A COMMENTARY UPON THE PRECEDING OBJECTS OF INQUIRY:

With a view to appreciate and explain the relative importance of each, in enabling the Medical Inquirer and Jurist, to arrive at just conclusions, in cases of complicated doubt and difficulty.

CASE I. THE PATIENT IS LIVING, AND MEDICAL ASSISTANCE IS REQUIRED.

This is the least complicated case that can occur; the medical inquirer has not only the advantage of the patient’s testimony, but that also of his own observations upon the symptoms and circumstances of the case. We have already stated that the declaration of a person, made under an apprehended pending dissolution, is by the law of this realm considered tantamount to an oath, (see vol. i. p. 165), and we have also stated what it becomes our duty to repeat in this place, that in recording such testimony, we must be prepared to combat various errors and prejudices: we do not mean to deny that the awful situation in which the patient is placed will not, in general, secure us against any wilful misrepresentation, 7but we contend, that a person acting under the influence of bodily suffering is very apt to fall into numerous fallacies respecting the transactions in which he may have been previously engaged; especially in such cases as usually constitute the objects of medico-judicial inquiry, where the passions not unfrequently increase the natural disturbance of the mind, while the eagerness which is so justly felt for the detection of the author of the injury, will tend rather to heighten than to correct any hallucinations under which the sufferer may happen to labour; for on such occasions the imagination is always ready to supply the want of testimony, and to fill up the spaces which actual observation may have left vacant.

Patients have not unfrequently laboured under the impression of their having taken poison, when there can never have existed the least ground for such a suspicion, and yet their general conduct has been in complete opposition to the idea of insanity:^[1] a curious case of this kind is related in the Sepulchretum of Bonetus; and even during the progress of the present work, the author was consulted upon an illness, which the patient seriously attributed to the operation of a slow poison, declaring that it had been secretly administered during a philanthropic visit to one of our public prisons. Dr. Esquirol^[2] also relates the case of a lady, twenty-seven years of age, who in the last stage of phthisis pulmonalis perceived in her room the odour of burning charcoal, and immediately conceived that there was a design against her life; in consequence of which she left her lodging, and sought another abode, but the fumes 8incessantly pursued her, and she died fully convinced that she was the victim of some malicious persecution.

But of all the fallacies with which we have to contend, no one is more dangerous in its effects, or more frequent in its occurrence, than that which leads them to mistake the identity of the offender; we have already alluded to this fallacy (vol. i. p. 440), and we shall hereafter have occasion to refer to it.

When a medical practitioner is summoned to investigate a case, in which severe sufferings have supervened, without any apparent or assignable cause, the following interrogatories are calculated to elicit data for a just conclusion.

Previous state of the patient, with respect to bodily health and strength?—The knowledge of these facts will materially assist us, not only in explaining the violence of the present symptoms, but in estimating their indications, in forming some opinion with regard to their causes, and in prognosticating their results.

The age and occupation are also to be ascertained. Violent tormina of the bowels, and other symptoms resembling those of acute poisoning, are frequently explained at once, by learning that the individual in question has been engaged in some trade or manufactory, from which he has been necessarily exposed to metallic exhalations; thus painters, gilders, smelters, and others, from living almost constantly in an atmosphere charged with such fumes, are always liable to sudden and violent attacks, dreadful cholics, paralysis, and premature death. See our chapter on the poison of Lead, vol. 2, p. 336, and that on Aerial Poisons, page 457.

Present symptoms of the patient.—Having gained the necessary information with respect to the previous 9history of our patient, we are prepared to investigate the symptoms under which he at present labours, and to inquire into the circumstances of their accession, progress, order of succession, intensity, and duration. If this investigation be conducted with skill, we shall be enabled to form some opinion respecting the origin of the sufferings, and, perhaps, to distinguish the invasion of a spontaneous disease from the effects of acute poisoning: upon this latter point, however, we shall require the aid of much collateral information,^[3] as whether the patient has ever suffered in a similar manner at any previous period, or whether any part of his family or friends have experienced a similar attack at the present time? If the reply to this latter query be in the affirmative, we may look for a common cause of the complaint, and be led to suspect that it may arise from the ingestion of some acrid matter. We should therefore proceed to discover the nature of the meals last taken as to quantity and quality; the practitioner should, at the same time, pay particular attention to the state of the different persons affected, and to the existence or absence of vomitings and stools. The following case, reported by Morgagni, and quoted by Orfila & Foderé, may be introduced as affording good illustrations of those points of inquiry, whose importance we are anxious to enforce. “In the month of May, 1711, four persons, that is to say, a priest, two women, one of which was his sister-in-law, and another person, all in good health, and on a journey, stopped at an inn to dine. Setting out on their road after dinner, the priest in a short time felt himself so ill in his 10bowels, that he was obliged to dismount from his horse. Notwithstanding the copious evacuations, both upwards and downwards, the pain increased every moment, and it was necessary to take the patient back to Céserne, the place where they had dined, and where the priest arrived half dead. A medical man who was called in, thinking he had only to deal with an ordinary cholic, employed a number of fomentations, glysters, purgative draughts, and anodynes; although he saw that one of the women had also strong evacuations with pains and faintings, and that the other person complained of pains and of a weight at the stomach, he never suspected the presence of a poison, because the other woman had no complaint, and the landlord protested with many imprecations, that there was nothing dangerous in his dishes; however, the evacuations saved the patients, and as they diminished a little next morning, it allowed of their removing into the neighbourhood of Morgagni’s residence, whom they immediately called in. This great physician having ascertained whether there was any dish at the table of which the woman who was in good health had not eaten, and having found that it was a great dish of rice which had been first served up, concluded from this circumstance that it was this dish that contained the poison. The difficulty however, was, that the priest who had eaten the least, and who had been on the whole extremely abstemious, was precisely the person who had suffered the most, and the soonest; that the woman, who had eaten more than the priest, had been less sick than he; and that the other person, who had eaten more than all the rest, was the one who was the least incommoded.”

Was there no cheese rasped over this rice? demanded 11Morgagni. They answered in the affirmative; the priest who had little or no appetite, ate scarcely any thing but the cheese. In that case, said Morgagni, you understand already that there was arsenic among that cheese, which had probably been prepared for killing rats, and not having been laid away with sufficient care, some one had taken it to serve up with your rice during the time that you were hurrying the landlord to send up your dinner. These conjectures were verified by the confession of the landlord himself, who, having learned that the patients were out of danger, was no longer afraid to acknowledge that such had been the cause of this unfortunate accident.

The practitioner, says Orfila, will not be able to form a correct judgment in cases of this kind, if he neglect to pay attention, first, to the state of the stomach of the different persons poisoned; in fact, those who have taken a great quantity of food or drink, would feel in general less severe symptoms than others; second, to the nature of the dishes and of the drinks, as well as to the quantity that each person may have eaten or drank; third, to the existence or absence of vomitings and stools. It is evident that it may happen, that some persons have eaten a tolerably large quantity of a poisoned dish without any serious symptoms taking place, for this very reason, that the quantity of the food was considerable, and that it easily produced copious evacuations, by means of which the poison had been expelled. Numerous cases of culinary poisoning might be adduced in this place, in illustration of the important lights which are to be derived from the investigations which form the subject of the present chapter; but we have already considered the subject very fully 12under the head of poisons; and in the history of the effects of copper and lead, we have particularly explained the evils that may arise from the careless use of such metallic utensils in cookery.

Whether any and what remedies have been used; by whom recommended; and by whom administered?—The importance of this part of the enquiry is too obvious to require explanation; we are to learn from it whether the administration of the medicines might not have accidentally contributed to the aggravation of the symptoms they were designed to allay; suppose, for instance, we were to be told that the patient had resorted to copious libations of brandy to mitigate the sufferings of the bowels, which were afterwards found to depend upon Enteritis; the inference is obvious—but in performing this part of our professional duty, the greatest caution is necessary, and we must take care that our own medical opinions do not carry us to an unjustifiable extent in our reprehension of the plan of treatment which has been pursued by others; a striking instance of this want of propriety occurred in the late celebrated trial of Donnell, and was very properly denounced by the court, (see page 161 in the second volume, and Appendix, p. 304.) But there still remains another reason why we should cautiously and attentively examine any medicine that may have been administered, and it would be right in the practitioner to procure a portion of such medicine, with a view to its future analysis; for it has happened that where the assassin has supposed that his first dose would be insufficient to effect his purpose, he has artfully insinuated an additional dose in the medicines which are administered for the relief of his victim, and thus the hand, which is treacherously held out with promises 13of succour, adds a stronger poison to the cup; this occurred in the diabolical case of Mary Bateman,^[4] better known by the name of the Yorkshire witch, who having poisoned a family with arsenic, sent a jar of honey, mixed with corrosive sublimate, for their relief.

A knowledge of the nature of the medicines that may have been taken, will also assist the chemist in his examination of the matter vomited, as we have fully explained under the history of Poisons.

Appearance of the evacuations.—This should always be attended to, for although it can hardly afford, in itself, a satisfactory indication, yet we have shewn, in the course of our history of poisons, that it may concur with the facts to heighten the probability of a case. The chemist will also require them for examination.

CASE II. THE PATIENT IS DEAD.—THE ATTENDANTS CAN FURNISH ONLY AN IMPERFECT ACCOUNT OF HIS DISSOLUTION.

In conformity with the plan upon which we have arranged the objects of inquiry into the causes of sudden sickness and death—that of beginning with the most simple and plain, and passing in regular gradation to the more complicated and obscure problems, the present case, in which the patient is dead, but the attendants are able to furnish some history, however imperfect, very naturally constitutes the connecting link between that in which the 14patient is living, and that in which the great avenues of information are entirely closed upon us by the death of the individual, and the total absence of all direct testimony. The plan, therefore, upon which the investigation of this case is to be conducted, is in a great measure to be derived from the application of those precepts which are contained in the other cases; that relating to the examination of the attendants being collected from the first, and all that concerns the death, from the third.

There is, however, one object of inquiry which may be mentioned in this place with peculiar propriety, as the obscure and often erroneous evidence which is given in cases of sudden death, during an affray, renders it highly important to learn, whether the deceased had died during a paroxysm of passion. We have little doubt but that many persons have been convicted of murder, where the death of the individual in question, was the sole effect of the high state of irritation in which he had been placed. That life may be suddenly extinguished by the violent impulse of passion we have already shewn under the consideration of Syncope (p. 26), and we are farther prepared to assert that Apoplexy^[5], and other fatal diseases may also, in certain states of predisposition, result from the same powerful cause; 15violent transports of the mind may likewise occasion the return of any particular disease to which the patient had been formerly subject, as epilepsy, and other spasmodic diseases; they may likewise bring a chronic disease at once to a fatal crisis, as we have seen in the case related at page 29 of the 2d volume; the fact has been also well illustrated by Dr. Gordon Smith, in the case which occurred to a surgeon of his acquaintance in one of the midland counties, of which the following is an outline. “In the course of an altercation between a man and his wife, the woman died, and a clamour was raised that the husband had murdered her: an inquest being held, a verdict was returned against him, and he stood his trial at the following assizes; he was, however, acquitted, for it appeared in evidence that he had not even touched his wife during the quarrel. The deceased was a person of an extremely violent temper, and on opening her body, it was found that she had been labouring under suppuration of the liver, and that an abscess had burst into the cavity of the abdomen, in consequence of the agitation into which she had been thrown.” Baron Larey describes the case of a person who had been violently wounded in the thorax by a sword in a duel; but the man was progressively recovering, when in the fourth month from the period of the injury, he died suddenly in consequence of a violent fit of anger; upon dissection, the heart and pericardium exhibited traces of inflammation. We should also learn, if possible, whether the deceased had been at the time of death in a state of intoxication: for in such a condition a comparatively slight injury may occasion death. The following case, related by Dr. Cheyne, in which Mr. Charles Bell was concerned, we quote from Mr. Shaw’s excellent Manual 16of Anatomy^[6], (p. 165.) “An industrious man returning home from his work, found his house empty; the bed he was to lie upon, and the tools of his trade, sold for liquor by his wife, whom he found in a gin shop, where she had been drinking and dancing. He brought her home, and in the passage of his house struck her, and ordered her to go up stairs; she refused to go; he carried her upon his shoulders, and the contention continuing up stairs, he struck her again. There having been no one present, we have only the husband’s account of her death. He said that whilst sitting on her chair, she fell down, upon which he threw her on the bed, conceiving that she was in a fit, such as he had seen her in formerly. Some of her neighbours coming in, found her dead. Mr. C. Bell was requested to examine the body of this woman. The man was afterwards tried at the Old Bailey, for murder, when Mr. Bell deposed, that upon taking out the brain, and tracing the vessels in the base, the anterior artery of the cerebrum going off from the internal carotid of the left side, was found torn half way across. The cause of this woman’s death was the bursting of the blood from the ruptured vessel; as to the cause of the rupture, Mr. Bell’s opinion coincided with the best authorities in pathology, that there is a state of the vessels, in which an external injury or shock is more apt to produce rupture; and drunkenness may be supposed to be the artificial state of excitement 17which most resembles this state of the vessels. Being asked whether the blows were the cause of the rupture, he said he conceived it very likely that a shock would rupture the vessel; and being then asked whether he conceived that this woman was more likely to have a vessel ruptured, from having been intoxicated—he was of opinion that intoxication, and the struggle, were likely to produce such a degree of activity of the circulation in the head, that a less violent blow might produce rupture, than what, in other circumstances, would have proved fatal.” The prisoner was acquitted.—At the York assizes in the year 1820, a somewhat analogous question arose,—whether the deceased might not have been attacked with apoplexy during the struggle? The light of anatomical dissection will be required in such a case, and the remarks which Mr. Shaw has offered upon the subject, appear to us to be extremely judicious and valuable; if, says he, effusion of blood be found between the dura mater and scull, and if a bruise on the scalp corresponds to the part, we may conclude that it has been caused by the blow; but if blood is found between the dura mater and the brain, though we should discover the marks of blows, or even fracture of the scull, still the question may be entertained whether the patient might not have been attacked with apoplexy during the struggle.

How soon is the deceased supposed to have died, after the alleged cause of his dissolution.—This is a very important question, for by learning the length of the interval between the attack and the death, we shall at once be enabled to accept as probable, or reject as impossible, the accounts given by the friends and neighbours. Thus, poisons, in general, require 18some time for their operation. Apoplexy does not generally destroy life under several hours^[7].

CASE III. THE PERSON IS FOUND DEAD, AND THE HISTORY OF HIS DISSOLUTION IS UNKNOWN.

The deep obscurity in which this case is necessarily involved, can alone be dissipated by the concentrated light of circumstantial evidence, derived from the inspection of the dead body, in the exact situation and posture in which it was found, and that of the surrounding objects; from the information afforded by competent witnesses, respecting the previous history of the individual in question; and, lastly, from anatomical dissection.

In conducting such an inquiry the most trifling incidents connected with the deceased should not pass unheeded, for however unimportant they may at first, individually, appear, we shall often find that in combination they will afford the principal data for the solution of our problem. With how many examples will the history of crime present us where the more minute circumstances have alone furnished the “damning proofs” of guilt? Their apparent insignificance in such cases would seem to exempt them even from 19the usual precautions of concealment, and more especially from those artful measures by which the designing assassin seeks to cast an impenetrable veil over the more direct evidences of his crime.

1. Circumstances to be learnt by the Inspection of the Body.

That the inspection of the body could furnish the satisfactory means of discovering the cause of its death, is an opinion which has been very naturally entertained from the earliest ages; although it is easy to perceive that the extent and just value of the indications, which such a practice is capable of affording, could never have been appreciated until the more advanced periods of physiological knowledge.

As the ancients exposed their sick on the high roads, for the advantage of receiving from the casual passenger his opinion and experience respecting the particular malady under which they laboured, so did they expose the bodies of persons, supposed to have been murdered, in order that each spectator might candidly observe their appearance, and freely inquire into the circumstances which attended their decease; thus, as we are informed by Pliny, was the body of Genucius, a tribune of the Roman people, on his being found dead in bed, brought forth to the assembled multitude, who, unable to discover any external marks of violence, pronounced his death to have been a visitation of the gods; and we learn from Tacitus, that the remains of Germanicus, who was poisoned by Piso, were exposed in the market place of Antioch; thus too, in conformity with ancient custom, was the bleeding corpse of Julius Cæsar exposed to public gaze and animadversion. 20The decisions, however, which such a custom was intended to facilitate, were generally perverted by the delusions of credulity and superstition. Among the more prominent instances of the latter source of fallacy, we may notice a belief that has extended even into later days—that upon the presence of the murderer the wounds of his victim will bleed afresh!

“O gentlemen, see, see! dead Henry’s wounds

Open their congeal’d mouths, and bleed afresh!

Blush, blush, thou lump of foul deformity;

For ’tis thy presence that exhales this blood

From cold and empty veins, where no blood dwells;

Thy deed, inhuman and unnatural,

Provokes this deluge most unnatural.”—

Richard III. act 1. s. 2.

Situation and attitude of the body.—It cannot be too generally known that, upon the discovery of a dead body, its situation and attitude should never be disturbed until it has been examined by competent persons. The information which the medical inquirer may obtain from his observations upon the position of the dead body, is often important and decisive; it may even, in some cases, furnish data for determining whether the death was occasioned by accident, suicide, or murder. We may, for example, find the deceased in a posture which he could never have himself assumed, whence we should be led to conclude that he had not fallen by his own hands. In the case of the disputed suicide of the Earl of Essex^[8] in the 21tower, much information was lost by the body having been stripped and removed before a due examination took place; the hasty manner in which this was performed, excited on that, as it necessarily must on all similar occasions, very considerable suspicion respecting the motives which could prompt so premature and unnecessary an interference. An attention to the posture of the body is also important in cases of wounds, which should always be examined with reference to this circumstance. It has also been very justly observed, that a person in a fit, or in a state of intoxication, might fall accidentally into such a posture, as to be actually suffocated by the pressure of his own hand, or that of any resisting body upon his throat. If such a case were to occur, all evidence of the fact would be destroyed by any officious interference that might change the exact posture in which the body was found.

General appearance of the countenance, as to colour, vascular turgescence, or congestion, and morbid physiognomy.—The observation of the countenance of a deceased person will very frequently furnish the medical inquirer with a useful hint in the investigation; we have, for instance, already spoken of the expressive physiognomy of a strangled person, (page 45) and in the course of our work, the reader will find ample illustrations of the general importance of the subject.

Whether any discharge issues from the mouth, nostrils, ears, or any other orifice.—The appearance of froth about the mouth indicates that the death of the person has not been instantaneous, but sudden, either from apoplexy, epilepsy, or any other violent cause, see Appendix, p. 273. In drowned persons the mouth and nostrils are covered with foam. In epileptic paroxysms 22there is sometimes an involuntary discharge of fæces, urine, and semen; the evacuation of the fæces very generally occurs in cases of strangulation, and sometimes in those of apoplexy. The appearance of blood flowing from the ears would indicate a violent death from some external cause.

Apparent age of the deceased.—It is important to notice this circumstance, as it will not only assist us in identifying the individual, but, at the same time, point out the diseases of which he was most susceptible, and those of which he was less liable. In relation to such an object the question of age was keenly debated on the trial of Donellan, for an account of which we must refer the reader to the evidence printed in the Appendix. Apoplexy rarely occurs except in the middle or decline of life. Hippocrates says chiefly between the 40th and 50th year. Aphor. Sect. vi, 57.

Description of his person, as to bulk, stature, obesity, muscular powers, &c.—Many are the reasons which render a full and accurate investigation of these points an extremely important part of the inquiry. To say nothing of their use in identifying the individual, they will point out the diseases to which such a habit of body would render him liable; and we shall be enabled to deduce a general inference as to the probable state of his health. If suspicions should exist against any individual, we shall be thus prepared to arrive at some probable conclusion with regard to the degree of resistance which the deceased might be able to offer; by comparing which with the powers of the supposed assailant, some valuable circumstantial evidence may be elicited.

Conformation of the neck as to shortness, thickness, &c.—The apoplectic conformation may be said to be indicated by a large head, red face, short and thick 23neck, broad shoulders, capacious thorax, prominent abdomen, low stature, robust limbs, and considerable corpulence; this last indication, however, is liable to many exceptions, for dry and spare constitutions, if any confidence is to be placed in the comparative tables of Rochoux, are more frequently even attacked with apoplexy, than the plethoric. Under this subject we may notice that the habitual use of tight ligatures disposes to the disease. Portal speaks of an ambassador who was attacked with apoplexy, after having long employed general compression, for the reduction of excessive corpulence. Dr. Donald Monro states that he has known soldiers carried off by apoplexy, in consequence of stricture on the veins of the neck, from their having been obliged to wear their cravats too tight. Winslow has made a similar observation in the Memoirs of the Academy of Sciences for the year 1741.

Probable period that has elapsed since the extinction of life.—Before the process of putrefaction has commenced, we can only adduce an opinion upon this subject from the circumstance of the coldness, rigidity, and general complexion of the body. Under ordinary circumstances, the body looses its vital heat in a very short space of time, and cadaverous^[9] stiffness takes place and continues until relaxed by the progress of putrefaction; but there are many circumstances that appear capable of controlling and modifying this general result; the heat of the body is not only abstracted with very different degrees of celerity in different situations, but even in the same situation, in death from different causes. Portal and other physiologists have observed, that after 24death from apoplexy, the temperature of the body is frequently maintained, even above the natural standard, to a period beyond that in which it would be totally abstracted from an inanimate mass under other circumstances.^[10] It has been laid down as a general rule, that the more sudden the death, the longer is cadaverous stiffness from taking place, M. Orfila also states, that if the body of a person suffocated, either by a non-respirable gas, or by strangulation, be cold or stiff, we may be certain that more than twelve hours have elapsed since the fatal event, for in death by such causes, the heat of the body is preserved for at least that period; this statement is corroborated by Richerand, who says that in asphyxia from carbonic acid, the blood preserves its fluidity, the limbs their flexibility, and the body its natural heat for some hours after death. When the process of putrefaction has established itself, we must deduce our conclusions from the extent of its progress, always taking into consideration the collateral circumstances which may have operated in retarding or accelerating its developement, such as the state of the atmosphere in relation to temperature and humidity, the particular circumstances of the spot in which the body was found, &c.

The determining, as accurately as possible, the length of time the individual has been dead, is not only important in cases of murder; it may be highly 25essential to the ends of justice in questions of survivorship; the following curious case, cited by Dr. Male,^[11] will not only serve to substantiate this assertion, but it will, at the same time, afford a triumphant instance of the application of chemical science in promoting the due administration of the laws. It is well known that when dead animal fibre is exposed, for a certain period, to the action of a current of water, it becomes converted into a fatty substance, resembling spermaceti, and known to chemists under the name of adipocire. The period of time required to effect this change has been the subject of dispute. At the Lent assizes held at Warwick, in the year 1805, a cause was tried, in which a gentleman, who was insolvent, left his own house with the intention, as it was presumed from his preceding conduct and conversation, of destroying himself. Five weeks and four days after that period, his body was found floating down a river. The face was disfigured by putrefaction, and the hair separated from the scalp by the slightest pull; but the other parts of the body were firm and white, without any putrefactive appearance. The clothes were unaltered, but the linen was exceedingly rotten. On examining the body, it was found that several parts of it were converted into adipocire. A commission of bankruptcy having been taken out against the deceased a few days after he had left his home, it became a question of great importance to the interests of his family, to ascertain whether he was living at that period. From the changes which the body had sustained, it was presumed that he had drowned himself the day he left home; and to corroborate 26this presumption, the evidence of Dr., now Sir George, Gibbs, of Bath, was required, as he had lately been engaged in experiments^[12] upon this subject. He stated on the trial, that he had procured a small quantity of this fatty substance by immersing the muscular parts of animals in water for a month, but that it required five or six weeks to produce it in any quantity. Upon this evidence the jury were of opinion that the deceased was not alive at the time the commission was taken out, and the bankruptcy was accordingly superseded.

Whether any, and what marks, punctures, contusions, echymoses, dislocations, or other injuries, are to be observed about the face, neck, chest, or any other parts of the body; and how far their appearance and character demonstrate the nature of the operation, or instrument by which they were inflicted?—Upon the discovery of a dead body, it becomes one of the first objects to ascertain the nature, extent, and direction of any wounds, or marks of violence, that may be observed. Whether they be merely superficial, or extend beyond the local injury and penetrate the cavities, will be a matter of subsequent investigation by dissection. The examination of deep wounds, in the first instance, is comparatively unimportant, for they are not liable to obliteration by incipient putrefaction; whereas marks and bruises, unless they be carefully inspected before the body undergoes this change, will not be easily distinguished from spontaneous discolouration. This precaution is highly important in those cases in which we suspect the person to have been strangled; when we shall generally discover a circular mark about the neck produced by extravasated 27blood, or, if the act has been committed by the hand, irregular patches corresponding in some places with the fingers and nails of the assailant; traces of violence will be frequently also discoverable on the chest which will answer to the impression of the knees. Upon examining the body of Sir John Dinely Goodere, who was murdered on board the Ruby ship of war in 1741, the surgeon’s mate stated that he found the marks of nails and fingers on his neck; this testimony was satisfactorily fortified by another witness, who declared that on looking into the cabin, he had seen a hand on the neck of the deceased. An accomplice also confessed that after having strangled him with their hands, they drew a rope tight about his neck.^[13] A very satisfactory instance of the same kind occurred to the author of the present work, during his residence in the county of Cornwall; and he feels no inconsiderable satisfaction in reflecting upon the train of circumstances, through which he was enabled, by his evidence at the assizes of the county for 1814, to secure the conviction of the murderer. The evidence was wholly circumstantial, and the relation of it is well calculated to illustrate the great importance of the particular line of investigation, which it is the object of the present chapter to elucidate. For these reasons he is induced to compile from his notes the following brief sketch of the case. A Cornish peasant, engaged in attending upon the light-house on the western coast, was found dead in a field near the public road leading from Penzance to the “Land’s end,” on Sunday, December the 12th, 1813; he was lying in a dry ditch, with his stick at a little distance from him; 28one of his shoes was down at the heel, and both were smeared with mud; his pockets were empty. The body was taken to a public house in the village, and the coroner having received notice of the occurrence, an inquisition was taken, and the verdict of wilful murder returned against some person or persons unknown. The body was afterwards buried, but a rumour having arisen that the anatomical inspection had not been sufficiently minute and satisfactory, it was, by an order of the magistrates, disinterred; and the author was desired to assist in the further investigation of the subject. Upon examining the body, which had not yet advanced so far in putrefaction as to obliterate the traces of violence, or to confuse the appearances they presented, patches, arising from extravasated blood, were seen in different parts of the throat, and distinct abrasions corresponding with the nails were visible; the face presented the physiognomy of a strangled man. On the chest, bruises, evidently occasioned by the pressure of the assailant’s knees, were also noticed. Upon dissection the brain was found excessively turgid with blood. The rest of the organs appeared in a perfectly healthy, and natural condition. It is worthy of remark that the field in which the deceased was found contained several shafts of abandoned mines; upon visiting the spot the author observed tracks in the grass, as if it had been scraped, proceeding in a direction from the hedge next the public road to that in the opposite part of the field, and under which the body was found; near the former hedge also some fragments of a glass bottle were discovered. The deceased, it appeared, had been at Penzance for some medicine, and it was proved that he had left that town, on his return to the light-house, with a phial in his pocket. 29All these circumstances combined, placed the matter beyond conjecture. He had evidently been strangled, probably at the spot where the glass fragments were found, which were undoubtedly the remains of his phial, broken during the scuffle; besides, it would appear that he had been dragged along the field from this spot to the opposite hedge, for marks denoting such an act were visible on the grass, and this received farther confirmation from the condition in which the shoes of the deceased were found. Who then committed the murder? From the circumstances of its having been perpetrated in a field containing several old mines, without any attempt on the part of the villain to avail himself of the advantage which these caverns would have afforded for the concealment of the dead body, the author was convinced that the perpetrator of the deed would be found in some stranger to the country, for such a one alone could be unacquainted with the mines to which we allude. The suggestion of this idea very naturally gave a direction to the line of inquiry. Were any suspicious strangers in Penzance or its neighbourhood? Had the deceased been seen in the society of any person unacquainted with the country? He had been seen, it was discovered, playing at cards in a public house with some of the privates of the artillery stationed in the Mount’s Bay, amongst whom was a very powerful and athletic Irishman, of the name of Burns, who had lately landed, and immediately enlisted into the corps. Burns was accordingly arrested on suspicion, when the purse of the deceased containing thirty shillings was found on his person. He was, moreover, unable to shew where he was at the time the deceased left Penzance, in the evening; and he was subsequently recognised by two witnesses who had seen him accompanying 30the deceased on the road towards the Land’s End. It is only necessary to add that he was convicted and hanged; and it is not the least satisfactory part of this case to state, that on the evening previous to his execution he confessed to the author, that all the circumstances of the case occurred precisely as we have stated, that he strangled his victim with a pocket handkerchief, but that from the difficulty of completing the act, he was compelled to press his knees upon his chest. In the year 1763, a person of the name of Beddingfield was found lying near his bed, with his face on the floor, and with one hand round his neck. It was argued that he had probably fallen out of bed in a fit of apoplexy, and that the pressure of his own hand had occasioned the marks that were visible on his throat; and a verdict was returned in conformity with such an opinion. Circumstances,^[14] however, arose which excited a strong suspicion against the wife and a man-servant named Ringe, and they were accordingly charged with the murder, tried at Bury St. Edmonds, and condemned. Before execution the man confessed that he had strangled the deceased, having seized him while asleep by the throat, with his left hand.

Whether the wounds observed in the body were necessarily of a mortal nature, or sufficiently severe to have caused immediate death?—It will be generally impossible to solve this problem without the aid of dissection, for although such injuries may appear extensive, we have already in the course of the present inquiries shewn the fallacies to which such indications are exposed, (see our chapter on wounds, vol. ii, page 31116) and the practitioner who ventures to give his judgment on such an occasion, without adequate data, will render himself contemptible in the eyes of the profession, and dishonest in the opinion of the public.

Whether they were inflicted during life?—In discriminating between a wound inflicted upon the living body, and one which has been artfully occasioned after death, for the purpose of embarrassing judicial inquiry, it will be essential to observe, whether any hemorrhage has taken place, externally, or internally, and, moreover, to ascertain whether the blood so effused had coagulated. An instructive illustration of this point is furnished in the very extraordinary trial^[15] of Green, Berry, and Hill in the year 1678, for the murder of Sir Edmonsbury Godfrey, a zealous protestant magistrate, during the pretended popish plots in the reign of Charles the second. It appeared from the evidence of one Praunce, that Sir Edmonsbury was strangled by a handkerchief in Somerset house, on a Saturday night, and after remaining concealed until the following Wednesday, he was carried at midnight into the fields beyond Soho, where he was thrown into a ditch, and his own sword thrust through his body, in order to excite a belief that he had committed suicide. Upon the trial, Messrs. Skillard and Cambridge, surgeons, stated that the sword must have been passed through the body after death, as there was no evacuation of blood, which must have happened had such a wound been inflicted during life.^[15] With regard, however, the fact of hemorrhage being received as a test of life, a few observations may be necessary; it must be remembered that 32extensive wounds may be inflicted on the living body, with but little or no effusion of blood, but such wounds always belong to the class of lacerations, see vol. ii, p. 123. On the other hand, the knife of the anatomist not unfrequently draws considerable blood from the dead body, and wounds have been known to bleed long after life has fled; a fact which, as we have already observed, has been raised by superstition into prophetic importance. The orifice of a vein that may have been opened during life will sometimes bleed afresh after death; this occurred to a very considerable extent in the body of the Prince Royal of Sweden, who had died of apoplexy. John Lees,^[16] the subject of the noted inquest at Oldham, bled after he was laid in his coffin; but, under such circumstances, the blood is never found in the state of coagulation.

If it be determined that such wounds have been inflicted during life, it then becomes important to solve the following questions.

Whether they resulted from an act of suicide or otherwise; whether from accident or design?—There are certain acts of violence which we feel no hesitation in declaring are not likely to be accomplished by the individual himself; such are incisions, or gun-shot wounds on the back of the body, and, perhaps, fractures of the skull; with regard to wounds in the throat, the death of the Earl of Essex, during his imprisonment in the Tower, has given rise to much speculation, and the reader will find an interesting 33digression upon the subject in the history of Bishop Burnet. Some stress has, in a late case, been laid upon the fact of the wound being even and regular, which it was asserted would not have happened had it been inflicted by the hand of an assassin—because any struggle would have made it irregular. This is really a refinement that we do not pretend to understand. Is not convulsive action likely to disturb even the cold and calculating admeasurements of the suicide? instances have frequently occurred where even the chin has been cut during the operation, as in the case which lately occurred near the Serpentine river in Hyde Park, and yet no grounds existed to excite the least suspicion of murder.

Where the individual has perished by fire arms, the circumstance of his fingers being found discoloured by the combustion of the powder in the pan has been alluded to by authors as a proof of suicide, and it certainly carries some weight with it, although the crafty assassin might contrive to produce such an appearance. The state of the linen of the deceased, as indicating the effects of a struggle, may furnish some evidence upon these occasions; and cases have occurred where bloody marks have been discovered on parts of the body, which, from their situation, could not have been produced by the deceased. In Hargrave’s State Trials^[17] there is a very remarkable instance of a woman who was found in bed with her throat cut, and a knife sticking in the floor near her; three of her relations were in an adjoining room, through which it was necessary to pass to the apartment of the deceased; the neighbours were alarmed, and the body was viewed; these relations 34declared she must have destroyed herself; but, from a particular circumstance, they were suspected, and found guilty of the murder; for on the left hand, was observed the bloody mark of a left hand, which of course could not be that of the deceased. How often has the left hand^[18] of the murderer betrayed his deeds of blood!

Whether the cloaths of the deceased betray any odour of spirit, tobacco, sourness, or putridity?—In every case of mysterious death it is an important object to ascertain whether the deceased had been in a state of intoxication; of which the odour of the clothes may in some cases furnish a presumptive proof. It will be seen by consulting our chapter on “Death by exposure to Cold,” that the life of an individual may, under certain circumstances of intoxication, be extinguished by a very slight degree of cold; see vol. ii, page 60.

Whether any articles have been broken or injured in the pockets?—The case of the Cornish murder related at page 27 affords an example of the value of this inquiry; but in appreciating the indications which it may furnish, we must view the circumstance in relation to the other features of the case, when it may acquire an importance which the fact did not individually assume; or it may lose by such a comparison the little value which it appeared to possess.

Whether there is reason to believe that the deceased had been robbed?—We are to derive from this question a probable argument in support of the fact of 35suicide, for in such a case it is not reasonable to expect any evidence of robbery. In the unfortunate case of suicide lately committed in Hyde Park, a base sixpence was found in the pocket of the deceased; had he been plundered, the robber would not have left the base coin, which in the dark and hurry he could not have distinguished. In the instance of a travelling empiric, of the name of Evans, or Evando, as he called himself, for the sake of euphony, who was found dead in a ditch in Cornwall, the exact sum was discovered in his pocket, which he had taken in change at the last public house. Any memorandum found on the person of the deceased, in his own hand-writing intended to convey directions, or his last wishes, to his friends, is a strong presumptive proof that he fell by his own hand. The remains of any poison found about him is one of those facts that is equally favourable to the suspicion of murder as of suicide. We must be allowed to observe that upon the occasion of an unknown person being found dead, some responsible individual should examine the contents of his pockets, and having, if possible, acquired every information as to his name and residence, he should carefully enclose every article so found in a paper, and place his seal upon the packet, and his signature, and the date of the event, upon the cover.

If the deceased be a female, whether there be any marks or bruises that would indicate the commission of a rape?—The importance of this inquiry need not be argued, nor is it necessary in this place to point out the indications which may confirm our suspicions upon this subject. We must refer the reader to our chapter on rape, vol. I, p. 416. The interesting trial of Abraham Thornton, for the murder of Mary Ashford, abounds with curious evidence upon this point.

36

2. Circumstances to be learnt by an examination of surrounding and collateral objects.

The information which may be occasionally derived from the state of the objects surrounding the body, will be best illustrated by the numerous cases in which they have furnished the principal means of discovery.

Whether the spot in question be of a description to explain the cause of the deceased having been found there; or how far its retired situation excites the suspicion that the body has been conveyed thither for concealment, or some other purpose?—Having examined all the circumstances which attach to the person of the individual, we should direct our attention to the spot in which the body is found. The Cornish case which is related at page 27, offers an admirable illustration of the utility of such observations. The nature of the place may perhaps suggest the probability of the person having fallen down from some height, in which case any appearance of wounds must be examined with reference to such a suspicion. We may also in the progress of such an inquiry be led to conclude that the spot may have been infested with some unwholesome vapour, destructive of life; the various circumstances which may contribute to the generation of noxious air have been fully examined under the head of Suffocation, vol. ii, p. 48, and were we to discover a dead body in the vicinity of a lime-kiln, or in an unventilated apartment, where charcoal^[19] had been burning, or 37in a cellar where carbonic acid might probably have accumulated, we should derive an important clue for the investigation.

Whether any indications of a struggle having happened on the spot are visible on the ground, or herbage near the deceased; and whether any footsteps can be traced near the body?—The Cornish case presents itself to us again in illustration of this question. There are also several cases where impressions upon the snow have led to the detection of the guilty party. In the case of Wm. Spiggot, Wm. Morris, David Morgan, Walter Evans, Charles Morgan, and David Llewellin, for the murder of Wm. Powell, Esq. at Glenareth, in Caermarthenshire, March 30, 1770, footsteps were traced from Powell’s house (a deep snow having just fallen) to that of Charles Morgan, who was in consequence apprehended, and did not long deny the fact. Some very interesting evidence was delivered upon the subject of footsteps, on the celebrated trial of Abraham Thornton, for the murder of Mary Ashford, at the Warwick assizes of 1817. William Lovell, a workman at Penn’s Mills, and several other witnesses, spoke as to the presence and direction of the footsteps of a man and a woman, which approached each other at one spot; their appearance shewed that the persons had been running, and dodging each other, “as well from the stride, as the sinking in of the ground, and the little scrape at the toe of the woman’s shoe.” The footsteps were afterwards compared with the shoes of Thornton, and found to coincide; the shoes, moreover, had a particular nail, called a sparrow bill, the impression of which was also perceptible. The same comparison was made with the shoes of the unfortunate Mary Ashford, and with a result which appeared to be 38equally satisfactory and conclusive. Instances have also occurred in which the presumption of guilt against certain persons has arisen from the absence of such marks; this happened in the murder of Mr. Jeffries, by Elizabeth Jeffries, his niece, and John Swan, his servant, at Walthamstow, in July 1751; in which case the perpetrators of the deed were suspected to have been domestics, from the single circumstance of the dew on the grass surrounding the house not having been disturbed on the morning of the murder, which must have happened, had any persons left the premises.

Has there been any thunder storm?—For an account of the appearances in the body of a person, who has been thus suddenly deprived of life, we must refer the reader to our chapter on “Death by Lightning,” vol. ii, p. 63. It will, at the same time, be right to consider, whether the death of the person in question can have arisen from an exposure to the rays of the sun, which has occasionally happened in the harvest field—“And Manasses was her husband, of her tribe and kindred, who died in the barley harvest. For as he stood overseeing them that bound sheaves in the field, the heat came upon his head, and he fell on his bed, and died in the city of Bethulia.” Judith, chap. viii, v. 2, 3. Sauvage relates the case of several young persons, who suffered an asphyxia from sleeping in an open field, exposed to the rays of the sun; and it may deserve notice in this place, that in such cases, hemorrhage from the nose is not an uncommon occurrence; the appearance of blood will thus receive an explanation which might otherwise excite unjust suspicions of violence.

Whether any, and what weapons are lying near the body; and what is their position in relation to it?—Much 39light may be thrown upon the inquiry by an attentive examination of the weapons found near the deceased; and some interesting cases are recorded, wherein this circumstance alone led to their developement. In the year 1764, a citizen of Liege was found shot, and his own pistol was discovered lying near him; from which circumstance, together with that of no person having been seen to enter or leave the house of the deceased, it was concluded that he had destroyed himself; but on examining the ball, by which he had been killed, it was found to be too large ever to have entered that pistol; in consequence of which, suspicion fell upon the real murderers. The wadding of the pistol has also in several instances offered the means of affixing the accusation on the guilty. The Lord Chancellor, in a debate in the House of Lords, in November 1820, quoted a very curious case in which the wadding of the pistol was found to correspond with a torn letter in the possession of the murderer.

If the body is found in the water, are there any and what reasons for supposing that it was killed by other means, and subsequently thrown into the water?—This question has upon several occasions been discussed with great eagerness; see the Reports of the Edinburgh Colleges in the case of Sir James Standfield, in our Appendix, p. 225; and also Extracts from the medical evidence in the case of Spencer Cowper, Esq. for the murder of Sarah Stout, ibid. p. 230. We have already, under the consideration of the phenomena of drowning, p. 35, endeavoured to appreciate the true value of the several indications which have been received as physiological evidence upon this subject, such as the presence of water^[20] in the stomach and 40lungs, the buoyancy of the body, &c. We have therefore only to observe in this place, that upon such occasions there will generally exist collateral circumstances to fortify our judgment; where, for instance, mud, or sand, are found under the nails, or any grass or weeds are discovered in the grasp of the deceased, the inference will be strong that the person died under water; on the contrary, if we discover mortal wounds, or any marks of violence inflicted upon the body, by weapons, we may very justly suspect that the deceased was murdered, and subsequently thrown into the water. But in conducting this enquiry we must be aware of the fallacies to which it is exposed; a person may in the act of drowning accidentally receive bruises and lacerations, or he may have been driven against rocks and stakes by the force of the current. The following case, related by Dr. Gordon Smith, offers a very good illustration of this point. “A few years ago, a man who had leaped from each of the three bridges into the Thames with impunity, undertook to repeat the exploit for a wager. Having jumped from London bridge he sunk and was drowned. When the body was found, it appeared that both his arms were dislocated, in consequence of having descended with them in the horizontal, instead of the perpendicular position.” If we arrive at the conclusion that the body was drowned, we have next to inquire whether the event was accidental or malicious? and whether the act was perpetrated by the deceased or others? The solution of these problems is to be generally effected by the examination of what may be called the 41external circumstances of the case; the locality of the water may be such as to account for the deceased having accidentally fallen into it, or its situation may at once preclude the possibility of such an event. The suspicion of the person having been violently thrown into the water by the hands of the assassin, will be fortified by the discovery of footsteps on the brink, and by the indications of resistance on the part of the deceased, as manifested by the appearance of bruises on the arms and other members of the body. In the case of Mr. Taylor who was murdered at Hornsey, in December, 1818, marks of footsteps, deep in the ground, were discovered near the new river; and on taking out the body, the hands were found clenched, and contained grass, which he had torn from the bank. If the person be found in the water tied hand and foot, there is a strong presumption that he was forcibly placed in such a situation; and yet there are two instances on record which afford very extraordinary exceptions to the truth of such a conclusion. The one occurred in the end of June, 1816, in the case of a gauging-instrument maker, who had been missing from home for several days. His body was discovered floating down the Thames; and on being taken out, his wrists were found tied together, and made fast to his knees, which were in like manner secured to each other. He had been in a state of mental derangement for two years. The cord with which he had tied himself was recognised as one that had hung from the ceiling over his bed, by which he used to raise himself up, having been confined to his bed for several weeks; he was a good swimmer, and it was presumed he had taken the precaution to prevent himself from swimming. The verdict was “found drowned.” The other instance 42occurred two years afterwards. A man, aged 28, with a wife and children, was reduced to great distress. On a certain day he took an affectionate leave of his family, declaring he would not return until he had obtained some employment, by which he should be able to procure them bread. The following day his body was taken out of the new river, with his hands and legs tied. A card with his address was found in his pocket; and also three-pence; when he left home he had five-pence, and it was supposed that he had purchased the cord with the deficient sum. The verdict in this case was “insanity.”

If the deceased be found hanging by the neck, whether he was suspended during life, or hung up after death? Whether it was an act of suicide or murder?—In cases where the deceased has been hanged alive, we shall find the trace of the rope in the neck very distinctly marked by a deep discolouration; whereas, the effect occasioned by such a ligature upon the dead body, will be far less striking. We have also to inquire whether the deceased has any wounds, or whether, upon dissection, the usual appearances are found which generally occur in hanged persons. But, should any marks of external violence present themselves upon such an occasion, we must judge of them with caution. They may perhaps be purely accidental. Dr. Male supposes a case in which the person, with the view of speedily destroying life, may have thrown himself off with violence, broken the rope, and wounded himself by falling upon articles of furniture, and yet had sufficient fortitude again to suspend himself. “An apprentice boy, in my neighbourhood,” says this author, “working alone in an attic, tied one end of a rope loosely round his neck whilst his master was from home, probably without 43any intention of destroying himself, and twisted the other round the projecting part of the top of a door, the planks of which were irregular and somewhat divided; a small stool, on which he stood, slipped from under him, when he fell forwards, striking his temple against the corner of a box which cut him to the bone; he lay along the floor, his head and shoulders only elevated a few inches above it; the cord not being tied, had run nearly its whole length, and then caught between the planks of the door; in this state he perished. The wound was magnified by popular rumour into many, and vengeance was denounced against the innocent master, who was accused of having first killed, and afterwards suspended the boy. On examining the boy the mark of the cord was found to extend from ear to ear; the vessels of the brain were turgid, the thyroid cartilage broken; the nails blue, and the hands firmly closed. From this and other important circumstantial evidence, the coroner’s jury were convinced that the charge was unfounded.” Dr. Smith remarks that, except in the instance of children, or extremely feeble persons, it is very difficult to hang an individual by force, unless the situation be remote, and no interruption likely to take place; or the assailants be numerous and powerful enough, (as in the celebrated case of Porteus) to set all interference at defiance.

Persons have been accidentally hanged, as in the case above cited from the work of Dr. Male, and instances are recorded where the operation has been resorted to as a mode of exciting passion. In all such cases of doubt and difficulty, each particular circumstance, however minute, must be noticed—the nature of the ligature—the manner in which it is fixed—the state of surrounding objects, are often 44capable of throwing light upon the transaction. In the case of George Hebner, a tailor, who was found hanging to the top of a bedstead, in a garret of a house of ill-fame in Dean Street, East Smithfield, kept by a widow of the name of Hughes, the manner in which the hands of the deceased were tied behind his back, and his handkerchief was drawn over his face, proved most decidedly that he had not strangled himself. Upon examining the rope round his neck, it was found to have been fastened by what is termed a sailor’s knot; in consequence of which circumstance a sailor named Richard Ludman, together with the aforesaid Eleanor Hughes, were indicted for the murder, found guilty, and executed.

If the deceased be found in an apartment, whether it be in a house of ill-fame?—Although the act of sudden death in a brothel very naturally excites the suspicion that some act of violence may have been committed, yet this feeling should not be carried too far; we must remember that the individual has been thus exposed, in an increased degree, to the occurrence of several of those natural accidents by which life is so suddenly extinguished; apoplexy, hæmopthysis, and syncope have assailed those who might have been predisposed to such diseases, at the moment of sexual indulgence. In persons advanced in life the trunks of the internal, carotid, and basilary arteries are frequently diseased, and are therefore very liable to rupture whenever the blood is accumulated in any unusual quantity, or the circulation is preternaturally accelerated.

45

3. Circumstances to be learnt by the Interrogation of competent witnesses.

It is merely necessary to enumerate the facts which it is our duty to elicit by such an inquiry, in order to shew their importance and relations; we shall therefore conclude this part of our subject without any farther comments, and proceed to furnish such directions as may enable the medical witness to complete his investigation by the anatomical examination of the body, without which, our preceding researches can never be received as satisfactory and conclusive. “Inspectio ejusmodi cadaveris adeo necessaria est, ut omissa ea, nihil certi de reo statui possit.”^[21]

4. Circumstances to be learnt by Anatomical Dissection.

After the observations which we have already offered upon the subject of wounds, it can be scarcely necessary to urge the necessity of a speedy examination of the more superficial lesions, which are likely to be effaced, or changed in character by the progress of decomposition; “putredo mutat formam cadaveris et lesionem.” The deeper wounds may at the same time be inspected, but the greatest care should be taken that they are not extended during the dissection, for unless they be preserved, as far as it is possible, in their natural condition, we shall not be able to establish a satisfactory connection between the external injury, and the internal lesions with which it may be complicated. Having complied with these injunctions, we are to proceed to lay open the cavities. The order in which these operations are to be performed is not of much moment; but let it be generally 46understood that the discovery of what may appear sufficient to account for death in one cavity, ought never to prevent our proceeding to the investigation of the rest.

Dissection of the brain and its membranes.—The body having been placed on its breast, and the chin raised and supported by a block of wood, the anatomist must proceed by making an incision over the top of the head, from the root of one ear to that of the other; and then by dissecting off the integuments, so as to invert one flap over the face, and the other over the occiput, he will be able to discover whether the scalp has sustained any injury, as indicated by the presence of abscesses, sinuses, contusions, and extravasations; he will, at the same time, ascertain whether any fissure or fracture exist, or any morbid change has occurred in the bone, such as sponginess, exostosis, caries, or exfoliation. In performing this part of his duty, we trust he will not mistake, as Hippocrates^[22] confesses he once did, a fracture for a suture, and vice versa. It is not always easy, however, to determine whether a fracture discovered in the cranium, was produced during life. If it should have occurred immediately before the death of the person, there will be found coagulated blood upon the bone and in the fissures; if the individual has survived for some time, there will be marks of inflammation, and perhaps the formation of pus in contact with the skull; but if a fracture has been occasioned in making the dissection, an accident which may occur in the most careful hands, the blood in the fracture will not be coagulated, nor will there be any effusion around the portions. The skull-cap may 47be now removed; for which purpose the cranium is to be sawed in a circular direction, about a finger’s breadth above the superciliary ridges, and lateral sinuses; the operation must be conducted with great care, or we shall be in danger of wounding the dura mater; the bone must be then divided by a few slight strokes with the chissel and mallet. We shall always find a strong adhesion between the inside of the cranium, and the dura mater; partly, in consequence of the small blood-vessels with which these surfaces are connected, and partly, from the close application of the fibrous structure of the membrane to the bone, and which will vary with the age of the subject, and the form of the skull; the handle of the scalpel carefully introduced will afford the best instrument for overcoming this resistance, and will not be liable to lacerate the dura mater, or to injure the brain. In effecting the separation, the meningeal vessels frequently deluge the whole surface with blood, a circumstance that deserves attention, in as much as their plenitude marks the congestive state of the brain; it shews also that the blood is in a liquid condition, a fact to which some importance has been attached, as it is supposed to occur more particularly in cases of suffocation. The inner surface of the skull may be inspected with the view of ascertaining whether it be carious. The dura mater, thus brought into view, may exhibit marks of inflammation; or coagulated blood or pus may be discovered on its surface, especially in cases where external violence has been inflicted; and it is particularly worthy of notice that such an extravasation, or injury, is not necessarily under the fracture, or part of the cranium upon which the violence that produced it, had been received; on the contrary it often happens that disorganization 48occurs in the hemisphere opposite to that upon which the blow was struck; a phenomenon to which the term “contre coup” has been aptly applied.^[23] The dura mater may now be removed and thrown back, by dividing it all round the margin of the skull, and separating its attachment to the crista galli with a pair of scissars; before we part, however, with this membrane, we should observe whether any osseous deposits,^[24] or other morbid alterations are visible in its texture; for such changes are not uncommon in the dura mater, especially in the falx: the tunica arachnoidea thus brought into view may present various morbid appearances; it may be opaque, or water may be found effused under it.^[25]. The pia mater often exhibits its veins turgid with blood, which indicates that some impediment had existed to the return of the circulation from the head to the heart. It is very important to distinguish between this appearance and that which is the result of the inflammation of the membrane; in this latter case, it should be remembered, that the small arterial branches are the vessels gorged with blood;^[26] and which are so multiplied as to form, by their numerous anastomoses, a beautiful network. In true inflammation also the membrane will be found thickened. There is still another source of fallacy with 49which the anatomist may have to contend in his examination of this organ, a state of vascular congestion, arising after death, from the effect of gravitation. In attending however to the position of the head, and to the circumstances above mentioned, it will not be difficult to establish a just diagnosis upon these occasions. Before cutting into the brain, we should observe whether the convolutions are furrowed as usual, for when much fluid is contained in the ventricles, as in hydrocephalus, the sulci are more or less obliterated. Such a change, therefore, will offer a precaution to the anatomist, to proceed slowly in his dissection, so that the accumulated fluid may not escape. Where a person has been suddenly killed, while in a state of health, the ventricles will, on examination, appear merely lubricated with a fluid; but in cases where the patient has died after protracted disease, more or less serum will be found in these cavities. In our examination of the substance of the brain, we ought to notice its consistence and tenacity, for in many recorded cases, a part of the medullary mass has been found so morbidly soft as to have assumed nearly the consistence of custard; and it has been said to have occurred in cases of fatuity; it seems, however, more correct to consider it as the effects of inflammation: the phenomenon must be carefully distinguished from that natural deliquescence which the whole of the brain undergoes after death, when in an incipient stage of putrefaction. In some instances, the texture of the brain has been found tougher than is natural, and even to have been dry and friable. (See our observations upon the brain in cases of mania, vol. i, p. 327.) Scrophulous and encysted tumours, hydatids, abscesses, and extravasated blood, may also occur, and its cavities may be 50distended with fluid. The state of the larger blood-vessels should be attentively inspected, for in persons advanced in life there appears to be a strong disposition to disease in the internal carotid and basilary arteries. The great importance of minutely inspecting every part of the brain cannot be too frequently, or too forcibly urged, in cases of forensic inquiry. The instances already recorded (page 16) are sufficient to sanction this assertion; and to these, we may add the following illustration which is to be found in the article Cas Rares of the Dictionnaire des Sciences Medicales, by M. Fournier, who was called upon for his opinion in a case of alleged murder at Brussels.^[27] The deceased had quarrelled with another man, some blows had been interchanged, and he had died a fortnight afterwards, emaciated and completely exhausted. Two of the lowest order of practitioners in France, officiers de Santé, as they are called, inspected the body, and pronounced that death had taken place in consequence of the blows. M. Fournier discovered an extensive suppuration in the brain, with a very carious state of the inner surface of the cranium, and learnt that the deceased had been afflicted with head-aches for twenty years. He therefore declared it to be his opinion, that the man had died of a disease of long standing. In this opinion we concur, but it is not equally clear that the crisis was not accelerated by the violence which he had sustained.^[28]

We ought not to quit the examination of the head, until we have examined the base of the cranium, in 51order to determine whether any fracture exists in that part; a curious case is related by Mr. Charles Bell,^[29] of a person who died suddenly some weeks after having received an injury of the head, when it appeared, on dissection, that the base of the skull had been fractured, and that the foramen magnum having been thus roughened, a sudden turn of the head had forced a spiculum of bone into the spinal marrow. The brain has also received fatal injuries from the introduction of pointed instruments through the orbits; Macklin, the comedian, was tried for killing a brother actor by the thrust of his cane. Thomas Dangerfield, one of the celebrated and perjured witnesses on the Popish plot, in the reign of Charles II, was killed by Mr. Robert Francis, by the blow of a cane, the end of which penetrated the orbit.^[30] The author also well remembers the case of an old woman, who, in a fit of intoxication, fell to the ground upon the stem of the tobacco-pipe with which she was smoking, when it penetrated the orbit, and occasioned immediate death; the cause of her dissolution was never suspected until after dissection, as no external wound was visible. In some cases it may be considered expedient to extend our anatomical researches into the spinal column, which may be effected by sawing off the transverse processes. The cervical vertebræ should always be examined where dislocation of the neck can be suspected; for in such cases death may be produced without leaving any external vestige of the injury. This has frequently occurred to coachmen and others, who have been crushed while driving under low archways, by which the nerves, necessary for the support 52of the vital organs have been compressed or lacerated, and death has in consequence ensued. If the cervical vertebræ should be dislocated, a general paralysis will follow, and life can no longer be maintained. M. Petit relates the case of a boy suspended by the head, who striving to disengage himself dropped down dead; and Dr. Monro saw a case where four of the cervical vertebræ were dislocated by a fall, which ended fatally in a few hours.

Dissection of the contents of the thorax.—An incision must be made through the integuments, in a straight line from the os hyoides to the navel; we are then to open into the cavity of the abdomen, for the sake of affording the anatomist free space for his dissections in the chest; and this is to be effected by incisions from the navel to each spine of the ilium, so that we shall have thus described by our dissection a figure resembling the letter Y inverted, thus . In performing this part of our labour, it is essentially necessary to avoid puncturing or injuring any of the viscera; where such a blunder has been committed the dissection has lost much of its value. The integuments of the breast are then to be carefully dissected so as to expose the cartilaginous articulations of the ribs, which must be cut through on both sides; the clavicles should also at the same time be separated from the sternum, by dividing the loose cartilage which unites them. The latter bone, together with the cartilaginous portions of the ribs, must be next turned upwards over the face, so that the cavity of the thorax shall be brought into view. In some cases it will be found expedient to make a still more extensive exposure of this cavity; for which purpose a broader flap must be turned up in front, by extending our dissection of the parietes of 53the thorax farther towards the back; and, instead of cutting through the cartilaginous extremities of the ribs, dividing the bones themselves with a saw. In bending back the sternum, or flap in front, we must take care and divide the mediastinum with the scalpel as near the bone as possible, in order to avoid making any opening into the pericardium, which would otherwise be very apt to happen. As soon as an opening is effected into the thoracic cavity, the lungs collapse, unless the adhesions formed between them and the pleura should prevent it. Our first object will be to observe whether any quantity of fluid is present in the chest, and whether it be limpid, as in dropsy; turbid and containing flakes of coagulated lymph, as in cases preceded by much inflammatory action; or purulent, as in empyema. Having removed the liquid, should any be present, by the application of a large sponge, we must proceed to examine the lungs, as to their colour and general appearance; and, by the introduction of a blow-pipe into the trachea, we should by means of the mouth or bellows inflate these organs, so as to ascertain the degree of distention of which they are susceptible. We may at the same time inspect their structure more minutely by raising each lobe with the hand, introduced into the cavity of the thorax for that purpose. We are next to cut into their substance in order to observe whether they are gorged with blood, and inflamed; whether they are crepitous and light, or dense like liver; and whether they contain any tubercles; should these latter bodies be discovered, we have to ascertain their magnitude, extent, and maturity, and whether any of them have been developed into vomicæ. The anatomist should be cautioned not to mistake the deep colour, and compact 54texture which occur in the depending portions of the lungs, from the mere accumulation of blood in consequence of gravitation, for an inflamed state of the organs; in which latter case a crowd of fine vessels injected with blood of a florid colour furnish a diagnosis that cannot be mistaken.

In cases where a violent effort has preceded death, violet-coloured spots containing venous blood may be perceived on the surface of the lungs, and which are true ecchymoses, occasioned by the rupture of some small vessels. Such phenomena must be carefully distinguished from the livid, black spots, which have been observed in cases of narcotic poisoning, and which are characterised by a more dense, and less crepitating texture. In this stage of the dissection, we may conveniently extend our examination into the trachea, and bronchiæ, and observe whether these tubes contain frothy mucus as in drowning; coagulated blood, as in pulmonary hemorrhage; pus, as in the event of the rupture of a vomica or impostume; or ropy and tenacious mucus or lymph, as in croup, tracheal inflammation, and bronchitis; or chyme, as may occur in cases of intoxication, and diseases of the brain, where vomiting has taken place during a state of insensibility.^[31] We shall at the 55same time be enabled to ascertain whether any mechanical obstruction, from the presence of foreign bodies, exists in the pulmonary passages, and which might have occasioned death to the patient, as related under our history of suffocation, vol. ii, p. 57.

56The pericardium may now be laid open by a longitudinal incision, and we should note the quantity of fluid found in this cavity; in that of a healthy subject there is generally as much as a tea-spoonful of serum. It is important also that we should observe the quality, as well as quantity, of this liquor. Blood has occasionally been found in this situation, when neither a rupture of the heart, or any of its vessels could be discovered; in such cases Dr. Baillie is of opinion that the blood has either passed through the coats of the vessels upon the surface of the heart, by transudation, or been poured out by the relaxed extremities of the small vessels opening upon the surface of that portion of pericardium which 57forms the immediate covering of the heart.^[32] The general appearance of the heart, as to colour, flaccidity, size, and external character, should be observed before its cavities are opened; for the energy of the heart may, in some degree, be inferred from the tension of its fibres, and the red colour of its substance; on the contrary, the opposite appearances would indicate a very different condition of this vital organ, as is well illustrated in the asphyxia idiopathica of Mr. Chevalier.^[33] It is not very unusual to find adhesions connecting the heart more or less closely to the pericardium; and it is perhaps worthy of remark that the length of these adhesions will furnish, in some measure, an indication of the interval that has elapsed, since the occurrence of the inflammation by which they were produced; for they become gradually elongated by the heart’s motion. Dr. Baillie has noticed in his “Morbid Anatomy” an appearance which the author has frequently met with in his dissections,—a white opaque spot, as if from a thickening of the pericardium; in some cases, it is not broader than a sixpence, at other times, it equals in size that of a crown piece; it is most commonly situated on the surface of the right ventricle, and consists of an adventitious membrane formed on a portion of the pericardium, which covers the heart, and may be easily dissected off, so as to leave that membrane entire. The attention of the enquirer is directed to the subject with a view to remind him, that the appearance is one that ought not to be considered as morbid in its origin, or dangerous in its effects. In acute rheumatism a fatal translation of the disease to the heart sometimes occurs, in which case, its surface 58will be found encrusted with coaguable lymph.—The condition of the blood-vessels forms the next object of research; and they should be examined previous to the removal of the heart, as to their calibre, and thickness, and whether any inflammatory indications are observable, or any aneurism; this latter disease has often existed without exciting any suspicion during life. In opening the body of George II, the aorta was found callous at the lower border of its curvature, and so dilated at its upper border, that it was as thin as the finest paper, in which part the rupture took place, and which was succeeded by a fatal hemorrhage; and yet the king, before his death, had not the slightest symptom that appeared to deserve much attention. In every case of sudden death the heart should be removed from the body for the purpose of examination, and no anatomical evidence should be received as conclusive, unless such an operation has been duly performed. For this purpose, the blood-vessels should be first secured by ligatures, for it is very essential to prevent the effusion of blood; and, having then separated it from its attachments, we should proceed to examine the organ in the following manner. Slit open, longitudinally, by means of scissars, the right auricle, at its foreside, then make an incision from the mouth of the pulmonary artery to the point of the heart, guarding against the accident of injuring the two sets of valves; now cut open the whole length of the pulmonary artery, except at its beginning, and at its valves, which ought to be left entire; lastly, open the pulmonary veins, and then the left auricle and ventricle, in a similar manner with what was done to the corresponding parts of the right side.

We beg to direct the attentive consideration of the anatomist to this important part of the inquiry; he 59ought to notice the quantity of blood contained in the cavities of this organ, as well as its colour, and state of coagulation, especially in relation to the arterial and venous sides of the heart; the indications which such an examination may afford will be fully appreciated by referring to our chapter upon “the causes and phenomena of sudden death,” and that upon “suffocation.” In examining the cavities of the heart, especially the ventricles, it not unfrequently happens, that a mass of coagulated lymph, of a yellowish colour, and of considerable firmness, is found to occupy them; this phenomenon, from the manner in which its processes extend into the fasciculi of muscular fibres of the heart, has acquired the name of “polypus of the heart,” and was regarded by the older anatomists as a very common and fatal disease. It is necessary to observe that the phenomenon is now better understood, and it is universally admitted to be the result of slow coagulation after death. The state of the valves of the heart should be attentively inspected, for a disease in these parts may have been the cause of the sudden death which we are endeavouring to discover. The three semi-lunar valves at the origin of the aorta, and the mitral valves, are sometimes in a state of ossification; those placed at the commencement of the pulmonary artery, and the tricuspid are less disposed to take on morbid action than the preceding ones that occupy the arterial side; indeed, there are very few well authenticated instances of such a change. Such a state of the valves of the heart necessarily places the life of the individual in extreme jeopardy, a rupture may be induced, and thus prove instantly fatal, or the action of the heart may be suddenly arrested, and a fatal syncope be the result; and from the suddenness with which 60death takes place in such cases, there is no doubt that many persons so dying, have been erroneously included in the list of apoplectic deaths. In certain diseased states of the valves, the extremities of the body become gangrenous, as if the heart were unable to propel its blood to the extreme parts: the author well remembers two females who were admitted into the Westminster hospital, with a disease of this kind, in which the gangrene gradually extended upwards, and that, after death, the valves of the heart were found ossified. The coronary arteries are occasionally ossified, a circumstance which often accompanies a diseased state of the valves of the heart, and that of the aorta; a change which has been regarded as giving rise to the disease, termed angina pectoris, but which would seem to be symptomatic of any morbid state of the heart. In some cases the heart itself has been found ruptured; we have already offered some observations upon this event, under the history of syncope, p. 27. Dr. Baillie has seen only one case, and in that, the blood escaped into the pericardium, and the person instantly expired.

Examination of the abdomen.—In proceeding to the examination of this cavity, and its contents, the first appearance to be noticed, is that of the peritoneum, in which we have to observe whether any marks of inflammation exist, as displayed by a crowd of very small vessels, injected with florid blood, and a change in the texture of the membrane, by which it appears to be thickened, more pulpy, and less transparent. The existence and character of any fluid in the abdominal cavity should be noted, for its nature will be found to be immediately connected with the nature and extent of the disease by which it has been produced; if the liver be schirrous, the fluid will be 61tinged with bile, and of a yellowish colour; if extreme debility accompany the disease, it will often be of a chocolate colour, from the admixture of blood; should no disease exist in any of the viscera, it will resemble that of the serum of the blood. Previous to the removal of the viscera for more minute examination, it will be proper to observe their general situation and appearance, and to notice particularly whether the calibre of the visceral tube be natural, distended, or contracted; in some instances its diameter is sensibly diminished, as in cases of poisoning by lead. It sometimes occurs that the intestines are glued together with extravasated lymph; and, at others, that the abdominal viscera are more or less joined together by adhesions, which are the effects of former inflammation; these adhesions become gradually so elongated as to produce little or no inconvenience. If upon opening the cavity of the abdomen we should have reason to suspect the existence of any perforations in the stomach or bowels, the anatomist must proceed with great caution, so as not to enlarge their diameters, or alter their appearance. In the case of Miss Burns, the medical report lost much of its value, from the want of due precaution in this particular; see our account of the dissection, vol. ii, page 178. Should the contents of the stomach or intestines have escaped into the general cavity, we should be careful in collecting such matter, with a view to its future analysis. The size and appearance of the stomach must be noted, and we should observe whether any marks of inflammation, or gangrene, are visible on its external surface; in tracing the intestinal tube through its course, any appearance of inflammation, or phlogosis, should be attentively examined; for which purpose a ligature may be passed at some distance 62above and below the patch, and the portions of the intestine be then removed. In many cases it will be essential to remove the stomach, as where poisoning is suspected; for which purpose double ligatures, about an inch asunder, must be placed above the cardia, and similar ones in the duodenum; the division may then be made by the scalpel in the space between them. The stomach should be examined without delay, for no one who has not been engaged in such researches, can form an idea of the rapidity with which this viscus loses its characteristic appearances by exposure to air. The stomach is to be slit open with a pair of scissars, care being taken that none of its contents are lost. If the deceased had been found in the water, the quantity of that fluid, found in this viscus, should be noted; and under such circumstances, the presence of any weed, mud, or other extraneous matter, requires particular notice. The quantity of alimentary matter will also afford an object of remark, and it will be right to observe whether, by odour or inflammability, the presence of any spirit can be detected. Having then disposed of the contents of the stomach, and referred them to the chemist for examination, we proceed to examine the viscus itself; in the first place, we should be careful in ascertaining whether any white, or shining particles adhere to its coats; if so, the substance must be preserved for future analysis; the cardia and whole interior of the stomach is to be carefully inspected, and every indication of inflammation, ulceration, gangrene, and schirrosity, is to be noted in reference to its exact situation and appearance; with a view to deduce an opinion as to the probability of its being the effect of poisonous ingesta, or of recent, or remote disease. The mucous membrane of 63the stomach should be squeezed between the fingers, and the nature of the matter, if any should ooze out, must be noted, which on some occasions will furnish a valuable diagnosis; where, for instance, the person had died of melæna, a black matter, similar to that vomited will exude, a phenomenon which is never visible in cases of acrid or corrosive poisoning. We have already entered so fully into the history of gastric perforations, that it will be only necessary to allude to them on this occasion; see vol. i, page 164. The state of the villous coat should always be minutely inspected, we should however be cautious in pronouncing every red appearance as indicative of inflammation; it may in some cases depend upon the presence of colouring matter derived from the ingesta; (see the case related in vol. ii, p. 231.) Nor ought the state of the œsophagus to be overlooked, which in cases of poisoning will afford an important indication; it should, therefore, be removed from the body; had this dissection been performed in the case of Miss Burns, the medical witnesses on that memorable occasion, would have been spared, at least, one great cause of censure. It is not impossible but that the œsophagus may be ruptured in a violent paroxysm of vomiting, and thus be the cause of death. Boerhaave relates an interesting case of this kind, which occurred to Baron Van Wassener, Admiral of Holland.

Rupture of the stomach is an occurrence which sometimes takes place from the action of vomiting, during the progress of ulceration, when the membranes of this viscus are nearly perforated. It also occasionally happens from external violence. In the Medical Repository,^[34] a case of ruptured stomach is 64related by Mr. Brown, in which the accident must have been occasioned by the action of the diaphragm and abdominal muscles, at the time of exertion, the stomach of the individual having, from disease, been less capable of sustaining any degree of violence. The following are the particulars of the case; “A coal-heaver, aged 50, whilst stooping in the act of lifting some coals, placed his hand suddenly on the pit of the stomach, and complained of severe pain in that situation; this was immediately succeeded by two deep sighs, when he dropped down and expired. On dissection, the parts immediately round the opening were in a higher state of vascularity than the rest, and put on a decidedly torn appearance, which was also observable in the peritoneal coat.”