Text-book of forensic medicine and toxicology

by R. J. M. Buchanan

62. The circumstances which indicate whether the child died before, during, or after parturition, and how long after it, are the signs of its having undergone putrefaction within the womb; the marks on the crown, feet, buttocks, shoulders, &c., indicating presumptively the kind of labour, and whether it was likely to have proved fatal to the child; the state of the lungs, heart, and great vessels, showing whether or not it had breathed; the nature of the contents of the stomach and of the intestines; the presence of foreign matters in the windpipe; the state of the umbilical cord, or of the navel itself, if the cord be detached.

63. In order to examine properly the state of the lungs, heart, and great vessels, with a view to determine whether or not the child had breathed, the inspection should be made in the following order: Attend, first, to the situation of the lungs; how far they rise along the sides of the heart; to their colour and texture; whether they crepitate or not. Then secure a ligature round the great vessels at the root of the neck, and another round the vena cava above the diaphragm. Cut both sets of vessels beyond the ligatures, and remove the heart and lungs in one mass, which must be weighed and put into water, to ascertain whether the lungs, with the heart attached, sink or swim. In the next place, put a ligature round the pulmonary vessels, close to the lungs, and cut away the heart by an incision between it and the ligature. Lastly, ascertain the weight of the lungs; whether they sink or swim in water; whether blood issues freely or sparingly when they are cut into; whether any fragments swim in the instances where the entire lungs sink; and in every instance of buoyancy whether fragments of them continue to swim after being well squeezed in a cloth.

64. The general question to be considered in relation to the cause of death is, whether the appearances are such as to be traceable to the act of parturition, or whether they indicate some form of violent death. The directions given in Divisions V., VI., and VII. apply to infants as well as adults; but the following points are specially to be noticed in cases of supposed infanticide:

In relation to wounds and contusions, the possibility of minute punctured wounds of the brain or other vital organs; in reference to injuries of the head, the effusion of blood under the scalp, not in the situation where it could have been produced during labour, or fracture of the bones not producible by compression of the head during labour, and not connected with defective ossification of the skull; in reference to the allegation that the head was injured by the child suddenly dropping from the mother, when not recumbent, the presence of sand or other foreign matters on the contused scalp, and the existence of more than one injury of the head; in relation to suffocation, the external and internal signs of this form of death—marks of compression of the mouth, and nose, and throat, and the presence of foreign matters in the mouth and throat, air-passages, gullet, or stomach, especially if the body be found in contact with similar substances; in reference to bleeding from the navel-string, a bloodless state of the body, without any wound to account for it; in reference to poisons, most commonly narcotics, the absence of any of the above appearances, with an otherwise healthy state of the body; in reference to starvation and exposure, emaciation of the body, absence of food from the stomach, and an empty, contracted condition of the intestines; in reference to the possibility of the child having been suddenly expelled, and having fallen on the floor or into privies, &c., the state of the navel-string is to be noted—whether long or short, whether remaining attached to the child and connected with the after-birth, indicating rapid labour, or, if divided, whether it had been cut or torn across. Nature of the ligature used, if any.

65. The circumstances noticed in Sects. 60, 61, 62, 63, 64, compared with the signs of recent delivery in the female, will lead to the decision of the question whether the suspected female be the mother of the child. These circumstances may be shortly recapitulated as being the signs of the degree of maturity of the child—the signs on the body of the kind of labour, the signs which indicate the date of its death, and the interval which elapsed both between its birth and death, and between its death and the inspection.

EXHUMATIONS

It becomes necessary sometimes to exhume the bodies of persons who have been buried. The cases which generally call for this always unpleasant proceeding are those where a suspicion of poisoning or violence has arisen some little time after the burial of the supposed victim. Or the necessity may arise to show that the body buried is that of a person whose death it is absolutely necessary to prove. In the case of Livingstone, though this can scarcely be called a case of exhumation, yet an examination some months after death of the arm of the corpse alleged to be that of Livingstone, proved the existence of a badly united fracture which the deceased was known to have had.

In conducting the exhumation, it is necessary that the medical experts should be present to see the body removed from the coffin, and also any person or persons who may be in a position to speak as to the identity of the corpse—as, for instance, those who dressed it and prepared it for burial. The person who made the coffin may also be of assistance to speak as to its identity. As soon as the medical men are armed with the proper authority, no time should be lost in order to get the body as fresh as possible, and at once prove or disprove the accusation of the crime, which, in the case of innocent persons, cannot be too quickly removed. The best time to take up the body, if in the summer, is early in the morning; and, in all cases, the examination, if possible, should be made during daylight. Everything necessary for making a medical inspection should be taken, and also a table on which to place the body. Rubber gloves should be worn. A pail containing a solution of some disinfectant, for the inspectors to wash their hands after the exhumation is finished, should be close at hand. And it is as well to expose the body for a short time to the air before beginning the inspection. There is seldom any risk to health in removing a single body, yet certain precautions are necessary; thus it is as well to stand on the windward side of the corpse. Vaults should not be entered as soon as they are opened, but time allowed for their ventilation. Carefully note the amount of preservation of the coffin, and, if broken, if any of the surrounding earth is in contact with the body. This precaution is necessary in cases of suspected mineral poisoning (as in arsenic, &c.), and it is as well also to save one or two pounds of the earth immediately above the coffin for analysis. The body may then be examined externally, any hair left on head or face preserved for identification; and then an inspection of all the cavities made, the contents of the stomach and bowels being placed in dry earthenware jars or glass bottles, corked and capped with thin indiarubber skin, and so tied and sealed that the string must be cut or the seals broken in order to open them. The ends of the string should be sealed in the presence of the authorities. In the examination, the instructions previously given should be carefully followed. All injured or diseased parts should be removed and preserved whenever this is practicable. Soft parts not intended for analysis may be preserved in a concentrated solution of salt.

Beyond what Period is it useless to Exhume a Corpse?—There is no scientific limit, for even the bones may show that violence has been used, or may point to the identity of a corpse, as in the case of Livingstone just mentioned. Pregnancy may be detected. The medical inspectors must proceed with the inspection unless they can positively say that the progress of decay is such as to render the examination nugatory in relation to its special objects. Casper mentions the case of a man whose body was three times exhumed for different purposes. In Scotland the law imposes a limit of twenty years, but in England the law is silent on the point; in France a limit of ten years from the date of the supposed crime; and in Germany, the limit is thirty years, if the offence is that punishable with death, the time varying from three to thirty years with the nature of the crime.