IX. Examination in Cases of
Criminal Abortion
57. In suspected criminal abortion, when the woman survives, the chief points for inquiry are: The proofs of recent delivery, the ascertaining of facts tending to show that she has been subjected to manœuvres with instruments, and the occurrence of symptoms traceable to the action of any of the drugs reputed as capable of causing abortion.
When the woman has died, the points requiring special attention at the dissection are: The state of the womb, as regards its size and the condition of its lining membrane, in reference to the probable period of delivery; the condition of the intestinal canal, in reference to the action of irritant drugs; of the mucous membrane of the bladder, in reference to the action of cantharides; close inspection of the womb and vagina, in reference to mechanical injuries, especially punctured wounds; and any appearances that the death may have been caused by inflammation in the organs of the pelvis, or by bleeding from the wound.
X. Examination in Cases of
Infanticide
58. In cases of suspected infanticide, certain specialities must be borne in mind. The cavity of the head should be laid open with a pair of scissors. In opening the abdomen, the navel should be avoided, so that the state of the vessels of the navel-string may be examined correctly. This is done by carrying two incisions from the ensiform cartilage to each of the anterior superior spines of the ilia, and by deflecting downwards the triangular flap thus formed.
59. The inquiry in cases of infanticide should be conducted with reference to the five following distinct questions: (1) The probable degree of maturity of the child? (2) How long it has been dead? (3) Whether it died before, during, or after delivery, and how long after? (4) Whether death arose from natural causes, neglect, or violence? and (5) Whether a suspected female be the mother of the child?
60. The points to be attended to for ascertaining the probable degree of maturity of the child are: The general appearance and development, the state of the skin, its secretions, and its appendages; the hair and nails; the presence or absence of the pupillary membrane; the length and weight of the whole body; whether the navel corresponds or not with the middle of the length of the body; the situation of the meconium in the intestines; the size of the testicles in the case of males, and in either sex the size of the point of ossification in the lower epiphysis of the thigh-bone. This is easily observed by making an incision across the front of the knee into the joint, pushing the end of the thigh-bone through the cut, slicing off the cartilaginous texture carefully until a coloured point is observed in the section, and then, by successive very fine slices, ascertaining the greatest diameter of the bony nucleus. This does not exist previous to the thirty-sixth week of gestation, and in a mature child is about one-fourth of an inch in diameter. Has the infant been washed? Absence or presence of vernix caseosa. Nature and character of the wrappings, if any, found on the child.
61. The points of chief importance in reference to the period which has elapsed after death are those specified in the last clause of Sect. 17—it being borne in mind that the bodies of infants are often concealed in ash-pits and dunghills, and that in these circumstances putrefaction is very rapid.
Plate.—Section through the epiphysis
of the lower end of the femur showing
ossification centre, in a full-term fœtus.