Aids to Forensic Medicine and Toxicology

PART I. Forensic Medicine

FORENSIC MEDICINE

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I. Crimes 1 II. Medical Evidence 2 III. Personal Identity 10 IV. Examination of Persons found Dead 12 V. Modes of Sudden Death 13 VI. Signs of Death 16 VII. Death from Anaesthetics, etc. 19 VIII. Presumption of Death; Survivorship 20 IX. Assaults, Murder, Manslaughter, etc. 21 X. Wounds and Mechanical Injuries 21 XI. Contused Wounds, etc. 22 XII. Incised Wounds 23 XIII. Gunshot Wounds 24 XIV. Wounds of Various Parts of the Body 26 XV. Detection of Blood-Stains, etc. 30 XVI. Death by Suffocation 34 XVII. Death by Hanging 35 XVIII. Death by Strangulation 35 XIX. Death by Drowning 36 XX. Death from Starvation 38 XXI. Death from Lightning and Electricity 38 XXII. Death from Cold or Heat 39 XXIII. Pregnancy 40 XXIV. Delivery 41 XXV. Foeticide or Criminal Abortion 42 XXVI. Infanticide 44 XXVII. Evidences of Live-Birth 46 XXVIII. Cause of Death in the Foetus 50 XXIX. Duration of Pregnancy 50 XXX. Viability of Children 51 XXXI. Legitimacy 52 XXXII. Superfoetation 53 XXXIII. Inheritance 54 XXXIV. Impotence and Sterility 54 XXXV. Rape 55 XXXVI. Unnatural Offences 59 XXXVII. Blackmailing 60 XXXVIII. Marriage and Divorce 60 XXXIX. Feigned Diseases 63 XL. Mental Unsoundness 67 XLI. Idiocy, Imbecility, Cretinism 68 XLII. Dementia 70 XLIII. Mania, Lucid Intervals, Undue Influence, Responsibility, etc. 71 XLIV. Examination of Persons of Unsound Mind 76 XLV. Inebriates Acts 78

PART II. Toxicology

TOXICOLOGY

I. Definition of a Poison 80 II. Scheduled Poisons 80 III. Classification of Poisons 83 IV. Evidence of Poisoning 85 V. Symptoms and Post-Mortem Appearances of Different Classes of Poisons 86 VI. Duty of Practitioner in Supposed Case of Poisoning 89 VII. Treatment of Poisoning 90 VIII. Detection of Poison 91 IX. The Mineral Acids 94 X. Sulphuric Acid 95 XI. Nitric Acid 97 XII. Hydrochloric Acid 98 XIII. Oxalic Acid 98 XIV. Carbolic Acid 100 XV. Potash, Soda, and Ammonia 101 XVI. Potassium Salts, etc. 103 XVII. Nitrate of Potassium, etc. 103 XVIII. Barium Salts 104 XIX. Iodine--Iodide of Potassium 104 XX. Phosphorus 105 XXI. Arsenic and its Preparations 107 XXII. Antimony and its Preparations 112 XXIII. Mercury and its Preparations 113 XXIV. Lead and its Preparations 116 XXV. Copper and its Preparations 117 XXVI. Zinc, Silver, Bismuth, and Chromium 118 XXVII. Gaseous Poisons 120 XXVIII. Vegetable Irritants 123 XXIX. Opium and Morphine 124 XXX. Belladonna, Hyoscyamus, and Stramonium 127 XXXI. Cocaine 128 XXXII. Camphor 129 XXXIII. Tetrachlorethane 129 XXXIV. Alcohol, Ether, and Chloroform 130 XXXV. Chloral Hydrate 134 XXXVI. Petroleum and Paraffin Oil 134 XXXVII. Antipyrine, Antefebrin, Phenacetin, and Aniline 135 XXXVIII. Sulphonal, Trional, Tetronal, Veronal, Paraldehyde 137 XXXIX. Conium and Calabar Bean 138 XL. Tobacco and Lobelia 139 XLI. Hydrocyanic Acid 140 XLII. Aconite 143 XLIII. Digitalis 144 XLIV. Nux Vomica, Strychnine, and Brucine 145 XLV. Cantharides 146 XLVI. Abortifacients 147 XLVII. Poisonous Fungi and Toxic Foods 148 XLVIII. Ptomaines or Cadaveric Alkaloids 150

Index 152

AIDS TO FORENSIC MEDICINE AND TOXICOLOGY

PART I. Forensic Medicine

FORENSIC MEDICINE

I.--CRIMES

Forensic medicine is also called Medical Jurisprudence or Legal Medicine, and includes all questions which bring medical matters into relation with the law. It deals, therefore, with (1) crimes and (2) civil injuries.

1. A crime is the voluntary act of a person of sound mind harmful to others and also unjust. No act is a crime unless it is plainly forbidden by law. To constitute a crime, two circumstances are necessary to be proved--(a) that the act has been committed, (b) that a guilty mind or malice was present. The act may be one of omission or of commission. Every person who commits a crime may be punished, unless he is under the age of seven years, is insane, or has been made to commit it under compulsion.

Crimes are divided into misdemeanours and felonies. The distinction is not very definite, but, as a rule, the former are less serious forms of crime, and are punishable with a term of imprisonment, generally under two years; while felonies comprise the more serious charges, as murder, manslaughter, rape, which involve the capital sentence or long terms of imprisonment.

An offence is a trivial breach of the criminal law, and is punishable on summary conviction before a magistrate or justices only, while the more serious crimes (indictable offences) must be tried before a jury.

2. Civil injuries differ from crimes in that the former are compensated by damages awarded, while the latter are punished; any person, whether injured or not, may prosecute for a crime, while only the sufferer can sue for a civil injury. The Crown may remit punishment for a crime, but not for a civil injury.

II.--MEDICAL EVIDENCE

On being called, the medical witness enters the witness-box and takes the oath. This is very generally done by uplifting the right hand and repeating the oath (Scottish form), or by kissing the Bible, or by making a solemn affirmation.

1. He may be called to give ordinary evidence as a common witness. Thus he may be asked to detail the facts of an accident which he has observed, and of the inferences he has deduced. This evidence is what any lay observer might be asked.

2. Expert Witness.--On the other hand, he may be examined on matters of a technical or professional character. The medical man then gives evidence of a skilled or expert nature. He may be asked his opinion on certain facts narrated--e.g., if a certain wound would be immediately fatal. Again, he may be asked whether he concurs with opinions held by other medical authorities.

In important cases specialists are often called to give evidence of a skilled nature. Thus the hospital surgeon, the nerve specialist, or the mental consultant may be served with a subpoena to appear at court on a certain date to give evidence. The evidence of such skilled observers will, it is supposed, carry greater weight with the jury than would the evidence of an ordinary practitioner.

Skilled witnesses may hear the evidence of ordinary witnesses in regard to the case in which they are to give evidence, and it is, indeed, better that they should understand the case thoroughly, but they are not usually allowed to hear the evidence of other expert witnesses.

In civil cases the medical witness should, previous to the trial, make an agreement with the solicitor who has called him with reference to the fee he is to receive. Before consenting to appear as a witness the practitioner should insist on having all the facts of the case put before him in writing. In this way only can he decide as to whether in his opinion the plaintiff or defendant is right as regards the medical evidence. If summoned by the side on which he thinks the medical testimony is correct, then it is his duty to consent to appear. If, however, he is of opinion that the medical evidence is clearly and correctly on the opposite side, then he ought to refuse to appear and give evidence; and, indeed, the lawyer would not desire his presence in the witness-box unless he could uphold the case.

Whether an expert witness who has no personal knowledge of the facts is bound to attend on a subpoena is a moot point. It would be safer for him to do so, and to explain to the judge before taking the oath that his memory has not been sufficiently 'refreshed.' The solicitor, if he desires his evidence, will probably see that the fee is forthcoming.

A witness may be subjected to three examinations: first, by the party on whose side he is engaged, which is called the 'examination in chief,' and in which he affords the basis for the next examination or 'cross-examination' by the opposite side. The third is the 're-examination' by his own side. In the first he merely gives a clear statement of facts or of his opinions. In the next his testimony is subjected to rigid examination in order to weaken his previous statements. In the third he is allowed to clear up any discrepancies in the cross-examination, but he must not introduce any new matter which would render him liable to another cross-examination.

The medical witness should answer questions put to him as clearly and as concisely as possible. He should make his statements in plain and simple language, avoiding as much as possible technical terms and figurative expressions, and should not quote authorities in support of his opinions.

An expert witness when giving evidence may refer to notes for the purpose of refreshing his memory, but only if the notes were taken by him at the time when the observations were made, or as soon after as practicable.

There are various courts in which a medical witness may be called on to give evidence:

1. =The Coroner's Court.=--When a coroner is informed that the dead body of a person is lying within his jurisdiction, and that there is reasonable cause to suspect that such person died either a violent or unnatural death, or died a sudden death of which the cause is unknown, he must summon a jury of not less than twelve men to investigate the matter--in other words, hold an inquest--and if the deceased had received medical treatment, the coroner may summon the medical attendant to give evidence. By the Coroners (Emergency Provisions) Act of 1917, the number of the jury has been cut down to a minimum of seven and a maximum of eleven men. By the Juries Act of 1918, the coroner has the power of holding a court without a jury if, in his discretion, it appears to be unnecessary. In charges of murder, manslaughter, deaths of prisoners in prison, inmates of asylums or inebriates' homes, or of infants in nursing homes, he must summon a jury. The coroner may be satisfied with the evidence as to the cause of a person's death, and may dispense with an inquest and grant a burial certificate.

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