Medical Jurisprudence, Volume 2 (of 3)

To aid the administration of justice in cases of homicide is not only the most useful, but the most frequent, application of medical jurisprudence; this subject, as well for its complexity as for its importance, must be subdivided into many heads. It is first necessary that the medical practitioner should determine by examination, inspection, or dissection, whether the matter ought to be referred to the criminal tribunals, or whether the decease of the party is to be attributed to any of those natural causes, which are generally classed as “Death by the Visitation of God.” In some instances this examination will take place in aid of the coroner’s inquest, in others it will be preparatory to it; in both cases it is equally important that it should be minutely, faithfully, and ably conducted; for it is on the medical report that the first impressions will be founded, and the prejudices created by it in the public mind may not easily be effaced by any subsequent investigation. If, however, it be determined that the cause of death has been violent, it is then necessary to enquire to which of the classes of homicide the act is to be attributed.

“Homicide, properly so called, is either against a man’s own life, or that of another.” 1 Hawk. P. C. 102.

The first offence constitutes the crime of suicide or felo de se.

The second has many varieties; it may be justifiable, excusable, or wilful; and this last again, may be with, or without, malice prepense, which constitutes the difference between manslaughter and murder; both are felony, the one with,[1] the other without, the benefit of clergy; to these and their numerous subdivisions we shall separately direct the attention of our reader; having first, by a general view of the physiology of death, and some practical observations on the best modes of investigation, prepared the way for a minuter examination of many of those various modes of destruction to which human life is liable.

OF REAL AND APPARENT DEATH.

If life be defined, that power by which organized beings are enabled to resist the physical and chemical operation of surrounding agents, it follows that death must be marked by the occurrence of those phenomena to which the elective attractions, no longer suspended or controlled, will necessarily give rise; hence putrefaction has been considered by many authors as the only certain sign of dissolution; unfortunately, however, this process of decomposition does not immediately display its agency by visible effects; the countenance has remained unchanged for a considerable time after death, and cases have occurred in which its colour and complexion have not only been preserved, but even heightened. This difference in the celerity with which the body putrefies did not escape the observation of the ancients, and like every other mysterious occurrence, was attributed by them to divine interposition; we accordingly find that their poets mentioned those who preserved the appearance of freshness after death, as favoured persons, who had fallen by the gentle darts of Apollo and Diana; thus Hecuba[2] declares that Hector, although dead for twelve days, still remains fresh, like one who had died by the hands of Apollo. On the other hand, in certain morbid states of the living frame, so feebly do the powers of life resist the operation of physical agents, that if the body cannot be said actually to enter into a state of putrefaction, it may at least assume appearances so analogous as to be mistaken for it. The test of death, therefore, must rather be sought for amongst those signs which indicate the quiescence, or cessation of the functions of life, than from those which manifest the decomposition of the organs by which they are performed; and here again it may be imagined that no difficulty or fallacy can occur; the total cessation of respiration, pulsation, sensation, and all motion, it might be supposed, would indicate to the least experienced the departure of life, while the general aspect of the body, its pale and livid hue, the coldness of its surface, and the stiffness of its limbs, we might conclude were signs so palpable and satisfactory as to defy the possibility of doubt. To the skilful medical practitioner we apprehend such signs must ever be unequivocal; but we are not prepared to say that a common observer may not be sometimes deceived by them; in cases of extreme debility, as in the latter stage of fever, and where the patient is confined in vitiated air, the exhaustion may be so considerable as to lend all the appearance of death; indeed that such cases have occurred we have no less a testimony than that of the philanthropic Howard, who, in his work on Prisons, says, “I have known instances where persons supposed to be dead of the gaol fever, and brought out for burial, on being washed with cold water, have shewn signs of life, and soon afterwards recovered.” Hippocrates, in his Epidemics, also mentions the case of a woman who, being in appearance dead, from fever, was recovered by throwing thirty amphoræ of cold water over her body. _Diemerbroeck_[3] relates the case of a rustic who having appeared to die of the plague, discovered after three days no signs of respiration, but, on being carried to the grave, recovered and lived many years afterwards; and Paul Zacchias relates an analagous case which occurred at the hospital of Santo Spirito at Rome. At a period when the small-pox raged with such epidemic fury, and physicians so greatly aggravated its violence by their stimulating plan of cure, there can be no doubt but that many persons were condemned as dead who afterwards recovered; amongst the numerous cases that might be cited in support of this opinion, the following may be considered as well authenticated: the daughter of Henry Laurens, the first President of the American congress, when an infant, was laid out as dead, in the small-pox; upon which the window of the apartment, that had been carefully closed during the progress of the disease, was thrown open to ventilate the chamber, when the fresh air revived the supposed corpse, and restored her to her family; this circumstance occasioned in the father so powerful a dread of living interment, that he directed by will that his body should be burnt, and enjoined on his children the performance of this wish as a sacred duty.

We can also imagine, that women, after the exhaustion consequent on severe and protracted labours, may lie for some time in a state so like that of death, as to deceive the by-standers; a very extraordinary case of this kind is related in the Journal des Sçavans, Janvier 1749.

Dr. Gordon Smith, in his work on Forensic Medicine, has observed that in cases of precipitancy or confusion, as in times of public sickness, the living have not unfrequently been mingled with the dead, and that in warm climates, where speedy interment is more necessary than in temperate and cold countries, persons have even been entombed alive; we feel no hesitation in believing that such an event may be possible; but the very case with which the author illustrates his position is sufficient to convince us that its occurrence would be highly culpable, and could only arise from the most unpardonable inattention; “I was” says Dr. Smith, “an eye witness of an instance in a celebrated city on the continent, where a poor woman, yet alive, was solemnly ushered to the margin of the grave in broad day, and whose interment would have deliberately taken place, but for the interposition of the by-standers;” if the casual observer was thus able to detect the signs of animation, the case is hardly one that should have been adduced to shew the difficulty of deciding between real and apparent death. Many other illustrations might be adduced, but it is not our intention to amuse the reader with a relation of those numerous nugæ canoræ that enliven several popular productions on the subject of trances, premature interments, and extraordinary resuscitations; the public have always betrayed a morbid curiosity upon the subject, and the stories of persons buried alive have ever found a ready access to our credulity, as well as to our compassion.

Amongst the different anecdotes which have been brought forward in support of the popular belief in the frequency of living interment, and in proof of the fallacy of those signs which are commonly received as the unerring indications of death, we read of numerous instances where the knife of the anatomist has proved the means of resuscitating the supposed corpse; Philippe Peu, the celebrated French accoucheur, relates, himself, the case of a woman, upon whose supposed corpse he proceeded to perform the cæsarean section, when the first incision betrayed the awful fallacy under which he operated; the history of the unfortunate Vesalius, physician to Philip II. of Spain, furnishes another instance, upon which considerable stress has been laid; upon dissecting a Spanish gentleman, it is said that on opening the thorax the heart was found palpitating; for which he was brought before the inquisition, and would probably have suffered its most severe judgment, had not the king interceded in his behalf, and obtained for him the privilege of expiating his offence by a pilgrimage to the Holy Land.[4]

_M. Bruhier_[5] also relates a case on the authority of M. l’Abbé Menon, of a young woman who was restored by the first incision of the anatomist’s scalpel, and lived many years afterwards. With respect to the instance of Vesalius we would make this general observation, which will probably apply to most of the cases on record; that the movements which have been observed on such occasions are not to be received as demonstrations of life, they merely arise from a degree of muscular irritability which often lingers for many hours after dissolution, and which, on its apparent cessation, may be even re-excited by the application of galvanic stimuli.

But there is a propensity in the human mind to believe in these horrors, because between credulity and fear there is an inherent affinity and alliance; and it may be very safely asserted, that there is nothing of which we have a greater instinctive horror,[6] than of any force by which our voluntary exertions are totally repressed; hence it is, as Cuvier has remarked, that the poetic fictions best calculated to insure our sympathy, are those which represent sentient beings inclosed within immoveable bodies; the sighs of Clorinda issuing, with her blood, from the trunk of the cypress, as related in the fable of Tasso, would arrest the fury of the most savage mortal; and the sufferings which attended the confinement of Ariel, by the witch Sycorax, within the rift of a cloven pine, are described by Prospero as being of so pitiable a description as to move the sympathy of the very beasts of the forest.

--------“She did confine thee, By help of her more potent ministers, And in her most unmitigable rage, Into a cloven pine; within which rift Imprison’d, thou didst painfully remain A dozen years.”