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All other original copies are filmed beginnin (meaning "CON- TINUED"), or the symbol Y (meaning "END"), whichever appliea. Un des symbolee suivanta apparattra sur la derntire image de cheque microfiche, selon le caa: le symbols —»> signifie "A SUIVRE", le symbols ▼ signifie "FIN". ^^apa, platea, charts, etc., may be filmed at different reduction ratios. Those too large to be entirely included in one exposure are filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diagrams illustrate the method: Les cartea, planches, tableaux, etc., peuvent itte filmie i des taux de rMuction diffirents. Lorsque le document est trop grand pour itre reproduit en un seul clichi, 11 est filmi i partir de Tangle supirieur gauche, de gauche i droite, et de haut en baa, en prenant le nombre d'images nicessaire. Les diagrammes suivanta illustrent la mithode. 1 2 3 1 2 3 4 5 6 LEGAL MEDICINE. Bv WYATT JOHNSTON, M. D., OP MONTREAL, CANADA. ' Jour. Am. Med. Assoc, June, 1899. » Ann. d'Hyg. pub., p. 442, 1899. » Rev. de m^d. l^g., Jan., 1899, » Ibid., Dec. 3, 1898. ♦ Ibid., Aug., 1899. 519 & ^ ' -/ m Bpitome. — By the death of Maschka on Feb. 5, 1899, we lost one of the most prominent medicolegal authorities. As a result of last year's agitation, we note the passage by the French Chamber of Deputies of the Cruppi law, by which, in every criminal investigation, the Stare allows the suspected person to choose an exptrt to investigate the case in his behalf, at the expense of the government. Tiie expert must be selected from a list revised annually by the courts. Steps have also been taken in France and Canada to provide a special diploma to qualify for medicolegal practice. The Clu-istian scientists have come into collision with the law in manslaughter cases. The subject of rigor mortis has been studied from a purely physical standpoint by A. Lacassagne, with most interesting results. Babes and E. Malvoz have published impor- tant new observations on the relations of infection and putrefaction to legal medicine. The announcement by Beskreda of hyperleukocytosis in connection with certain toxic conditions opens a new and interesting field of inquiry. Clitninology. — The voluminous literature of the subject has this year contained little that is novel or important. The pleading of Brower,' that asexualization is the most promising means of reducing crime, h.as been put on a practical basis by the suggestion of McCassy,^ that crimi- nals, especially those imprisoned for rape, should be offered their liberty at any time on condition of submitting to castration previous to discharge. MEDICAL JURISPRUDENCE. The Cnippi law, referred to above, has met with a good deal of criticism. Leredu^ claims that the defence .should not be limited in their choice to an official list of experts. Motet * considers that the new law will lead to constant differences between experts and prove doubly costly to the State. Ducor' insists upon the necessity of a higher standard of technical knowledge for exp-^rts. The text of the law is given in Sem. mid. of July 5, 1899. I/'exercise ae la Medecine et le Charlatinisme is the title of an important monograph by P. Brouardel, already published partly in the n j^j 520 LEGAL MEDICINE. Ann. d'Hyg. pub} Though specially relating to practice under French laws, it contains much that is of general interest. It is in the same form as the rest of the series by the same writer. The chapters upon accidents in connjctiou with anesthetics, narcotics, and erroneous prescriptions are specially interesting. The law in its relation to physicians is discussed by A. N. Taylor,^ L.L.B., in a series of articles treating of legal medicine from the forensic standpoint, which form a valuable addition to the literature of the subject. W. A. Purrington' has jmblished a work entitled legal decisions affecting physicians, dentists, druggists, ai^d health-boardS; the law in relation to dentistry being the part most fully dealt with. Grassl* records 2 cases in which a conviction for assault was obtained against surgeons who operated without permission. In 1 case no objection was made until the physician took legal proceedings for collecting the fee for the operation in question. R. M. Lizys' discusses the French statutes relating to malpractice. Carl Stoss * reviews the leg^l questions regarding SUrgical operations and medical treatment in the light of cases whicii have come before German courts. DEATH AND CONDITIONS AFFECTING DEAD BODIES (THANATOLOGY). On the Cause and Varieties of Rigor Mortis. — A. Lacassagne and E. Martin ^ state that the determining factor in the onset of rigor mortis is the drying of the muscles and tissues. Those which first lose the fluids of the body by hypostasis — e. g., jaw, sternoraastoid — become rigid earliest. If the body is inverted and placed on the face, the order is reversed. In artificial desiccation by ligatiug with an Esniarch immedi- ately after death the depleted limb becomes rigid before the rest of the body. Chemic dehydrating agents produce similar effects. By post- mortem injection of fluids Brown-Sequard and Richet were able to retard the onset of rigidity. [The above statements do not explain why the heart is one of the first parts of the body to become rigid.] A New Sign of Death. — The influence of respiration and putre- faction on the radiography of the lungs. S. Ottolenghi* finds that (in accordance with Bougardes's statement) dead lungs are more opaque to the x-rays than living ones, and show darker at the borders, but the dif- ference is not sufficient to give us decisive results in the case * >ersons recently dead (24 hours), and only becomes well marked with ne onset of decomposition. Gas-formation in dead lungs gives rise to clear areas not likely to be confused with the appearances during life. Ehrle' reports the rapid destruction of a child's body after in- fanticide. The body was buried in sand, near the surface, in unusually hot weather. The surface of the body was charred slightly and the entire interior converted into a blackened pulpy mass in about a week. » Paris, 1899, Baillifire. ' N. Y. Med. Jonr., 1899. ■ » New York, E. B. Treat, 1899. ♦ Friedreich's Bliitter, July, 1899. » Paris Theses. 1899. « Lchmann, Berlin, 1899. ' Arch. d'Anthrop. crim., Mav, 1899. « Viertelj. ger. Med., 1899. » Correspondenz-Bl. d. Wttrtt. Aerzte., No. 26, 1899. 3r:^s&i, DEATH AND CONDITIONS AFFECTING DEAD BODIES. 521 Subpleural Bcchymoses in Death from Primary Heart- failure. — A. Scluilz ' points out that with a strophanthin prepa -ation, which in its essential action is primarily a cai'iliac depressant, very numer- ous and well-iuarked subpleural and subperieardial ecchymoses are con- stantly present after fatal doses. Postmortem Contractibility of Muscles to Electricity. — J. Babinski^ states that contraction is lost first in the facial muscles. These pass through a phase in which the faradic res])onse is lost, but the vol- taic remains, with tiie normal formula inverted (PFC > NFC and NOC > POC), thus being analogous to the reaction of degeneration. The irritability persists in the muscles after disappearing from the terminal nerve-filaments. D. Mirte^ has studied secondary postmortem atelectasis of the lungs of the newborn. After death the atelectasis tends to extend to the deeper parts of the lungs from the surface. In premature fetuses aera- tion is scattered in minute areas at various points in the lungs. In lungs which have breathed some days the extension of postmortem atelectasis is very slow. In lungs with inflammatory lesions it occurs more easily. In inflated lungs it occurs readily and early, and these do not have the (Central aerated nucleus of lungs which have breathed. H.Schmidt* concludes, in a monographic article upon drowning", that the only reliable appearances are those in the digestive and respira- tory organs, the tympanum, and the blood. The signs indicating the duration of immersion are indirectly of importance. It is important to recognize the injuries to which drowned bodies are subject after death. The association of a fatal wound with drowning usually indicates suicide. In doubtful cases giving a negative result it should be stated simply that the examination has not shown indications of violence. l^dema of the laryngeal folds in immersed bodies, accord- ing to M. Richter,* is not a certain sign of drowning, but is not as easily produced postmortem as has been stated. Out of 18 experiments with children's bodies edema was found 8 times. With extirpated larynxes it occurred 34 times o«it of 77 experiments. In 23 immersed bodies it was found 9 times. Thus, it is not characte !stic of drowning, but occurs postmortem when the circumstances are favorable. Once present, it does not disappear with the onset of putrefaction, and does not require long immersion for its production. Focke^ discusses thoroughly the medicolegal jearings of death from tetanus. The autopsy findings alone are inconclusive unless the specific bacillus is demonstrated by inoculation or culture-method ; and even in this case the proof is only absolute if the material is obtained from deep tissues or foreign bodies in them, as the surface of tissues is exposed to external contamination. The connection of the tetanus with a well-defined injury is necessary. Medicolegal Pathology of Brain-injuries.— 4tllpi' '' lays stress upon the following pointG : Autopsy-results alone are insufficient to es- tablish a diagnosis of fatal concussion of the brain without knowledge of ' Viertelj. ger. Med., Apr., 1899. » Acad. d. Sc. med. di Palermo, 1899. 6 Wien. klin. Woch., 25, 1899. ' Ibid. » Soc. de Biol., No. 15, 1899. * Friedreich's Blatter, 1 and 2, 1899. « Viertelj. ger. Med., Suppl., i., 1899. 522 LEGAL MEDICINE. the symptom!?. Instant loss of consciousness he considers characteristic. The injury must be exceptionally violent. In cases complicated by alco- holism the question is whether the amount taken could have caused death within the time elapsed. Pressure-symptoms from intradural hemor- rhage begin some hours after the injury. Traumatic hemorrhages are usually cortical, and spontaneous hemorrhages deep-seated. The trau- matic are usually smaller and multiple ; deep traumatic hemorrhages are usually associated with meningeal hemorrhage. Lacerations of brain- substance indicate alterations of pressure in the cranial cavity. Projec- tiles of small caliber may lodge in the brain without causing unconscious- ness. Brain-injuries never in themselves cause suppuration. In another article* he pronounces it douVjtful whether diabetes ever really rosuUs from brain-injury, and discusses at length the medicolegal symptomatol- ogy of brain-injury. Corriere ^ describes the alterations of blood in experimental asphyxia. The most notable observation was in animals asphyxiated by CO2 in which a great number of eosinophile cells were presented. Alterations of the Nerve-tissues in Death by Starvation. — S. Placzek' found that in rabbits dead from starvation the Nissl bodies were greatly diminished, but still present. He found by the Marchi stain degenerative changes in the posterior columns. [His results differ from those of Schaffer and Jacobson, who studied the question separately, with mutually divergent results.] Spinal Changes in Death by Hunger in Man. — Placzek,* referring to his previous article, says that the degeneration described there was not recognizable by Weigert's method. He reports the result of examination of a case of death by hunger in an insane woman. [Body showed a decided panniculus adiposis.] There was a distinct wasting of the Nissl bodies. Gaelano Corrado' reports the occurrence of striking changes in the nerve-cells of auimals killed by electric shock. These consist in a deformed, eroded, ragged appearance of the contour, with granular and vacuole formation and disturbed arrangement of the chromatin. A New Anatomic Sign Concerning Death by Burning. — F. Strassmann,^ in 2 cases in which an extradural blood-extravasation was at first regarded as proof that an existing fracture of the skull had occurred during life, was able to demonstrate the contrary from the circumstance of the blood-clot being surrounded by melted fat. The occurrence of hemorrhages postmortem witliin closed cavities, through the effects of heat, has already been explained.' Strassmann was able experimentally to reproduce the condition. Harvey Littlejohn ^ reports 3 cases of fatal burning, in one of which pseudohemorrhage of the meninges from combustion occurred. In ano^^hei' ease, a woman of 82, the left leg was completely destroyed up to the knee, although the fire had lasted only J hour. Lacassagne and E. Martin ^ have applied the term hepatic doci- Viertelj. ger. Med., Siippl., i., 1899. 'Soc.de Biol., Feb. 11, * Ibid,, July, 1899. 1899. » Viertelj. ger. Med., Apr., 1899. * Acad. Medico-Chir. di Nepali, No. 52, 1898. • Viertelj. ger. Med., Jan., 1899. ' 8ee Year-Book for 1899, p. 973. « Edinb. Med. Jour., May, 1899. , » Arch. d'Anthrop. crim., Jan., 1899, DEATH AND CONDITIONS AFFECTING DEAD BODIES. 623 masia to denote the test for glyco;j;on and sugar in the liver. They find that while it is present in ra|)idly fatal cases of poisoning, it is absent in conditions having a prolonged death-agony. In alcoholic poisoning it is absent, and also in diabetics, unless these die suddenly when in fair health. A number of medicolegal applications are instanced, for which the original article should be consulted. Facies Sympathique in Hanging.— E. Martin • concludes that : 1. In hanging a peculiar apj)earance of the face exists, which he calls facies sympathique. 2. Pupillary inequality is a condition produced during life, permitting the affirmation that the hanging has not been seen on a dead body. 3. The sympathetic lesion is probably the cause of the lividity through vasomotor paralysis and dilatation. A case^ is recorded of the suicide of a man by filling his mouth with gunpowder and setting fire to it. He was conscious on reaching the hos- pital, but died in 12 hours. The autopsy showed laceration of the throat, esophagus, and Itmg-alveoli, with interstitial emphysema. Suicide in Edinburgh. — Harvey Littlejohn ^ gives a statistical and medical review of experience in Edinburgh during the past 45 years. Schuchardt* reports an unusual injury of the neck in hanging by an iron wire. A man was found hanging by a wii'e taken from a funeral wreath off his wife's bier. The furrow on the skin was 5 mm. wide. Two Cases of Suicide in the Insane. — L. Scabia* states that in botii cases a quantity of pebbles was swallowed, producitig intestinal ulceration. One case recovered after passing 357 pebbles, weighing together 774 gm. The other swallowed 20 stones and several buttons and had 7 submucous ecchyraoses of the stomach and esophagus, and died of bronchopneumonia. Payr ^ observed a fatal case of fat-embolism after brisement forc6 of a contracted knee-joint. A complete status thyraicus and lymphaticus existed in this as well as in the 4 other recorded cases. In such cases the heart is not able to withstand fat-embolism, and the bones become rare- fied and fattily degenerated from prolonged stay in bed, whicjh makes this a serious intervention, Dififerential Diagnosis of Traumatic and Spontaneous Cerebral Hemorrhage. — Schilling'' gives the following criteria: Spontaneous hemorrhages are central, and extend from within outward, usually from branches of the Sylvian artery, usually from a single source. Pathologic changes are found in the vessels of the brain and in the general circulation. The heart or the kidneys show pathologic changes. In traumatic hemorrhages without fracture of the skull, dural, subdural, or subarachnoid hemorrhages occur in a single spot or at several points. Traumatic central hemorrhages are accompanied by meningeal hemor- rhages. The absence of surface hemorrhages forms a very important indication against trauma. They are caused by contraction and expansion of the cranial cavity. • Arch. d'Anthrop. criin., Mar., 1899. ' Jonr. Am. Med. Assoc, Jan. 13, 1899. ' Ibid. * Aertzl. Sachverst. ZeitunR, No. 12, 1899. » Rivistad. med. leg., Mar., 1899. « Munch, med. Woch., No. 28, 1898. ' Aertzl. Sachverst. Zeitung, Mar., 1899. 624 LEGAL MEDICINE. WOUNDS AND DISABILITY PROM INJURY (TRAUMA- TOLOGY). «^ Zacher' lias reprinted, with cxpliuiatorv text, the English, Swedish, Norwegian, Danish, Anstrian, Russian, Finnisli, Swiss, French, and Italian statntes dealing with the plans for State insurance of laborers against accident and disease. A general medicolegal study of the subject of posttraumatic dis- ease has been made by A. Crouhel.* Estimation of the Effects of External Injury upon Exist- ing Disease in Accident-insurance Practice. — F. Kiderlen' points out that : 1. Existing disease may be made worse directly or indi- rectly by external injury. 2. Owing to the existing disease the injury may have unusual consequences. 3. It may increase the effect of injury upon earning pov?er ; e. us. This is due to slight tendency to form callus in the cranial bones and to the tendency of the edges to become displaced. Separation of periosteum and dura from the edges by hemorrhage or enclosure of soft tissues is another cause. Atrophy and absorption of edges may also occur, leaving a wide cleft. In young children there is a tendency to separation of the edges from relatively greater effusion and the distensibility of the cranium. Fractures during the first 3 years tend to end in defects. The meningo- cele formations exaggerate this tendency (traumatic spurious cephalo- hydrocele). Very few authentic postP'*>rtem records are available. Chiari reports 2 postmortems in such eases, 1 from the effects of forceps. Varices and Accident.— Wagner* concludes that: 1. Varices cannot originate from trauma. 2. Existing varices may be aggravated from the effects of injury. 3. Existing varices may be developed more rapidly from therapeutic measures rendered necessary by accidents. 4. Such varices tend in some cases to induce flat-foot. 5. The agg"'ivation of varices should, under the above circumstances, be estimated as one of the effects of the ac(;i(lent. W. Herzog^ finds that traumatic gangrene after severe crushing injuries, or even subcutaneous ones, is due to lesions of the inner coats of the arteries. Gangrene of Skin.- G. RiehP reports 4 cases of self-inflicte Viertelj. ger. Meii., Apr., 189!). » Unfallvers. Praxis, 22, 1899. » Gaz. des Hfipitaux, No. 54, 1899. * Monats. Unfallheilk., 6, 1899. » Munch, med. Woch., May, 1899. « Ibid., Mar. 14, 1899. » Diss., Kiel, 1899. » Unfallvers. Praxis, Mar., 1899. * Charite Annalen, xxiii. WOUNDS AND ACCIDENTAL INJURIES. 527 case was that of a 33-year8-old woman, who .struck her occiput in falling from a ladder. PrcxHurc-syniptom.s and paralysis were present 1 month after; death in ,'J jnontiis. There was a sarcoma of the corresponding region < f the right occipitid l()l)e. The fourth <5ise was that of a 41- years-old workman, in whom, 5 months after repeated blows on the head, sarcoma of the frontal lobe was diagnosed. Traumatic Gastrectasia. — Kocher ' reports the case of a man of 34, who fell 2 meters, striking his right side on a ship's bulwark. Intes- tinal obstruction occurred, subsiding without operation, but followed by gastrectasia, recognized 3 years later. The symptoms were relieved by gastroenterostomy. Extensive |)erihepatitis and adiiesions about the region of the liver were found at the operation. UlLcr of Stomach caused by Trauma. — C. Thiem * tells of a healthy man of 47, who was struck in the epigastrium by the snout of a cow, and who felt immediate pain, transitory in nature. Eleven days after he vomited blood, bcame quite anemic. Some tenderness and ful- ness remained in the epigastrium 9 months later. Improvement followed dietetic treatmtnt. Thiem thinks this was not purely autodigestion, but that autoinfection of the stomach-wall took place when it was bruised. Dovie' reports the case of a man who was kicked by a horse in the right side of the abdomen. Obstinate constipation and vomiting followed. Ltiparotomy showed a constriction at the pylorus. Gastroenterostomy was followed by improvement. Lewie* states that when empty the stomach is not exposed to direct injury. The full stomach, on the contrary, lies directly against the anterior wall. This does not suffice in itself to explain gastric ulcer, conditions of anemia, etc., being more lik ' ', chronic traumatic effects, such as result from tight lacing and repe: nressure. [These are really not traumatic effects in a legal sense as reguids accident.] Twelve cases illustrating the direct effects of trauma are given ; also some cases from strains during exertion, etc. Some experiments upon animals are also reported. The pressure of corsets is regarded by Rasnmssin as an important factor. Kronlein * reports 2 cases. The first case was that of a trainer, a man of 24, who fell from a h;>rse, striking the pit of the stomach on the pommel of the saddle. Four weeks later he began to vomit after eating. Hemate- mesis was present in 4 months. Resection of the pylorus was done at 8 months. Death. The second case was in a workman of 48, who jumped from a hayrick, and struck a fork against the pit of the stomach. No ill- effects immediately. Next night tf'ere was severe pain in the left side; unable to work. The following week there were loss of appetite, vomit- ing, and tenderness near the xiphoid. Cure followed laparotomy and resection of the pylorus. The gradual onset is explained by sup- posing that the injury was beneath the- mucrsa. Brandenberg,* in studying nemia and injury, found that out of 3052 laborers 80.2% were founc' predisposed, and 19.8% not so. Of those disposed, traumatic hernia occurred in only 0.32%. ' Afertzl. Sachverst. Zeitnng, 5, 1899. » Diss., Berlin, 1898. » Mittheil. a. d. Grenzgeb., Band 4, 1899. « Monats. f. Unfallheilk., May, 1899. ♦ Diss., Kiel, 1898. • Correspbl. Schw. Aerzte., Mar., 1899. 528 LEGAL MEDICINE. Stmssmann/ in discussiug abdominal hernia and trauma, re|K)rts a case from carrying a too heavy sack, cites several cases, aud states that he does not think the established proof of predisposition should negative the claim when the connection of result and exciting cause is clearly made out. Noack^ investigated tlie subject of peritoneal adhesions after severe compression of the abdomen, causing severe colic and constipa- tion. He reports 4 new cases, the interval from injury being 1 to 10 years. Hemorrhagic Pancreatitis due to Traumatism. — Ferrand* reports the case of a man of 39, wiio died 6 months after receiving a violent blow in the epigastrium. In the region of the pancreas 2 to 3 liters of bloody fluid were effused, the pancreatic tissue being infiltrated with blood and sclerosed. The organ was enlarged. Isolated Injury of Pancreas.— E. Stern* reports 2 cases, one that of a 37-years old navvy, who was crushed between tlie buffers of -a railway train ; the othev that of a man of 38, who was run over by a carriage. The first caoe was fatal after 7 months. A large cyst had formed, which led to local inflammation and a fistula leading to the left pleura. In the other case death occurred 4 days after the injury, and the gland was found divided transversely. Cyst of Pancreas following Trauma. — I. von der Haau ^ relates the following case : Dec. 3, 1895, 1. D. I., a boy of 9, while coasting, was struck in the region of the stomach by a playmate's sled. Shock, vom- iting, and pain in the epigastriinn followed. After 3 months there was noted a large timior in the epigastrium. Aspiration gave fluid with amylolitic properties. Three hours afterward symptoms of acute peri- tonitis led to immediate opening of the abdomen, but all trace of the cyst had disappeared. Good recovery, with reappearance of the cyst in 3 weeks. Second operation resulted in fistulous opening, which soon healed. [This is the only case reported in a child.] C. Thiem ® contributes cases illustrative of the gynecologic effects of accident. He reports 2 cases of pelvic inflammation : 1. Prolapse of vagina, ascribed to accident — lifting heavy sacks ; felt pain in abdo- men — only asked for medical advice 3| months later. Disallowed. 2. Retroversion ; healed inside of the 13-weeks limit, which precludes dis- ability claims; pain came on during act of lifting a heavy basket. No traces of injury were left. C. Thiem '^ 'also states that dilatation of the oviducts cannot be considered an eflect of accident. In one alleged case, caused by carrying a basket, pyosalpinx was present. F. H. Kornfeld^ discusses the decisions of the German Reichsver- icherungant in reference to gynecologic effects of accident. In a case of alleged accidental prolapse the judgment of the first court was reversed on appeal, on the grounds that neither the accident nor the con- nection of the condition with an accident had been proved. The woman ' Aertzl. Sachverst. Zeitunj,', Heft 10, 1890. ' Mittheil. ii. d. (Jrcnzgeb., Band 4, Ileft o. ♦ Viertelj. per. Med.. Oct., 1899. « Monats. f. Unfallhlk., Jan., 1899. 8 ibid., Jan., 1899 ' Seni. m^d., Nov. 23, 1898. ' Jour. Am. Med. Assoc, Julv 8, 1899. ■' Ibid., Sept., 1899. WOUNDS AND ACCIDENTAL INJURIES. 529 complained of a sudden pain while working a hand-pump, and had old pelvic disease. Bruns * reviews recent literature on nerve-disorders due to injury. Muller'' tells of a case of tabes following trauma. A stable- man, aged 29, was knocked down by a horse, wliich trod on his breast and broke his right leg. Symptoms began 4 months later. The patient had had a slight venereal infection 10 years before. E. Trommu"' reports cases [alleged] of tabes after trauma, in one of which symptoms appeared in a man of 42, 8 weeks after crushing of his left foot. In the other case exposure to cold was the history. Mendel,'* however, states emphatically that tabes cannot ensue from injury, though it may be aggravated as a result. Irle gives very full citations of the literature on the subject. Loewe * relates cases of loss of deltoid muscle, with preservation of power to raise *^he arm. He reports 3 cases. W. Wagner and P. Stolper* have written a very full and instructive monograph upon injuries of the vertebrae and spinal cord. Tillman^ reports experiments with apparatus to imitate conditions of concussion of the brain. Ho explains the lesions as due to changes in volume and to the differences in the specific gravity of the cranial contents. E. Levy ^ makes report of 4 cases of metastatic meningitis after injury, in which all local rauses, such as head-injury, oar-disease, etc., were excluded, and with no metastases elsewhere i» the body. One case has been previously reported by E. v. Hnffmami. S. Paget ^ has observed voracious hunger and thirst after in- jury or" disease of the brain. He gives 11 cases. Diabetes was excluded in all. Medicolegal Relations of Traumatic Hysteria. — Peirce Bailey'" gives a useful and practical discussion of the causes leading to confusion in assigning damages in this class of cases. Traumatic Nerve-diseases in Children. — P. Schuster and K. Mendel " I'eport a case of traumatic hysteria in a girl of ] 1 , 1 of astasia abasia in a girl of 12, and 2 of hysteric monoplegia in girls of 15 — all following trauma. Paralysis Agitans from Trauma. — R. Krafft Ebing,'^ out of 1 10 cases, found 7 (4 males and 3 females) in which trauma appeared to be the cause. In 1 case an interval of 6 years elapsed before the onset of the tremor. In all of the above 7 cases the tremor began at the site of the injury. In the remainder it began at a remote point, usually in the upper extremity. Kohler^'' reports a case of a man, of independent means, 61 years old, who fell on his right arm in March, 1893. Tremor began in the same arm two months later. The case improved somewhat after treatment. Traumatic Amyotrophic I^ateral Sclerosis. — Hauck " cites the case of a healthy laborer, wiio cut his left arm and right leg in 1881. * Aertzl. Sachverst. Zeitiing, May, 1899. • Schmidt's Jahrbiich., No. 7. 1899. » Berlin. i Med. Kec, Mar. 14, 1899. " VVien. klin. Woch., .Ian. 12, 1899. '* Aertzl. Praxis, 13, 1899. 630 LEGAL MEDICINE. Since then there has gradually developed a muscular atrophy of the left hand and right log. Multiple Sclerosis from Trauma.— Ji. licick ' relates the case of a laborer, aged 34, who received a violent blow from a plank u})on the forehead, followed immediately by lot^s of consciousness, bleeding from the mouth and nose, and paralysis of the left side. Four months after- ward there were headache, loss of sexual vigor, and pains and paresthesia in the feet. Speech was thick. Tremor was not well marked. No im- provement followed treatment. Spinal Concussion. — Stolper ^ finds that in his exj)erience the so- called cases have been either cases with symptoms of contusion and lacer- ation of the cord or vertebral column, or cases in which psychosis could be invoked as an explanation of the severity of the subjective symptoms in the absence of objective ones. K. S(!hmaus' outlines the present state of knowledge concerning Spinal commotion. He considers that the proof of a pure spinal commotion has not yet been given, as no case recorded has been free from lesions of the vertebral column. He considers that a line must be drawn between spinal and vertebral commotion, and that the previous cases are not sufficiently exact to exclude sources of error Leppmann,* as a result of a medical investigation of noise, says that in order to })roduce serious consequences the noise must have lasted for a considerable period. Those most likely to be injurious to health are : noises during sleeping-hours ; noises which are unequal, with alternating shrill or very deep tones, especially when intermittent, as the anticipation has a disturbing influence; noises associated with vibration of the floor or table or working implement. The absolute intensity of noise is the least important factor, as we have no scientific means of recording sound intensity. G. Gottwald " has written a monographic article on the relation of caries of the ear to legal medicine. Rath ® reports on the connection between head-injury and ear- disease. John Thompson^ detected simulated deafness by a j)honendoscope being placed with the tubes in both of the patient's ears ; then a tuning- fork was connected with it by touching its tympanum, and the tube from the patient's sound ear disconnected near the body of the instrument without his noticing it. Treitel * deals with the estimation of ear-diseases after injury. He holds that every case of head-injury should undergo exj)ert exaniina- tion of the ear as soon as the condition of the patient permits it. At that time sinudation is more easily detected than later. Care must be used in syringing ears imme; of the corpuscles. Formalin as a Reagent in Examining Blood-stains. — G. Puppe' finds that in combination with an alkali and Pacini's or Rous- sini's solutions this substance has the property of preserving the form of the blootl -corpuscles for microsco])ic examination, while the coloring- matter may be extracted for chemic and spectroscopic tests. The altered blood-pigment is soluble in alcohol. [The test promises to be of much value, as the methods in use have not permitted this.] C. Ipsen^ recommends for the chemic detection of carbon monoxid in blood agitation in a tightly closed test-tube to which a few drops o^' ciiustic alkali solution and a little pure glucose have bee i added ; monoxid blood becomes cherry-red and normal blood blackish red. He claims that 8^ to 10% of monoxid is sufficient to produce the reaction. A control-tube with normal blood should be used. L. Wacholz^ finds that the grape-sugar test recently recommended by Ipsen is inferior to the tannin-test in doliciicv. Infectious Diseases and Ih of a woman who had died of nephritis, and had been taking potassium i(Mlid, and who presented the atypical cutaneous ernj)ti(>n. Neuburger' contributes an article upon SUblitnate-poisonitig. A good literary review of the whole subject is given, including 200 references. F. Strassmann * states that the passage of sublimate through the placental circulation shows that in poisoning by large doses the sublimate is found in the fetus ; but in repeated small doses this is not the case. He explain.- this by the fact that the placental lesion occurs in several cases, which favor the transmission. Asphyxia from Hydrogen Sulfid in Sewer-gas. — L. Surro* reports the case of 6 workers in sewers, who were overcome by the gases. Five were resuscitated. In the fatal case the gas from the blood, re- ceived a few hours after death, blackened lead-acetate pajicr, and the urine also gave this reaction. No spectroscopic changes could be detected in the blood. No anatomic lesions were found at the atitopsy. R. Alberici * has studied the diffusion of alcohol in dead bodies. Experiments on dogs show that after postmortem introduction of alcohol into the stomach, it is recoverable in the heart, lungs, liver, and spleen. In the muscles, kidneys, and brain it was only found when more than 12 hours had been allowed for its diffusion. Wodke' records injuries to health in safety-match factories from potassium bichromate. The lesions consist of ulcerations of the nasal septum, caused by the inhalation of irritating particles. C. Richet' found the toxicity of thallium (0.055 gm, per kg. of dog) to be about the same as lithium and other substances which resemble it chemically, though it follows the law that the rarer metals of a group are more toxic than the common ones. G. Carri&re^ writes upon the influence of anthrax-infection on strychnin-poisoning. The resistance to the poison was not altered duriuf^ the tirst hours after infection, when it increased and subsequently diminished. Nitronaphthalin vapor is mentionefl as a cause of opacity of the cornea by V. Hauke,'" It comes on jjradually, making objects look hazy. In the central zone of the cornea is a grayish, ill-defined opacity, due, on closer examination, to closely set vesicles. P. Petit" calls attention to certain toxic accidents in connection with enamels dissolved in benzin. The trouble is due to the presence of carbon disulphid in crude benzin. » Viertelj. ger. Med., July, 189<1. » Aertzl. Sachverst. Zeitung, Afar. 4, 1899. " Ann. d'Hyg. pub., Mar., 1899. ' Viertelj. ger. Med., Oct., 1899. » Ibid., No. 3, 1899. ' Wiener Med. gessellscli., Feb. .*?, 1899. ♦ Arch. f. Anat. phvs., 8npp].. 1899. • Kivista di Med. Leg , Mav, 1899. «S()c. de Biol., No. 12, 1899. '" Wien. klin. Woch., No. 27, 1899. " Jour, des Brasseurs; Ann. d'Hyg. pub.. Mar., 1899. i: SEXUAL. 535 Acute P8ychosi8 from Salicylic Poisoning. — Saloschin * records a (!ase in which an anemic girl of 31, suffering from acute rheumatism, was given 18 gm. of sodium salicylate in 36 hours, and became vio- lently delirious with hallucinations and delusions, these disappearing completely in 18 hours. Associated with this were the dulness, head- ache, and tinnitus characteristic of the drug. SEXUAL. .' Neugebauer^ has minutely studied the injuries to the female sex- ual organs during coitus. Records of 157 cases, divided into the fol- lowing 30 groups, are given : 1. Severe hemorrhage with normal laceration of hymen. 2. Hyraenovaginal rupture. 3. Laceration of the hymen, and extending to stretching of the rest of the vulva. 4. Perforation of the hymen, leaving normal orifice intact. 5. Stripping off' of hymen at line of attachment to vulva. 6. Lesions of vulva with false passages in greater labia. 7. Laceration of hymen extending to urethra. 8. Lacer- ation of clitoris or meatus. 9. Laceration of navicidar fossa. 10. Laceration of frtenum labiorum pudendi. 11. Laceration of perineum. 12. Laceration of sphincter ani. 13. Laceration from anal orifice to mons veneiis. 14. Coincidence of several of above lacerations. 15. Longitudinal laceration of first vaginal wall. 16. Longitudinal laceration of anterior vaginal wall. 17. Of lateral wall. 18. Laceration of pos- terior vaginal fornix, superficial. 19. Laceration of posterior vaginal fornix extending down to the parametrium. 20. Laceration of the posterior vaginal fornix, parametrium, and peritoneum. 21. Laceration of the vaginal fornix opening Douglas's culde.sac, with prolapse of intestine. 22. Laceration of the vaginal fornix and prolapse of the cervix. 23. Lesions of the bladder with hemorrhage in cellulitis. 24. Vesicovaginal fistula. 25. Paravaginal false passage. 26. Rectovaginal fistula. 27. Laceration of perineum into rectum. 28. Vulval sinus from hymen. 29. Perforation of septum of duplex vagina. 30. Perforation of septum of a bifid hymen. Persistence of Hymen after Marriage. — TJAnjou mid., 1899, reports 3 cases after 10, 15, and even 20 years respectively of mar- ried life. The first 2 were observed through examinations necessitated by intercurrent disease. In the other case the parties wished before adop- ting a child to know if the sterility of the woman was absolutely per- manent. A. Mantzavinds^ relates a case of false accusation of rape. The act said to have been committed the previous day by ac^cused, a boy. No marks of violence were seen, although energetic struggle was alleged, but blood was seen on the chemise and drawers. The genitals were blond- stained, and the hymen recently ruptured and bleeding. Employment of an anesthetic; or narcotic was excluded. On digital examination a broken hen's egg (!) was found in the vagina. The girl's parents subse- quently admitted having forcibly introduced it in order to simulate the appearance of rape. > Wien. kliii. Rnndschan, May, 1898. ' Monatsli. f. geburtsh., Band 9, Heft 3. * Indep6ndance inddicale; Arch. d'Anthrop. crim., Mar., 1899. 636 LEGAL MEDICINE. F. Nftugebauer ' gives au analysis of 50 cases of marriage betwe»ill persons of the same sex, with several cases of divorce from errors of sex. Injury of Domestic Animals by Sexual Perverts. — A. Guille- heau^ emphasizes the importance of veteriuarians being familiar with the evidence of such acts. In cases of sadisin valuable cattle were Ibund to be destroyed. The unnatural sexual acts were, l.ovvever, fatal only in the case of hens; these showed rupture of the liver and fatal bleeding, and sometimes broken bones. In 1 case human spermatozoa were found in the cloaca, which was unusually v/idened. Wounds of the vagina, with rectal anil peritoneal perforation were met with in cattle subject to sadistic acts. In 1 case a cattle-tender was shown to have introduced a pitchfork handle into the vagina and twisted it round. Case of Precipitate I^abor in a Primipara of 43. — Knepper^ tells of a child that was born with only very short pains, taken for desire for defecation, into a chamber-pot. The escape of the liquor amnii was first noted afterward. The child was a girl, weighing 3000 gm., diam- eters of the head not given. About 4 months later a slight prolapse of the anterior vaginal wall was noted. Exceptional Cause of Syncope during Accouchement. — P. de la Touche* relates the case of a woman, weak and in ])oor health, who was confined alone. After feeling with her hand the head protruding from the vagina the labor did not advance. She then passed in a pair of scissors between the head and jierineum, and divided the perineum. The pain caused her to faint. Subsequently, on coming to, the child lay between her legs. She tied a knot on tlie cord. On the arrival of the neighbors the child was found to be dead. Self-inflicted Vaginal Injuries by a Fragment of Copper Sulphate. — Kulin"says that a girl of 23 had a discharge of slimy blue fluid from her vagina ; the vaginal nmoosa was eroded and discolored blue-gray ; there was deop-seated corrosion of the posterior vaginal wall, with sloughing of the surface. She had placed a piece of blue vitriol, as large as a plum, in the vagina to relieve constipation. After separation of the slouglis the wound healed rapidly. Coflfin-birth. — A case is reported by Langerhans.'' The body, that of a girl of 16, dead of phthisis, was placed upon the autopsy -table 60 hours after death, in February, with no signs of decomposition. The attendant noticed a prolapse of the uterus, and on his return about 20 minutes later the head of the child was seen to be completely delivered. There were no signs of liqtior amnii. Pregnancy had not been diagnosed. The development of the child indicated 7|- months. MENTAL. G. Villeneuve and E. P. Chagnon^ report a number of cases in which lunatics were condemned by mistake by the courts. This subjec;t has also been made the subject of a very full discussion by the French Con- gress of Alienists in 1899. » Rev. de Gvn., Mar. and Apr., 1899. ' Schweizer Arch. f. Thierlieilk., i., 1899. » Viertelj. ger. Med., Oct., 1899. ♦ Ann. d'Hvg. pub., Apr., 1899. » Viertelj. ger. Med., .July, 1899. « Ibid., Jan., 1899. ' L'Union m^d. dii Canada, June, 1899. / / L mg