WOUNDS
Legal Definition.—According to the statute (24 and 25 Vict. c. 100, sec. 18), the word “wound” includes incised, punctured, lacerated, contused, and gunshot wounds. But to constitute a wound within the meaning of the statute, the whole skin, not the mere cuticle, or upper skin, must be divided (R. v. M‘Laughlin, 8 C. & P. 635). But a division of the internal skin, e.g. within the cheek or lip, is sufficient to constitute a wound within the statute (R. v. Warman, 1 Den. C.C. 183). If the skin be broken, the nature of the instrument with which the injury is inflicted is immaterial, for the present statute extends to wounding, &c., “by any means whatsoever.” A wound from a kick with a boot is within the statute (R. v. Briggs, 1 Mood C.C. 318). Injuries, burns, and scalds—which, in accordance with the above definition of a wound, are not wounds—are provided for under the clause, “or cause any grievous bodily harm to any person.”
Casper defines “an injury” to be “every alteration of the structure or function of any part of the body produced by any external cause.” Taylor proposed the following as the best definition which can be given to the word “wound,” whether in a medical or legal sense, viz. that it is “a breach of continuity in the structures of the body, whether external or internal, suddenly occasioned by mechanical violence.” This would include dislocations, fractures, either simple or compound, injury to the skin or mucous membrane, and to internal organs. Burns and injuries due to the action of corrosives are excluded from the category of wounds.
Concerning Wounds in general.—Great care must be taken to ascertain the exact site and course of the injury on the body, as this precaution will greatly assist in answering the questions: Is the wound dangerous to life? Does it cause grievous bodily harm? Is it suicidal, that is, inflicted by the person on himself; or homicidal, inflicted by another? The solution of the question of the dangerous character of the wound is left to the professional knowledge of the witness, who may be required to state his reasons for considering the wound dangerous to life. His mere assertion will not be accepted. “The safest course,” says Elwell, “for the witness, in regard to all these questions, is to give a true and plain account of the wound, describing it minutely, and the probable consequences that may attend it.” In relation to their danger to life (apart from so-called “simple” wounds which are not usually extensive, heal easily, and cause little trouble in their course), wounds may be considered dangerous to life when they are so extensive, or on account of their position and relation to important structures when they would prove fatal without the intervention of surgical skill; and when the danger is imminent. A mortal wound is one which is rapidly followed by death. Wounds, however, which in themselves could not be regarded as dangerous to life, may become so by intercurrent complications, such as erysipelas or other infective process. As a general rule, only those wounds in which the danger to life is imminent should be stated as dangerous to life. Compound fracture of the bones of the cranium, injury to any large arterial trunk, or to any of the internal organs, may be considered as “dangerous to life”; but where the danger is more remote, as in the probable supervention of tetanus, erysipelas, &c., the medical opinion must be more guarded. But the medical witness should always bear in mind that death may follow the slightest injury. A case is recorded of death in forty-eight hours after extraction of a tooth. The contrary also holds good, for the most fearful injuries have been followed with recovery.
The following suggestions may help the practitioner in the formation of his opinion as to the probable danger of a wound:
1. The extent of the injury. 2. The character of the instrument used in the infliction of the wound. 3. The violence suffered by the parts. 4. The size and importance of the blood-vessels and nerves injured. 5. Is the wound healing or likely to heal well, and is the constitutional disturbance severe or slight? 6. Age of the sufferer. 7. Is there any constitutional taint likely to render even a slight wound more severe, or even dangerous to life? 8. Has the previous medical treatment been skilful or otherwise?
Should the injured party be found dead, a careful post-mortem examination will alone determine the probable part the injury bore in the production of the fatal result.
Points of Importance to be Noticed
in Examination of a Dead Body
found Wounded.
1. Note situation, extent, depth, breadth, length, and direction of wound. Take careful measurements, in order to determine the character of the weapon, and the organs of the body injured.
2. Is there any appearance of ecchymosis, or is the effused blood liquid or coagulated?
3. Examine wound as to presence of pus, adhesive inflammation, gangrene, or foreign bodies.
Why? Presence of pus, &c., will show that death must have taken place some time after the wound was inflicted.
4. In all examinations of wounds, be careful to disturb as little as possible their outward appearance, in order to compare the wound with the suspected weapon.
5. All notes should be taken during such examination, or immediately after.
6. Make a careful examination of all the important organs of the body.
Why? In order to disprove the suggestion that death was due to other causes—poison, disease, &c. This is important, as in the case of a girl who, dreading a whipping, swallowed some arsenic, from which she died, yet her father was tried for causing her death by the severity of his punishment.
7. Only facts should be stated in the Report; no inferences should be drawn or suggested.
8. In describing the appearance of wounds use simple untechnical language, and avoid superlatives and high-flown words to describe and explain simple facts.
9. In gunshot wounds, note position of body, state and contents of the hands, and the direction of the wound in relation to external objects.
Note also in all kinds of wounds the relationship of the wound to cuts or rents in the clothes of the deceased.