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Feigned Diseases

Antipyrine Antifebrin Phenacetin And Aniline

Lead And Its Preparations

Sale Of Poisons; Scheduled Poisons

Presumption Of Death; Survivorship

Barium Salts

Marriage And Divorce

Idiocy Imbecility Cretinism

Iodine--iodide Of Potassium

Death From Lightning And Electricity

Evidences Of Live Birth

The signs of live birth prior to respiration are negative and positive.
A negative opinion may be formed when evidence is found of the child
having undergone intra-uterine maceration. In this case the body will be
flaccid and flattened; the ilia prominent; the head soft and yielding;
the cuticle more or less detached, and raised into large bullæ; the skin
of a red or brownish-red colour; the cavities filled with abundant
bloody serum; the umbilical cord straight and flaccid.

A positive opinion is justified when such injuries are found on the body
as could not have been inflicted during birth, and are attended with
such hæmorrhage as could only have occurred while the blood was
circulating. Fractures of the cranium from accidental falls (precipitate
labour) are as a rule stellate, and are situated on the vertex or in the
parietal protuberance. The fractures from violence are more extensive,
usually depressed, and accompanied by laceration of the scalp.

The evidences of live birth after respiration has taken place are
usually deduced from the condition of the lungs, though indications are
also found in other organs. The diaphragm is more arched before than
after respiration, and rises higher in the thorax in the former case
than in the latter. The lungs before respiration are situated in the
back of the thorax, and do not fill that cavity; they are of a dark,
red-brown colour and of the consistence of liver, without mottling.
After respiration they expand and occupy the whole thorax, and closely
surround the heart and thymus gland. The portions containing air are of
a light brick-red colour, and crepitate under the finger. The lungs are
mottled from the presence of islands of aerated tissue, surrounded by
arteries and veins. The weight of the lungs before respiration is about
550 grains, after an hour's respiration 900 grains; but this test is of
little value. The ratio of the weight of the lungs to that of the body
(Ploucquet's test), which is also unreliable, is, before respiration,
about 1 to 70; after, 1 to 35. Lungs in which respiration has taken
place float in water; those in which it has not, sink. There are
exceptions to this rule, on which, however, is founded the hydrostatic
test. As originally performed, this test consisted merely in placing
the lungs, with or without the heart, in water, and noticing whether
they sank or floated. The test is now modified by squeezing, and by
cutting the lungs up into pieces.

The objections to the test as originally performed are--(1) That the
lungs may sink as the result of disease--e.g., double pneumonia. (2)
That respiration may have been so limited in extent that the lungs may
sink, owing to large portions of lung tissue remaining unexpanded
(atelectasis). (3) Putrefaction may cause the lungs to float when
respiration has not taken place. (4) The lungs may have been inflated
artificially. Few of these objections apply, however, when the
hydrostatic test, modified by pressure, is employed. To take these
objections in detail, it may be stated: (1) If the lungs sink from
disease, the question of live birth is answered. (2) This objection is
too refined for practical use. The lungs sink, there is an absence of
any of the signs of suffocation, and the matter ends. The examiner has
only to describe the conditions which he finds, and is not required to
indulge in conjectures as to the amount of respiration which may or may
not have taken place. (3) Gas due to putrefaction collects under the
pleural membrane, and can be expelled by pressure, and is not found in
the air cells. The lungs decompose late, hence in a fresh body
putrefaction of the lungs is absent; in a putrefied child, if the lungs
sink, it must have been stillborn. The so-called emphysema pulmonum
neonatorum is simply incipient putrefaction.

The lung test simply shows that the child has breathed, but affords no
proof that the child has been born alive. The child may have breathed as
soon as its head protruded, the rest of the body being in the maternal
passages. The child is not born alive until it has been completely
expelled, although it is not necessary that the umbilical cord should
have been cut.

In addition to these tests, live birth may be suspected from the
following conditions: The stomach may contain milk or food, recognized
by the microscope and by Trommer's test for sugar; the large
intestines in stillborn children are filled with meconium, in those
born alive they are usually empty; the bladder is generally emptied
soon after birth; the skin is in a condition of exfoliation soon after
birth. The organs of circulation undergo the following changes after
birth, and the extent to which these changes have advanced will give an
idea of how long the child has lived: The ductus arteriosus begins to
contract within a few seconds of birth; at the end of a week it is about
the size of a crow quill, and about the tenth day is obliterated. The
umbilical arteries and vein: the arteries are remarkably diminished in
calibre at the end of twenty-four hours, and obliterated almost up to
the iliacs in three days; the umbilical vein and the ductus venosus are
generally completely contracted by the fifth day. The foramen ovale
becomes obliterated at extremely variable periods, and may continue open
even in the adult.

Importance of late has been attached to the stomach-bowel test. If the
stomach and duodenum contain air, and consequently float in water, the
chances are that the child did not die immediately after birth; this is
known as Breslau's second life test, and the lower the air in the
intestinal canal, the greater is the probability that the child survived

The umbilical cord in a new-born child is fresh, firm, round, and bluish
in colour; blood is contained in its vessels. The cord may be ruptured
by the child falling from the maternal parts in a precipitate labour,
and the ruptured parts present ragged ends. It is seldom that a child
bleeds to death from an untied or cut umbilical cord, and the chances in
a torn cord are still more remote. The changes in the cord are as
follows: First it shrinks from the ligature towards the navel; this
change may begin early, and is rarely delayed beyond thirty hours; the
cord becomes flabby, and there is a distinct inflammatory circle round
its insertion. The next change is that of desiccation or mummification;
the cord becomes reddish-brown, then flattened and shrivelled, then
translucent and of the colour of parchment, and falls off about the
fifth day. The third stage, that of cicatrization, then ensues about the
tenth to the twelfth day. The bright red rim round the insertion of the
cord, with inflammatory thickening and slight purulent secretion, may be
considered as evidence of live birth, and the stage at which the
separation of the cord by ulcerative process has arrived will point to
the probable duration of time the child has existed after birth.

There are many fallacies in the application of any of these tests, and
the whole subject bristles with difficulties. The medical witness would
do well to exhibit a cautious reserve, for if the child dies immediately
after birth it is almost impossible to prove that it was born alive.

Next: Cause Of Death In The Foetus

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