Henry Harvey Littlejohn and Thomas Allan Ingram

“ Ordinary homicide may be accomplished by several modes that may sometimes be ascertained by examination of the body, e.g. poison.
As a preliminary in all cases of homicide, it is the duty of the medical jurist in the first place to ascertain the fact of death, and to distinguish between real and apparent death; and then to determine, if possible, the period at which death took place.
Infanticide, or child murder, is by the British law treated with the same severity as the murder of an adult. Indeed infanticide as a crime distinct from murder has no legal recognition. ”

“ Wounds penetrating both sides of the chest are generally considered as fatal; but possibly there may be recovery from such. Wounds of the abdomen, when they do not completely penetrate, may be considered as simple wounds, unless when inflicted with great force, so as to bruise the contents of the abdominal cavity; in that case they may produce death without breach of surface, from rupture of some viscus, as sometimes happens from blows or kicks upon the belly. Wounds injuring the peritoneum are highly perilous, from the risk of severe inflammation. ”

“ When proofs of respiration—it may be to such an extent as to leave no doubt as to live-birth—have been found, the cause of death is then to be investigated. Wounds, and other forms of injury, must be sought for. There may be signs of strangulation, suffocation, puncture of the fontanelles and consequent injury to the brain, the administration of a poison, or other means of procuring death. ”

“ History of Forensic Medicine
The true origin of medical jurisprudence is of comparatively recent date, although traces of its principles may be perceived in remote times. Among the ancient Greeks the principles of medical science appear only to have been applied to legislation in certain questions relating to legitimacy. In the writings of Galen we find, however, remarks on the differences between the foetal and the adult lungs; he also treats of the legitimacy of seven months' children, and discusses feigned diseases. ”

“ Death from burning is generally accidental, very rarely suicidal, and when homicidal is usually employed to conceal traces of other violence inflicted upon the body. In large conflagrations death is not always due to burning. Charred bodies may be found presenting various injuries due to the fall of beams, crushing, the trampling of others trying to escape, &c., or fractures and lacerations may be due simply to the action of the heat. Death may result from such injuries, or from suffocation by the gases of combustion, before the victim is affected by the actual fire. ”

“ Duration of Human Life.—The chances of human life form an important subject of inquiry, and on deductions from comparisons of birth and death rates is founded the system of annuities, insurance against loss in sickness, and the insurance of lives. ”

“ Death from extreme heat usually occurs in the form of burning and scalding, attended with destruction of a large portion of the cutaneous structures. Here the cause of death is obvious. The human body is capable of exposure to very hot air—as is seen in Turkish baths—for a considerable period with impunity. Sunstroke is a cerebral affection brought on by too great exposure to a hot atmosphere, especially whilst undergoing fatigue. ”

“ Punctured wounds or stabs require minute attention; for there have been instances in which death has been produced by an instrument so small as a pin thrust into a vital part. Wounds of the head are always dangerous, especially if the blow has been severe. The person so wounded may die without division of the skin, or fracture of the bones, as happens in what is known as concussion of the brain. ”

“ The fact that a body may be suspended after death, and that if this be done speedily whilst the body is still warm there may be a post-mortem mark undistinguishable from the mark observed in death from hanging, must not be forgotten.
Suffocation may occur from the impaction of any substance in the glottis, or by covering up the mouth and nose. It is frequently of accidental origin, as when substances become accidentally impacted in the throat, and when infants are overlaid. The phenomena are those of pure asphyxia, which have already been detailed. ”

“ The signs of pregnancy are of the utmost importance to the medical jurist. He may be called upon to pronounce upon the virtue of a female, to sustain or rebut a plea for divorce, to determine whether a capital sentence shall be carried out, or to determine whether it is probable that an heir will be born to an estate. ”

“ Development of the Human Frame.—The development of the physical and mental powers of the human being is a factor of great consequence in determining criminal responsibility, civil responsibility, or the power of giving validity to civil contracts, and in determining the personal identity of a living person or of a corpse. Human life is usually divided into the five periods of infancy, childhood, youth, manhood and old age. ”

“ Suicide and accidental death from these causes are still more common.
Drowning is thought to produce death occasionally by the suddenness of the shock causing suspension of the functions of circulation and respiration—by shock without a struggle. The usual mode of death appears, however, to be by the circulation of unoxygenated blood through the brain acting as a poison upon that organ; and this is attended with all the phenomena of asphyxia, as in suffocation. ”

“ The Signs of Death.—The determination of the actual existence of death assumes a certain importance in tropical countries, where the necessity for speedy interment may involve a risk of burial alive. Such an accident cannot well occur where a medical man confirms the existence of death, and in the United Kingdom, where burial rarely takes place before the lapse of forty-eight hours, such changes usually occur in the body as to render any error practically impossible. ”

“ The blood, which during life is equally distributed throughout the body, gravitates to the most dependent parts and develops a discoloration of the skin which is known as post mortem lividity or post mortem staining. At a variable period of time, dependent on the cause of death, also the temperature and moisture of the air to which the body is exposed, decomposition or putrefaction sets in. ”

“ In cases of fatal wounding, among the points to be noted, which will help to decide the question, are the situation, direction and extent of the wound, the position in which the body and any weapon may be found, together with the presence and distribution of any blood marks and the signs of a struggle. In wounds caused by firearms the injury, if suicidal, is usually situated in a vital and accessible part of the body, the temple, mouth, and chest being the favourite situations ”

“ Even wounds of the scalp may prove fatal, from inflammation extending towards the brain. Punctured wounds of the head are more dangerous than cuts, as more likely to excite fatal inflammation. When the brain and its membranes are injured, all such wounds are generally fatal. Wounds of the face or organs of sense are often dangerous, always disfiguring, and productive of serious inconvenience. Wounds of the neck are always serious whenever more than the skin is divided. The danger of opening large blood-vessels, or wounding important nerves, is imminent ”

“ Vegetable dyes may likewise give red solutions, but they may be distinguished from blood by the addition of ammonia, which alters the colour of the former, but rather intensifies the red colour of a blood solution.
The differentiation between human blood stains and those produced by the blood of other animals, more especially domestic animals, is a matter of great importance to the medical jurist. When the blood stain is fresh, measurement of the corpuscles may decide the question, but in the case of dry and old stains it is impossible to make the distinction. ”

“ A point of considerable interest, which has sometimes given rise to doubt as to the poisonous character of meat in certain instances, is, that the same food may be poisonous at one time and not at another. ”

“ From 1829 Great Britain produced an abundant crop of literature on forensic medicine. Sir Robert Christison’s admirable treatise on Toxicology, Dr A. S. Taylor’s Principles and Practice of Medical Jurisprudence (1905 edition, by F. J. Smith) , the same author’s Elements of Medical Jurisprudence, Dr Guy’s Forensic Medicine, and Ogston’s Lectures on Medical Jurisprudence have become well-known and widely circulated works. The separate memoirs of Taylor, Christison, Guy and others are also storehouses of facts and deductions in the science. America, too, has not been behindhand in the race. ”

“ It must be borne in mind that, although live-birth cannot be affirmed in the absence of signs of respiration, the presence of these signs is not proof of live-birth in the legal sense of the term. The law demands for live-birth a separate existence of the child after delivery ”

“ This last is an important fact; because we are not always to consider the spot where the body of a person killed by a wound of the heart, and apparently remaining where he fell, is found as that in which the fatal wound was inflicted. Instances have occurred of persons surviving severe wounds of the heart for several days. Broken ribs are never without danger; and the same may be said of severe contusions of the chest, from the chance of inflammation extending inwards. ”

“ The phenomena attending asphyxia are as follows. As soon as the oxygen in the arterial blood, through exclusion of air, sinks below the normal, the respiratory movements grow deeper and at the same time more frequent; both the inspiratory and expiratory phases are exaggerated, the supplementary respiratory muscles are brought into play, and the breathing becomes hurried. As the blood becomes more and more venous, the respiratory movements continue to increase both in force and frequency. ”

“ The above phenomena are not all observed except in cases of sudden and entire exclusion of air from the lungs. In slow asphyxia, where the supply of air is gradually diminished (e.g. in drowning) , the phenomena are fundamentally the same, but with minor differences. The appearances of the body after death from drowning are various. There may be pallor of the countenance, or this may be livid and swollen. The air passages are filled with frothy mucus, and there may be water in the stomach. The ends of the fingers are often excoriated from grasping at objects ”

“ Wounds of the stomach or intestines, or of the gallbladder, generally prove mortal, from the effusion of their contents into the peritoneal cavity producing fatal inflammation. Wounds of the liver, spleen or kidneys are generally soon mortal, from the great vascularity of those organs. Wounds of the extremities, when fatal, may generally be considered so from excessive haemorrhage, from the consequences of inflammation and gangrene, or from the shock to the system when large portions of the limb are forcibly removed, as in accidents from machinery, and in wounds from firearms. ”

“ Impotence and sterility may arise from organic or from functional causes, and may be curable or incurable. Impotence (q.v.) is taken cognisance of by the law courts as a ground of divorce, and might, of course, be urged as a defence in a case of rape. Sterility is not a ground of divorce, but might be a question of importance in cases of legitimacy.
6. Pregnancy.—This subject presents one of the widest fields for medico-legal evidence. The limits of age between which it is possible, the limits of utero-gestation, and the signs of pregnancy may all in turn be the subjects of investigation. ”

“ Marriage.—Under this head the medical jurist has to deal principally with the nubile age, viewed in the light of nature and according to legislative enactments, and with such physical circumstances as affect the legality of marriages, or justify divorce.
In Great Britain the age at which the sexes are first capable of propagating the species is later than in more southern climes. Ordinarily it does not occur before fifteen years of age for the male and fourteen for the female ”

“ There is much, however (e.g. the existence of a double or bifid uterus) , to countenance the view that a double conception is possible.
8. Monsters and Hermaphrodites.—To destroy any living human birth, however unlike a human creature it may be, is to commit a crime. Blackstone states that a monster which hath not the shape of mankind hath no inheritable blood; but the law has not defined a monster, nor what constitutes a human form. The same author states that if, in spite of deformity, the product of birth has human shape, it may be an heir. ”

“ Death from Asphyxia.—Among the forms of violent death due to this cause are drowning, hanging, strangulation, garotting, smothering, suffocation from choking, mechanical interference with the expansion of the chest walls, as when persons are crushed together during a panic in a fire, breathing poisonous gases, such as carbonic acid or carbonic oxide. ”

“ Manhood (or Womanhood) is the period of perfection of all the bodily and mental powers. It ceases in woman with the cessation of the monthly flow at about forty-five years of age; but in man it often extends to a much later period of life. ”

“ The period of total abstinence from food required to kill an adult is unknown, and greatly depends upon whether there be access to liquid. In some cases persons have been able to subsist on little or no nourishment for long periods, the body being in a state of quasi-hibernation.
7. Death from Extremes of Temperature.— (1) Death from cold is not often observed in the British Isles. A portion only of the body, as the extremity of a limb, may perish from extreme cold. ”

“ Youth is marked at its commencement by the changes which occur at puberty—the development of the genitals in both sexes, the appearance of hair on the genitals, the appearance of a beard in the male, the development of the breasts in the female, the appearance of the monthly flow in the female, and the ability to secrete semen in the male. ”

“ Personal Identity.—Where the identity has to be established or disproved after long absence, exposure to foreign climates and hardships, wounds, &c., the problem has often been extremely difficult. The data for identifying a person are individual and family likeness, stature, the colour of the eyes, peculiarities of garb and manner, recollection of antecedent events, but more especially marks on the persons either congenital or acquired. Such are naevi or mother's marks, scars, and disunited or badly united fractures, known to have existed upon the missing person (see Identification) . ”