REMARKS ON MEDICAL JURISPRUDENCE.

THERE are three important caſes in which Surgeons are particularly called up⯑on to aſcertain by diſſection the cauſe of death. Firſt, where external injury has been ſuffered. Secondly, where it is ſuſpected poiſon has been adminiſtered. Thirdly, where a woman is accuſed of having mur⯑dered her child. Theſe are occaſions which require in the ſurgeon a practical knowledge of anatomy, without which he can never ac⯑curately diſtinguiſh appearances that may ariſe from injury or diſeaſe, from thoſe ſpontaneous changes all dead bodies neceſſa⯑rily undergo. A good practical anatomiſt is rare among ſurgeons, even in a great city, [2]and ſeldom or never to be met with in the country; from this defect many dreadful miſtakes have been committed, to the ſcan⯑dal of the profeſſion, and irretrievable in⯑jury of the perſon accuſed.

THERE are no fituations in which the ge⯑neral malignity of popular clamour is more conſpicuous than in thoſe of ſuppoſed mur⯑der: no ſooner is a perſon ſuſpected, than the rumour of it rapidly ſpreads, and as it flies exaggerates every circumſtance that may tend to criminate the unhappy culprit. To young practitioners thoſe are eſteemed favourable occaſions for diſplaying their medical diſcrimination and attracting pub⯑lic attention: Opinions are haſtily promul⯑gated, generally contradictory, often ab⯑ſurd, and frequently grounded on ſuppo⯑ſitious facts. The conſequence is, that the accuſed is publickly condemned before he is juridically tried, and falls at laſt, per⯑haps an innocent victim to popular preju⯑dice. I have on many occaſions been preſent at inqueſts where the attending ſurgeon, unuſed to diſſection, did not even know the method of expoſing to view the different cavities of the body; and it may readily be conceived how little capable he muſt have been to decide on ſo important a point. [3]Yet in thoſe caſes the ſurgeon, when called on, has no alternative; he muſt either avow his ignorance, or deliver his opinion; and in the ſtruggle between conſcience and pride, I very much fear the former is often ſacri⯑ficed to the latter.

THERE is not (I will affirm) on record a more melancholy and ſtriking inſtance of the unhappy effects of popular prejudice, and the fatal conſequences of medical igno⯑rance than the caſe of Captain Donnellan, who was executed in England about ten years ago, for the murder of Sir Theodo⯑ſius Boughton: It appears that eight or nine days after Sir Theodoſius was buried, a ſurgeon had the body raiſed, although it was in the month of June, and proceeded to the diſſection, notwithſtanding a phyſi⯑cian and another ſurgeon preſent declared that, from the putrid ſtate of the body, no information could be obtained on which any opinion could be grounded reſpecting the cauſe of death; and that ſuch an inveſti⯑gation was even attended with much per⯑ſonal danger: yet regardleſs of this joint opinion and advice, the firſt ſurgeon pro⯑ceeded in the diſſection, ſaying, that to him ſuch a ſubject was rather a poſy; and de⯑cidedly gave his opinion, that Sir Theo⯑doſius died of poiſon, nor could the teſti⯑mony [4]of the celebrated John Hunter, who ſwore that it was impoſſible to inveſtigate the cauſe of death in ſuch a ſtate of gene⯑ral putrefaction, do away the impreſſion of the firſt evidence, on either the mind of the JudgeThe judge is always conſidered as the advocate of the priſoner;—in Capt. Donnellan's caſe he ſeems to have acted as lawyer for the crown. or Jury; for the firſt, in his charge, oppoſes to the opinion of Hunter, which he ſays, he can call but a doubt, the poſitive declaration of the firſt ſurgeon who opened the body and of ſome phyſicians, that the deceaſed died of poiſon. Now Hunter's opinion was poſitive as to the phyſical impoſſibility of deciding on the cauſe of death, and only doubtful when interrogated as to the adminiſtration of poiſon. In this country a caſe not long ſince happened, where the medical men concerned decided that a man died of poi⯑ſon; and I have very good reaſon to believe his death happened in conſequence of a rupture.—The unfortunate accuſed in both caſes were convicted, and ſuffered an igno⯑minious death, for crimes they, both, at their dying moments, in the moſt ſolemn manner denied.

No ſtronger inſtances can be adduced of the fatal and melancholy effects of popular [5]prejudice when joined with medical igno⯑rance. From this it appears how neceſſary it is for ſurgeons to avail themſelves of every opportunity that may tend to im⯑prove them in practical anatomy, by which they will acquire a knowledge of the na⯑tural appearance of the contents of the dif⯑ferent cavities, and when called on, be able to diſcriminate with accuracy between a ſound and diſeaſed ſtate of the parts, and not miſtake thoſe changes which take place after death for morbid appearances, a cir⯑cumſtance that I have known ſometimes to have happened to experienced ſurgeons not uſed to diſſection.

WHEN it is neceſſary to inſpect a body, in order to aſcertain the cauſe of death, the ſooner afterdeath the inſpection takes place the more accurate the inveſtigation will prove. As thoſe remarks are particularly addreſſed to the younger part of the pro⯑feſſion, it is neceſſary to point out the moſt material circumſtances that ſhould be at⯑tended to in the general order of the diſ⯑ſection.

THE firſt object of enquiry ſhould be in⯑to the principal circumſtances that attend⯑ed, and have been deemed to have occaſi⯑oned the perſon's death; for thoſe, when [6]known, will direct the ſurgeon's attention in opening the body, to many important points that otherwiſe might poſſibly (in the hurry of diſſection) eſcape him. Fully informed as to all thoſe circumſtances, the body ſhould be cleaned and placed on a ta⯑ble, in clear day-light; candle-light, for obvious reaſons, is extremely improper on ſuch occaſions. The external appearances ſhould be firſt carefully examined, and we ſhould diſtinguiſh between thoſe bloody ſuffuſions and putrid diſtenſions which al⯑ways rapidly take place after ſudden death, in full habits, from thoſe that may ariſe from contuſion or diſeaſe. Thoſe are cir⯑cumſtances that require the utmoſt caution in the ſurgeon, for people not uſed to in⯑ſpect dead bodies are very apt to be ſtruck by ſuch appearances, and inſtantly decide that the perſon's death was cauſed by ſome injury. After a careful examination of the external ſurface of the body, we begin to open the different cavities, but firſt the one in which we may expect to find the cauſe of death; if it proceeded from exter⯑nal injury, we cannot be at a loſs where to begin; but if from poiſon, the ſtate of the alimentary canal ſhould be our principal object.

AND here I muſt requeſt the young prac⯑titioner ſtudiouſly to avoid all unſeaſon⯑able levity, or making any remarks on the caſe as he proceeds in the diſſection, for the attendants are attentive and will recollect; and I have known ſome inſtances where the occaſional remarks of the ſurgeon and his ultimate deciſion did not correſpond.

THE three great cavities are thoſe we ge⯑nerally expoſe. I will begin with the head.

I NEED not remind the young ſurgeon, that before he proceeds to open the head, he ſhould have it clean ſhaved. In ſhort, I cannot too ſtrongly recommend in diſſecti⯑on, the utmoſt attention to cleanlineſs, and a decorum that ſhould prohibit the ex⯑poſing unneceſſarily any parts that may hurt the feelings of the lookers on, or caſt an injurious reflection on thoſe of the pro⯑feſſion.

THE ſcalp ought to be firſt carefully ex⯑amined. If there appears any contuſion, wound, or ſpontaneous ſeparation of the pericranium from the ſkull, the extent of thoſe different injuries ſhould attentively be traced. We ſhould next proceed to ex⯑amine the cranium, and let the young ope⯑rator be careful not to fall into the error of [8]Hippocrates, who miſtook a ſuture or na⯑tural ſulcus for a fracture, all injuries of the bone ſhould be traced and carefully attended to. The upper part of the crani⯑um being removed, the dura mater becomes expoſed; this membrane in its natural ſtate has a firm, vaſcular, and filamentous connexion to the whole inſide of the ſkull, its detachment therefore in any part muſt be the effect of violence or conſequence of diſeaſe. In large extenſive fractures and depreſſions where death has ſuddenly fol⯑lowed, we frequently find a conſiderable detachment of the dura mater under the part injured, and more or leſs extravaſated blood on its ſurface; in other injuries of the cranium, it becomes ſubſequently de⯑tached by inflaming and ſuppurating; but let me caution the ſurgeon to proceed far⯑ther in his diſſection, before he pronounces on the cauſe of death. Before we have done with the dura mater, the ſtate of the ſinuſes ſhould be remarked, as they are frequently found in many injuries of the brain unna⯑turally diſtended with blood. We ſhould then expoſe the pia mater to view; it is a vaſcular web, and the connecting medium between the various veſſels that pervade the brain. When death is the conſequence of concuſſions of the brain or injuries of the cranium, we will find the cauſe of death [9]either in extravaſation, ſuppuration, or a ge⯑neral collapſion of the brain, ſo that it does not fill the cavity of the cranium. If death immediately ſucceeds the injury, we muſt look for extravaſation either on the ſurfaces of the pia mater, corpus calloſum, in the ventricles or about the baſis of the brain; for all ſhocks which the head receives are readily communicated to the pia mater, and either produce a temporary ſuſpenſion of the circu⯑lation through it (as happens when a man is knocked down or ſtunned) or elſe ſome of the fine veſſels are ruptured, and a fatal ex⯑travaſation of blood enſues. In the various injuries of the cranium which after ſome time cauſe death, we always find the ſuppu⯑ration formed in the pia mater; for the effect of all concuſſions are inſtantaneouſly propa⯑gated throughout this vaſcular membrane; and although a rupture of ſome of the finer veſſels may not be produced, ſtill the tempo⯑rary derangement in the general circulation through the brain, particularly when com⯑bined with local injury, muſt ever be looked on as a ſtrong exciting cauſe to future in⯑flammation and ſuppuration; and this is every day confirmed by experience: for in more than five-and-twenty years extenſive practice, in which time I have opened more heads than, I believe, moſt other practiti⯑oners, [10]I never, in a ſingle inſtance, found the contrary.

SHOULD our inſpection have for its object the aſcertaining the cauſe of diſeaſe, our en⯑quiry muſt be directed by the leading ſymp⯑toms that attended it; apoplexy or hydro⯑cephalus are the two moſt frequent occaſions for ſuch examination: in the firſt extravaſa⯑tions of blood are frequently found in the ventricles from a rupture of ſome of the veſ⯑ſels in the plexus choroides, or in the folds of the pia mater; in the ſecond, we ſhould take care not to miſtake the water, that is generally found in the ventricles, for a mor⯑bid accumulation.

As to other diſeaſed appearances that may occur in diſſections of the brain, ſuch as ſtea⯑toma and fungous tumors of the dura mater, thoſe enquiries do not admit of any particu⯑lar direction.

WE now proceed to the examination of the thorax; and, firſt, we ſhould carefully examine any wound that may externally ap⯑pear, and trace its traject: Obſerve whether the ribs, ſternum, or dorſal vertebrae, be fractured. After this is done, the cavity of the thorax ſhould be expoſed. We ſhould ex⯑amine [11]the different cavities, right and left, the duplicature of the pleura or mediaſtinum, the pericardium, and ſee whether there be extravaſation of blood, water or matter, in any of thoſe different cavities. We ſhould obſerve whether the lungs fill the cavity of the thorax, or are in a collapſed ſtate, and perhaps wounded: it is often difficult to trace a wound through the lungs. I have more than once been embarraſſed on ſuch occaſi⯑ons, and but for the extravaſation in the ca⯑vities would have found it difficult to deter⯑mine whether the ſword paſſed through the lungs or heart, for by the collapſion of the parts the traject of the wound became effaced. Our next object ſhould be to examine whe⯑ther the lungs are inflamed, gangrened, tu⯑bercular, or any part of them in a ſtate of ſuppuration: on thoſe points we may decide from their appearance, weight and denſity, or by cutting into them, the large blood-veſ⯑ſels, and the thoracic duct ſhould next be in⯑ſpected; and we ſhould carefully look whe⯑ther aneuriſm, polypi, or wound has taken place in them. Having ſatisfied ourſelves as to thoſe different points, we proceed to open the abdomen.

THE external appearances as to wounds, contuſions and fractures of the vertebrae, [12]ſhould be firſt enquired after; then the dif⯑ferent parts of the abdomen, where ruptures uſually appear, ſhould be carefully examined. In caſes of ſuſpected poiſon, great attention ſhould be paid to this enquiry, for the ſymp⯑toms of a rupture under the circumſtances of ſtricture may, by the ignorant, be imputed to the adminiſtration of poiſon, as, in both caſes, the patients are harraſſed with inceſ⯑ſant vomitings, &c. Satisfied as to all thoſe points, we proceed to expoſe the cavity of the abdomen, and examine if it contains ex⯑travaſations of water, matter or blood: the firſt will be at once obvious; the ſecond may be in the cellular membrane that envelopes the pſoas muſcles, or lines the pelvis. Blood will generally deſcend and be found about Poupart's ligament. The different viſcera next ſhould be accurately inſpected, leſt any of them ſhould be wounded, or in a diſ⯑eaſed ſtate. I need not ſurely remark, that the urinary paſſages, and organs of genera⯑tion lie outſide the abdomen; and if there appears any neceſſity for it, they may be ſe⯑parately examined.

WE next proceed to open the alimentary canal; and abſtracted from wounds, our en⯑quiry will be directed in general to aſcertain whether poiſon had been adminiſtered; this [13]we do by an accurate examination of the ſtomach and inteſtinal canal, and a che⯑mical analyſis of their contents; but it will be firſt neceſſary minutely to enquire into the leading circumſtances and ſymptoms that preceded the perſon's death. Poiſon is a very relative term. It is an old adage, that what is one man's meat is another man's poiſon. It depends not only on the quality, but the quantity, of the ſubſtance given, and its activity on the vehicle in which it is mixed or ſuſpended. There are but few poiſons that have not been medi⯑cinally adminiſtered from time to time, without producing any dangerous com⯑plaints; nay, Morgagni affirms that moun⯑tebanks have been known to ſwallow arſenic rolled up in ſuet, or lard, and retain it for ſome time in their ſtomachs; then vomit it up, without ſubſtaining the leaſt injury.

ALTHOUGH it is difficult to define poiſon medically, yet mankind judge rationally, and conſider that as poiſon, which given in a certain quantity, induces ſudden death, and which is adminiſtered in ſuch quantity for ſuch purpoſe.

POISON may be drawn from the mineral, vegetable, and animal kingdoms. The two [14]firſt will form the only objects of our pre⯑ſent enquiry, being the ſubſtances uſually given for the purpoſe of poiſoning. Of the mineral poiſons arſenic is moſt frequently adminiſtered; the action of all mineral poi⯑ſons is immediately on the ſtomach; which it throws into violent ſpaſms, induces in⯑ceſſant vomiting, pain, hiccough, diſtention of the abdomen, and in ſome caſes which I have ſeen, it appeared as if drawn in to⯑wards the back, frequent deliquium, cold ſweats, convulſions and death; the body turns ſuddenly putrid, becomes horridly inflated; the head, tongue, fauces, mon⯑ſtrouſly ſwelled and black; the whole car⯑caſe emits the moſt putrid ſtench, and the ſcarf-ſkin peels off on touching it. On view⯑ing the ſtomach, it appears inflated, often inflamed with gangrenous ſpots, or rather ſuffuſions, here and there ſpread over its ſurface, and the blood veſſels diſtended. When opened, the villous coat has all the appearance of having ſuffered great inflam⯑mation: often an eſchar is obſerved, en⯑circled by an inflammatory ring: this has been deemed characteriſtic of the action of arſenic; but, I know to a certainty, that it is not. An inverſion of the inteſtinal canal is alſo frequently ſeen. Having finiſhed the anatomical inſpection of thoſe parts, we [15]next proceed chemically to examine the contents of the ſtomach: I am convinced that many erroneous and fatal opinions have been drawn in thoſe caſes from the moſt bungling and inaccurate proceſſes: the moſt deciſive methods of aſcertaining the exiſtence of arſenic in the contents, is by expoſing the detached ſubſtance we deem to be arſenic to the effects of fire, when an aliaceous ſmell will be emitted; to make the experiment uſually tried on copper, which it turns white; or to precipitate it by a preparation of ſulphur. If we but for a moment conſider the circumſtances that happen previous to death, the inceſſant vomitings, conſtant dilution, and often ſmall quantity of the poiſon taken in, it will not be ſurpriſing that it ſhould elude all chemical inveſtigation, and that the whole of the poiſon may be frequently ejected ſoon after it has been received, al⯑though its deleterious effects continue. Be⯑ſides, few bodies are opened until twelve or twenty-four hours after death; and at thoſe periods very important changes rapidly take place; ſo that to detach arſenic from all adventitious ſubſtances (under thoſe cir⯑cumſtances) is more to be wiſhed for than expected, and all mineral poiſons, as to their immediate action, if given in ſuch [14] [...] [15] [...] [16]quantity as to produce ſudden death, are ſimilar in their effects and local appear⯑ances.

I ATTENDED two healthy men that were poiſoned by drinking claret made up with ſugar of lead—a frequent practice in cor⯑recting ſour wine; they both died in the courſe of forty eight hours after; and it was impoſſible, either from the ſymptoms that preceded death, or the appearances found on diſſection, to determine what kind of mineral poiſon had been adminiſtered.

VEGETABLE poiſons, particularly the laurel, may be ranked among the moſt pow⯑erful; their action ſeems more immediately to engage the nervous ſyſtem, than locally to affect the ſtomach; therefore con⯑vulſions, epilepſy, apoplexy, and death, ſoon ſucceed: nor can the effects, particu⯑larly of the laurel, be obſerved, on inſpect⯑ing the ſtomach and alimentary canal.— Any opinion founded on the ſmell of the contents, or giving them to a dog diſguiſed in food, I conſider of no weight in deciding on ſo important a queſtion. I will juſt re⯑mark, that where death has in a few hours followed the adminiſtration of poiſon, if mineral, the excitement is firſt local; ſoon after the nervous ſyſtem becomes affected: [17]if vegetable, the nervous ſyſtem becomes at once engaged, and no characteriſtic local ef⯑fect can be perceived on diſſection. In either caſe death ſeems to me to be more immedi⯑ately produced by pain, the fatigue of vomit⯑ing, convulſions, and, in ſhort, general ſym⯑pathy, than from any organic injury.

I HAVE been frequently called on in caſes of death, where poiſon was ſuppoſed to have been given; and after the moſt accurate anatomical inveſtigation, I never could de⯑cide, the appearances were ſo ambiguous. Should this appear extraordinary, it ought to be remembered that in all caſes of ſudden death, (particularly if the deceaſed was of a full habit), the body ſwells, and ſuddenly turns putrid: although this event may in a ſhorter time take place, and in a more exten⯑ſive way, where poiſon has been adminiſ⯑tered; yet this is a matter involved in ſo much doubt, and depends ſo much on con⯑tingency ariſing from ſeaſon, ſituation, and various other circumſtances, as to render it of little weight in deciding on ſo important a point.

POISONS of all kinds induce ſudden pu⯑trefaction, and ſo do ſpirits, when drank to ſuch exceſs as to cauſe death.—I remem⯑ber the caſe of a woman accuſtomed to drink [18]ſpirits in ſuch quantities as to be almoſt continually drunk: this woman was found dead in her room; I was called a few hours after; ſhe was then ſo putrid that I ſmelt her from below ſtairs. On examining the body, it was horridly inflated, burſting with putrefaction, the ſcarf ſkin peeled off with the ſlighteſt touch. On opening the ſtomach, an aliaceous ſmell, or that of garlic, was ex⯑tremely perceptible; this convinced a gentle⯑man preſent, that arſenic had been adminiſ⯑tered. It was in vain I informed him that arſenic, unleſs expoſed to the action of fire, was inodorous: the family became alarmed, doubt and terror ſeized them; Providence directed me to a cloſer examination, and I found a box of aſafoetida pills (which ſhe uſually took from time to time) in the win⯑dow. This immediately ſo ſtruck me, that I turned out the contents of the ſtomach into a baſon, and found a pill undiſſolved. I need not mention from what impending mi⯑ſery a huſband (who was the perſon ſuſ⯑pected of having poiſoned her) was ſaved.

AS to the appearances of inflammation and gangrene, all who are converſant in diſ⯑ſections, know that they indicate the com⯑mencement of putrefaction as frequently as the effects of diſeaſe.—There is hardly a ſtomach of thoſe who die of ſhort illneſs, that [19]does not preſent ſuffuſed ſpots, the gaſtric juice often acts on the ſtomach as a ſolvent af⯑ter death, and from this cauſe the ſtomach has been found eroded in different parts, as if acted on by ſome of the mineral poiſons, which by the ignorant may be taken for morbid ap⯑pearances; I therefore am decidedly of opini⯑on, that unleſs arſenic is found actually in the ſtomach, all the other marks of its having been adminiſtered, are extremely equivocal, and ſhould be of no weight in determining on a point of ſo much conſequence, and where (ſhould any miſtake ariſe) the accuſed perſon may ſuffer an ignominious death.

JURIES therefore in all caſes of ſuſpected poiſon, in forming their opinion, ſhould at⯑tend more to the other circumſtances that may occur in the courſe of the trial, than to the report of the ſurgeon; all medical opini⯑ons in thoſe caſes being more frequently founded on mere conjectures, than real facts, are little to be relied on.

THE next circumſtance in which the opi⯑nion of a ſurgeon is uſually demanded, is, the caſe of ſuppoſed infanticide.

I HONOUR the memory of the late Doctor Hunter, for a paper which he publiſhed in the ſixth volume of the London Medical Ob⯑ſervations, [20]on this ſubject; it is replete with anatomical diſcrimination, directed to the moſt humane purpoſes. He is of opinion (and that founded on long experience and an intimate knowledge of the feelings of the ſex, in the moſt critical and trying moments) that infanticide is rarely a premeditated act. —In fact, women who are pregnant, with⯑out daring to avow their ſituation, are gene⯑rally poor, deluded, credulous creatures, abandoned by the objects of their affection and cauſe of their misfortune, often left to ſtruggle with neglect, poverty, and diſeaſe. Under the preſſure of thoſe circumſtances, they retire to ſome ſolitary place when in labour, and abandon themſelves, in deſpair to the event, without ſeeking any aſſiſtance. Delivery in thoſe circumſtances is frequently attended with haemorrhage either during the time, or immediately after; the placenta is detached, it frequently lies half in the vagina and os uteri, for want of aſſiſtance; a deli⯑quium is frequently induced, from terror and loſs of blood; and when the unfortunate woman recovers, perhaps ſhe finds the child dead; and in this ſituation, ſurely her con⯑cealing the cauſe of her ſhame is an impulſe of nature, and ſhould not be adduced as a proof of guilt: Yet this very circumſtance (without making any allowance for the ſtate of mind in thoſe moments of terror and ſhame) gives riſe to ſuſpicion, and often leads to an [21]enquiry, that in the event, has conſigned many an innocent woman to an ignominious death. If the appearances of poiſon are found extremely equivocal on diſſection, thoſe of infanticide are ſtill more ſo; no judgment abſtracted from evident external injury, ought to have the leaſt weight; the ſuffuſed and bloated look of a child in thoſe caſes, is rather characteriſtic of its being ſtill⯑born, particularly if occurring after a tedious or difficult labour.—The experiments gene⯑rally tried on thoſe occaſions, in order to aſ⯑certain whether the child was born alive or not, are all made on the lungs: it is con⯑cluded, if they float on being thrown into water, that the child came into the world alive; if they ſink, that it was born dead: no appearances are leſs to be relied on. Pu⯑trefaction will occaſion the lungs to be ſpe⯑cifically lighter than water, and cauſe them to ſwim on the ſurface although they never had been inflated, and by inflammati⯑on they may become denſe, and ſink to the bottom, although the child had breathed; beſides, the child may have partially or juſt breathed, and expired on being born.—In ſhort, all ſuch appearances ſo much depend on a variety of contingent circumſtances, as render them of little importance in determin⯑ing in caſes of ſuſpected infanticide.

HAVING anatomically inſpected the body, the young ſurgeon ſhould retire, and recon⯑ſider the caſe before he makes his report: his character is at ſtake, as well as the ac⯑cuſed perſon's life; both, by imprudence, may be irretrievably loſt. In delivering his opinion, or explaining the cauſe of death, the ſurgeon's narrative ſhould be ſimple and candid; let him uſe as few technical terms as poſſible, both for the better information of the jury, and to avoid giving a lawyer an opportunity of embarraſſing him.

AS, abſtracted from wounds, fractures, and other external injuries, the cauſes of death are generally equivocal; wherever the ſurgeon cannot aſcertain them beyond the poſſibility of a doubt, he ſhould decide in favour of the accuſed: better ninety and nine guilty ſhould eſcape puniſhment than one innocent perſon ſuffer.

THE remaining points to be conſidered are the manner of making reports, and the attendance on inqueſts.

NO people ſuffer more from malicious proſecutions than thoſe of the lower order in Ireland; every diſpute is with them generally terminated fuſtibus et gladiis; and [23]he who has got the worſt of the battle, ſwears againſt the victorious party: two motives ſeem principally to induce them ſo uniformly to have recourſe to law for re⯑dreſs; the firſt is reſentment, the next money; and in the purſuit of both, it is impoſſible to deſcribe the flagrant inſtances of perjury every day exhibited in our Crown Offices.—I never attended a trial of this kind that I was not ſhocked at the contra⯑dictory aſſertions of both parties, many of which I knew, at the inſtant, to have no foundation in truth: the witneſſes are gene⯑rally tutored for the evident purpoſe of per⯑jury previous to the trial, and, in the com⯑mon language, are ready to ſwear any thing that may be deemed conducive to gaining their ſuit. The mode of proſecution is ſimply as follows:—When a man has re⯑ceived a wound, or any other injury, he immediately goes to a magiſtrate and lodges examinations againſt the perſon from whom he received it, and ſwears he is under the care of a ſurgeon, and his life is in danger; the magiſtrate grants a warrant for appre⯑hending the offending party, and, if taken, he is immediately committed to goal.— Now, all this is generally done without much enquiry whether the allegations are well-founded or not.

TO be committed to goal is, in itſelf, I conceive, a very great puniſhment, and I am convinced has been the means of corrupt⯑ing many an innocent man; for ſhame and character, thoſe barriers againſt vice, are at once loſt: the accuſed muſt lie in priſon until bailed out, on the ſurgeon's report of the perſon injured being out of danger. How many honeſt innocent men have I known ruined before this report was ob⯑tained, their families in ſupporting them in priſon, reduced to beggary, and them⯑ſelves, by wicked aſſociation, the effects of deſpair, the loſs of character, become drunken, idle, and profligate during the remainder of their lives.

THERE is hardly a man in ſociety that may not innocently become the unfortu⯑nate victim of a malicious proſecution. To convince the moſt incredulous, and to ſhew to what extent ſuch things are ſometimes carried, I will, out of many inſtances, pro⯑duce one.

A CLERGYMAN of the eſtabliſhed church hearing his wife and ſervant-maid diſput⯑ing in the kitchen about ſome trivial mat⯑ter, went down and only interfered ſo far as to repel ſome rudeneſs offered by the girl to her miſtreſs, by puſhing the ſervant one [25]ſide. She either accidentally, or on purpoſe, fell againſt the dreſſer, and received a ſlight contuſion over the eye, of no ſort of conſe⯑quence; ſhe immediately went up ſtairs, ſtood at the ſtreet door, told the people paſſing by ſhe had been almoſt murdered by her maſter; and to confirm this aſſertion, ſhe immediately dropped into an apparently ſtrong epileptic fit. She was then carried as one expiring to an hoſpital, and without far⯑ther inquiry the unfortunate clergyman and his wife, were both dragged to Newgate. The indignation of the populace was at ſuch an height, that the windows of his houſe were broken, and the furniture thrown out into the ſtreet. In the evening the account of this dreadful murder was cried about the ſtreets by the news-hawkers. The next day this woman was removed out of the hoſpital to private lodgings, where ſhe continued to be attended by ſome of the faculty for ten or twelve days, during which time ſhe never could be got to ſhew the leaſt ſigns of ſenſe or recollection, but ſeemed to be (particularly when examined) violently agitated and convulſed. I was at this time called into conſultation, and on examining her rather unexpectedly, I was at once convinced ſhe laboured under no real complaint, and that ſhe was a vile im⯑poſtor: [26]There are two objects a medical man ſhould have in view in thoſe inquiries —to alarm the party by fear of operation, or to rouſe them into ſudden paſſion by abuſe: I took the latter method, and with ſome harſh expreſſions told her, I would inſtantly ſend her to Channel-row; ſhe, as one electrified bounced up, and ſwore I dare not: My buſineſs was now effected; I im⯑mediately went to the late Sir Samuel Brad⯑ſtreet, related the whole tranſaction, and had the clergyman and his wife liberated. On coming back I called to ſee in what ſituation my patient was, but ſhe, as ſoon as I had left the houſe, put on her clothes, and decamped without leave.—It is need⯑leſs to comment on this caſe; I will only add, that the terror and ſhame, of being ſo publickly expoſed, made ſuch impreſſion on this poor man's mind, as brought his life into the moſt imminent danger; and the expences attending his confinement, &c. ſurrounded as he was with a large family, conſiderably injured his circumſtances.

IN order to obviate thoſe abuſes in our medical juriſprudence, magiſtrates ſhould not grant a warrant for committing a man to goal on the mere oath of the injured perſon, and unleſs the attending ſurgeon [27]certifies his life to be in danger. When a perſon is once committed to goal for an offence of this nature, without a ſurgeon's report, that the injured party is not in dan⯑ger of his life, he cannot be admitted to bail. Formerly giving certificates of this kind formed a very lucrative part of the practice of ſurgeons, for they often, in thoſe caſes, with-held making any report until paid their demand for their whole attend⯑ance. I have known thirty, forty, nay eighty guineas, given, before a report could be obtained. In ſhort, if the accuſed was rich, or if they thought they could get much money, all parties muſt be ſatisfied before a report would be thought of.—It is impoſſible to conceive the diſtreſs that this iniquitous practice has reduced whole fa⯑milies to. I have known the poorer people in ſuch circumſtances, ſell or pawn every neceſſary they poſſeſſed, in order to get as much money as would ſatisfy the ſurgeon, who was generally the principal object, and releaſe perhaps a huſband or brother from priſon. During this negociation, it was al⯑ways thought neceſſary that the injured perſons ſhould keep in bed, and appear ex⯑tremely ill; and they were generally ſo well inſtructed, and ſuch good actors, that it re⯑quired no ſmall ſhare of diſcrimination to detect them, for they would ſuffer even ſe⯑vere [28]operations, or any thing that was thought neceſſary to the carrying on the deception. I have in many of thoſe caſes unexpectedly viſited a fellow and found him eating heartily of beef-ſteaks, who perhaps two hours before appeared with all the ſymptoms of a fractured ſkull. Out of many inſtances I will produce one:—A man deemed to be rich, gave another a blow with a ſtick on the head, and cut him: he was the next day ſworn againſt, and lodg⯑ed in goal; the man was attended by a ſurgeon long ſince dead: another was call⯑ed: no report could be made, as no terms were offered by the man in goal, that would be accepted. Days and weeks paſſed in this kind of negociation; for although the man was wealthy, he was tenacious: At length a third ſurgeon was called; he found that the man had originally but a ſlight cut: but that it had been thought neceſſary (on account of irregular ſhiverings which the man ſaid he had) to ſcalp him: (an opera⯑tion as then performed attended with the moſt exquiſite pain, and by which the ſkull was laid bare to near the breadth of half a crown.) No other dangerous circumſtance appearing, the conſulted ſurgeon, fully con⯑vinced of the impoſition, in order to terrify the man propoſed that he ſhould be imme⯑diately trepaned; the patient enquired the [29]nature of that operation; the other coolly replied, it was only to bore a hole through his ſkull with an inſtrument much like a large augre. This was going too far;— terms were immediately propoſed, and accept⯑ed: the ſhiverings ceaſed, and the man in goal (after a confinement of ſix weeks) was releaſed, at the expence of near five hundred pounds.

THE Royal College of Surgeons early ſaw thoſe flagrant abuſes, and have done every thing in their power to counteract them; for by one of their by-laws, no member of the college can demand more than two guineas for a report to a magiſtrate; and ſhould he be convicted of making a falſe and corrupt one, he is publickly expelled the college.

THE only point that remains for conſi⯑deration, is, the attendance on inqueſts. This has always been deemed a profeſſional duty which ſurgeons owe to public juſtice; and undoubtedly, in moſt caſes, it really is ſo: however, public motives alone will ſel⯑dom induce men to act contrary to their pri⯑vate intereſts.—To attend an inqueſt is, to the ſurgeon, unprofitable, the loſs of time highly inconvenient, and in the event may be productive of very diſagreeable conſe⯑quences; for he is bound to appear at the [28] [...] [29] [...] [30]trial, whence, ſhould he be abſent, even on the moſt preſſing profeſſional occaſion, he may be heavily fined.—Thoſe are very ſtrong motives for ſurgeons to endeavour, as much as poſſible, to avoid being engaged on ſuch occaſions. I was myſelf fined fifty pounds by the late Judge Robinſon, although he had been previouſly informed that I had only juſt quitted the court, on being ſent for to a man whoſe thigh I had amputated in the morn⯑ing, and who was ſaid to have had a bleeding from the ſtump: to this excuſe the judge paid not the leaſt attention, as, I believe, he ſuppoſed it to be ill-founded; ſo impoſed the fine. It is true, I got it taken off next day. But there is ſomething extremely humiliating and vexatious in the various applications ne⯑ceſſary to be made on thoſe occaſions.

A SURGEON not long ſince had a keeper put on his houſe, in conſequence of a green⯑wax proceſs, for non-attendance, although he had not been half an hour abſent from court; but unfortunately the trial com⯑menced in the interim. This caſe was ex⯑tremely diſtreſſing, for he was a man ſur⯑rounded with a ſmall family, and could not poſſibly command half the ſum. The conſe⯑quence was, the keeper remained on his houſe for eight weeks, as the judge who impoſed the fine was abſent on circuit, and nothing [31]could be done in the affair until he came back. So after ſuffering this diſgrace, and being at more than ten pounds expence, at length the fine was remitted.

WHEN thoſe different circumſtances are duly conſidered, no reflection can juſtly fall on gentlemen of the profeſſion, for endea⯑vouring to avoid an attendance that muſt ſo materially interfere with their other duties. However there can be no doubt that it is ex⯑tremely neceſſary that inqueſts ſhould be properly attended, and that the worſt conſe⯑quences may ariſe, and frequently do, from the want of a good anatomiſt and experienced ſurgeon to aſſiſt on thoſe occaſions. It is abſolutely ſhameful that, in caſes where life and death are at iſſue, the jury, in the more important point of the trial, ſhould have no better direction to form their opinion by, than (perhaps) the evidence of an appren⯑tice, ſo that juſtice may be evaded, or inno⯑cence condemned.

THE buſineſs of attending inqueſts ſhould be therefore made a diſtinct appointment, or annexed to ſome of the preſent profeſſional eſtabliſhments: ſo that in all caſes of ſup⯑poſed murder, the inſpection of a good ana⯑tomiſt and experienced ſurgeon, may no longer be a matter of mere contingency.

BEFORE I conclude thoſe general remarks, I requeſt the reader will conſider that it ne⯑ver was my intention to go much into detail. The ſubject undoubtedly is important, and required more time and attention than I was able to give it; but, if what I have advanced, will lead to any uſeful enquiry, or be the means of detecting ignorance or defeating malice, my views are fully completed.