_The Caustic Alkaline Earths_ 325
Quick Lime 325
Symptoms of poisoning by Lime 325
Organic lesions 326
Tests for its detection 326
Baryta, and its Salts 327
Symptoms of poisoning by Baryta 327
Physiological action of it 328
Antidotes 328
Chemical tests for its detection 329
_Cantharides_ 330
Symptoms of poisoning by it 331
Organic lesions 332
Methods of detecting its presence 333
_Phosphorus_ 333
Symptoms of poisoning by it 333
_Mechanical Poisons, Powdered Glass, &c._ 334
Class II. ASTRINGENT POISONS 336
_Lead_ 336
Sugar of Lead, Plumbi super acetas 349
Goulard’s Extract, Liquor Plumbi sub-acetatis 350
White Lead, Sub-carbonate of Lead, Cerusse 350
Litharge, semi-vitrified Oxide of Lead 351
Red Lead, Minium 352
Symptoms of poisoning by the different preparations
of Lead 353
By small and repeated doses 355
Organic lesions 357
Physiological action of Lead poisons 358
Chemical processes for their detection 361
1. When it exists in some unknown state of
combination 361
2. Is dissolved in Wine 363
3. Is dissolved in Oils 364
4. Is mixed with alimentary matter 365
_Vegetable Poisons_ 366
Class III. ACRID OR RUBEFACIENT POISONS 371
Camboge or Gamboge 371
White Hellebore, Veratrum Album 372
Black Hellebore, Melampodium 374
Fœtid Hellebore, Helleborus fœtidus 375
Elaterium, Wild Cucumber 375
Colocynth, Coloquintida. Bitter Apple 377
Euphorbium 377
Savine, Juniperus Sabina 378
Aconite, Monks-hood 379
Nitre, Nitrate of Potass 381
Symptoms of poisoning by Nitre 381
Organic lesions 382
Chemical processes for its detection 382
Class IV. NARCOTIC POISONS 382
Opium, and its preparations 383
Symptoms of poisoning by Opium 388
Physiological action of Opium 390
Treatment in cases of poisoning by it 391
Organic lesions 393
Of the detection of Opium 394
Black Henbane, Hyoscyamus Niger 395
Prussic Acid, Hydro-cyanic acid 396
The Laurel (Prunus lauro-cerasus) and its distilled
water 396
Bitter Almonds 396
Action of Hydro-cyanic acid as a poison 396
Physiological action of Prussic acid 404
Antidotes 406
Organic lesions 407
Chemical processes for its detection 408
Class V. NARCOTICO-ACRID POISONS 410
Deadly Night-shade, Atropa Belladonna 410
Symptoms of poisoning by it 411
Physiological action 412
Organic lesions 412
Modes of detecting its presence 413
Stramonium, Thorn Apple 413
Tobacco, Nicotiana Tabacum 414
Symptoms of poisoning by it 418
Its physiological action 419
Hemlock, Cicuta 420
Nux Vomica 421
Cocculus Indicus 423
Poisonous Mushrooms 425
Symptoms of poisoning by them 428
Organic lesions 433
Antidotes 434
Alcohol 434
Symptoms of poisoning by it 436
Its physiological action 437
Treatment of persons in a state of Inebriety 439
Animal poisons 440
Class VI. SEPTIC POISONS 440
The Bites of Venomous Animals 440
Symptoms of the bite of a Viper 441
Physiological action of its poison 442
Putrescent Animal matter 443
Poisonous Fishes 449
Symptoms of Fish poisoning 451
Its origin 452
Aërial Poisons 456
Mercurial vapours 458
Sulphuretted hydrogen gas 462
Carburetted hydrogen gas 464
Chlorine; oxymuriatic acid gas 464
Sulphurous acid gas 465
Of Homicide, by Misadventure or Accident 466
A Synopsis of the objects of inquiry in cases of sudden and
mysterious sickness and death VOL. III.—1
Case I. The patient is living, and medical assistance is
required 1
Case II. The patient is dead—the attendants can furnish
only an imperfect account of his dissolution 2
Case III. The body is found dead—its history is unknown 2
1. Inspection of the dead body 2
2. Circumstances to be learnt by an examination of
surrounding and collateral objects 3
3. Circumstances to be learnt by the interrogation of
competent witnesses 3
4. Circumstances to be learnt by anatomical dissection 3
A Commentary on the preceding objects of Inquiry 6
Case I. The patient is living, and medical assistance is
required 6
Previous state of the patient, with respect to bodily
health and strength, 8
Age and occupation 8
Present symptoms of the patient 8
Whether any, and what remedies have been used; by whom
recommended; and by whom administered? 12
Appearance of the evacuations 13
Case II. The patient is dead—the attendants can furnish
only an imperfect account of his dissolution 17
How soon is the deceased supposed to have died after the
alleged cause of his dissolution? 17
Case III. The person is found dead, and the history of his
dissolution is unknown 18
1. Circumstances to be learnt by inspection of the body 19
Situation and attitude of the body 20
General appearance of the countenance, as to colour,
vascular turgescence, or congestion, and morbid
physiognomy 21
Whether any discharge issues from the mouth, nostrils,
ears, or any other orifice? 21
Apparent age of the deceased 22
Description of person, as to bulk, stature, obesity,
muscular powers, &c. 22
Conformation of the neck as to shortness, thickness,
&c. 22
Probable period that has elapsed since the extinction
of life 23
Whether any, and what marks, punctures, contusions,
ecchymoses, dislocations, or other injuries, are to be
observed about the face, neck, chest, or any other parts
of the body; and how far their appearance and character
demonstrate the nature of the operation, or instrument by
which they were inflicted? 26
Whether the wounds observed on the body were
necessarily of a mortal nature, or sufficiently severe to
have caused immediate death? 30
Whether they were inflicted during life? 31
Whether they resulted from an act of suicide, or
otherwise, or whether from accident or design? 32
Whether the cloaths of the deceased betray any odour
of spirit, tobacco, sourness, or putridity? 34
Whether any articles have been broken or injured in
the pockets? 34
Whether there is reason to believe that the deceased
has been robbed? 34
If the deceased be a female, whether there be any
marks or bruises that would indicate the commission of a
rape? 35
2. Circumstances to be learnt by an examination of
surrounding and collateral objects 36
Whether the spot in question be of a description to
explain the cause of the deceased having been found there,
or how far its retired situation excites the suspicion
that the body had been conveyed thither for concealment,
or some other purpose? 36
Whether any indications of a struggle having happened
on the spot are visible on the ground, or herbage near the
deceased, and whether any footsteps can be traced near the
body? 37
Has there been a thunder storm? 38
Whether any, and what weapons, are lying near the
body; and what is their position in relation to it? 38
If the body be found in the water, are there any, and
what reasons for supposing that it was killed by other
means, and subsequently thrown into the water? 39
If the deceased be found hanging by the neck, whether
he was suspended during life, or hung up after death?
whether it was an act of suicide or of murder? 42
If the deceased be found in an apartment, whether it
be in a house of ill-fame? 44
3. Circumstances to be learnt by the interrogation of
competent witnesses 45
4. Circumstances to be learnt by anatomical dissection 45
Dissection of the brain and its membranes 46
Dissection of the contents of the thorax 52
Examination of the abdomen 60
Examination of the uterus and its appendages 67
Examination of the skeleton 73
Case of Thomas Bowerman 80
Abortion and Infanticide 84
Physiological Illustrations—Abortion 93
Physiological Illustrations—Infanticide 98
I. To ascertain whether the child was born alive? 100
A. Inspection of the body of the Infant 98
B. Phœnomena displayed on the dissection of the
internal parts 107
Cavities of the mouth, œsophagus, larynx, and
trachea 107
Thoracic cavity 108
1. A fœtus may breathe as soon as its head is
without the vagina, and immediately die 113
2. The lungs may have been artificially inflated 115
3. The lungs may float, in consequence of
putrefaction 116
The cranial cavity 121
C. The character of the spot on which the body was
found 122
II. Whether, supposing the child to have been alive, its
death was the result of natural causes, of wilful
violence, or of negligence and abandonment? 122
Death by omission 123
A new-born child may perish by exposure to cold 127
Death by commission 127
Of Criminal Responsibility, and Pleas in bar of Execution 131
Of Punishments 147
Postscript 153
APPENDIX. PART I.
Statute 9 _Hen._ 5 1
Lordinance encontre les entremettours de fysyk et de
Surgerie 3
Statute 3 _Hen._ 8, _c._ 11. An act for the appointing of
Physicians and Surgeons 3
Statute 5 _Hen._ 8, _c._ 6. An act concerning Surgeons to be
discharged of Quests and other things 5
Statute 14 and 15 _Hen._ 8, _c._ 5. The privileges and
authority of Physicians in London 7
The Charter of Incorporation 7
32 _Hen._ 8, _c._ 40. For Physicians and their privilege 14
Statute 32 _Hen._ 8, _c._ 42. For Barbers and Surgeons 17
34 and 35 _Hen._ 8, _c._ 8. A bill that no common
Surgeons, may minister medicines notwithstanding the
Statute 23
1 _Mary_, _c._ 9. An act touching the Corporation of the
Physicians in London 25
6 and 7 _Will._ 3, _c._ 4. An act for exempting
Apothecaries from serving the offices of constable,
scavenger, and other parish and ward offices, and from
serving upon juries 27
Continued by 1 _Ann_, st. 1, _c._ 11 27
Made perpetual by 9 _Geo._ 1, _c._ 8, § 1 29
10 _Geo._ 1, _c._ 20. An act for the better viewing,
searching, and examining of all drugs, medicines, waters,
oils, compositions, used, or to be used, for medicines, in
all places where the same shall be exposed to sale, or
kept for that purpose, within the city of London and
suburbs thereof, or within seven miles circuit of the said
city 30
[This act has not expired.]
18 _Geo._ 2, _c._ 15. An act for making the Surgeons of
London, and the Barbers of London, two separate and
distinct corporations 30
55 _Geo._ 3, _c._ 194. An act for better regulating the
practice of Apothecaries throughout England and Wales 52
A Royal Charter granted to the Apothecaries of London, 30
Maii, 13 Jacobi 71
Royal Letter to the College of Physicians. _Charles R._ 92
To our trusty and well-beloved the Lord Mayor of our city of
London for the time being, and to the Deputy Lieutenants
and Commissioners of the Militia of London and Westminster
that now are and hereafter shall be, and to all other
Officers and Ministers whom it may concern. _Charles R._ 93
College Questions resolved by the Lord Chancellor and Judges
in the 5th of King _James_, his reign, An. Dom. 1607, 94
Concerning punishment and correction against offenders 96
Cases 98
Dr. _Bonham’s_ case 96
Dr. _Groenvelt_, versus Dr. _Burwell_ and others, Censors
of the College of Physicians 119
_William Rose’s_ case 127
Dr. _Stanger’s_ case 131
Habeas Corpus, and Censors Warrant for commitment of
Empirics 145
Dr. _Burgess’_ case 147
Dr. _Winterton’s_ Letter to the President 147
_Lilly’s_ Diploma. The license of _Dr. Sheldon_,
Archbishop of Canterbury, granted to _William Lilly_, the
Astrologer, to practice Physic, dated A. D. 1670 150
Order in Council, 26th July, 1809 151
_King_, _v._ College of Surgeons 153
Midwife’s Oath 160
Certificate of the College of Physicians concerning
the Midwives of London 162
59 _Geo._ 3, _c._ 41. An act to establish regulations for
preventing contagious diseases in Ireland. 14 June, 1819 164
14 _Geo._ 3, _c._ 49. An act for regulating Mad-houses 170
Report of the Select Committee appointed to consider the
validity of the doctrine of contagion in the Plague, 14th
June, 1809 185
_Chorley_, M.D. _v._ _Bolcot_, executor 187
_Lipscombe_, _v._ _Holmes_, Esq. 189
_Slater_, _v._ _Baker_ and _Stapleton_, C. B. 189
_Seare_ against _Prentice_ 194
APPENDIX. PART II.
_Severn, v. Olive_ 201
Two notes on the legal time for Human Birth, (from
_Hargrave’s_ Jurisconsult Exercitations) 209
APPENDIX. PART III.
The determination of the College concerning the questions
proposed to them by the King’s Majestie about the death of
_Joseph Lane_ 225
Case of _Standsfield_. Edin. Dec. 1, 1687 227
Report of the Chirurgeons of Edinburgh on the same case 228
Report of the College of Physicians 229
Extract of the medical evidence in the case of _Spencer
Cowper, Esq._ for the murder of _Sarah Stout_ 230
Extract from the evidence of Doctor _Anthony Addington_,
on the trial of _Mary Blandy_, at Oxford, 1752, for the
murder of her father by Arsenic 236
Extracts from the evidence delivered on the trial of _John
Donellan, Esq._ for the wilful murder, by poison, of _Sir
Theodosius Edward Allesley Boughton, Bart._ at the Assizes
of Warwick, March 30, 1781 243
Extracts from the evidence delivered on the trial of
_Robert Sawle Donnall_, Surgeon and Apothecary, for the
wilful murder, by poison, of his mother-in-law, Mrs.
_Elizabeth Downing_, widow, at the Assizes at Launceston,
March 31, 1817 277
The defence of _Eugene Aram_ for the murder of _Daniel
Clarke_ 311
ERRATA. VOL. I.
Page 176, note (_a_) after _Greenstreet_ and, insert _Greenstreet_.
Page 177, note (_a_) for _majorum_ read _magorum_.
Page 235, note (_b_) for _primes_ read _primis_.
Page 437, line 21, for _violation_ read _volition_.
VOL. II.
Page 188, line 2, for _Nicholls_ read _Mitchell_.
Page 362, line 16, for 301 read 303.
Page 347, line 19, for _portable_ read _potable_.
VOL. III.
Index, for p. 156-184, read 320-348.
INTRODUCTION.
MEDICAL JURISPRUDENCE[1] may be defined, a science by which medicine,
and its collateral branches, are made subservient to the construction,
elucidation, and administration of the laws; and to the preservation of
the public health.
It accordingly resolves itself into two great divisions—into _Forensic
Medicine_, comprehending the evidence and opinions necessary to be
delivered in courts of justice; and into _Medical Police_, embracing the
consideration of the policy and efficiency of legal enactments for the
purpose of preserving the general health, and physical welfare of the
community.
Under no circumstances does medical science assume so imposing and
dignified an attitude, as when regarded as a branch of legislation.
Disentangled from the web with which worldly caprice, credulity, and
empiricism, are ever seeking to embarrass the more ordinary path of her
labours, she at once displays her pride and strength in the number and
variety of her resources, and in the extent and importance of their
applications; while the professor of our art is thus enabled to support
additional claims upon the respect of the learned, the confidence of the
oppressed, and the gratitude of the public. In the active exercise of
his duties as a medical jurist, how exalted and honourable is the
occupation of the physician!—there is scarcely a circle of natural
science, upon the boundaries of which he does not impinge in some point
or other, of his extensive orbit. Trace his progress, for instance,
through the subject of poisons, and we shall soon perceive that it
involves within its range the departments of anatomy, physiology,
botany, mineralogy, zoology, and chemistry. If, again, we follow his
steps through the deviating and perplexing course of homicide, in how
many new and interesting forms will the principles of physiology present
themselves; how frequently shall we find ourselves engaged in the
solution of problems connected with the knowledge of pneumatics,
hydrostatics, and mechanics? If we attend him in the investigation of
nuisances, as affecting the health and comfort of the surrounding
inhabitants, we shall perceive that an acquaintance with the various
branches of natural philosophy, can alone enable him to appreciate the
nature and extent of the evil, or the value of the different plans that
may be proposed for its removal. While the intricate and perplexing
subjects of quarantine and plague police, will require for their
elucidation, the energies of a peculiarly constructed and well
disciplined mind, to concentrate the genuine lights into a focus, and to
dissipate the many specious, but false appearances, with which the
question of contagion has been distorted.
The institution of medicine and jurisprudence, necessarily arose as the
consequence of the physical and moral infirmities of our nature, and
must, therefore, have been nearly coeval with the origin of society. In
the earlier periods, however, of the world, the connection between these
sciences could only have been slight, and scarcely, perhaps,
perceptible; although we are strongly inclined to believe that _Medical
Jurisprudence_ has an origin far more ancient, and an influence far more
extensive, than modern writers have been willing to concede; an opinion
which we are prepared to support by the authorities of profane as well
as sacred writers, and by the history of civilized as well as barbarous
communities. It must be admitted, that no inconsiderable a part of the
institutions of the great law-giver of Israel, was a wise system of
medical police, well adapted for the preservation of the health, and the
amelioration of those evils to which the inhabitants of a tropical
climate must have been exposed; and we read, that Moses was skilled in
all the learning of the Egyptians. In Leviticus,[2] commands are given
to the priests to visit the houses infected with the plague of leprosy,
or with any contagious disease; to examine the inhabitants; to establish
quarantine; to scrape and white-wash the houses; to shut them up, and,
in bad cases, to pull them down. If we descend into later times, we
shall discover the same policy of associating the institutions of
medical police with religious ceremonials; by which the performance of
duties, essential to the preservation of the health, was more
effectually enforced. The author has observed, in the historical
introduction of his “_Pharmacologia_,” that bathing, which at one period
of the world was essentially necessary to prevent the diffusion of
leprosy, and other infectious diseases, was wisely converted into an act
of religion, and the priests persuaded the people that they could only
obtain absolution by washing away their sins by frequent ablution;[3]
but, since the use of linen shirts has become general, and every one has
provided for the cleanliness of his own person, the frequent bath ceases
to be so essential; and, therefore, no evil has arisen from the change
of religious belief respecting its connection with the welfare and
purity of the soul. Among the religious impurities, and rules of
purification of the Hindus, we shall be able to discern the same
principle, although distorted by superstition.[4] So, again, it is easy
to perceive, that the dangers consequent upon vinous inebriation in a
hot climate, suggested the Mahometan prohibition of wine. The religious
ceremonial observed by the ancients, whenever they proposed to build a
town, or to pitch a camp, was evidently an act of legislation, founded
on a just principle of physiology; they offered a sacrifice to the gods,
when the Soothsayer declared, _from the appearance of the entrails_,
whether they were propitious or not to the design. What was such an
inspection but a philosophical inquiry into the salubrity of the
district, and the purity of the waters by which it was supplied?—for it
is well known that in unwholesome situations, especially if swampy, the
viscera of the cattle will universally present an appearance of disease,
which an eye experienced in such dissections, would easily distinguish.
But, in order to shew the universality, as well as the antiquity, of the
policy which we are endeavouring to establish, we propose to furnish the
reader with an illustration, afforded by the superstitions of an
uncivilized race of modern times. The pearl-diver in the East-Indian
fisheries is constantly exposed, during his dangerous occupation, to the
attack of the _Ground-Shark_, a common and terrible inhabitant of all
the seas in those latitudes. In order to avoid falling in with this foe,
the adventurous Indian seeks for safety in supernatural means. Before he
begins diving, the priest, or conjurer, or, as he is termed in the
Malabar language, the _Pillal Karras_, or _Binder of Sharks_, is always
consulted, whose directions upon these occasions are received with
confidence, and followed with the most implicit obedience. The advice
which is given them, under the imposing weight of a religious ordinance,
has, for its sole object, the maintenance of the health of the diver,
and the adaptation of his body for the arduous occupation in which he is
engaged; and it is not a little curious to observe that in the
performance of this duty, the _Pillal Karras_ appears to display a
judgment, which the most enlightened views of modern physiology could
not improve. The diver, for instance, is enjoined to abstain from all
food for some time previous to his descent; a practice, the value of
which will be duly appreciated by those who read our chapter on the
physiology of Suffocation, vol. ii. p. 34.
In those countries, where it becomes necessary to check the increase of
population, we again find that ecclesiastical institutes are made
subservient to state policy; thus the religion of the Island of
Formosa[5] prohibits women becoming mothers before the age of
thirty-five years; and, should they become pregnant before that time,
the priestess procures abortion by violence[6].
In the book of sacred law of the Hindus,[7] the rules for the choice of
a wife are formally and minutely detailed, and will be found remarkably
conformable with our physiological notions respecting the transmission
of disease and deformity.
The knowledge of _Forensic Medicine_, if not as ancient and universal as
the Institutes of Medical Police, may still boast of an early origin,
and a very extensive influence; thus in _Deuteronomy_[8] in cases of
doubtful virginity, the Elders are to be consulted, in order that they
may deliver their judgment from the physiological evidence of the case.
In ancient nations the assistance of the philosopher and physician was
universally required for the prevention, as well as detection of crime;
thus was _Archimedes_ consulted by the king of Sicily, when a workman
was suspected to have fraudulently alloyed the gold in his crown. The
Romans, especially in the reign of _Severus_, _Antonine_, _Adrian_, and
_Aurelius_, constructed several laws, and reformed some others, in
conformity with the sentiments inculcated in the works of _Hippocrates_
and _Aristotle_; the capital crime of procuring abortion was accordingly
limited to those cases wherein the fœtus exceeded forty days; and the
_Emperor Adrian_ passed a decree upon the subject of legitimacy, as
connected with the period of utero-gestation, according to the
physiological opinions with respect to the possibility of retarded
delivery;[9] while _Numa Pompilius_ prohibited the burial of a pregnant
woman, or of one supposed to be pregnant, until the fœtus should have
been extracted, or the state of the uterus ascertained by
dissection.[10].
The trials by ordeal in the dark ages of modern Europe, when the
decision of the most important questions was abandoned to chance or to
fraud, when carrying in the hand a piece of red hot iron, or plunging
the arm in boiling water,[11] was deemed a test of innocence, and a
painful or fraudulent experiment, supplanting a righteous award, might
consign to punishment the most innocent, or save from it the most
criminal of men, have ever been deemed a shocking singularity in the
institutions of our barbarous ancestors. We are ready to admit the
justice of this charge generally; and yet we fancy that, upon some
occasions we are enabled to discern through the dim mist of credulity
and ignorance, a ray of policy that may have been derived from the
dawning of a rude philosophy. Trials by ordeal, as we are informed by
Mr. _Mill_, hold a high rank in the institutes of the Hindus. It appears
that there are no less than nine different modes of trial, but that _by
water in which an idol has been washed_, and the one _by rice_, are
those which we shall select as well calculated to illustrate the
observations which we shall venture to offer. The first of these trials
consists in obliging the accused person to drink three draughts of the
water in which the images of the Sun and other deities have been washed;
and if within fourteen days he has any indisposition, his crime is
considered as proved. In the other species of ordeal alluded to, the
persons suspected of theft are each made to chew a quantity of dried
rice, and to throw it upon some leaves or bark of a tree; they, from
whose mouth it comes dry, or stained with blood, are deemed guilty,
while those who are capable of returning it in a pulpy form, are at once
pronounced innocent. When we reflect upon the superstitious state of
these people, and at the same time, consider the influence which the
mind, under such circumstances, is capable of producing upon the
functions of the body, it is impossible not to admit that the ordeals
above described are capable of assisting the ends of justice, and of
leading to the detection of guilt. The accused, conscious of his own
innocence, will fear no ill effects from the magical potation, but will
cheerfully acquiesce in the ordeal; whereas the guilty person, from the
mere uneasiness and dread of his own mind, will, if narrowly watched,
most probably discover some symptoms of bodily indisposition, before the
expiration of the period of his probation. In the case of the ordeal by
_rice_, a result, in correspondence with the justice of the case, may be
fairly anticipated on the soundest principle of physiology. There is
perhaps no secretion that is more immediately influenced by the passions
than that of saliva. The sight of a delicious repast to a hungry man is
not more effectual in exciting the salivary secretion, than is the
operation of fear and anxiety in repressing and suspending it. If the
reader be a medical practitioner, we refer him for an illustration to
the feelings which he experienced during his examination before the
medical colleges; and if he be a barrister, he may remember with what a
parched lip he gave utterance to his first address to the jury. Is it
then unreasonable to believe that a person under the influence of
conscious guilt, will be unable, from the dryness of his mouth, to
surrender the rice in that soft state, which an innocent individual,
with an undiminished supply of saliva, will so easily accomplish?
These few examples will suffice to shew that Medical Jurisprudence had
an early origin; and yet we are ready to admit that its applications
were extremely desultory, and often, from the infant state of the
sciences upon which it rested, not only imperfect but erroneous; indeed
the question may be very fairly maintained, whether on many occasions
the evidence of the physician has not embarrassed where it should have
enlightened, and misled where it was called upon to direct the steps of
justice. Forensic medicine, however, could scarcely be considered as
constituting a branch of legislation, until its utility was publicly
recognised, and its assistance legally required. This admission will
compel us to assign to Germany the honour of its origin, for the Medical
jurist is first acknowledged, and his services formally required, in the
celebrated criminal code framed by _Charles_ the Fifth, at the Diet of
Ratisbon, in the year 1532, known by the name of the “_Constitutio
Criminalis Carolina_,” and which still constitutes the basis of the
criminal proceedings of the German courts. In the code it is enacted,
that medical men shall be consulted whenever death has been occasioned
by violent means, whether criminal or accidental, by wounds, poisons,
hanging, drowning, or the like; as well as in cases of concealed
pregnancy, procured abortion, child-murder, &c. The publication of such
a code very naturally awakened the attention of the medical profession,
and summoned numerous writers from its ranks. The first of whom were
_Bohn_[12], _Valentini_[13], _Boerner_[14], _Kannegeiser_[15], and
_Struppe_; _Alberti_[16], _Zittman_[17], _Richter_[18],
_Teichmeyer_[19], and _Stark_[20]; some years after whom came
_Hebenstreit_[21], _Ludwig_[22], and _Fazellius_[23].
The first German work of any authority is that of _John Bohn_, published
in 1689, and entitled “_De Renunciatione Vulnerum_,” in which the author
attempts to shew what wounds are necessarily fatal. In 1704, the same
Professor presented to the profession a forensic work of greater range,
for the purpose of giving rules for the conduct of physicians in
attending the sick, and in delivering evidence before a court of
judicature; it is entitled “_De Officio Medici, duplici, clinico et
forensi_.” At about, or rather previous to the publication of this
latter work, the celebrated Pandects of _Valentini_ appeared, which form
a compendious retrospect of the opinions and decisions of preceding
writers on Juridical Medicine. In his preface _Valentini_ endeavours to
enforce the necessity of cultivating this branch of Medical Science; and
although more than a hundred and twenty years have elapsed, how aptly
will his rebuke apply to the medical witnesses of the present
age—“_Evenit sæpe ut etiam illi qui magno Archiatrorum Practicorumque
felicissimorum titulo superbiunt, in publicis hujuscemodi occasionibus
facultatibus, ut Mus in pice, hæreant, ineptisque relationibus
facultatibus Academicis non tantum risum moveant, sed et omnem, qua
prius gaudebant estimationem protinus amittant._” This was followed by
the works of _Kannegeiser_, and of _Frederic Boerner_, medical professor
of Wirtemburg, on various subjects connected with Legal Medicine. The
system of _Alberti_ of Halle, in six volumes quarto, appeared in 1725.
Amongst the numerous questions elucidated by this laborious author, we
may particularize those relating to conception and utero-gestation; and
the reader will perceive that we have frequently availed ourselves of
his opinion upon these points. Nearly cotemporary with _Alberti_, were
_Zittman_, _Richter_, and _Teichmeyer_, from whose writings we have also
had frequent occasion to extract some valuable observations. In 1730 the
progress of Medical Jurisprudence was very considerably advanced by the
publication of the argumentative work of _Storck_, in which the utility
of medical knowledge in assisting the operation of the laws, is very
ably and warmly advocated. The _Anthropologia Forensis_ of
_Hebenstreit_, from which we have so frequently derived useful
information, did not appear until 1753, and was followed by the
_Institutes of Ludwig_, and the _Elements of Fazellius_. In 1781,
_Plenck_[24] published his Elementary work on Forensic Medicine and
Surgery; and in the following year the first volume of _Haller_’s[25]
celebrated Lectures on Juridical Medicine, in the execution of which he
takes the Institutes of _Teichmeyer_ as his text, correcting his errors,
and amplifying his opinions. This work was subsequently completed in
three volumes. In 1784, _Daniel_, by the title of his work[26] published
at Halle, first introduced the term of STATE MEDICINE, as expressive of
that branch of medical science of which we are now treating. The annals
of the close of the eighteenth century are enriched by several important
productions; amongst which may be particularized _Conspectus of
Sikora_[27], the _First Lines of Loder_[28], the _System of Metzer_[29],
and the _Delineations of Muller_[30]. If the reader be desirous of
further information respecting the German literature of State Medicine,
at this period, we must refer him to the great works of _Schlegel_[31]
and _Plouquet_[32]; _Struvius_ likewise in his _Bibliotheca Juris_,
(vol. i. p. 172) refers to the work of _Andreas Otto Goellicke_,
Frankfort, 1723, for an enumeration of the numerous medico-legal writers
of the earlier part of this age.
During the present century we have received two volumes from the pen of
_Metzger_; and in the year 1806, _Knappe_ and _Hecker_ commenced at
Berlin, a periodical publication, under the title of “_Critical Annals
of State Medicine_;” some years after which a similar work appeared
under the superintendance of _Professor Kopp_ of Hanau. In speaking of
the periodical works of Germany, we must not omit to mention that
conducted by _Dr. Scherf_, Aulic Counsellor at Detmold, under the title
of “_Contributions to the Archives of Medical Police_,” which extended
to eight volumes, and was afterwards continued under the appellation of
“_Isis_,” or “_Journal of Medical Jurisprudence and Police_.” To the
catalogue of writers already enumerated, we might add many more; but
having cited the most celebrated works we consider it unnecessary to
adduce farther demonstration of the indefatigable and laborious industry
of the German literati.
The middle of the sixteenth century may be stated as the epoch at which
the subjects of Medical Jurisprudence first excited much attention in
the schools of Italy. The earlier writers, however, would appear to have
studied the science rather with casuistical, than physiological views.
_Fortunatus Fidelis_, who has been regarded as the father of the
Medico-legal literature of Italy, first published his work “_De
Relationibus Medicorum_,” at Palermo, about the period above stated; it
was afterwards republished at Venice, and lastly at Leipsic, under the
care of _Paul Amman_, Professor of Botany and Physiology in that
University. It consists of four books, of which the following may be
received as an outline of the contents, _viz._ I. On Public Food; the
Salubrity of the Air; Pestilence. II. Wounds; Pretended Diseases;
Torture; Injuries of the Muscles; Medical Errors. III. Virginity;
Impotence; Hereditary Diseases; Pregnancy; Moles; the Vitality of the
Fœtus; On Birth; Monsters. IV. Life and Death; Mortality of Wounds;
Suffocation; Death by Lightning and Poisoning.
Amongst the earliest dissertations which appeared on questions connected
with the subject of Jurisprudence, and which merits notice on this
occasion, is one by _Frederic Bonaventura_, an eminent scholar and
physician of Urbino, in Italy, who flourished in the early part of the
seventeenth century, entitled, “_De Natura partus octomestris, adversus
vulgarem opinionem, libri decem._” Francof. 1601; an enormous folio
volume, containing upwards of one thousand pages, on this uninteresting
subject; in which he has introduced the opinions of different writers,
and an account of all the controversies that have been held on the
legitimate period of utero-gestation. The most celebrated however of all
the Italian works which have descended to us, is that of _Paul
Zacchias_,[33] physician to Pope Innocent the Tenth, who was long
considered as the only arbiter of questions relating to any of the
subjects of Juridical Medicine. The estimation in which this work was
universally held may be easily discovered, from the expressions with
which it is mentioned by all cotemporary writers. _Zacutus Lusitanus_,
in alluding to its value, exclaims “Emi,—vidi—legi—obstupui”! When we
consider the period at which it was written, it must certainly be
acknowledged as a very extraordinary work; that it should be overrun
with casuistical subtleties cannot be a matter of surprise; the style
too is entirely scholastic, full of digression, and prolix passages of
erudition, but such was the taste of the age in which it was composed.
We are also to remember that at this period, the philosophy of
_Aristotle_ alone directed the schools, and the doctrines of _Galen_,
illustrated by a thousand servile commentators were, according to the
judgment of that æra, the only sources from which medical opinions could
be legitimately deduced. The study of Anatomy had only then commenced
under the guidance of _Vesalius_, _Columbus_, _Fallopius_, and
_Eustachius_; while Surgery, notwithstanding the labours of _Paré_,
_Arceus_, _Andrew Dalla Croce_, _Aqua Pendente_, and other masters, was
in its mere infancy. Chemistry too was as yet full of conceit and
uncertainty; and Pharmacy was absolutely without any acknowledged
principles. As the great work of _Zacchias_ was composed at different
periods, with considerable intervals between each, we find numerous
repetitions, and contradictions. It is therefore evident, that although
the “_Quæstiones Medico-legales_” may afford much instruction to the
learned physician, it can be of no service to the student; this opinion
is justly expressed by “_Camerarius_[34]—_Quisquis Pauli Zacchiæ opus
legere cum fructu voluerit, insigni jam rerum medicarum notitia
instructus sit oportet; eo magis quod alia sit modernæ Medicinæ facies;
ditissimus enim thesaurus est liber iste, supplendus tamen subinde ex
aliis fontibus recentioribus._”
_Barnardin Ramazzini_, having been struck with the numerous accidents
which had occurred to Nightmen, was induced to direct his attention to
the causes and nature of the asphyxia by which they perished, and to
extend his investigation to the maladies to which the artisans in every
profession were more peculiarly subjected. He accordingly, in the year
1700, published at Padua, an excellent treatise on these affections,
entitled “_De Morbis Artificum Diatriba_,” a work which has retained its
credit as a standard production, and to which all subsequent works on
the same subject have been very largely indebted. It was translated by
_Fourcroy_, who also enriched it with many valuable notes in 1777. It
has also been presented to the public in many other countries, at
different periods, and under various forms; as by _M. Hecquet_, 1740;
_Skragge_, in 1764; _Bertrand_, in 1804; _Gosse_ of Geneva, in 1516; and
_Patissier_, in 1822.
In 1749, Professor _Beccaria_, of Bononia, published his work entitled
_Scriptura Medico-Legalis_, and _Bononi_ in his _Istruzioni Teorico
pratiche di Chirurg_: entered with considerable minuteness into the
subject of Forensic Surgery, especially in its relations to wounds. The
later production however, of _Giuseppe Tortosa_[35], the disciple of
_Caldani_, must be considered as the most elaborate and scientific of
all the Italian works on Medical Jurisprudence. The reader will find
that we have frequently referred to this author; and it is just to
state, that during the progress of our labours we have derived from him
no inconsiderable assistance, in ascertaining the sentiments of the
Medical Jurists of the Italian school, upon various casuistical as well
as physiological doctrines. The work is professed to have been written
with the sanction of his master, _Caldani_, and under the auspices of
_Franck_ of Pavia, and of _Plouquet_ of Turin. He includes in his plan
such subjects only as relate to Forensic Medicine, excluding those which
belong more correctly to the department of Medical Police. The work is
divided into three parts, _viz._ 1. Comprehending all the
principal objects of _Ecclesiastical_ jurisdiction. 2. Subjects
relating to the _Civil_ courts. 3. Those which relate to the
_Criminal_ courts. The subdivisions of each part are arranged in
the following order. PART I.—Conjugal Impotence.—Conjugal
Rites.—Monstrous Births.—Hermaphrodites.—Magic.—Of Persons
possessed of Spirits.—Miracles.—Ecclesiastical Fasting. PART II.
Age.—Pregnancy.—Birth.—Superfœtation.—Cæsarean Operation.—Simulated and
Dissimulated Diseases. PART III. Of Deflowering.—Sodomy.—Torture.—Legal
Examination of Wounds, and Dead Bodies.—Poisoning.—Infanticide.—Homicide
by wounding.—Fœticide.—Accidental Death.
The application of Medical science to jurisprudence may, practically
considered, be said to have commenced in France about the time of
Francis I; but it was not until after the publication of the
_Constitutio Criminalis Carolina_, that the French government, unwilling
to allow their criminal code to remain less perfect and refined than
that of their continental neighbours, decreed that the assistance of
physicians and surgeons should be legally required; and which was at
length rendered still more peremptory by letters patent granted by Henry
IV, in 1606, conferring upon his first physician the privilege of
nominating surgeons in every town to the exclusive exercise of this
important duty; and Louis XIV. in 1667, after having formally declared,
that all Reports which had not received the sanction of such an officer
should be invalid, ordered by a decree, in 1692, that a physician shall
always be present with the surgeon, at the examination of a body[36];
the surgeons, however, of those times were not distinguished by the
knowledge which they now possess; hence, in every thing that did not
directly involve surgical discussion and practice, their reports were
frequently defective. Magistrates were consequently induced to summon
the more learned physician to the assistance of the Juridical Surgeon,
long before it was enforced by the law; a practice, which like many
others, acquired force and regularity from repetition.
_Ambrose Paré_ is acknowledged as the first French writer on the subject
of Juridical Medicine, and his treatise on Reports, published in 1575,
was, for nearly a century, regarded as the only standard authority upon
these occasions; it was, however, at length, to a great degree,
superseded by the more accomplished treatises of _Gendri_ of Angers, in
1650, of _Blegni_ of Lyons, in 1684, and of _Deveaux_ of Paris, in 1693.
This latter work is one of very considerable merit, especially as it
regards the diagnosis and prognosis of wounds.
The eighteenth century, says _Foderé_[37], an æra remarkable for the
conversion of the human mind from the enthusiasm of poetry and the fine
arts, to the cultivation and study of the exact sciences, must be
considered as the auspicious dawn of medico-legal knowledge in France.
The spirit of emulation which animated the rival schools of Surgery and
Medicine, produced men, who enlightened by their talents every
department of the science of Medicine. Professor _Louis_, Secretary to
the Academy of Surgery, taught publicly in the schools the art of
resolving different questions in medical jurisprudence, which previous
to his time had never been practised. Numerous memoirs on its various
branches appeared in succession; eloquence allied itself to science, and
their combined efforts were displayed in this novel mode of benefiting
mankind. Upon the great principles of justice and humanity which
presided at the reform of the penal code, chairs of medical
jurisprudence were established in all the faculties of medicine. In
1788, _Louis_ published at Paris his letters on the certainty of the
signs of death, in answer to the dissertations of _Winslow_ and
_Bruhier_; and of whose judicious remarks we have availed ourselves in
the discussion of the subjects of “Real and Apparent Death.” (_Vol. II.
p. 15_). To the same author we are also indebted for memoirs on
Drowning, and on the means of distinguishing Suicide from Assassination
in cases of death by suspension. His Consultations on the celebrated
causes of _Monbailly_, _Syrven_, _Calas_, _Cassagneux_, and _Baronet_,
which are recorded in the “_Causes Célébres_,” must serve to exalt him
still higher in our estimation. _Winslow_ engaged his talents in the
investigation of the Cæsarean Operation, including its moral, political,
and religious relations. _Petit_ and _Bouvart_ entered the field as
controversialists, and disputed the opinions of _Louis_ on protracted
pregnancy, with considerable ability. The former of these philosophers
wrote also several memoirs on the phenomena of suspension and
strangulation; he, moreover, examined the question relative to the signs
of death from abstinence. _Lorry_ discussed the question of survivorship
with great acuteness and judgment. _Salin_ attempted to deduce from the
character of the organic lesions, an inference with respect to the
nature of the poison that inflicted them; and he illustrated this
opinion in an elaborate memoir on the research of the traces of poison
on the body of _Lamotte_, sixty-seven days after it had been deposited
in the earth; in which he decides that the death was occasioned by
_corrosive sublimate_.[38] And although the nice distinctions which this
ingenious writer laboured to establish never had any existence but in
his own imagination, yet the agitation of so important a question was by
no means unprofitable; it directed the attention of the physician to the
state of the organic lesions, and has ultimately led to some useful
conclusions. While _Salin_ was thus engaged on the subject of poisoning,
_Lafosse_ sought to distinguish the phenomena produced by death, from
the traces of violence inflicted during life upon the body. He,
moreover, developed the unequivocal signs of pregnancy and parturition.
_Professor Chaussier_, in the year 1789, by a memoir, to the Academy of
Sciences at Dijon, on the great importance of the study of juridical
medicine, excited a spirit of emulation which was productive of the
highest advantage. At about this period also the memorable
“_Encyclopédie Méthodique_,” was undertaken, in which the celebrated
authors already named contributed their powerful assistance, in
conjunction with _Professor Mahon_, in compiling the elaborate articles
upon Medical Jurisprudence. Such were the materials, says _M. Foderé_,
which enabled me to publish my first systematic work[39] on this science
in the year 1796.
In the first few years of the present century the science of juridical
medicine received numerous contributions from the French physicians. _M.
Vigné_, of Rouen, published in 1805 his humane and enlightened
reflections upon its practical applications; a work which bears internal
evidence of the science as well as the judgment of its author. In the
year 1807, the system of _Professor Mahon_ appeared, not, however, until
after the death of its author; _M. Fautrel_ having undertaken the charge
of arranging the manuscript, of illustrating it with notes, and of
giving it to the world.[40] Nearly at the same time the small, but
useful work of _Belloc_[41] was published; and in the following year
_Marc_[42] translated the German manual of _Rose_ on juridical
dissection, and enriched it with original observations; to which he also
subjoined two memoirs on the obscure subject of the “_Docimasia
Pulmonaris_.” We have deemed it necessary to introduce to our readers
this slight sketch of the literary history of Medical Jurisprudence in
relation to its progress in the several countries of Germany, Italy, and
France; for much of the information thus afforded we are indebted to the
elaborate system of _Professor Foderé_,[43] published in six volumes, in
the year 1813, and which must be regarded as a new work, rather than the
republication of that already noticed, as having appeared in 1796. From
this voluminous treatise we have frequently, in the progress of our
present undertaking, made copious extracts. It becomes our duty
therefore to present our reader with some account of the extent of its
objects, and the order of their arrangement. The author divides his work
into three parts, viz. the _First_ comprehending subjects of a mixed
nature, or those which admit of application to civil as well as criminal
cases, “_Médecine Légale mixte_.” The _Second_ exclusively relating to
criminal jurisprudence, “_Médecine Légale Criminelle_;” and the _Third_,
to medical police, “_Médecine Légale Sanitaire_.”
The work opens with a learned introduction, in which the importance of
the science is fairly examined, and its history pursued with much
detail, from its origin, to the period at which the author wrote. The
qualifications of the forensic physician are also considered, and the
different circumstances opposed to the success of his labours,
enumerated and appreciated. Then follow in succession the subjects of
the first division, viz. the different ages of human life, puberty,
minority, majority, with the anomalies to which the natural growth and
developement of the body are liable. Personal identity and resemblance.
The relative and absolute duration of life. The grounds of prohibition
in testatorship, such as habitual, periodical, and temporary insanity;
suicide; deaf and dumb state; somnambulism; intoxication. The
qualifications of testators and witnesses. Marriage and divorce.
Pregnancy, true and false. Parturition, and the signs denoting the death
of the fœtus in utero. Paternity and filiation. Premature and retarded
births. Monsters. Hermaphrodites. Survivorship. Signs of real and
apparent death. Treatment of the different varieties of Asphyxia.
Certificates of exemption, and diseases which exempt. Feigned,
dissimulated, and imputed maladies.
The _Second_ division commences with the third volume, and includes, in
their respective order, chapters on the examination of bodies found
dead. The distinction of assassination from suicide. Wounds. Poisoning.
Rape. Abortion. Concealment and substitution of the offspring; and
Infanticide.
The _Third_ division, with which the fifth volume commences,
successively treats of the preservation of the human species, and of the
means of remedying its physical degeneracy. Contagious, hereditary, and
epidemic diseases, and the precautions to be adopted against them. The
medical police of cities, with regard to aliment, arts, manufactures,
and attention to the sick. Military and naval hygiène; and, lastly, the
medical police of hospitals and prisons.
No work of similar calibre had been previously published, and its
execution is a sufficient proof of the profound erudition and sterling
ability of its author; but it is by no means calculated to assist the
inquiries of the English physician. It is often unnecessarily prolix and
minute, and is adapted only to the judicial courts of the continent.
Since its publication numerous writers on detached questions have sprung
up, and thrown much additional light on their obscurer points. The
subject of poisons has been very ably elucidated by the researches of
_Professor Orfila_[44], and in a work[45] still more recently published
by that distinguished professor, the applications of Toxicological
Science to Forensic inquiries have been more minutely considered.
The subjects of conception and delivery, with the various questions to
which they have given origin, have been very ably discussed by _M.
Capuron_;[46] from whose work it will be perceived we have derived much
satisfactory information.
After the historical view which we have taken of the continental
literature of the subject, we fear that the labours of our own
countrymen, in this department of science, will suffer a disparaging
comparison; and yet we trust that any temporary feeling of inferiority
and humiliation thus excited, will easily yield to the just conception
of the circumstances to which the neglect of the subject is to be
attributed.
Although numerous questions connected with objects of forensic
inquiry had been discussed and illustrated in the various periodical
journals of Great Britain, yet no work, professing to treat of
Medical Jurisprudence, appeared previous to the small and imperfect
production of _Dr. Farre_ in 1788, entitled “_Elements of Medical
Jurisprudence_,”[47] and which was rather an abstract of a foreign
work, than an original essay. The next in succession was a
“_Treatise on Medical Police_,” by _Dr. Robertson_, in two volumes,
published in 1808. In 1815 _Dr. Bartley_, of Bristol, presented us
with “_A Treatise on Forensic Medicine_,” than which it is
impossible to conceive any production more meagre or imperfect. _Dr.
Male_[48] is undoubtedly entitled to the grateful notice of the
medical historian, as the author of the first respectable English
book on forensic medicine.
The last, and by far the most comprehensive and instructive work that
has appeared in this country, is by _Dr. Gordon Smith_, entitled “_The
Principles of Forensic Medicine, systematically arranged, and applied to
British Practice_.” London, 1821.
In addition to the above writings, we may record the “_Medical Ethics_”
of _Dr. Percival_; which, although not intended, nor indeed calculated
for practical instruction, contains some interesting allusions to our
subject. Nor must we omit to enumerate the several valuable monographs
with which different English physicians have sought to advance the
progress of medico-legal inquiry; as, for instance, the celebrated paper
of _Dr. Hunter_, “_On the Uncertainty of the Signs of Murder in the case
of Bastard Children_;” _Dr. Haslam’s_ intelligent and judicious essay
“_On Medical Jurisprudence, as it relates to Insanity, according to the
Law of England_;” and _Dr. Hutchinson’s_ laborious “_Dissertation on
Infanticide_.”
Some of the more important subjects of Public Health, received also
early notice, and were very ably investigated by our physicians. The
plan of ventilating the holds and lower decks of ships, as proposed by
_Sutton_ in 1739, must have fallen into total neglect, through the
unaccountable prejudice of the Admiralty, had it not received the
powerful support of _Dr. Mead_, by whose advice experiments were
publicly made, the success of which was, in the year 1741, acknowledged
in an order of his Majesty that all vessels belonging to the Navy should
be provided with ventilators. About the same period _Hales_ published
his celebrated memoir on the various causes which influence the health
of seafaring men, and on the precautions necessary to be taken to
prevent those maladies which frequently display themselves in ships and
other confined situations; among which modes of safety the most
important was a plan of ventilation by means of very ingenious bellows,
and which were used with much success in the prisons of Porchester
castle, Winchester, and Newgate;[49] and in the several hospitals of
London, Bristol, and Northampton.
In the year 1803, on the presentation of a memorial to his late
Majesty’s ministers, urging the expediency of a Professorship of Medical
Jurisprudence, in the University of Edinburgh, a Chair was endowed, and
_Dr. Duncan, junior_, appointed to fulfil its duties; which, for many
years he has continued to perform, with infinite credit to himself, and
with equal advantage to the University and to the public. In the schools
of England we continue to suffer from the want of such an establishment;
_Dr. Harrison_, a few years since, read some lectures on the subject in
the Medical Theatre of Windmill street; and _Dr. Gordon Smith_, has
announced his intention of devoting himself to the duties of a public
lecturer on Medical Jurisprudence. _Dr. Elliotson_ has also lately
published his “Introductory Lecture of a Course upon State Medicine,”
which he proposes to deliver in the Anatomical Theatre in Southwark.
But it has been demanded, and in a tone, as it would seem, suggested by
the feelings of mortified pride and disappointment, how it can have
happened that in Britain, a country distinguished above all others for
the unceasing jealousy and circumspection with which every thing that
even remotely interests the life and comfort of the subject is
scrupulously regarded, a science so peculiarly calculated to control the
disorders of the social system, to rescue innocence from infamy or
death, and to lead to the detection and punishment of crime, should for
so long a period have been imperfectly appreciated, and utterly
neglected?
The answer to the charge is obvious, and, we trust, satisfactory. The
progress of medical knowledge, including its collateral branches of
science, can only within a few years be said to have rendered its
applications available to the laws; while the spirit of British liberty
and independence not only resists the perpetual intrusion of
authorities, so necessary in other countries for the preservation of the
public health, but insures, without the aid of legal enactments, all the
benefits which can accrue from domestic cleanliness and attention.[50]
But upon each of these points it will be necessary to offer some farther
remarks.
That the evidence afforded by an improving, but still precarious and
imperfect physiology, should have been indiscriminately received at the
tribunals of those countries where the decision of questions of justice
is too often influenced, and even directed by the subtleties of
casuistry, may be regarded as a subject of regret, but can scarcely
excite the feeling of astonishment. Nor can we, on the other hand, be
surprised to find, that the extreme jealously of the British courts of
judicature should have resisted testimony which admits of being
depreciated, or in any degree rendered questionable, by the doubtful
controversies of science. So rapid, however, has been the progress of
the leading branches of medical knowledge during the last ten years; and
so successfully have they disentangled themselves from the many fatal
fallacies with which they were encompassed, that the general prejudice
against their practical utility, in advancing the administration of
justice, must gradually subside, and the study of forensic medicine
become universally popular. To strengthen our conviction upon this point
we have only to compare the evidence of medical men, as delivered in the
courts of justice during the last, and present century. Even so late as
the period of _Sir Thomas Browne_, we find that learned physician
bearing public testimony to the reality of diabolical illusions, and
occasioning, by his evidence, the conviction and condemnation of two
unfortunate persons, who were tried at Bury St. Edmonds before the Lord
Chief Baron _Sir Mathew Hale_, on the capital charge of bewitching the
children of a _Mr. Pacey_, and causing them to have fits![51] In
examining the chemical evidence in cases of poisoning, let us only
compare that which was given by _Dr. Addington_ on the trial of _Mary
Blandy_, at Oxford in 1752, (_see Appendix, p. 236_) with that which has
been delivered on any of the trials of the present day. Compare again
the nature of the physiological evidence which has been received as
satisfactory and conclusive, in cases of infanticide, with that which is
acknowledged by the most distinguished physicians of our own times to be
wholly inadequate to establish even a presumption of guilt.
With regard to the next point under consideration, viz. the expediency
of an extended system of medical police in a free country like Great
Britain, we have only to observe that, if we examine the extent of such
institutions in the different states of Europe, we shall find it
universally conformable with the genius, circumstances, and necessities
of each government. Sweden, for instance, a country which from position,
climate, and population, is relatively feeble, has found it necessary,
for its very existence, to cultivate with assiduity the few resources
which nature has bestowed upon it; and, hence, by a well digested system
of medical statistics,[52] it has been enabled to achieve extraordinary
and brilliant actions, and to repair immense losses which it would
otherwise have been unable to survive.
In Paris there exists a complete system of “_Assainissement_,” or police
for the preservation of the public health. Its administration devolves
upon _M. le Préfet de Police_, who for some years resorted to chemists
and physicians for advice upon the different questions that might arise;
upon such occasions, however, it is evident that he could only obtain
that isolated advice, which, for want of having been properly discussed,
was frequently arbitrary and weak; he had indeed sometimes temporary
commissions, which were formed when any important problem was to be
solved. In the year 1802 a council of health was, on the recommendation
of _M. Cadet de Gassicourt_, permanently established. At first it only
consisted of four members; but the new avocations required day by day,
so multiplied their labours, that they were compelled in 1807 to
increase the number of members composing it to seven; and the particular
attention necessary to be paid to epidemical diseases determined _M. le
Préfet_ to add to it two physicians. The duties of this council of
health were, to watch over all insalubrious manufactories and workshops;
to collect observations on epidemics, and on the sources from whence
they arose. They had, moreover, the charge of superintending the
cleansing of the markets, rivers, slaughter-houses, butchers offal,
burying-places, sewers, &c. and also of inspecting the public baths; the
manufactories of the artificial, and the depots of the natural mineral
waters; the amphitheatres for dissection; of making statistical
researches on the bills of mortality; on the means of rendering the
theatres, hospitals, and other public places more salubrious; on the
best system for heating and lighting; on the composition of secret
remedies; suspected vessels, &c. When this council received its definite
organization, it was composed of the following persons, whose names are
a sufficient guarantee of the ability with which the duties of the
establishment must have been performed—_M. D’Arcet_, _M. Le Chevalier
Cadet de Gassicourt_, _MM. Deyeux_, _Berard_, _Huzard_, _Leroux_,
_Dupuytren_, _Pariset_, _Petit_, _Marc_, and _Girard_.
An establishment similarly constituted in this country, that should from
time to time report its labours to the home department, would without
doubt be attended with much advantage, and might suggest many police
regulations highly conducive to the health and welfare of the community.
Of the severity of the French system of police, “Pharmaco-legale,” the
reader may form some idea, when we inform him that, during the progress
of the present work through the press, an apothecary of Verdun has been
fined three thousand francs, for selling sulphuric acid to a woman who
had poisoned herself with it. We are very far from objecting to such a
system, especially where the respectability and knowledge of the vender
are not guaranteed by an adequate power vested in some medical
corporation. In Germany a mistaken policy exists of regulating every
thing connected with health by the law, and which has led to the
formation of a cumbrous code of contradictory, and often, injurious
enactments.
The legislature of Britain has been accused of apathy upon all subjects
in which the prosperity of commerce is not involved, and upon such
occasions it is said to display a morbid vigilance and activity; “so
truly mercantile are the English,” observes _Professor Raynal_, “that
they mix up commerce with their philosophy, and even with their
religion;” as a proof of this, he instances _Mr. Locke_, who, amongst
his arguments for converting the Indians, adds that, “by being thus
induced to cover their naked bodies, they would add to the consumption
of British manufactures.” We do not admit the allegation, and may be
allowed to ask, in what country the fruits of commerce are more
liberally devoted to the encouragement of science, or to the promotion
of religion? In truth, the benefits which are enforced by the legal
enactments of other countries, are in England the spontaneous
consequence of individual liberality; and what is that repose which the
jealousy of our rival neighbours has denominated apathy, but the placid
expression of satisfaction experienced by the whole community at the
active liberality of the numerous individuals of which it is composed?
We are, nevertheless, willing to admit that occasions do exist in which
the interference of the legislature might be made subservient to the
preservation of the public health; and, in the course of our work, we
have not felt any hesitation in directing the attention of the reader to
their several merits. We have, in particular, recommended some
enactments in cases of epidemic disease. Under such circumstances of
public calamity the people naturally look for the sympathy and support
of their government; and the general confidence inspired by a public
act, however unimportant in itself, will always be attended with
advantage; it will have the tendency to diminish the susceptibility of
the people, and to limit the ravages of disease. The sages of ancient
Rome were deeply sensible of this important fact in the œconomy of the
people; whenever, therefore, their city was threatened with pestilence,
a dictator was elected with great solemnity, for the sole purpose of
driving a nail into the wall of the temple of Jupiter; and thus, while
they imagined that they propitiated an offended deity, they diminished
the susceptibility to disease, by appeasing their own fears.
Much benefit might also be conferred on the operative classes of
society, by some judicious enactments that should ensure the adoption of
the various plans of safety and protection, which science has from time
to time discovered for the advantage of those who are engaged in the
more dangerous occupations and manufactories; but which, from the apathy
of some, and the prejudice of others, have been either heedlessly
neglected, or illiberally and insolently repulsed. The blind opposition,
which such inventions meet with, is well illustrated in the history of
the _safety lamp_ of _Sir Humphry Davy_, an instrument which has
completely succeeded in use, and yet such is the obstinacy of the
miners, that many of them continue to expose their own lives, and those
of their companions, by carrying open lanterns about the galleries of
the mines. The author of the present work has personally experienced the
same mortifying insensibility and opposition, in his attempts to prevent
the awful accidents that so frequently occur in the mines of Cornwall,
from the premature explosion of gunpowder,[53] in the operation of
blasting rocks.
In the processes of _needle-pointing_ and _dry-grinding_, the artisans
rarely live many years, in consequence of the organic mischief produced
in the pulmonary organs, from the fine metallic particles that are
inhaled during the operation; to obviate such a source of danger, the
Society of Arts offered a premium for any invention that might afford
security, and their gold medal was, in consequence, presented to _Mr.
Abraham_, of Sheffield, for his “_magnetic guard_.” Notwithstanding the
expediency of this apparatus, we understand that the greatest opposition
has been manifested by the workmen to its introduction. From the extreme
danger of the process their wages are very high, and they fear that the
adaption of any system that may diminish the risk will be followed by a
corresponding reduction in their pay.
Surely such a subject well deserves the attention of the legislature. In
France the _Prefet de Police_ would prohibit the carrying on of such
arts, unless every means of safety were applied. Such a measure was
adopted in the case of the _water-gilders_ in Paris, who hesitated to
employ the means of ventilation suggested by _M. d’Arcet_ for their
security. It is not our intention to recommend a jurisdiction so
absolute and summary, but some enactments should be framed that might
secure the safety of the artisan, without infringing upon the liberty of
the subject.
Wherever governments have interfered for the purpose of encouraging and
rewarding, or of prohibiting and restraining, particular medical
opinions or practices, the inexpediency of such interference has
generally been soon discovered and demonstrated. What could have been
more absurd than the attempt of the French parliament to proscribe the
use of antimony,[54] or the sale of poppy oil;[55] or the enactments of
the different governments of Europe to restrain the custom of smoking
tobacco.[56] The pension conferred by the French government upon _M.
Sigault_[57] for the invention of a new mode of facilitating delivery,
in cases of difficult parturition; and the medal which was struck to
commemorate it, were measures not less inconsiderate and absurd than the
vote, by our own parliament, of five thousand pounds to _Mrs. Stephens_
for the supposed discovery of a medicine that could dissolve a calculus
in the bladder. But it may be said that we are reasoning against the
propriety of a practice from its abuse—That may be very true; but our
object is to shew that such a practice is pre-eminently exposed to
fallacy and abuse. We profess ourselves, generally, hostile to the
policy of remunerating medical discoveries, as they have been termed, by
grants of money; although we cheerfully tender our homage and thanks for
the great service rendered this country and the world, by the liberal
support which the government has afforded to the cause of vaccination;
and were the minister even now to withdraw the necessary supplies for
the continuance of the vaccine board, the consequences that would, under
such circumstances, ensue, afford a subject of the most awful
consideration.
According to the view which we have taken of the subject of medical
police, as necessary to the welfare of this country, our attention is
necessarily directed to the Royal College of Physicians, as the only
legitimate source from which the government is to derive its
information, and the public their protection. No apology therefore can
be necessary for the minute research by which we have endeavoured to
ascertain and establish their existing rights and privileges. Under any
circumstances it must be an object of the first importance to the
profession, but at the present period the inquiry would seem to be
marked with a more than ordinary degree of interest, as the anticipated
removal of the College, and the increased attention which has been
recently drawn to the subject, appear to promise considerable
improvements not only in the interior arrangement of that learned body,
but also in their public relations.
His present Majesty has afforded an early instance of his regard for our
principal medical corporation, by an act of favour no less important to
the institution, than honourable to the learned and distinguished
physician who presides over its rights and interests, as will appear by
the following
ROYAL LETTER.
“THE KING desires SIR HENRY HALFORD, as President of the Royal College
of Physicians, to announce to the College assembled, that it is the
King’s pleasure in future, that the President for the time being, should
always hold the office of Physician in Ordinary to His Majesty. The King
has great pleasure in making this communication during Sir Henry’s
Presidency, from the sincere regard He entertains for him, and the very
high estimation in which He holds his character and abilities.
“Signed. G. R.
“_Carlton House,
Jan. 18th, 1822._”
_To which the College voted the following Address._
‘TO THE KING’S MOST EXCELLENT MAJESTY.
‘SIRE,
‘We, the President, Elects, and Fellows of the Royal College of
Physicians, humbly approach your Majesty with our most grateful
acknowledgments for the mark of Royal favour with which your Majesty has
been pleased to distinguish us by an order written and signed by your
Royal hand, addressed to SIR HENRY HALFORD, Bart. our President,
commanding him to declare to the College assembled your Majesty’s Royal
will and pleasure that every future President of the College of
Physicians, for the time being, shall hold the office of one of your
Majesty’s Physicians in Ordinary.
‘We associate, SIRE, with this mark of your Royal kindness the pleasing
remembrance of the circumstances of our original foundation by your
Majesty’s illustrious predecessor King _Henry_ the VIII, and dare to
presume from so gracious a proof of your confidence in us, that your
Majesty entertains a favourable opinion of our institutions and
discipline, as calculated to make our profession respected in this
country, above what it is in any other part of Europe, and most capable
of forming a Physician worthy to be placed near the sacred person of the
King.
‘To our President, SIRE, we entrust this expression of our dutiful
thanks, our loyalty, our attachment, and devotion to your Majesty, and
we pray that no weight of cares which your Majesty’s great office
imposes upon you may prove injurious to your health; and that Providence
in His infinite goodness, may continue to watch over a life so highly
important to the welfare, and happiness of your kingdoms.’
--------------
It now only remains for us to offer some observations upon the plan and
execution of the work before us.
The classification of the various topics of forensic medicine has ever
been a fertile source of controversy; and we will venture to assert
that, from the diversity, as well as versatility of the numerous
subjects involved in the study of medical jurisprudence, no arrangement
can ever be constructed which shall vie, in perspicuity and precision,
with that of most branches of natural science, the objects of which,
however numerous, maintain a mutual relationship, and admit of being
displayed in a striking and natural order of connection. If an
arrangement be attempted to meet the legal view of the subject, such,
for instance as that proposed by _Professor Plenck_, of Vienna, and
adopted by _Tortosa_ and many others, viz. of distributing the subjects
according as they relate to the _criminal_, _civil_, or _ecclesiastical_
court, we shall immediately perceive that the same subject will
frequently belong with as much propriety to one division, as to another,
and may require to be considered under all; thus, insanity must come
before a _civil_ court when the person is supposed incapable of managing
his own affairs; and before a _criminal_ tribunal, when the soundness of
a murderer’s intellect is disputed. _Professor Foderé_, it must be
admitted, escapes from this difficulty by creating, under the term
“_Medecine Lègale mixte_,” a division that comprehends subjects
appertaining at once to the civil and criminal law; but it will be
immediately perceived that such a scheme is far too general and
indefinite to ensure the advantages of systematic arrangement, or even
to merit the appellation of a classification. If, on the other hand, an
arrangement be projected upon purely physiological and pathological
principles, such as that adopted by _Valentini_, in his “_Corpus juris
Medico-legale_,” and which was followed by _Roose_, and very lately
preferred by _Dr. Elliotson_,[58] we shall find that similar
embarrassments will arise, with respect to their legal relations, as we
have just stated must attend their physiological bearings, where the
basis of the classification has an exclusive reference to the law. The
same objections will apply to the divisions of our respected cotemporary
_Dr. Gordon Smith_, who appears to have appreciated all the difficulties
of the subject, and, like ourselves, to have despaired of the success of
any attempt to surmount them. He arranges the subjects of forensic
medicine into three parts, viz. 1. _Those which regard the extinction of
human life_; particularly by unusual or violent means; such are many
kinds of sudden death, and all cases of homicide. 2. _Injuries done to
the person, not leading to the extinction of life_; such are disfiguring
and maiming, causing diseases, the violation of females, &c. 3.
_Circumstances connected with the physical system, that disqualify for
the discharge of civil offices, or the exercise of social functions_;
such are mental alienation, the existence of certain diseases, the want
of certain organs, &c.
After mature consideration, the arrangement which has been followed on
the present occasion, although greatly liable to the many objections
which we have so strongly urged against that of other writers, appears
to the authors to be the one best calculated to accomplish the mixed
objects of the publication. The ample synopsis of this arrangement, as
presented in the table of contents prefixed to the present volume, would
render any detailed account, in this place, superfluous. We have only to
observe that the work is divided into three parts, the _first_
comprehending the enumeration of the different medical corporations,
with an account of their charters, powers, and privileges, together with
the subjects of medical police. The _second_, all those subjects
connected with medical evidence, as applicable to _civil_ and
_ecclesiastical_ suits, in which the order of the subject corresponds
with that of the progress of human life from infancy to old age. The
_third_, the inquiries which are necessary to medical evidence, as
applicable to _criminal_ cases.
In limiting the boundaries of each division, it will be perceived that
we have strictly adhered to the general principle of excluding every
topic that had not some direct or constructive relation to the health,
life, and physical welfare of the subject. Had we regarded chemistry as
synonimous with medicine, and pursued the numerous subjects in which it
might be rendered available in the construction, elucidation, and
administration of the laws, we should have far exceeded the scope of our
labours, and have wandered into a rich and imperfectly explored region,
as boundless in its extent, as it is interesting in the novelty and
utility of its productions. In this case the subject of patents would
have formed a prominent feature in the second division of our work; for
so rapid is the progress of chemical science, and so precarious the
language by which its growing objects and phenomena are expressed, that,
in the present state of the law, it becomes an extremely delicate task
to draw the specification of a chemical patent in such terms as to
escape the snares which ingenuity is ever ready to invent for its
destruction. We cannot, perhaps, better exemplify the truth of this
position than by the relation of a case that has lately excited a
considerable share of public interest. A patent was granted to _Messrs.
Hall_ and _Urling_, for a new mode of manufacturing lace. The merit of
the improvement turned upon the mode of singeing or burning off the raw
ends of the cotton by a flame of gas, which was made to play rapidly
through the meshes of the lace, instead of the red hot cylinder, over
which it is commonly passed. The infringement of this patent by _Boote_
formed the grounds of the action. The defendant stated that he had
employed the flame of burning alcohol for this purpose, which not being
a _gas_, but a _vapour_, could not be said to fall within the meaning of
the plaintiff’s specification. Fortunately for the justice of the case,
an additional apparatus was required to draw the flame through the
meshes of the lace, and, without such a contrivance, the operation
whatever might be the nature of the combustible _gas_, or _vapour_,
employed, could not succeed; and since it is an acknowledged principle
that an adoption of any part is an infringement of the whole, a verdict
was returned for the plaintiff. But suppose the merits of the case had
wholly rested, as had been expected, upon the distinction between _gas_
and _vapour_; the chemical evidence would no doubt have urged that the
one being permanently elastic and incapable of condensation, must be
considered as very distinct in its nature from the other which admitted
of being condensed into a liquid. Under such a conviction the plaintiff
might probably have lost his verdict. But had the same trial, under the
same circumstances, been deferred only for a few weeks, the effect of
the chemical evidence must have been widely different, _Mr. Faraday_
having, within the last month, succeeded in condensing no less than
nine[59] of these gaseous bodies that were universally acknowledged to
be permanently elastic! and thus has this ingenious and indefatigable
chemist, by a happy generalization, annulled the supposed characteristic
distinction between _gas_ and _vapour_.
The subject of forgery, and of frauds upon banker’s checques,
accomplished by the well-known agency of acids in discharging ordinary
writing, would upon the same grounds have been considered as a
legitimate object of medical jurisprudence; and we should have proceeded
to inquire into the different chemical means by which such frauds might
be prevented.[60] The subject of nuisances would also have received a
more extended notice; and we should not have deemed it necessary to
limit our observations upon the detection of fraudulent adulteration to
those substances, the purity of which is essential to the health of the
community. But it is unnecessary to multiply examples in proof of the
latitude of the subject, or of the utter impracticability of any attempt
to pursue its ramifications in the present work.
In our physiological illustrations we have, upon all occasions, sought
to establish general principles for the solution of the various problems
of forensic medicine. It has been said that “it is not so much the
knowledge of the laws of physiology, as that of the exceptions to which
they are liable, that is required in elucidation of abstruse
medico-legal questions.” If this were admitted, the propriety of such
scientific applications might be altogether doubted. “_Leges fiunt de
his quæ vulgo, non de his quæ raro eveniunt_”; but, in truth, the
exceptions of Nature are but apparent—the mere illusions arising from
our imperfect view of her phenomena; and will diminish as our knowledge
increases, just as the motions of the heavenly bodies cease to appear
irregular as soon as their orbits are submitted to a more extended field
of observation.
The second volume of our work commences with a physiological research
into the “Causes and Phenomena of Sudden Death.” To the views developed
in this chapter we are the more particularly anxious to direct the
attention of the student, as they may be said to constitute the centre,
and master-key of forensic physiology; while the obvious importance of
their applications, in directing the treatment of asphyxia and cases of
poisoning, will convey a striking rebuke to those who still deny the
_practical_ utility of such researches. We might even extend this remark
to the more ordinary duties of the surgical practitioner, and in support
of its truth, maintain, that he can neither fully comprehend, nor
successfully treat the more important symptoms which attend injuries of
the head, without an acquaintance with those mutual relations which
subsist between the functions of the brain and heart, and those of the
organs of respiration. To an ignorance of such views we may trace the
origin of those discordant opinions which have existed with regard to
the proper mode of treating concussion, or compression of the brain.
Some practitioners, from having observed that the action of the heart
frequently becomes enfeebled on these occasions, have unconditionally
insisted upon the necessity of cordials; while others, reasoning upon
the state of the brain, have with equal confidence advocated the
propriety of immediate and copious depletion by the lancet. Let us see
how far a knowledge of the physiological doctrines to which we have
alluded will reconcile such conflicting opinions, and point out the
proper plan which ought to be pursued in such cases of difficulty.
It has been stated,[61] that the first violent impression upon the
brain, whether occasioned by an external force, or a “_coup de sang_,”
from hemorrhage within the skull, will be very liable to produce
syncope. This effect, when it occurs, ought of course to be
distinguished from the more ordinary symptoms of concussion and
compression, and which may be said to approach the nature of
suffocation, rather than that of syncope, as they depend upon impeded
respiration, from a failure in the action of the muscles which are
essential to it. In the former case it would be highly injudicious to
resort to the lancet, until the action of the heart shall have been
restored by cordials; whereas in the latter, prompt and copious
blood-letting must be considered as the most effectual of all the
resources of art.
For much of the novelty contained in this part of our work, the reader
will find that we are greatly indebted to the liberality and friendship
of _Mr. Brodie_, who afforded us the assistance of his _Manuscript
Notes_, from which he delivered his lectures from the anatomical chair
of the College of Surgeons.
With regard to the manner in which the subjects have been individually
elucidated, we may venture to hope that, in a work of such extensive
range, the reader will scarcely expect to find every department equally
elaborate in execution; our discretion on this point has been, in great
measure, directed by the degree of importance attached to each subject,
and the extent and nature of the popular fallacies with which it is
surrounded. In dealing with subjects thus embarrassed we have ever
deemed it a great point to clear away every adventitious incumbrance, so
as to make a naked circle around the object in dispute, and to afford an
uninterrupted view of it on every side. We have, therefore, in pursuance
of such a principle, endeavoured to bring the leading points of
controversy within the scope of a few prominent questions, that we might
discuss the merits of each with a share of attention commensurate with
our idea of its importance. The advantages of such a plan will receive,
we trust, a favourable exemplification in our history of poisons.
For our numerous quotations, if any apology be necessary, we may offer
that of the learned _Tortosa_, deeming it more expedient to incur the
charge of scholastic affectation, than to leave our readers in the dark,
as to the sources from which we have derived our information, and
particularly as we are thus enabled to furnish the student with various
references to which he may advantageously apply for more extended
information.
Some writers have objected altogether to the science of Medical
Jurisprudence, alleging that it is an unnecessary addition to the
already too numerous pursuits of the medical student; to their doctrine
we cannot assent, even though so high an authority as a dictum of _Sir
Wm. Blackstone_ is adduced in its support; the learned commentator says,
“for the gentlemen of the faculty of physic, I must frankly own that I
see no special reason why they in particular should apply themselves to
the study of the law; unless in common with other gentlemen, and to
complete the character of general and extensive knowledge—a character
which their profession beyond others has remarkably deserved. They will
give me leave, however, to suggest, and that not ludicrously, that it
might frequently be of use to families upon sudden emergencies, if the
physician were acquainted with the doctrine of last wills and
testaments, at least so far as relates to the formal part of their
execution.” It is not merely our object to show that, in common with
other gentlemen, medical practitioners should have some general
knowledge of the law, without which they cannot in any scene of life
discharge properly their duty either to the public or themselves; but to
demonstrate, that there are many and intricate branches of law, in which
the physician or surgeon, by competent knowledge, may not only
materially serve himself in reputation, and his patients by advice, but
also render important benefit to the community.
It is true that medical practitioners, for reasons hereafter stated, are
exempt from serving on juries, and are seldom charged with magisterial
duties, at least till they have retired from the more active employment
of their profession; it must be remembered, however, that they are
charged with important and peculiar jurisdictions; and it is impossible
to look at the various litigations which we have enumerated in the first
part of our work, without feeling that every member of the medical
colleges ought to possess some legal knowledge. Can the President and
Censors of the College of Physicians execute their power of fine and
imprisonment; can they restrain unlicensed intruders, or punish the bad
practices of ignorant pretenders, without some study of the law? can
they vindicate their rights without reference to the numerous acts of
parliament on which they are founded? can they prove the guardians of
the public health, without knowing the enactments by which it is
protected? can they advise the legislative or executive power on
numerous points submitted to their consideration, (as vaccine
inoculation, quarantine, &c.) without understanding the bearings of the
question referred to them? can they in fine do or advise any public act,
without considering either the existing law as it may stand, or the
policy and mode of future enactment? they may indeed state as much of
the medical, chemical, or physiological facts of each case as their
imperfect view may enable them to take; leaving it to the lawyer, who
knows no physic, to correct the errors of the physician who knows no
law. That acts of parliament have been framed on this principle of the
mutual independence of law and science, it were vain to deny; but that
they would have been better framed, if the parties employed in drawing
them up had possessed some understanding in common on the subject before
them, is equally indisputable. Let us therefore hope that, when our
reader shall have considered the many points in which medicine and its
branches may become auxiliary to legislation or government, he will feel
convinced that legal studies are not useless to medical practitioners in
their public capacity.
In considering the use of legal knowledge as applicable to private
practice, _Sir William Blackstone_ has mentioned one of many instances;
it would be useful if the medical attendant were acquainted with at
least the formal part of executing wills; in the moment of danger and
distress, when all around the bed of death are confused with fear, or
overwhelmed in affliction, the physician, probably a confidential
friend, whose duty and habit ensures self-possession, may be the only
person competent to advise. How many estates have been lost to the
intended heir, by the want of a third witness to a devise of real
property? or by an attestation informally signed, because the curtains
of the bed were drawn, and the testator could not see the witnesses?
From considering the last, let us turn back and enquire whether medical
observation may not be necessary in the first scene of life. A midwife,
unacquainted with the law of tenant by the courtesey, will scarcely note
whether a child, certainly dead within a minute of its birth, did in
that period move a limb or open an eye; he will not consider whether a
momentary quivering of the lip was a sign of independent vitality, or
the expiring remains of uterine life. If after a lapse of ten or twenty
years he should be examined in a court of justice on this point in order
to determine the right of the father to his estate for life, he will be
unable to satisfy his own conscience, or the ends of justice; but once
acquainted with the importance of these observations, he will never fail
to note the occurrence, whenever he has reason to believe that the
circumstances of the case may give rise to legal question.
In cases of impotence, sterility, idiotcy, and lunacy, the confidential
medical attendant is the first person consulted on the subject; how
often may he refute a groundless accusation, remove a causeless fear,
and prevent a public exposure, by forming and demonstrating correct
views of the subject? how often too may he aid the oppressed, defeat the
guilty, and protect the innocent, by a knowledge of the legal remedies
against fraud or coercion?
In many criminal cases too the surgeon is of necessity among the first
witnesses of the deed; is it not important that he should know what
evidence will be required to prove its perpetration? surrounded by
ignorant or prejudiced persons, his calm and accurate view, not only of
medical, but of general points, becomes of peculiar importance; yet if
he be unacquainted with the forms of judicial enquiry, unversed in the
history of criminal courts, he will be as little able to direct his
attention to the proper objects, or to divest his mind of undue bias, as
the most ignorant of the by-standers.
As we shall have frequent occasion in the course of this work to revert
to these points, we do not now dwell on them more minutely, than to
repeat our opinion, that a general knowledge of the law is not only
becoming to the medical practitioner in his character of a gentleman,
but highly useful and necessary to his professional career. We do not
expect that medical students shall become special pleaders, or that the
bar shall vie in chemistry and physiology with the professors of those
sciences; but we shall endeavour to point out to each the sources from
which they may draw information if they are desirous of acquiring it; we
are of necessity confined within narrow bounds; but if within those
limits we enable the two professions of law and physic to understand and
appreciate each other, our object is accomplished.
Medical Jurisprudence.
PART I.
1. _Of the College of Physicians._—2. _College of Surgeons._—3. _Society
of Apothecaries._—4. _Medical Liabilities and Exemptions._—5. _Public
Health._—6. _Quarantine Laws._—7. _Medical Police._
1. OF THE COLLEGE OF PHYSICIANS.
IT does not appear that the Professors of Physic were in any way
classed, or incorporated, in England, until the year 1522, although we
learn from the preamble of the Charter of Henry the Eighth, as well as
from the petition of the 9th of Henry the Fifth, that other countries
had long before that period established Medical Colleges, having
considered such a measure not only as necessary for the encouragement of
science, but as highly politic for the preservation of the public
health.