Medical Jurisprudence, Forensic Medicine and Toxicology. Vol. 1

Volume One

NEW YORK WILLIAM WOOD & COMPANY 1894

COPYRIGHT, 1894, BY WILLIAM WOOD & COMPANY

PRESS OF THE PUBLISHERS’ PRINTING COMPANY 132-136 W. FOURTEENTH ST. NEW YORK

CONTENTS.

PAGE

INTRODUCTION, v

MEDICAL JURISPRUDENCE, 1

The Legal Relations of Physicians and Surgeons. T. C. BECKER, 3

The Law of Evidence Concerning Confidential Communications. CHAS. A. BOSTON, 89

Synopsis of the Laws Governing the Practice of Medicine. W. A. POSTE and CHAS. A. BOSTON, 135

FORENSIC MEDICINE.

THANATOLOGICAL, 293

The Legal Status of the Dead Body. T. C. BECKER, 295

The Powers and Duties of Coroners. A. BECKER, 329

Medico-Legal Autopsies. H. P. LOOMIS, 349

Personal Identity. J. C. ROSSE, 383

Determination of the Time of Death. H. P. LOOMIS, 437

Medico-Legal Consideration of Wounds. G. WOOLSEY, 457

Medico-Legal Consideration of Gunshot Wounds. ROSWELL PARK, 591

Death by Heat and Cold. E. V. STODDARD, 627

Medico-Legal Relations of Electricity. W. N. BULLARD, 661

Medico-Legal Consideration of Death by Mechanical Suffocation. D. S. LAMB, 705

Death from Submersion or Drowning. J. C. ROSSE, 793

Death from Starvation. E. V. STODDARD, 813

INTRODUCTION.

THE terms FORENSIC MEDICINE, LEGAL MEDICINE, and MEDICAL JURISPRUDENCE have heretofore been used interchangeably to apply to those branches of state medicine and of jurisprudence which have to deal with the applications of medical knowledge to the elucidation of questions of fact in courts of law, and with the legal regulation of the practice of medicine.

MEDICO-LEGAL SCIENCE therefore includes all subjects concerning which members of the legal and medical professions may seek information of one another, each acting in his professional capacity. It consists of two distinct branches: that treating of medical law, to which the designation of MEDICAL JURISPRUDENCE properly applies; and that relating to the application of medical, surgical, or obstetrical knowledge to the purposes of legal trials, FORENSIC MEDICINE.

The term STATE MEDICINE, which is sometimes erroneously used as synonymous with forensic medicine, properly applies to a more extended field of medical inquiry; i.e., to all applications of medical knowledge to the public welfare. State medicine, therefore, while excluding medical jurisprudence, includes, besides forensic medicine, public hygiene, medical ethics, medical education, and military and naval medicine.

TOXICOLOGY, the science of poisons, may be divided into medical toxicology, whose object is the prevention or cure of all forms of poisoning, and forensic toxicology, whose aim is the detection of criminal poisoning. In its last-named relation toxicology differs from forensic medicine in one important particular. In all cases other than those of poisoning in which questions involving medical knowledge arise, the answers are entirely within the functions of the physician, the surgeon, or the obstetrician, but the problems of forensic toxicology require for their solution the further aid of the chemist and the pharmacologist.

Forensic medicine is an applied science, partly legal, partly medical, calling for information and investigation in widely divergent lines, and becoming more minutely ramified with the progressive advances in medical knowledge and in those sciences of which medicine is itself an application. Its development has been dependent partly upon the slow though progressive tendency of medicine from the condition of an empirical art toward that of an exact science, and partly upon the more rapid and more advanced development of criminal jurisprudence. Medical jurisprudence had reached a high development during the early history of the Roman Empire, and at a period long anterior to the first recognition of forensic medicine.

Although the literature of modern medico-legal science is very largely written from the medical point of view and by physicians, its earlier history is to be found in fragmentary form, partly in medical literature, but principally in the writings of historians, in the earlier criminal codes, and in the early records of legal proceedings.

In the earliest historical periods the functions now exercised by the priest, the lawyer, and the physician were performed by the same person, who, presumably, made use of what medical knowledge he possessed in the exercise of his legal functions. Among the Egyptians at a very early period it is certain that medical questions of fact were considered in legal proceedings, and that the practice of medicine was subject to legal regulation. According to Diodorus, “when a pregnant woman was condemned to death, the sentence was not executed until after she was delivered.” The same author tells us that “the physicians regulated the treatment of the sick according to written precepts, collected and transmitted by the most celebrated of their predecessors. If, in following exactly these precepts which are contained in the sacred books, they did not succeed in curing the sick, they could not be reproached, nor could they be prosecuted at law; but if they have proceeded contrary to the text of the books, they are tried, and may be condemned to death, the legislator supposing that but few persons will ever be found capable of improving a curative method preserved during so long a succession of years and adopted by the most expert masters of the art.” With the system of legal trial in use among the Egyptians it is difficult to imagine that the question of the existence of pregnancy in the one case, or of malpractice in the other, would not be the subject of contest, and, if contested, determined without the testimony of obstetricians or of physicians.

Medical knowledge among the Hindoos was further advanced than among the Egyptians. In the Rig Veda (about 1500 B.C.) occur a few medical references, among which is the statement that the duration of pregnancy is ten (lunar) months.

The earliest purely medical Sanskrit texts are the Ayur Vedas of Châraka and Sûsruta, which were probably written about 600 B.C., but which are undoubtedly compilations of information which had been handed down during many centuries before that time. In each of these is a section devoted to poisons and their antidotes (Kalpa), in which it is written that a knowledge of poisons and antidotes is necessary to the physician “because the enemies of the Rajah, bad women, and ungrateful servants sometimes mix poison with the food.” Full directions are also given for the recognition of a person who gives poison, and to differentiate the poisons themselves, whose number, from all the kingdoms of nature, is legion. The age at which women may marry is fixed at twelve years, while men may not marry before twenty-five. The duration of pregnancy is given as between nine and twelve lunar months, the average being ten. The practice of medicine is restricted to certain castes, and requires the sanction of the Rajah, and the method of education of medical students is prescribed.

It is singular that the Greeks were apparently destitute of any knowledge of legal medicine. Although medicine and jurisprudence were highly developed among them, allusions to any connection between the two are of very rare occurrence and uncertain.

The Hippocratic writings (ca. 420 B.C.) contain many facts which are of medico-legal interest: the possibility of superfœtation was recognized; the average duration of pregnancy was known, and the viability of children born before term was discussed, the relative fatality of wounds affecting different parts of the body was considered, and the Hippocratic oath makes the physician swear that he “will not administer or advise the use of poison, nor contribute to an abortion.” The position of the physician in Greek communities was an exalted one. No slave or woman might be taught medicine, although later free-born women were permitted to practise in their native places. Homer also refers to physicians as men of learning and of distinction. The Greek physician was therefore in a position, both from his information and from his standing in the community, to aid in the administration of justice.

The Greeks were also extremely litigious and possessed a code of criminal procedure which was elaborate, and in many respects resembled those now in use in England and the United States. The writings of the Greek orators, Demosthenes, Æschines, Lysias, Antiphon, Isocrates, etc., which have come down to us substantiate the claim of Ælian that “to Athens mankind is indebted for the olive, the fig, and the administration of justice.”

The writings of the Greek physicians contain no reference to any legal application of their knowledge, and certain passages in the writings of the orators seem to indicate that, while a physician was called to inspect and treat a wounded person, the testimony as to the patient’s condition was given in court by others.

Thus in the case against Euergos and Mnesibulus, in which an old woman had died some days after an assault, Demosthenes states that he notified the accused to bring a surgeon and cure the woman; but that as they did not do so, he himself brought his own surgeon and showed him her condition in the presence of witnesses. Upon hearing from the surgeon that the woman was in a hopeless condition, he again explained her state to the accused and required them to find medical aid. Finally, on the sixth day after the assault the woman died. He further asserts that these statements would be proved by the depositions.

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