Text-book of medical jurisprudence and toxicology

Front matter

Gass'KA 105/

Book '1^4

TEXT-BOOK

Preface

This Text-book has been written more particularly to meet the wants of students of Legal Medicine. The author is aware that the field has already been occupied by able and popular treatises on medical jurisprudence, well known to the professions of medicine and law ; but an experience of over twenty years, as a public teacher of this branch of science, has convinced him that students in both these professions, who desire to acquire a knowledge of medical jurisprudence, are too often deterred from their purpose by being confronted by the ponderous works of recognized masters, extending to three, and even six large octavo volumes.

To avoid the above objection, the author of the present work has endeavored to condense in a handy volume all the essentials of the science, and to present the various topics in a simple and familiar style, giving greater prominence, of course, to those of the greatest practical importance.

The subject of Toxicology occupies, as was proper, a considerable space, and has been carefully prepared ; special attention being bestowed upon the most important poisons — such as Arsenic, Strychnine, Opium, Prussic Acid, etc.

The chapter on Insanity is as full as the size of the volume would justify, and will be found, it is hoped, to

iii

IV PREFACE.

contain all the essential medico-legal points pertaining to this subject.

The author has not hesitated to avail himself freely of the materials so abundantly presented in the elaborate and classic works of Casper, Taylor, Beck, Wharton and Stille, Tidy, Guy, Tardieu, and others ; always desiring to give due credit to the authority quoted, and usually doing so at the time ; and he would embrace this opportunity to express his obligations to these authorities. He is sincerely desirous to encourage an increasing interest in the students of both medicine and law for that most important, but toomuch neglected, subject — Forensic Medicine; and he would indulge the hope that the present treatise, in its unpretentious size and style, may aid in so doing. Philadelphia, September, i88/f..

CHAPTER I. Introduction. page

Definition. — Importance to Students of Medicine and Law. — Order of Proceeding in a Medico-legal Case. — The Coroner's Inquest. — The Criminal Court. — Medical Evidence. — Medical Experts, — Dying Declarations. ............ 9

CHAPTER II. Phenomena and Signs of Death

Section I. — Molecular and Somatic Death. — The Immediate Cause of Death to be found in either the Heart, Lungs or Brain. — Post-mortem Evidences of these. — The "Signs of Death." — Cessation of Respiration and Circulation. — Changes in the Eyes. — Pallor of the Body. . . -25 Section II. — Signs of Death continued. — Loss of Animal Heat. — Post-mortem Caloricity. — Rigor Mortis. — Post-mortem Lividity, or Suggillation 32 Section III. — Signs of Death continued. — Putrefaction. — External and Internal Signs. — Adipocere. — Mummification. — How long since the

Death? 41

Chapter III

Medico-legal Investigations. — The Post-mortem. Responsibility involved. — Accuracy and Method necessary. — Examination of the surroundings. — External examination of the Body. — Internal examination. — Details of the Examination. — Measurements and Weights. —

Notes 56

Chapter IV

Presumption of Death and of Survivorship. Cases involving Presumption of Death and of Survivorship. — French Law of Survivorship. — Probabilities afforded by Age, Sex, and Mode of Death. ^ 6'^ CHAPTER V.

Personal Identity.

Section I. — Important Medico-legal bearings. — I. Identification of the Living. — Personal Appearance. — Peculiar bodily marks. — Remarkable Cases. ............. 69

V

VI TABLE OF CONTENTS.

PAGE

Section II. — II. Identification of the Dead. — Mutilated Remains. — Identification by means of the Skeleton, as to Age, Sex, and Stature. — Rules of Proportion. — Fractures, Deformities, and Callus. — Age of Bones. — Ex ■ amination of Hairs and Fibres. ........ 7^

CHAPTER VI. The Causes Producing Violent Death

Section I. — Death from Wounds. — Definition of a Wound. — Danger of. — Examination of the Body. — Absence of external marks of violence. — Wounds made before and after death. — Hemorrhage. — Ecchymoses. — Classification. — Homicidal, Suicidal and Accidental Wounds. . . .92

Section II. — Gunshot Wounds. — Differ from other wounds. — Deflection of the Ball. — Wounds made by Shot, Wadding and Powder. — Wounds of the Head, Neck, Spine, Chest and Abdomen. ...... 107

CHAPTER VII. Examination of Blood Stains

Importance of their identification. — Three methods of identifying. — i. The Chemical Tests. — 2. The Microscopic Test. — 3. The Spectroscopic Test.

— Blood Crystals 121

CHAPTER VIII. Burns and Scalds

Definition. — Classification. — Symptoms. — Cause of Death. — Post-mortem appearances. — Burns made before and after death. — Accidental, Suicidal and Homicidal Burns. — Spontaneous Combustion .134

Chapter IX

Death from Different Forms of Asphyxia. Section I. — Death from Suffocation. — Accidental, Suicidal and Homicidal Suffocation. — Post-mortem signs, ........ 143

Section II. — Death by Strangulation. — Modes of Strangulation. — External signs. — Internal lesions. — Accidental, Suicidal and Homicidal Strangulation. — Mark of the Cord, 146

Section III. — Death by Hanging. — Cause of Death. — Post-mortem appearances. — Cord marks. — Generally suicidal, . . . . . .151

Section IV. — Death by Drowning. — Mode of Death. — Time required. — Signs of Death, external and internal. — Accidental, Suicidal and Homicidal Drowning, 156

CHAPTER X. Death by Lightning

Medico-legal relations. — Mode of Death. — Post-mortem signs, . . .166

TABLE OF CONTENTS. Vll

CHAPTER XL

Death from Heat and Cold.

Diverse effects of Heat upon the body.— Post mortem appearances.— Effects of Cold. — Post mortem signs, 170

CHAPTER Xn.

Death by Starvation.

Accidental, Homicidal and Suicidal Starvation.— Pretended cases of voluntary starvation.— Symptoms, and Post-mortem signs.— Medico-legal relations,

CHAPTER Xni.

Death from Poisoning. — Toxicology.

Section L— Definition of a Poison.— Effects.— Proofs of Absorption.— Subsequent disposition of the Poison.— Elimination.— Cause of Death.— Circumstances modifying their action.— Antagonism of Poisons, . .178

Section II.— Evidences of Poisoning.— i. Evidences from Symptoms.— 2. From post-mortem lesions.— 3. Chemical Analysis.— Post-mortem Imbibition of Poisons.— Rules in performing a toxicological analysis.— 4. Physiological experiments.— 5. Circumstantial Evidence.— Medico-legal conclusions. — Classification, jg5

CHAPTER XIV.

Poisoning by the Mineral Acids.

Certain common symptoms.— Post-mortem appearances. —Treatment.

Chemical analysis.— Toxicological examination for the different Acids, 202 CHAPTER XV.

Poisoning by the Alkalies and their Salts. Section I.— Potassa, Soda, and Ammonia.— Similarity of effects.— Symptoms.— Fatal Dose.— Treatment.— Post-mortem appearances.— Chemical

analysis. ^je

Section II.— Poisoning by the Alkaline and Earthy Salts.— Nitrate of Potassium.— Bitartrate of Potassium.— Sulphate of Potassium.— Alum.— Chlorinated Potassium and Sodium.— Salts of Barium 220

CHAPTER XVI.

Irritants Possessing Remote Specific Properties. Section I.— Poisoning by Phosphorus.— Symptoms.— Fatal Dose.— Treatment.— Morbid appearances.— Diagnosis. — Chemical analysis.— Amorphous Phosphorus 224

Section II.— Poisoning by Iodine, Bromine, and Chlorine. . . .234 Vlll TABLE OF CONTENTS

PAGE

CHAPTER XVII.

Poisoning by Arsenic.

Metallic Arsenic. — Arsenious Acid. — Properties. — Symptoms. — Chronic Poisoning. — Fatal Dose. — Treatment. — Post-mortem signs. — Chemical analysis. — Toxicological examination. — Other Preparations of Arsenic. . 238

CHAPTER XVIII.

Poisoning by Antimony (Tartar Emetic). Properties of Tartar Emetic. — Symptoms. — Fatal Dose. — Post-mortem appearances, — Slow Poisoning. — Chemical analysis. — Toxicological examination. ............. 262

CHAPTER XIX.

Poisoning by Mercury (Corrosive Sublimate).

Corrosive Sublimate. — Properties. — Symptoms. — Post-mortem appearances. — Fatal Dose. — Antidotes. — Chemical analysis. — Toxicological examination. — Salivation, ........... 273

CHAPTER XX.

Poisoning by Lead.

Frequency of Chronic Poisoning, — Acetate of Lead, — Symptoms. — Treatment, — Post-mortem appearances, — Painters' Colic, — Lead Palsy, — Toxicological examination. .......... 285

CHAPTER XXI, Poisoning by Copper.

Accidental Poisoning. — Salts of Copper. — Fatal Dose. — Treatment. — Morbid appearances, — Chemical analysis, — Toxicological examination. . . 294

CHAPTER XXII.

Poisoning by Zinc, Bismuth, Tin, Iron and Chromium.

Section I, — Poisoning by Zinc. . . . . . . . ' 301

Section II. — Poisoning by Bismuth 305

Section III. — Poisoning by Tin, Iron and Chromium. .... 306 CHAPTER XXIII

Vegetable and Animal Irritants.

Section I. — Poisoning by Oxalic Acid. — Sources of the Acid in Nature. — Symptoms. — Fatal Dose. — Treatment. — Morbid appearances. — Chemical analysis. — Toxicological examination. — Binoxalate of Potassium. . , 308

Section II. — Poisoning by Carbolic Acid, . . . . . '315

TABLE OF CONTENTS. IX

PAGE

Section III. — Poisoning by Croton Oil, Elaterium, Castor Oil Beans, Colchicum and Savin. . . . . . . . . . -317

Section IV. — Poisoning by the Hellebores. — Veratria. — Yellow Jessamine. — Poisonous Mushrooms. 320

CHAPTER XXIV.

Animal Irritants.

Poisoning by Cantharides. — Poisonous Animal Food. — Sausage Poison. — Trichinosis. — Cheese Poison. — Poisonous Fish. — Putrescent Food. — Poisoned Flesh 325

CHAPTER XXV.

Class II. Neurotic Poisons.

Section I. — Narcotics. — Poisoning by Opium. — Nature of Opium. — Poisonous Symptoms. — Fatal Period and Dose. — Treatment. — Morphia. — Properties. — Tests. — Meconic Acid. — Tests. — Toxicological examination. 330

Section II. — Poisoning by Alcohol. — Acute Alcoholism. — Symptoms. — Post-mortem lesions. — Chemical analysis. — Detection in the Tissues. . 341

CHAPTER XXVI. 2. Anaesthetics.

Poisoning by Ether, Chloroform, and Chloral Hydrate. .... 345

CHAPTER XXVII.

Spinal Neurotics. — Poisoning by Nux Vomica. — Strychnia. Nux Vomica. — Strychnia. — Effects. — Fatal Dose. — Treatment. — Post-mortem lesions. — Diagnosis. — Chemical analysis. — Interferences. — Physiological Test. — Toxicological examination, . . . . . '351

CHAPTER XXVIII.

Cerebro-spinal Neurotics. — (i) Deliriants. Section I. — Poisoning by Belladonna.— Symptoms. — Atropia. — Fatal Dose. — Treatment. — Post-mortem appearances. — Chemical analysis. — Toxicological examination. .......... 373

Section II. — Poisoning by Stramonium, Hyoscyamus and Solanum. . . 376

CHAPTER XXIX. 2. Depressants.

Section I. — Poisoning by Tobacco and Lobelia. — Effects of Tobacco. — Post-mortem lesions. — Nicotina. — Properties. — Chemical reactions. — Toxicological examination. — Lobelia. ....... 380

X TABLE OF CONTENTS.

PAGE

Section II. — Poisoning by Hemlock — Conia. — Symptoms. — Post-mortem appearances. — Conia. — Chemical reactions. — Toxicological examination. — Other poisonous Hemlocks. ........ 386

Section III. — Poisoning by Aconite and Calabar Bean. — Properties of the Plant. — Effects. — Post-mortem appearances. — Aconitine. — Fatal Dose. — Treatment. — Chemical analysis. — Toxicological examination. — Calabar Bean. — Eserine 390

CHAPTER XXX. (3) Asthenics.

Section I. — Poisoning by Hydrocyanic Acid. — Natural Occurrence in Vegetables. — Pure and Officinal Acids. — Symptoms. — Fatal Period and Dose. — Treatment. — Post-mortem appearances. — Tests. — Toxicological examination. — Cyanide of Potassium, — Oil of Bitter Almonds. — Cherry-laurel Water. — Nitro-Benzole. 397

Section II. — Poisoning by Digitalis. — Symptoms. — Post-mortem lesions. — Fatal Dose. — Digitaline. — Chemical analysis. — Toxicological examination. — Case of De la Pomerais.— Poisoning by Cocculus Indicus. . . 409

CHAPTER XXXI.

The Alkaloids of Putrefaction. — Ptomaines.

416 CHAPTER XXXII.

Feigned Diseases.

Great variety of Simulated Diseases. — Fictitious and Factitious Diseases. — General Rules for Diagnosis. — Special Diagnosis. . . . . -419

CHAPTER XXXIII.

Pregnancy.

Cases where it becomes the subject of Medico-legal Investigation. — Signs of Pregnancy, Uncertain and Certain. — Unconscious Pregnancy. — Pregnancy in the Dead, .......... 432

CHAPTER XXXIV.

Criminal Abortion, or Foeticide.

Definition. — Frequency of Abortion from Natural Causes. — Proofs that a Foetus has been destroyed. — Signs afforded by the Mother. — Age of the Foetus. — Means employed, . . . . . . . . .441

CHAPTER XXXV.

Infanticide.

Section I. — Definition. — A Live Birth. — I. Questions relating to the Infant. — Was it born alive? — Signs of Death before birth. — i. Proofs of a Live Birth derived from the Lungs. — The Hydrostatic Test, . -455

TABLE OF CONTENTS. XI

PAGE

Section II.— 2. Proofs of a Live Birth derived from the Organs of Circulation, and the Abdominal Organs. — Peculiarities of the Foetal Circulation. — Uncertainty of these signs. — Desiccation of the Umbilical Cord. — Proofs of a Live Birth from the Stomach and Intestines, .... 468

Section III.— Cause of Death in the newborn child.— (i) Causes acting during Birth.— Compression of and by the Cord.— Protracted Delivery.— Debility, Hemorrhage, Fracture of Skull.— (2) Causes acting after Birth.— Congenital Malformation and Disease.— Exposure.— Improper Food. — Wounds and Injuries. — Suffocation. — Strangling. — Drowning. — Poisoning.— Accidental Causes.— Mode of conducting the Examination, . 473

Section IV. — II. Questions relating to the Mother. — Signs of Delivery. — Early Signs. — Examination of the Milk. — Concealed Delivery. — Concealment of Birth. — Pretended Delivery, 49^

CHAPTER XXXVI.

Legitimacy. — Inheritance.

Section I. — Medico-legal Importance. — Ordinary term of human gestation. — Protracted gestation. — Argument from analogy of the Lower Animals. — Premature Delivery. — Early Viability of the Child. — Live Birth in Civil Cases, 49^

Section II. — Tenancy by Courtesy. — Laws concerning Legitimacy. — Paternity. — AffiHation. — Superfoetation. — Doubtful Sex in Hermaphroditism, . 504

Section III. — Impotence. — SteriHty. — Impotence. — Causes. — Procreative Power of the Male. — Crypsorchides and Monorchides. — Sterility. — Procreative Power in theFemale. — Legal Decisions, 51 1

CHAPTER XXXVII.

Rape.

Section I. — Legal Meaning. — Duty of the Examiner. — Rape on Children. — May be confounded with disease, . . . . . . . • 5^^

Section II. — Rape on Adult Women. — Possibility of, without consent. — If unconscious. — Effects of Ether. — Case of Co7n. v. Beale. — Evidences of Rape on Adults. — Condition of the Hymen. — Seminal stains. — Evidences of Rape on the Dead. — Unnatural Crimes. — Legal relations of Rape, 522

CHAPTER XXXVIII.

Insanity.

Section I. — Medico-legal difficulties of Insanity. — Civil and Criminal Responsibility. — Legal Terms. — Illusions, Hallucinations and Delusions. — Concealment of Delusions. — Lucid Intervals. — Classification, . . . 535

Xll TABLE OF CONTENTS.

PAGE

Section II. — (i) Defective Development of the Faculties. — Idiocy, Physical marks of. — Pathological marks. — Imbecility. — Cretinism. — Legal relations of Idiocy and Imbecility, ........ 542

Section III. — Lesions of the Mental Faculties subsequent to their development. — General Intellectual Mania — Symptoms. — Melancholia — Symptoms. — Partial Intellectual Mania. — Moral Mania. — Monomania. — Kleptomania. — Pyromania. — Dipsomania. — Responsibility of Drunkards. — Somnambulism, ........... 545

Section V. — Dementia. — General Paresis. — Post-mortem Lesions, . . 558

Section VI. — Medico-legal relations of Insanity, — Deprivation of Liberty. — Signing Certificates of Insanity. — Testimony in Criminal Cases. — Testamentary Capacity. — Opinions in relation to Marriage, and Education of Children, ............ 566

Section VII. — Criminal Responsibility. — The Plea of Insanity as a bar to capital punishment. — Importance of a correct understanding of the subject. — A mere " Knowledge of Right and Wrong" not sufficient. — Condition of the Will, or Self-Control, — Emotional Insanity, . . . -571

Section VIII. — Simulated, or Feigned Insanity. — Pretended Insanity in Criminals. — Importance of ascertaining the motive. — Means taken to conceal the crime. — Mania, the form usually feigned, .... 576

CHAPTER XXXIX.

Medical Malpractice.

Definition, — The Physician not an Insuror, — Certain established principles. — "Ordinary Skill." — Errors in judgment. — Frequency of civil suits. — Liability of Druggists, .......... 582

CHAPTER XL.

Life Insurance.

Meaning of the Term. — Conditions of the Policy. — Concealment of Facts. — Relation of Intemperance and Suicide to Life Insurance, . . .591

Appendix. — Corpus Luteum.

599 Index.

TEXT-BOOK

AND

TOXICOLOGY.

Chapter I

DEFINITION. — IMPORTANCE TO STUDENTS OF MEDICINE AND LAW. — ORDER OF PROCEEDING IN A MEDICO-LEGAL C\SE. — THE CORO- NER'S INQUEST. — THE CRIMINAL COURT. — MEDICAL EVIDENCE. — MEDICAL EXPERTS. — DYING DECLARATIONS.

Medical Jurisprudence, or Legal or Forensic Medicine, as it is sometimes named, may be defined to be the science which applies the knowledge of Medicine to the requirements of Law. To aid in the discovery of truth, which is the great purpose of the Law, every department of human knowledge should be made to contribute, and Medicine among the rest. When certain cases are presented for legal decision, affecting the life or property of an individual, and these cases require for their proper elucidation an appeal to medical knowledge, they are termed medico-legal cases, and the science on which they are based is named Medical Jurisprudence.

It should require no argument to show the importance of the knowledge of this science to the student and practitioner of both the professions of medicine and law. The former cannot entirely evade its claims, although he may 7, 9 seek to do so, since the very nature of his profession, together with his assumed pubHc position as an accredited physician, renders him Hable at any moment to be confronted with a case involving the intricate questions of homicidal, suicidal, or accidental death ; of infanticide ; of criminal abortion ; of rape ; of drowning, and of numerous other similar cases, all of which, when they become the subjects of legal investigation, must necessarily depend for their proper elucidation, chiefly, if not solely, upon the physician who had previously given his professional attendance in the case, and who must subsequently give his evidence before the court and jury. How important, then, that the practitioner of medicine, even though he may have no special leaning towards legal medicine, should become acquainted at least with the general principles and leading facts of this science. A proper regard, both for his own professional reputation and the general interests of the community, should constrain him not to neglect so important and practical a branch of knowledge. And as regards the profession of the law, it is difficult to understand how a criminal cause of any kind can be satisfactorily conducted without some knowledge . of medical jurisprudence, inasmuch as criminal law is indissolubly connected with legal medicine. It is much to be regretted that many of the present generation of lawyers in this country, graduate in their profession without the slightest knowledge of medical jurisprudence. Indeed, strange as it may appear, it is entirely ignored in some of our law schools, whilst in others, although professedly taught, it is not made obligatory upon the student, and therefore is virtually disregarded. The consequence of such neglect must be either, that criminal law is entirely abandoned by many distinguished practitioners, causing such cases to fall into the hands of

RELATION OF MEDICINE TO LAW. 11

inferior persons, who are not always the best quahfied to conduct them ; or else, when a really important criminal case is undertaken, the lawyer finds himself compelled to cram for the occasion, and is subjected to no little annoyance, and loss of time, in preparing for the impending trial. In truth, in such cases he is necessarily obliged to depend almost exclusively upon his medical witnesses, both as to the general mode of developing his case, and especially as to the manner of questioning the expert witnesses on either side.

The superficial observer is often surprised at the intimate relationship subsisting between the two great sciences of medicine and law. As has just been shown, numerous cases brought before a court and jury can only be settled by an appeal to medical knowledge ; sometimes it is to one department of medicine, and sometimes to another ; and it not infrequently happens that several branches of medical science may be simultaneously called into requisition, in order to aid the law in arriving at a proper decision. For example, — is the case one of suspected homicide, where a dead body has been discovered under suspicious circumstances ? Who but the skillful anatomist and pathologist, by a carefully conducted autopsy, can shed the requisite light upon it ? Is it a case of alleged rape, or criminal abortion, or infanticide? Who so well qualified to conduct the investigation as the well trained obstetrician ? Or is it a case involving the dark suspicion of criminal poisoning? Who shall impart the necessary information upon which may hang suspended the life or death of the accused, save he who is thoroughly acquainted with the mysteries of toxicology ? Thus it may happen that, in a multitude of cases, the well instructed practitioner of medicine, when called upon to act the part of the legal physician, may be obliged to bring into requisition all the various departments of his science.

It is, perhaps, as a medical witness, that medico-legal knowledge is of the most important service to the physician. After he has accomplished the investigation of the case before him by a carefully conducted autopsy, or by a critical toxicological examination, with perhaps the aid of microscopy, and by other methods of scientific research, there yet remains the all-essential duty of giving the results of his investigations to the court and jury, in the form oi evidence; and to be prepared to do this in the proper manner, constitutes the chief acquirement of the medical jurist.

The Coroner's Inquest. — The first public duty imposed upon the legal physician is to testify before the Coroner's Inquest. In all civilized countries a special officer, named the coro7ier, is appointed to investigate the unknown, or unexplained causes of sudden death, whenever this occurs under suspicious circumstances. For example, a dead body is discovered on the highway or in some sequestered spot, with, or without marks of external violence, or it may have been dragged out of the river; the body of a new-born child has been found in a well or cesspool, or discovered floating in the water; a stranger is discovered, in the morning, dead in bed, at some hotel, far distant from his home; or a person in apparent sound health suddenly drops dead in the street, or in his room. In all these, and analogous cases, the law very wisely provides that a careful investigation shall be instituted, so as to ascertain whether the death was due to natural causes, or whether it was the result of violence. If the latter, then the nature of this violence, e.g. whether from a wound (gunshot or otherwise), a bludgeon, an axe, hammer, or other blunt weapon; or whether occasioned by a fall. In the absence of all external marks of violence, — then, might the death not have been pro-

THE CORONERS INQUEST. lo

duced by poison? In each one of these cases, the farther question must be solved — was the death homicidal, suicidal, or accidental?

The coroner's jury usually consists of six men (the number is not definitely fixed in this country), who are mostly selected from the neighborhood where the inquest is held. Their duty consists in (i) viewing the body and establishing its identity, and (2) in holding the inquest, which is a sort of petty court, wherein inquiry is made as to the cause of death, and (in a case of homicide) to ascertain, if possible, the guilty culprit. For this purpose, witnesses duly subpoenaed and sworn are examined, and the medical man who has performed the post-mortem examination (whether he be the coroner's recognized physician, or some other who has been specially appointed for this purpose) now makes his detailed report, and gives his opinion as to the real cause of death. The jury having heard the evidence, and consulted together, bring in their verdict, which is usually in accordance with the report of the medical officer. In some cases, particularly in cities, where the coroner has one or more specially appointed physicians, it is not considered necessary that the jury should personally view the body before holding the inquest ; it being regarded as sufficient that the body has been properly identified by the examining physician, and the autopsy carefully made, and the result duly reported.

It will be observed that the special duty of the coroner's inquest is to discover the real cause of death; usually it does not fall within his province to discover the person who caused it. Nevertheless, it does sometimes happen that in the course of the investigation, suspicion may so strongly point to some particular individual, as to warrant the coroner to commit him to prison, to await further investigation. The usual verdict in cases of violent death (shown to have been neither suicidal nor accidental) is, that of murder, or manslaughter, against some person, known or unknown.

As the post-mortem examination is an inseparable part of the coroner's inquiry, and, in fact, constitutes its most important factor, it is indispensable that it should be performed in the most careful and thorough manner; and no one is fit to undertake it but a skilled anatomist and pathologist. The medical man should never permit himself to be hurried in this work ; he should allow himself ample time, and always perform the autopsy by daylight, if possible, inasmuch as he might fail to distinguish certain alterations of color by artificial light. When it is remembered that the most serious issues may be at stake — even those of life and death- — it will be acknowledged that the utmost caution should be exercised in conducting the autopsy. There may be cases, involving strong suspicion of murder, where it might be deemed advisable that the post-mortem examination should be performed by two independent experts, in order to avoid the imputation of ex parte influence. One of these medical examiners should represent the State, and the other the accused.

In giving his evidence before the coroner's jury the medical man should not undervalue the situation. Although the inquest be held in some remote hovel or barn, and the jury be composed of rude, illiterate persons, he should not fail to remember that his testimony is all taken down by the proper officer, and that it will surely confront him at the approaching trial. This fact should alone be sufficient to impress upon him the seriousness of the occasion, and remind him of the importance of drawing up his report with due care and accuracy.

MEDICAL EVIDENCE. 15

TJie Criminal Court. — After the coroner's inquest the case (if a criminal one) is sent to the Grand Jury, who institute a prehminary examination, and either ignore it altogether, or else find a true bill. In the latter event, the case next comes before the judge and petty jury, for trial. To this trial the medical witness is summoned by a subpoena, which he cannot evade, but which it is his duty to obey. Before this court and jury, he will undergo a most strict and impartial examination as to his opinion of the cause of death, and the reasons on which this opinion is founded. He will be questioned most closely, in the cross-examination, as to his professional knowledge and acquirements, the extent of his opportunities for making such investigations as the one now pending, the accuracy of his post-mortem, or toxicological examination, the modes of distinguishing between wounds made before and after death, the method of discriminating between the effects of poisons and of disease, the danger of confounding these latter together, the liability to mistake in chemical results, and a hundred other matters, which will annoy and confuse the medical witness to no small degree, unless he be prepared beforehand, by his thorough medico-legal knowledge and training. A medical witness so properly fortified, need have no fear for himself; for, as he goes upon the stand honestly, to testify to the truth, "he need only," in the language of the late Professor Taylor, "bear in mind two considerations: first, that he should be thoroughly prepared on all points of the subject on which he is to give evidence; and secondly, that his demeanor should be that of an educated gentleman, and suited to the serious occasion on which he appears."

In the matter of Medical Evidence there are several points that require a brief notice here. After opening the case before the court, the prosecuting attorney, or some one

IG MEDICAL JURISPRUDENCE.

associated with him in the prosecution, calls the witnesses and examines them "according to the rules of evidence;" this is technically called the exaiiiinatioji iji chief. The *' rules of evidence " prohibit counsel, in the examination in chief, from putting leading questions to the witness, i. e., questions that suggest their own answers; and for the reason that the witness may be supposed to be willing to say anything favorable suggested to him by his own counsel, and to repress anything unfavorable. The replies of the witness, however, should always be given with equal clearness and precision, to both the counsel for the defence, and for the prosecution.

The cross-examination next follows : this is conducted by the counsel for the prisoner, and is especially aimed at contradicting and overthrowing, if possible, the witness's previous testimony. To this end, the counsel plies the witness with questions which are strongly " leading," and such as may most strongly suggest any facts or circumstances which he had previously withheld, and which may appear favorable to his client. A counsel for the defence is allowed very considerable latitude in the cross-examination of the witness, and the latter should always be well prepared to meet the attack, with conscious strength, and calm and dignified composure. If, however, the advocate transcends, as he is sometimes tempted to do, the bounds of propriety and decorum, the witness has always the right to appeal to the court for protection. It is far preferable to adopt the latter course, than to attempt to argue, or recriminate with counsel, since the latter has the witness always at disadvantage on the stand.

The re- examination sometimes follows the cross-examination of the witness, when it becomes necessary to clear up, or explain any matter that may have been obscured by the cross-examination.

EXPERTS. 17

After the examination of the State's witnesses, that of the witnesses for the defence follows. And here the same general line of examination is pursued as in the former case. When the medical witness for the defence is put upon the stand, a most unpleasant exhibition is, not unfrequently, made, of one expert directly contradicting another expert on the opposite side, and both of them medical men of equal standing and worth in the profession, and in the community. Such professional tilting is sometimes sneeringly designated as the " war of the experts," and is certainly deeply to be regretted, as it tends greatly to prejudice both the court and the public against expert testimony in general; and this, of course, to the detriment of justice.