3. EXPERIMENTAL
Under this head will be treated Identity and the examination of the Living and the Dead, Real and Apparent Death, Cause of Death, Exhumations, and Autopsies.
Identity
Examination of the Living.—With regard to the identification of the living, the presence of a medical man is seldom required, but there are many occasions when his opinion may be sought. Thus, under the Factory Acts, he may have to examine children about whose age doubts may have arisen. The Table on [p. 33], giving the periods at which the teeth appear, will assist him. A medical man may also be requested to give an opinion as to the mental soundness or unsoundness of an individual. He may also be consulted in cases where questions have arisen as to the existence and character of certain marks on the body—of deformities, either congenital or produced subsequent to birth, or of doubtful sex. The marks which most frequently give rise to differences of opinion are nævi materni, scars, and tattoo marks. In cases of doubtful sex, the male organs may resemble the female, the female the male, or they may be blended together in about equal proportions.
In all cases where an examination of a living person is required, the consent of the person must be obtained, the nature of the examination explained, and that any facts recorded will be used as evidence if required. If the person refuse to be examined then it must not be carried out.
Cicatrices.—The following questions may be put to the medical expert—(1) Do scars ever disappear? (2) Can the age of a scar be definitely stated?
In reply to the first and second questions, I shall quote the words of the late Professor Casper: “Consequently the scars occasioned by actual loss of substance, or by a wound healed by granulation, never disappear, and are always to be seen upon the body; but the scars of leech bites, or lancet wounds, or of cupping instruments, may disappear after a lapse of time that cannot be more distinctly specified, and may therefore cease to be visible upon the body. It is extremely difficult, or impossible, to give any certain or positive opinion as to the age of a scar.”
All cicatrices should be examined with oblique light and the aid of a lens. In the early stages a cicatrix is of a red colour, changes to brown, and later to white, and the surface glistens. In the intermediate stages one could not give any positive evidence of the age of a cicatrix. The probability is that a red cicatrix is a recent one, a white cicatrix is not recent.
I have seen well-defined cicatrices upon the back of a Russian, after incisions made by the blades of a cupping instrument fourteen years previously, and in an Englishman after twenty-five years (R. J. M. Buchanan).
Devergie states that where the brand of a galley-slave has vanished, it may be recalled by slapping its usual position with the palm of the hand. The scar remains white, while the skin round it is reddened. A change of temperature to the part will sometimes cause the reappearance of a vanished scar. Washing may also help to reproduce scars. Cicatrices produced in childhood may grow with the ordinary growth of the individual. The shape of a cicatrix will depend upon the character of the wound which produced it; on the nature of the healing process; on the elasticity or tension of the skin; on the convexity of the part; and on the looseness of the subcutaneous cellular tissue. An incised wound healing by the “first intention” will most probably leave a white linear cicatrix; on the other hand, a wound healing by granulation will leave a more or less irregular scar. The position of a wound on the body also modifies the subsequent cicatrix; thus a linear cicatrix is produced when the wound is in the long diameter of the limb, a more or less oval one when across the limb. The retraction of the skin in the latter case tends to draw the skin at right angles to the line of incision, thus approximating the extremities of the cut, increasing it in breadth and lessening it in length. Owing to one or more of the above-mentioned conditions the typical cicatrix of an incised wound is elliptical, tending, however, in some cases to assume a circular form. Linear cicatrices are found chiefly between the fingers and toes, and where the cutaneous surfaces are concave. In gunshot wounds the resulting cicatrix is depressed and disc-shaped, and more or less adherent in the centre to the subcutaneous tissues, and if the weapon be fired close to the surface of the body, grains of unburnt powder may be seen in the surrounding skin. Cicatrices from burns are, as a rule, large, irregular, and superficial, and frequently give rise to deformity. A scar left by caustics is circumscribed, deep and depressed in the centre. Cicatrices in the groins are probably venereal; those in the neck and under the jaw, strumous. Scars from operation incisions are much less evident now than when wounds were more likely to suppurate and heal by granulation. It is remarkable, after an incision made with aseptic precautions and healing by first intent, as time progresses the cicatrix becomes less and less noticeable, but they can be detected by methods described above. Fine punctures and stitch cicatrices may eventually leave little or no trace.
Dupuytren and Delpech state that the tissue formed in a cicatrix is never converted into true skin—the rete mucosum when once destroyed never being re-formed. It contains no sebaceous glands, sweat glands, or hair follicles, and is but slightly vascular. This may account for the white colour of ordinary cicatrices, but even to this rule exceptions may be taken, and dark brown patches of pigment have been known to mark the situation of old lacerated wounds. It must be remembered also that in irregular wounds and in incised wounds which may heal with an uneven joint, that portions of skin may become embedded or grow into the scar tissue and give rise to difficulty in forming an opinion. I have seen a well-defined dark coloration of the skin continue for three months after the application of a mustard plaster, followed at the time by desquamation.
Tattoo Marks.—With regard to tattoo marks, the question of their disappearance gave rise to considerable discussion in the celebrated Tichborne case. On this subject the experiments of Hutin, Tardieu, and Casper appear to point to the fact “that tattoo marks may become perfectly effaced during life,” but that after death the colouring matter with which the marks were made may be found in the lymphatic glands. This is especially the case when vermilion is used. The most permanent marks are made with Indian ink, powdered charcoal, gunpowder, washing blue or ink, and vermilion. These are given in the order of their permanency. Hutin found that in 506 men who had been formerly tattooed, the marks had disappeared from 47 of the number. Not only does permanency depend upon the colouring matter used, but also upon the depth to which it has penetrated. If superficial, it may gradually become effaced. If the material be carried down to the papillæ, it will remain permanent, and can only be removed in such a way as to leave a scar. But besides the spontaneous disappearance of tattoo marks from the lapse of time, these marks may be artificially removed, and in such a manner as to prevent the possibility of a definite opinion being given as to their primary character. The presence of a scar in the situation of a well-known tattoo mark is suspicious. Thus, the Claimant had a scar on a part where it was sworn that Arthur Orton had been tattooed. The application of strong acetic acid, potash, hydrochloric acid and glycerole of papain appears to be the means adopted for the removal of tattoo marks. Efforts are made to remove superficial tattoo marks by removing the particles with needles. Tattoo marks according to their position and design are useful evidence of identification.
Birth Marks.—The presence and characters of birth marks should be noted for purposes of identification. Their removal may be possible, but, except in such as are small and superficial, the process used for removal leaves traces behind in the form of cicatrices or irregularities of surface, which may generally be detected in oblique light and with the aid of a good lens. Large moles or nævi may he excised, but a cicatrix will remain, which will differ in shape from the original mark.
Congenital Deformities.—These offer no difficulty and are in many cases permanent, such as intra-uterine amputations, constrictions, abnormality of limbs, &c. Such conditions as hare-lip, cleft-palate, herniæ;, &c., may be altered by surgical procedure, but leave permanent records of this. Peculiarities in twins are interesting as to their being of the “mirror image” or “identical” type.
Anthropometry.—This is principally used for the identity of habitual criminals. The Bertillon method is based upon certain measurements of the body, the principal of which are (1) the length of the head, (2) width of head, (3) length of body, (4) length of trunk while sitting, (5) distance between tips of mid-fingers with arms outstretched, (6) length of left forearm, left middle finger, and left foot, (7) length and width of right ear, (8) colour of irides. These measurements place the person in one or other class, according to the special system of classification.
Fig. 1.—First line (from left to right), plain impressions of whorl (thumb), arch (second finger), radial loop (forefinger).
Second line, rolled impressions of whorl (thumb), ulnar loop (fourth finger).
Finger Prints.—These are largely used as a means of identification in criminal cases, either by prints left upon articles, or by prints definitely made by the police authorities as a record for identification purposes.
On articles, the finger prints may be rendered more visible by dusting with some finely powdered material of dark colour which will adhere to the impression, which may then be photographed and enlarged.
For purposes of record, the impressions are taken directly upon a suitable surface of the bulbs of the fingers and thumbs after having coated them with printer‘s ink. The impressions thus made show individual peculiarities in the distribution and arrangement of the ridges of the skin; and the chances of the markings of two individuals being alike is about one in sixty-four millions. By means of the pattern of these ridges, prints may be classified under the headings of arches, whorls, and loops, with certain recognised modifications of these. (See [Figs. 1] and [2].)
Fig. 2.—First line (from left to right), plain impressions of whorl (forefinger), ulnar loop (thumb), arch (second finger).
Second line, rolled impressions of whorl (thumb), ulnar loop (third finger).
Eyes and Veins.—The angle of the eyes to the middle line of the face is an aid to identity; this will show whether the equator of the eye is on a plane at a right angle to the middle line, or above or below it. Tamassia lays much stress upon the arrangement of the veins on the back of the hands, which is an individual characteristic and one which is not easily altered or likely to be. By compressing the arms with a ligature the veins are made to stand out in relief and the backs of the hands are photographed.
Other Peculiarities.—The identity of the accused may be further proved by the absence or malformation of the teeth corresponding with a bite on the party assaulted, or the impression of the teeth on soft articles like cheese. Peculiarities of dentistry may be useful in identification. Or it may be proved that the wound inflicted could only have been made by a left-handed person, or in a manner peculiar to those engaged in the slaughtering of animals—e.g. is the cut from within outwards, as employed by butchers? The correspondence in the size and peculiarities of the foot of the prisoner and the footprints found in the vicinity of the crime is important as evidence. There is considerable difference of opinion as to the size of a footprint on the ground, Mascar of Belgium asserting that it is smaller than the foot that made it, Caussè, on the contrary, that it is usually larger. It should be borne in mind that the size of the footprint varies in running, walking, and standing, being smallest in running and largest when the individual is standing, which may account for the difference of opinion of the two observers just mentioned. This fact should always be borne in mind when an examination is required to be made of the footprints in the neighbourhood of the crime. A mark in the footprint showing that the sole of the boot had been patched, or in the case of the naked foot that there was some deformity of the toes, would of necessity be important. The mark of the naked foot smeared with blood has, in several cases, led to the identification of the culprit. Photographs may be used as a means of identification. Casts of footprints may be taken by smearing the print carefully with oil, and pouring in liquid plaster of Paris, or by dusting it over with powdered paraffin wax, and then melting it by holding a hot iron over the print; this may be repeated until a sufficiently thick cast is obtained. Hot solution of gelatine in water, mixed with oxide of zinc and glycerine to the requisite consistence, may be used for the purpose.
Dyeing of Hair.—As a means of disguise the hair may be dyed, or the colour may be changed from dark to light. For darkening the hair, preparations containing permanganate of potash, or the acetate of lead, bismuth, or nitrate of silver, are most frequently employed. Sticks of nitrate of silver or lunar caustic are used for darkening eyebrows and moustachios. A wash containing sulphide of potassium is used before the application of the lead solution. This removes the grease, and helps the rapid formation of the black sulphide of lead. Preparations of henna are fashionable for the production of shades of copper to rich brown. To detect fraud, some of the suspected hair should be steeped in dilute nitric acid, the acid driven off by gentle heat, and the nitrate dissolved in distilled water, and then sulphuretted hydrogen passed through the solution, the result being the formation of the black sulphide of lead. If silver be present, the addition of hydrochloric acid will throw down the insoluble chloride of silver. If careful examination be made of dyed hair, it will be found that the dye is irregularly taken by the hair; the hair loses lustre, and I have not unfrequently seen the hair close to the scalp white, or at least several shades lighter than the rest. The scalp may also be seen more or less discoloured, especially when nitrate of silver is used and applied by the individual himself.
For lightening the natural colour, solutions of chlorine, of peroxide of hydrogen, nitric and nitro-hydrochloric acids, of varying strengths, are used. It must be remembered that the action of chlorine is by no means uniform. The hair retains the odour of chlorine for some time, even after repeated washing, and is hard, stiff, and brittle. Devergie states that he has not succeeded in producing a perfect whitening of the hair in less than from twelve to twenty hours. It must be borne in mind that, under certain circumstances, dark hair may become suddenly white. I have seen large patches of grey hair over the head, the result of repeated attacks of neuralgia.
In the examination of persons whose hair is alleged to have been dyed, it is necessary to compare the dyed hair with that from other parts of the body, e.g. the pubes, or axilla, to wait and watch for irregularities of colour as the hair grows, new growth being free from dye, and if necessary to shave the part and compare the new growth with other hair, also to examine carefully the skin in the position where the dye has been applied. In one case which I noted, a man had been in the habit of touching the moustachios and eyebrows with lunar caustic, having previously damped it with his tongue; in time it produced argyria which coloured the whole of his face, the body generally, but most noticeable on the face.
Fig. 3.—Photo-micrograph of transverse section
of normal hair follicle, × 250.
(R. J. M. Buchanan.)
Examination of a Person said
to have been Assaulted
Carefully examine the bruises, wounds, &c., to see if they could have been inflicted as described. Ask no questions that may suggest an answer. Examine all weapons said to have been used, and hand them over to the police. In all cases where danger to life is imminent, send for the Authorities, and take dying declarations, as these may become evidence of vast importance, and, if properly taken, are as valid as if given on oath.
Identity of the Dead
Much of what has been said under the heading of identity of the living is applicable in examinations to establish identity of the dead. The latter requires certain special details of examination owing to the peculiar circumstances which may be present demanding them. The material subject to examination may be incomplete, and difficulties arise, so that it is essential to record every minute detail which may be of value as evidence.
The purposes of examination under this heading are mainly related to the questions of stature, age, sex, and special peculiarities of the body.
It will be useful here to emphasize the importance of making a detailed examination of the body. The examination, particularly the external inspection, should be made in daylight.
If the body be seen where first discovered, note should be taken of the exact position and attitude, of any signs of a struggle, of footprints to or from the body; of bottles, medicines, vomit, or excreta near the body, and which should be collected and retained. The expression and colour of the face, the condition of the hands, the condition of the dress as to tears and stains, the heat, amount of rigidity or putrefaction, the presence of wounds and vital reaction in them.
If the body has been removed from the place where found, make similar notes, remove the clothes, and compare any cuts if present in the clothes with those on the body. Record for identification—nævi, moles, tattoos, scars, hare-lip, cleft-palate, the mammæ, abnormalities of fingers, teeth, bones, limbs, joints, &c.
An examination of the mouth, for the presence or absence of false teeth, or of any peculiar formation of the jaw, may lead to the identification of the body. In the case of Dr. Parkman, the recognition by a dentist of the false teeth worn by the deceased led to identification of the remains, and also to the discovery of his murderer. The presence of an ununited fracture, as in the case of Livingstone, may lead to the identification of the body. In one case where a man was said to have died from a fracture of the ribs recently caused by a blow, it was found on examination that the bones were united by a firm callus, clearly showing that the skeleton produced could not be that of the man alleged to have been murdered.
Record the height and if possible the weight. Note the sex, the probable age, nutrition, and cleanliness or otherwise. Examine all wounds, bruises, and describe them carefully, and marks, e.g. strangulation or throttling. Examine the hands carefully and describe their peculiarities, also the colour of hair and eyes. Examine all the apertures of the body for foreign bodies, or abnormal conditions, and, in females, record carefully the condition of the external genitalia and the presence or absence of the hymen.
Although a more detailed account of the method of carrying out post-mortem examinations is given later on, it will not be out of place here to point out briefly the steps of examination. I would again emphasize the importance of making a thorough and complete internal examination, leaving no organ unexamined. If there be no call for special examination of the thorax or abdomen first, commence with the examination of the surface of the brain, then proceed downwards. Note the direction of any wounds and their depth. Examine all organs for morbid changes, and in females, the vagina and uterus. Examine the larynx and œsophagus. Remove injured bones and examine joints. Remove the spinal cord. Always remember to note the contents of the stomach and bladder in reference to the period at which death may have occurred. Weigh all organs. Always remember the probability of poisoning, and make your examination accordingly.
All fragments or injured parts of a body or its organs should be preserved, and photographs taken of them.
It is better for two medical men to conduct the examination together. Do not make the examination without an order from the coroner. A medical man who is alleged as implicated in the cause of death should not be present.
Identification of the dead may present special difficulties where mutilation of the body has taken place, or where the body has been severely burnt, or is disfigured as in cases of explosions or advanced putrefaction. In such cases, fragments of clothes, ornaments, and dental work may afford valuable evidence.
Occupation Marks.—As an aid to identification, it is important to remember that certain trades leave marks by which those engaged in them may be identified.
Thus, in shoemakers there may be more or less depression of the lower portion of the sternum, due to constant pressure of the last against the bone.
Tailors work sitting, with the legs crossed and the body bent forward. The body is thus cramped, and the abdomen drawn in, and the thorax projects over it, due to the manner of sitting. They frequently have a soft red tumour on the external malleolus. A like tumour, but not so large, may also be found on the external edge of the foot, and a corn on the little toe.
Photographers have their fingers blackened by nitrate of silver, pyrogallic acid and other developers, or stained yellow with bichromate of potash.
Seamstresses have the index finger of the left hand roughened by the constant pricking of the needle.
Copyists have on the little finger of the right hand, near its extremity, a corn, and at the end of the middle finger a hard groove made by the pen.
Violinists have corns on the tips of the fingers of the left hand, harpists on both hands.
In smokers of pipes the incisors and canines are more or less worn by the mouthpiece, but sometimes the groove is between the canines and bicuspids. In cigarette smokers, the forefinger and thumb are stained with tobacco juice, also between the index and middle fingers, on the dorsum.
In coachmen, corns may be formed between the thumb and index finger, and between the index and the second finger of the left hand, from the pressure of the reins, and between the thumb and index finger of the right hand, from the pressure of the whip.
In bricklayers, from the constant action of picking up bricks, the flattening of the tip of the thumb and index finger of the left hand is not uncommon.
Plasterers have corns on the external surfaces of the thumb and index finger, due to grasping the “hawk” on which the plaster is placed during their work.
Joiners and carpenters have callosities on the palm of the right hand from grasping their tools, and between the thumb and index finger of the right hand, also over the first interphalangeal joint of the right index finger. The right shoulder is lower than the left.
The finger-ends of turners and coppersmiths are also more or less flattened; in the latter, a deposit of the metal may take place.
To ascertain the time which may have elapsed since death.—This can scarcely be determined with precision, as so much depends upon the conditions under which the body may have been placed. The subject under consideration is, therefore, beset with difficulties, and its elucidation will require the greatest care on the part of the medical expert. A careful attention, however, to the subjects treated in the following pages will help to clear up many a doubtful point.
COOLING OF THE BODY
| (1) External circumstances. |  | Covered by bed-clothes, or otherwise | ||
| unexposed, when cooling will be dry | ||||
| slower than in cold air quickly moving. | ||||
| (2) Condition of the |  | Slow, if fat. | ||
| body itself. | ||||
 | 1. Wasting diseases. Quick. | |||
| 2. Suffocation. Slow. | ||||
| (3) Kind of death. | 3. Cholera, yellow fever, | | Increase | |
| rheumatic fever, and | of heat | |||
| cerebro-spinal meningitis. | after death. | |||
The following circumstances must also be taken into consideration: (1) Age. (2) Air—(a) moving; and (b) at rest. (3) Moisture. (4) Warmth. (5) Nature of the supposed cause of death, as affecting cooling of the body, and promoting the rapid advance of putrefaction. (6) Presence or absence of the rigor mortis. Bodies may be preserved for months if exposed to intense cold.
The following Table, compiled from the experiments of Devergie, may be of use in aiding the expert to form his opinion, but it must be borne in mind that, from the great difficulties which surround the subject, the statements made are only approximately correct. The table is divided into four stages or periods, the last being that in which putrefaction commences:—
First.—From a few minutes to twenty hours after death—Animal heat more or less present, but seldom continuing longer than ten or twelve hours. Muscles contract on the application of galvanic stimuli, and in the earlier stage to blows.
Second.—From ten hours to three days—Body quite cold and rigor mortis well marked; muscles do not contract on the application of stimuli. The age, mode of death, and other collateral circumstances must, more or less, be taken into consideration before an opinion can be given.
Third.—From three to eight days—The body is quite cold, and cadaveric rigidity has passed off. The muscles no longer respond to any galvanic or mechanical stimulus. The stage is modified and somewhat shortened in summer.
Fourth.—From six to twelve days—Commencement of putrefaction. Putrefaction may, however, take place on the first or second day after death; so that, as before stated, care must be taken before any positive decision can be given.
Stature.—As a general rule the length of the body is equal to the distance between the tips of the middle fingers with the arms outstretched. If an arm be missing, the length of the remaining one multiplied by two, with the addition of 6 inches for each clavicle and 1½ inches for the width of the sternum, will give the approximate height. The femur is said to be equal to .275 of the body height. If the skeleton be entire, the addition of 1½ inches for the soft parts should be made.
Where only a limb or long bone or part of one be available, it is not possible to give anything more than an approximate opinion of the height.
Sex.—When mutilation, putrefaction, or charring has taken place, by which the genitalia have been demolished, it may be difficult to determine the sex. Evidence will be afforded by the distribution of the pubic hair, which in the male reaches as high as the umbilicus, but is horizontal with few exceptions in the female. Males have more hair on the body generally.
The presence of moustachios and beard and the length of the hair on the head will assist in sex determination.
The breasts if present will denote the sex, also the uterus, which withstands putrefaction and burning to a marked degree.
Remains of clothing and ornaments will indicate the sex of the wearer.
Lineæ albicantes on the abdomen, buttocks, and breasts indicate the female sex, and the probable occurrence of previous pregnancies. It must, however, be remembered that lineæ albicantes occur in males who have been stout or had the abdomen distended by disease.
The Skeleton in Relation to Identification.—When a complete skeleton is submitted for examination, the chief points to elucidate are the age and sex. These will be noted further on. It may happen that a single bone, separate bones, or only a part of one is obtainable, when there may be considerable difficulty in expressing a definite opinion. The questions to be answered are: Are they human or belonging to the lower animals? When the bones are entire the answer is not very difficult to settle; but when parts of bones have to be dealt with, one has to be very careful in forming conclusions, and the fragments may have to be submitted, to a skilled anatomist. One may not be able to express an opinion about bones of the lower animals, other than to state they are not human. The services of a skilled Comparative Osteologist may be necessary to decide the nature of the animal.
When fragments resembling bone have to be examined, the microscope will be necessary to determine their osseous structure. When several bones have to be examined it may be possible to build up part or the whole of a skeleton. Duplicate bones will indicate remains of more than one creature. All fragments and bones should be carefully described, measured, and photographed.
By the character of the bones one may be able to determine the sex to which they belong and the approximate age. As a general rule the bones of the female are smaller, lighter, and less marked by muscular and other attachments.
The thorax in the female is deeper than in the male, the sternum shorter and more convex, the ensiform cartilage thinner and ossified later in life. The cartilages of the ribs are larger and the ribs smaller than in the male. The ribs are more oblique and may show the results of long corset pressure. The body of the sternum is over twice the length of the manubrium in the male, less than this in the female.
The length of the twelfth rib in the male averages 103 mm., in the female 83.8 mm. The pelvis exhibits marked differences. The sacrum of the male is more curved than that of the female, which is straighter in the upper half and more curved in the lower. The male pelvis is more compact, deeper, rougher, and narrower. The pubic angle is smaller, the obturator foramen is oval, and the ischia incurved. The female pelvis is more open, shallower, wider, not so rough, a wider pubic angle, and shallower and broader symphysis, the ischia are everted, wider apart and flatter, and the obturator foramen triangular. The inlet of the female pelvis is greater in all its diameters.
The skull in the male is heavier and larger, the markings and ridges being more pronounced, the mastoid processes, occipital protuberance, zygomatic and superciliary ridges are more prominent, and the capacity greater than in the female.
In the female the jaw is less prominent and has a wider angle.
The lumbar curve is longer in the female, and the lumbo-sacral angle greater than in the male.
The angle made by the neck of the femur with the shaft is about a right angle in the female, more obtuse in the male. It must be remembered that these differences between the sexes are not present to the same degree before puberty, so that prior to it the examination offers little evidence as to sex.
When examining bones any injuries to their structure or other abnormalities should be noted. The skull must be carefully examined for fractures, especially the base, which may be easily overlooked. Injuries to vertebræ should be looked for. The presence of callus will indicate that fracture has occurred at a period before death long enough for its formation.
Age.—There are several data which enable one to form a fairly accurate opinion as to the age of a body, these are especially useful in earlier years and intra-uterine life.
The more general are the size, height, development, the presence or absence of signs of puberty, the state of dentition, the greyness of the hair; in the female the atrophic condition of the uterus after the menopause, and the character of the lower jaw.
In addition are the time of life at which centres of ossification appear and the union of epiphyses to the shafts of bones and bones with each other.
In intra-uterine life centres of ossification appear by the end of the sixth month in the os calcis, manubrium, and the bodies and laminas of the sacral vertebræ; by the seventh, in the first piece of the body of the sternum and the astragalus; by the eighth, in the second piece of the body of the sternum; at full term in the cuboid, third piece of the sternal body, first coccygeal vertebra, and the lower epiphysis of the femur.
All traces of the fontanelles have disappeared by the end of the fourth year. The angle of the jaw in infants and young children is obtuse; as dentition proceeds, the body becomes deeper and the angle alters so that towards adult life it approaches a right angle, the ramus is longer and the body has become well developed with a mental foramen midway between upper and lower borders. In the new-born, the mental foramen is low down as the body of the jaw is practically all alveolar. In old people the angle again becomes obtuse and the alveolus disappears as the teeth are shed, and the mental foramen is at the upper border.
Table of the Eruption
of the Teeth
| Age— | Eruption of teeth. | Temporary. | ||||
| Lower | central | incisors, | 7 | months. | ||
| Upper | “ | “ | 8 | “ | ||
| “ | lateral | incisors, | 7-10 | “ | ||
| Lower | “ | “ | 10-12 | “ | ||
| First molars, | 12-14 | “ | ||||
| Canine teeth, | 18 | “ | ||||
| Second molars, | 22-24 | “ | ||||
| First molars, | 6 | years | Permanent. | |||
| Middle incisors, | 7 | “ | ||||
| Lateral incisors, | 8 | “ | ||||
| First bicuspids, | 9 | “ | ||||
| Second bicuspids, | 10 | “ | ||||
| Canines, | 11-12 | “ | ||||
| Second molars, | 12-13 | “ | ||||
| Wisdom teeth, | 18-25 | “ | ||||
Examine the lower jaw. The ramus forms an obtuse angle in full-grown fœtus, a right angle in adult life, obtuse in old age from loss of teeth.
Table showing the Periods at which Points
of Ossification appear after Birth
| Years of Life. | Bones in which Centres of Ossification appear. |
| 1. | Fourth piece of the body of the sternum; coracoid process |
| of scapula; head of humerus; os magnum (carpus); | |
| head of femur; upper end of tibia; external cuneiform | |
| (tarsus). | |
| 2. | Lower end of radius; unciform (carpus); lower end of tibia; |
| lower end of fibula. | |
| 3. | Great tuberosity of humerus; patella; internal cuneiform (tarsus). |
| 3-4. | Upper end of fibula. |
| 4. | Great trochanter (femur); middle cuneiform (tarsus). |
| 4-5. | Scaphoid (tarsus); lower end of ulna. |
| 5. | Lesser tuberosity (humerus); internal condyle (humerus); |
| trapezium and semi-lunar (carpus). | |
| 5-6. | Upper end of radius. |
| 6. | Scaphoid (carpus). |
| 7. | Trapezoid (carpus). |
| 10. | Upper end of ulna. |
| 12. | Pisiform (carpus). |
| 13-14. | External condyle (humerus); small trochanter (femur). |
Periods of Union of Epiphyses with the Shafts of Bones,
and of Bones with each other
Table showing the Development of the Embryo
according to the Lunar Months
Table giving the Measurements, according to the Months,
of the Extremities of the Fœtus in
the Order of their Development
| Third. | Fourth. | Fifth. | Sixth. | Seventh. | Eighth. | Full Period. | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Humerus | 3½ | lines. | 8 | lines. | 13-15 | lines. | 16 | lines. | 20-22 | lines. | 23-24 | lines. | 3 | inches. | ||
| Radius | 2½ | “ | 8 | “ | 12 | “ | 16 | “ | 17 | “ | 18-19 | “ | 2 | “ | 8 | lines. |
| Ulna | 3 | “ | 8 | “ | 13 | “ | 17 | “ | 18 | “ | 22-23 | “ | 2 | “ | 10 | “ |
| Femur | 2-3 | “ | 4-5 | “ | 12 | “ | 17 | “ | 19-21 | “ | 24 | “ | 3 | “ | 6 | “ |
| Tibia | 2-3 | “ | 4-5 | “ | 12 | “ | 17 | “ | 19-21 | “ | 21-23 | “ | 3 | “ | 2 | “ |
| Fibula | 2½ | “ | . . . | 12 | “ | 17 | “ | 19-21 | “ | 21-23 | “ | 3 | “ | 1 | “ | |
Table showing the Maximum and Minimum Dimensions of the Osseous
Nucleus of the Inferior Femoral Epiphysis from the Seventh
Month of Intra-Uterine Life to Two Years after Birth
| INTRA-UTERINE | EXTRA-UTERINE. | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Days. | Months. | |||||||||
| Seventh | Ninth | Mature | 1-8 | 9-15 | 16-28 | 1 | 3-6 | 7-12 | 2-24 | |
| lines | lines | lines | lines | lines | lines | lines | lines | lines | ||
| Maximum | 2 | 4 | 3½ | 3½ | 2½ | 5 | 4 | 8 | 7 | |
| Minimum | “ | ¾ | 1 | ¾ | 1½ | 2 | 2 | 3 | 5 | |
| No. of Children (125) examined | 31 | 9 | 52 | 8 | 3 | 2 | 9 | 3 | 6 | 2 |