Upon each of these heads we shall offer such observations as appear to us to be essential to ensure the safe judgment of the practitioner. Several of the questions, involved in the inquiry, have already engaged our attention in the first volume of the present work, under the history of conception; while the industry with which the numerous authorities on the subject of infanticide, and its scientific relations, have been lately collated by Dr. Hutchinson,[[66]] in England, and Professor Capuron, in France, will justify us in giving to this branch of our work the character of a commentary, rather than that of a regular history.
On the discovery of the body of a newly-born infant, it becomes our first duty to ascertain whether the spark of life be entirely extinct; if the sensible proofs of absolute death should be absent, no time is to be lost in subjecting it to those means[[67]] which are best calculated to excite it to vigorous life, such as external warmth, frictions, inflation of the lungs, &c.
Having satisfied ourselves that the child is dead, we are to proceed to such inquiries, as may enable us to furnish the best possible evidence on the case, in a court of judicature, viz.
1. To ascertain whether the Child was born alive?
In the absence of all direct testimony, our investigation is to be conducted upon principles very similar to those which we have already recommended in those obscure cases of death in which “the person is found dead, and the history of his dissolution is unknown.” See vol. iii, p. [2]. The appearances of the corpse—the character of the spot in which it was found—the report of competent witnesses—and the phenomena displayed on dissection, are, in both cases, the circumstances from which we are to elicit data for the solution of our difficult problem.
A. The inspection of the body of the infant. By this we are first to learn, whether it had arrived at that degree of maturity which is essential for enabling it to sustain an independent existence—“etoit il viable?”[[68]] If it can be fairly shewn that the child had not reached the end of the seventh month of uterine gestation, the charge of infanticide ought to be withdrawn, although we are well aware that various opinions might be cited in support of a contrary position. (See Physiological Illustrations, vol. i, p. 243.) The weight of the child is a circumstance which should always be ascertained, as being capable of throwing some light on the question at issue. If the fœtus has passed the period of seven months, it will generally weigh four pounds, although upon this point again a difference of opinion has unfortunately existed.[[69]]
The length of the fœtus, at the full term, is said to vary less than its weight. It is generally from nineteen to twenty-two inches. Seventeen and twenty-six will include the two extremes. Professor Chaussier has presented us with a scale of relative admeasurements, from which he thinks we may deduce the age of a child. He asserts that at the full term of gestation, the middle of the body of the fœtus corresponds exactly with the umbicus; at the eighth month it is two or three centimeters higher; that it approaches still nearer the sternum at the seventh month; and at the sixth falls exactly at the abdominal extremity of that bone.[[70]] If this statement is to be relied upon, we should be able to conclude, says Dr. Smith, that when the middle of the length of the body falls at the cartilago ensiformis, the fœtus must be under the seventh month, and consequently could not have continued to live after birth.
The surface of the fœtus will moreover present an appearance, arising from its great vascularity, which is very characteristic of its immaturity; the red hue, however, to which we more particularly allude, is not acquired until the vessels have attained a certain capacity, and the circulation a considerable degree of vigour; and it is worthy of remark that the appearance becomes again obscure, as the developement of the fœtus advances, from the increasing opacity of the integuments, but in those parts where the deposition of fat in the cellular membrane is wanting, the redness will remain conspicuous, as in the palms of the hands, or in the soles of the feet. The head still maintains an unjust proportion to the rest of the body; the bones of which it consists are extremely soft and yielding; and, on account of the extent of the fontanelles, the connection between them is extremely imperfect. The eye-lids are closed; the hair on the eye-brows and the eye-lashes but thinly scattered; the pupil is generally closed by a membrane; the nails are wanting, or scarcely apparent. The sexual organs will also afford some characteristic appearances. In the male, the testes, between the sixth and eighth month are in progress towards the scrotum; at the end of the seventh they are not yet found there. The scrotum is generally of a bright red colour. In females the vulva is projecting, and the labia separated by the protuberance of the clitoris.
The general external appearance of a fœtus may, moreover, indicate the important fact of its having been retained in the uterus after its death. Lecieux observes that the ordinary term which it remains in the womb, in this state, is from five to twenty days; and that, according to the length of this period, the body will have lost more or less of its consistence and firmness; the limbs become lax, and the muscles are readily torn; the epidermis may be removed by the slightest friction; the skin also assumes a purplish, or brownish-red colour; there is often some bloody serum effused in the cellular tissue, just beneath the skin, especially about the cranium;[[71]] the umbilical cord is large in circumference, soft, infiltrated with serum, livid, and is very readily torn; the thorax is flattened, the head falls into different shapes, and becomes flattened from its own weight; the membranes which serve as a bond of union to the several bones of the cranium, are much relaxed. The brain is in a nearly fluid state, and emits a fetid odour.
We should next proceed to a more minute and particular inspection of the external appearances; for which purpose the body should be cleansed from the dirt and impurities with which it may be invested, taking care to notice upon this occasion, whether the surface be covered with that sebaceous matter usually present on the skin of newly-born infants, and whether any mud or other matter, capable of stopping the mouth and nostrils be found about them. The head should also be shaved, in order that the fontanelles and sutures may be carefully examined with a view to ascertain whether any injury had been committed on the brain through these avenues. A midwife was executed at Paris for having introduced fine and sharp wires into these parts, before the heads of the unfortunate infants were expelled from the vagina, and consequently before respiration could have taken place. Every appearance of ecchymosis, or wound, should be inspected with attention, in order that its true character may be verified; and upon this occasion it will be important to bear in mind that on the surface of dead bodies, especially on those parts on which they have lain, superficial livid marks, arising from stagnation of blood in the small vessels of the skin will very generally present themselves, and which have received the name of sugillations, in contradistinction to that of ecchymoses, which are produced during the life of the individual. As the people, observes Dr. Hutchinson, are apt to regard the former of these discolourations as signs of violence, and as such propositions have even been maintained in courts of judicature, it is highly essential to obviate the possibility of litigation on this point, by removing a layer of the skin where such lividness is present, to shew that it is confined to this organ, and is not attended with infiltration of blood in the cellular tissue.