2. In Favour of Criminal Violence
(a) The fact of the umbilical cord being divided by some sharp instrument and not torn. A caution must be here inserted, for Taylor mentions a case where rupture of the cord occurred in such a manner that it could not be decided whether it had been intentionally cut or torn.
(b) Extensive fracture of one or more of the bones of the cranium.
(c) Fracture and dislocation of the neck.
(d) Presence of incised wounds, and other evidence of violence.
N.B.—In all doubtful cases, a guarded opinion should be given, stating simply that the dissection does not reveal anything contrary to the statements offered as to the cause of death.
III. Congenital Disease in one or more of the Fœtal Organs.—In all cases the presence of congenital disease must be sought for.
IV. Neglect or Exposure, constituting “Infanticide by Omission.”—Under this head may be mentioned the following:
(a) Neglecting to place the child in such a position that it may breathe freely.
(b) Neglecting to protect the child from extremes of cold or heat.
(c) Neglecting to feed it with the food appropriate to its age. (See Signs of Death from Starvation, [pp. 132 et seq.])
(d) Neglecting to tie the umbilical cord.
To give answers to these questions will in many cases be impossible, and each must be decided by such circumstances as present themselves in each individual case. For instance, if the body be found stiff, blanched, naked or nearly so, lying on the ground, the vessels of the interior gorged with blood, whilst the superficial vessels are contracted and can be seen only with difficulty; at the same time, the hydrostatic test shows that respiration has taken place, and in the absence of all external or internal causes—the probability is in favour of death by cold. In close relation with the present subject is the question—
Has the Infant bled to Death?—Fatal hæmorrhage from the cord may occur, especially if it be divided by a sharp instrument close to the body of the child. As a rule, hæmorrhage does not occur from a ruptured cord. (The signs of death from hæmorrhage have been noticed, page 81.)
How Long did the Child survive its Birth?—The answer to this question is by no means easy, and the data on which a decision can be based are not very reliable. The presence or absence of the vernix caseosa should be noticed. In still-born children the closed eyelids, when raised, do not remain open; in the live-born, on the other hand, the eyes remain half open even after repeated attempts to close them. Another guide to the determination of the length of time the child survived its birth may be found in the absence or presence of the meconium in the intestines. The meconium—so-called from its resemblance to inspissated poppy juice—is found in the large intestine as a dark-greenish pasty mass, more or less filling that portion of the bowel. In the upper portions of the intestines it varies from a light-yellowish or greyish to a greenish-brown colour, till in the large intestine it assumes the colour and consistence above mentioned. It is generally discharged by the infant in from four or five to forty-eight hours after birth. In breech presentations it may be passed during the process of delivery, although the child be still-born; but its entire absence from the intestines is presumptive of existence for some days after birth.
Fig. 27.—Photo-micrograph of
starch granules, × 250 (potato).
(R. J. M. Buchanan.)
The following are some of the points to be considered in forming a diagnosis: (1) Changes in the skin. (2) Changes in the umbilical cord. (3) Changes in the circulatory system.
Table showing how long a
New-born Child has Lived.
1. Changes in the Skin.—Exfoliation of the cuticle. The time at which this occurs is so variable as to be of little value in a medico-legal inquiry.
2. Changes in the Umbilical Cord.—Mummification of the cord is not of the slightest value as a proof of extra-uterine life; but the separation of the cord which occurs between the fourth and seventh day, especially when cicatrisation has taken place, is a sure sign that the child must have lived four or five days at least. Two other appearances of some value may also be noted, namely:
(a) In fresh bodies, the appearance of a bright red ring about a line in breadth, which surrounds the insertion of the cord, and which is formed within the uterus.
(b) A similar red ring, about two lines broad, around the insertion of the cord, accompanied with “thickening, inflammatory swelling of the portion of the skin affected, and slight purulent secretion from the umbilical ring itself.” This latter condition Casper considers as affording “irrefragable proof of the extra-uterine life of the child.”
3. Changes in the Circulatory System.
(a) Ductus Arteriosus.—Arterial duct. A contracted condition of this duct is of no value as a proof that a child has survived its birth; for the duct is liable to become contracted, and even obliterated, before the birth of the child.
(b) Ductus Venosus.—Nothing certain is known as to the exact time when this duct closes; the condition of the vessel is, therefore, of no assistance in determining the possibility of the child having survived its birth. The duct has been found closed in a still-born child; and in one child, which lived for a quarter of an hour, both the ductus arteriosus and the foramen ovale were found closed. Cases are also on record in which these fœtal channels were found open after thirty days of extra-uterine life.
(c) Foramen Ovale.—What has been said of the preceding may be said with regard to the foramen ovale.
N.B.—To sum up, therefore, in the fewest words, any attempt at forming an opinion on the docimasia circulationis may result in a fatal error on the part of the medical witness, as it is impossible to determine with any accuracy by days the period of their closure. As a general statement, however, the following, according to Bernt and Orfila, is the order in which obliteration of the fœtal vessels takes place: (1) The umbilical arteries. (2) Ductus venosus. (3) Ductus arteriosus. (4) Foramen ovale.
Synopsis
1. Infanticide is not regarded as a specific crime.
2. To be tried by the same rules of evidence as apply to murder.
3. The law presumes that every child is born dead, till proof to the contrary is given.
4. Onus of proving live birth devolves on the prosecution.
5. The body need not be found in order to obtain conviction of the suspected party, if not of infanticide, at least of concealment of birth.
The medical evidence, however, depends on the body being found and examined.
The medical witness may be examined on one or more of the following points:
- (1) The recent delivery of the accused.
- (For “Signs of Recent Delivery,” [see page 155 et seq.])
- (2) Maturity of the child found.
- (3) Was the child still-born or live-born?
- (4) Cause of death.
- (5) Lastly, as to the mental condition of the mother.
- Puerperal mania, &c.
6. In absence of proof of infanticide, the woman, in England, may be tried for concealment of birth, that is, disposing secretly of the body, whether the child be born dead or alive.
7. In Scotland, a woman may be tried for concealment of pregnancy when the child is dead or missing, if she do not call for or make use of help or assistance in the birth; but the case is quashed, if the child be shown alive by the mother to others.