Text-book of forensic medicine and toxicology

by R. J. M. Buchanan

1. Examination of the Substances expelled from the Womb.—The substances expelled from the womb often become the subject of judicial inquiry, and the medical man may be required to give his opinion as to their probable nature.

Dr. Gallard has called attention to the following:

1. During the last six months of pregnancy, abortion, even when it occurs spontaneously, goes through the two stages as at full time, i.e. the expulsion of the products of conception is, as a rule, preceded by rupture of the membranes, followed after a time by the expulsion of the placenta.

2. In the first three months this order of things is absent, for it is the rule to see the fœtus expelled entire en bloc without rupture of the membranes.

3. If, then, we find during the first three months of pregnancy the products of an abortion in which the membranes have been ruptured and the embryo expelled alone, we must look for a pathological cause for this infraction of a general rule; and if no disease of the embryo or of the mother is found, we are justified in attributing the abortion to mechanical means used directly against the products of conception. Charpentier has shown that this rupture of the membranes is not an absolute proof of criminal abortion; but in eighteen cases of spontaneous abortion M. Leblond only found rupture of the membranes in one, and in this the membranes presented an abnormal friability.

The questions may be asked—(1) Is it a fœtus?—(2) Is it a mole? If so, is a mole also a fœtus?—(3) Is it merely the coats of the uterus, and unconnected with pregnancy?

1. Is it a Fœtus?—The development of the fœtus is given on pp. 35, 36 et seq.

2. Is it a Mole?—This question gives rise to another: Is a mole a fœtus? To this the answer must be in the affirmative. Moles, being the diseased appendages of the fœtus, vary in character, and have been described by obstetrical writers under the following heads: (a) Hydatiginous; (b) Carneous; (c) Fatty Moles.

(a) Hydatiginous Moles are a result of a diseased condition of the villi of the chorion. The villi become dropsical, and hang in masses like a bunch of grapes.

(b) Carneous Moles.—These are the result of hæmorrhage into the chorion. The blood becomes organised, and a fleshy mass is formed, to which in some cases a withered fœtus is attached.