R. J. M. Buchanan

“ Letheby defines a poison as “anything which otherwise than by the agency of heat or electricity is capable of destroying life, either by chemical action on the tissues of the living body, or by physiological action from absorption into the system.” ”

“ Murder is constituted in law by any wilful act causing the destruction of human life, whether plainly intended to kill, or displaying such utter and wicked recklessness as to imply a disposition depraved enough to be wholly regardless of the consequences. Murder may be the result of personal violence, poison, or by the committal of some other serious crime, as where anyone causes the death of a woman in the attempt to procure criminal abortion, rape, or by the exposure of an infant which results in its death. The use of weapons is not essential. ”

“ Medical men will consult their own dignity and that of their profession by remembering that in cases of alleged insanity, as in fact in all other cases when their opinion is sought, they are not justified in taking sides. Their evidence will be the more valuable in proportion to the care they take in examining into the facts of the case, and the good sense and judgment shown in their examination of the patient. ”

“ Human ingenuity is not wanting among those who, for private ends, pretend to be suffering from disease. The soldier or sailor, anxious to escape the dangers of active service, finds a ready means of evading his duties by shamming; the prisoner, in order to lighten the burden of his punishment, does the same. A man declares himself impotent to save the expense of keeping an alleged bastard child, or to avoid punishment for rape. ”

“ The face depicts misery, the eyebrows raised, and the person moves about incessantly, picking up objects and replacing them, moaning and uttering the same phrases expressive of misery and hopelessness, wringing the hands, and rocking the body to and fro. ”

“ Homicidal strangling is as common as homicidal hanging is rare. It is difficult to hang a man, but easy to strangle him, because consciousness is rapidly lost, and the victim is unable to offer any resistance once the cord is tightened round the neck. In homicidal strangling the murderer generally uses a great deal more violence than is necessary, and so there is found after death much more local injury in such cases.
Severe local injuries, such as fracture of the laryngeal cartilages or hyoid bone, denote homicide, as they are rarely noticed in suicidal strangulation. ”

“ The Stomach.—Casper considers that the presence of fluid in the stomach, corresponding to that in which the body is found, is “an irrefragable proof of the actual occurrence of death from drowning,” and that the swallowing of it must have been a vital act of the individual dying in the water. The absence of water from the stomach does not negative death from drowning. Water is not always present. It is possible for it to reach the stomach of a submerged body after death.
Water in the intestines is a more reliable sign of death from drowning, and indicates submersion during life. ”

“ Dying Declarations.—The principle on which these are accepted is founded, partly on the awful situation of the dying person, and partly on the absence of interested motives in one on the brink of eternity, and which is supposed to obviate the necessity of a cross-examination. The law presumes that any one cognisant of impending death will tell the truth, and such declarations are equal to evidence on oath. The greatest care must be taken by the medical man who is called in to see a person supposed to be dying, with regard to any declaration he or she may wish to make. ”

“ General paralysis may accompany any of the forms of mental derangement, but it is generally preceded by a stage of melancholy. As the paralytic affection becomes more marked, there is a concurrent loss of memory and incapability of mental association, and all sense of duty is lost; the patient becomes careless as to his person, and dirty in his habits. He expresses himself as possessed of great property, and boasts of the wonderful deeds that he can or has accomplished. ”

“ A surgeon does not undertake to perform a cure, nor does he profess to bring the highest professional skill into the consideration of the case; but he does undertake to bring a fair and reasonable amount. The degree of skill required by law is good common sense, or such knowledge as the operator had, joined with a good purpose to help the afflicted, even if such interference rendered the patient a cripple for life. ”

“ Mania is the result of a morbid condition of the brain, and to express which “the term raving madness may be used with propriety, as an English synonym for mania. All maniacs display this symptom occasionally, if not constantly, and in greater or less degree.” Like other diseases, mania observes the same pathological laws. There is a period of incubation, during which the true state of the patient is in most cases misunderstood, or not appreciated. Mental exaltation may exist from the first onset of the disease, or the attack may be ushered in by a stage of gloom or despondency. ”

“ Amos writes: “In the event of a man twice married dying, and leaving a daughter by each marriage, his estate would be equally shared by the daughters of the two [Pg 185] marriages; but if we suppose that there is also a son by the second marriage, born in a doubtful state, the legal effect of his momentarily surviving birth would be to disinherit the daughter of the first marriage entirely, and transfer the whole of the estate to the daughter of the second marriage, she being sister to the male heir, while the daughter of the first marriage is only half-blood.” ”

“ The heart, moreover, continues to contract after the lungs have ceased to perform their duty. Death is thus due to apnœa—that is, death beginning at the lungs—and not to syncope. Death in some cases is from neuro-paralysis or nervous apoplexy. In death by shock, which in most cases is instantaneous, both sides of the heart are equally filled. Death, the result of disease, may present all the signs of death from suffocation, and no suspicion may be aroused as to the cause of death from the post-mortem appearances, especially if putrefaction have set in. ”

“ It is often a difficult matter to distinguish the effects of compression from those common to drunkenness or narcotic poisoning. The odour of the breath and the history of the case will assist in forming an opinion. Concussion of the brain may prove fatal without either fracture of the skull, effusion of blood within the cranium, or any other change being observed on dissection, death being caused by the shock given to the whole nervous organ, which, being unrelieved, speedily lapses into annihilation of function.
The symptoms of compression—a full, strong, and often irregular or slow pulse ”

“ All that is necessary is that there should be such proof of duration of pregnancy as made a living birth possible. If the accused can bring forward a witness to whom she communicated her pregnancy, or called for assistance at the birth, or (it is believed) can prove that the child was born dead, she is entitled to an acquittal.
It has also been said that a woman ought not to be convicted of “concealment of pregnancy,” if at the time of delivery the fœtus do not appear to have reached the seventh month of intra-uterine existence. The birth of a “child,” whether dead or alive, is essential ”

“ Death may even result from suffocation—the skin, in this case, presenting a cyanosed appearance. The mouth is excoriated, the lips shrivelled and blistered. In children, when the acid has been poured far back into the mouth, by forcing the bottle backwards before emptying it of its contents, the mouth may more or less escape injury, and the signs in it of corrosive poisoning be absent. The teeth may become loose, and fall out of the mouth. The mental faculties remain clear, death generally coming on suddenly, the patient dying convulsed or suffocated. ”

“ If a majority of the jury are not satisfied with the medical evidence, they may require the coroner, in writing, to summon another legally qualified practitioner, named by them, to make a post-mortem examination, with or without analysis of the contents of the stomach and intestines, and give evidence as to the cause of death. A medical practitioner who fails to obey the summons of a coroner, issued in pursuance of the Coroners Act, is liable to a penalty not exceeding five pounds, unless he shows good and sufficient cause for not having so done. ”

“ MENTAL UNSOUNDNESS
In the whole range of medical jurisprudence there is no subject more interesting, more difficult, or more important than the diagnosis of insanity, and its relation to the criminal responsibility of individuals. It is impossible, in the short space at our disposal, to do more than to offer a few remarks which may assist the student in the elucidation of some of the most important cases which may engage his attention.
Legal Definitions.—Three forms of mental disorder are recognised in law:
1. A nativitate, vel dementia naturalis—idiocy or imbecility. ”

“ In the case of a husband seeking a nullity of marriage on the grounds of impotence or sterility in his wife, the question at issue is not whether she can bear children, but can she permit sexual intercourse? ”

“ Death by drowning occurs when the breathing is arrested by watery or semi-fluid substances, blood, urine, or the muddy semi-fluid matter found in cesspools and marshes. It is not necessary for the whole body to be submerged. Death may result if the face alone be immersed, as in the case of a man in a fit of drunkenness being drowned in the water contained in the imprint of a horse‘s hoof left in the mud. ”

“ To destroy the organic matter, the moist method is the one in general use: After reducing the contents of the stomach or the viscus to a pulp, they are mixed with distilled water to the consistency of thin gruel, and placed in a flask with some crystals of potassium chlorate—half an ounce to each pound of the liquid. Pure hydrochloric acid is added, and the flask gently heated on a water bath, a mixture of chlorine and oxides of chlorine is given off and gradually breaks up the organic matter, converting at the same time any mineral poison present into the chloride. ”

“ Dreadful pain is felt in the stomach, attended with constant eructations, and vomiting of a brownish or blackish matter, mixed with blood. Mucus, together with, in severe cases, portions of the mucous membrane of the stomach, may be detected in the vomited matters, which have an intensely acid reaction, changing the colour and destroying the texture of cloth or other material on which they may fall. The act of swallowing is attended with intense pain, and not infrequently is rendered quite impossible. The thirst is intense, the bowels are confined, and the urine is diminished in quantity. ”

“ Medical Jurisprudence, Forensic Medicine, or Legal Medicine are terms for that science which teaches the application of the knowledge of all branches of medical and surgical science and art to the solution of every question connected with the conservation of the species and the administration of Justice. ”

“ Arsenic is not, as a rule, a corrosive poison. One case is, however, on record where it acted as a corrosive, but the purity of the arsenic in that case has been questioned. Its action is that of an irritant, causing inflammation in the stomach and bowels of those who have taken it; and it appears that fatal effects are produced whether the poison be swallowed or introduced into the system in any other way—e.g. by injection into the rectum or vagina, or applied to the surface of the body. ”

“ A medical practitioner may be called upon to give evidence as to the capacity of a testator to make a valid will. An ordinary person witnessing a will does so to fact only, but if a medical man do so it implies that he was of the opinion that the testator was fit to make a will and of a sound and disposing mind. In making an examination of a person for fitness to make a will, the medical man must endeavour to find out if the testator understands the nature of his action, and all the details associated with it ”

“ Allen and Pepys, on the other hand, stating that 10 per cent. of the gas would cause death. Bernard considers that it is not poisonous, as it can be injected into the bodies of animals without injury, and that its action is purely negative; it is irrespirable in the same sense as pure hydrogen or nitrogen is—simply, therefore, causing death by suffocation. Whatever may be the true explanation of its action, it is enough for all practical purposes to know that death follows when it is breathed, even when mixed with a normal amount of oxygen. ”

“ Your duty is to request the woman to allow of the necessary examination, giving her the warning which every magistrate or coroner is bound to give to any person charged with a crime, before requiring an answer to a question which may be used in evidence against her at the subsequent trial. The innocent and the guilty may alike object to an examination, but the presumption is against the party declining, if several have voluntarily submitted. A young lady committed suicide rather than submit to an examination by two medical men under an order from the coroner. ”

“ The evidence of live birth in civil is somewhat different from that required in criminal cases. The viability of the child is determined in Scotland by its crying; in France, by its respiration; in Germany, “the LIVE BIRTH of a child is to be held proven when it has been heard to cry by witnesses of unimpeachable veracity present at its birth”; but in England, the pulsation of the child‘s heart, or any tremulous motion of the muscles, however slight, has been considered as satisfactory proof of live birth. ”

“ If the stomach or part of the intestines present any remarkable appearance, examination may be reserved, if convenient, till a future opportunity; but in every circumstance it must be preserved and carried away, as it may itself be an important article for analysis. The throat and gullet may be examined at once, and preserved with their contents, which, if abundant, may be kept apart in a bottle. In addition to the alimentary canal and its various contents, portions of the solid organs of the body ought to be secured for analysis. The most important are the liver, spleen, and kidneys. ”

“ We know not the cause, but certain poisons appear to select a particular route for their exit—thus iodide of potassium leaves by the urine; mercury and its salts by the saliva; arsenic and eserine, the active principle of the Calabar bean, in small quantities, by the stomach, &c. We are, however, prepared to show that all poisons must enter the blood before they produce their effects, and that almost simultaneously with the entrance of the poison into the blood a process of elimination begins, and that fatal effects depend upon absorption taking place more rapidly than elimination. ”

“ A medical man should also be very careful never to give any medicine “to bring on the courses” if he has the slightest suspicion of pregnancy, even as a “placebo” to satisfy an importunate patient, for should abortion be otherwise procured, his really harmless medicine may be accused with the result, and a grave suspicion be raised against him, to say the least.
The term abortion is understood in medicine to mean the expulsion of the contents of the fœcundated uterus before the sixth month of pregnancy, that is, before the child is considered viable. ”

“ If his delusion were that the deceased had inflicted a serious injury on his character and fortune, and he killed him in revenge for such supposed injury, he would be liable to punishment. “Here,” says Maudsley, “is an unhesitating assumption that a man, having an insane delusion, has the power to think and act in regard to it reasonably, ... that he is, in fact, bound to be reasonable in his unreason, sane in his insanity.” ”

“ In Scotland they are always excluded, although, by mutual consent, “experts” may remain to hear the general evidence on which they are to express their opinions, but when an expert is giving his opinion the others must leave the Court. In the latter country also, a medical witness who has been in Court cannot be examined on the facts of the case, but only on matters of opinion. A medical man is, however, sometimes allowed, on a special motion, to remain, although he is to be examined as to facts, and withdrawn when other witnesses are to be examined as to facts to which he is to speak. ”

“ Certainly, in recent cases of mania—cases which have lasted more than six weeks, and in young persons in whom I have seen the maniacal attack pass into dementia—I have known the most acute paroxysms of mania exist, rapid and violent talking, continual motion, inability to recognise surrounding persons and objects, a disposition to tear and destroy clothes and bedding, without any heat of the scalp or of the surface, without either flushing or paleness of the face, with a clean and natural appearance of the tongue, and a pulse no more than eighty or eighty-five. ”

“ The child may be a witness if she understands the nature of an oath or understands the duty of speaking the truth, but her evidence must be corroborated by some other material evidence in support thereof, implicating the accused. The carnal knowledge of a girl above thirteen and under sixteen, or of any female idiot or imbecile woman or girl, under circumstances which do not amount to rape, but which prove that the offender knew at the time of the commission of the offence that the woman or girl was an idiot or imbecile, constitutes a misdemeanour. ”

“ A mortal wound is one which is rapidly followed by death. Wounds, however, which in themselves could not be regarded as dangerous to life, may become so by intercurrent complications, such as erysipelas or other infective process. As a general rule, only those wounds in which the danger to life is imminent should be stated as dangerous to life. Compound fracture of the bones of the cranium, injury to any large arterial trunk, or to any of the internal organs, may be considered as “dangerous to life” ”