211

ECCHYMOSIS IN THE DEAD BODY.

but if ecchymosis can be produced by violence to the recently dead, clear that a continuance of active life is not necessary for its produc The following case shows how these facts may be misapplied. A V man was seen to strike one of his companions. The person struck suddenly. On a post-mortem examination the mark of a bruise was over the sixth and seventh ribs on the right side. About a fort before this blow was struck the deceased had met with an acciden heavy box fell on his right side, knocked him senseless, and nearly k him. The question at issue was, whether the ecchymosed mark on side was owing to the blow struck shortly before the man died, or to fall of the box upon his body a fortnight previously. It was sugges on the authority of Casper, that, as the man died soon after the blow struck, the ecchymosis could not have arisen from the blow, but th was most probably due to the fall of the box a fortnight before. (Lar 1870, vol. 2, p. 35.) Such a case does not present much difficulty. the ecchymosed mark was blue or livid and without any marginal col it was probably the result of the blow struck just before death. If blood is fluid at the time of violence, and the small capillary vessels torn through-sudden death following-a blow may cause the effusio blood and the production of a mark on the skin. The warm liquid bi thus effused will find its way into the cellular tissue and produce usual external appearance. If in the case quoted the ecchymosis had 1 produced a fortnight before, it would have shown some changes of c at the margin, as described in the next paragraph. When the injur deep-seated, ecchymosis may appear at a distance from the site of the jury. This is well seen in blows about the hips; and a blow on the of the leg may manifest itself by ecchymosis around and below knee.

The changes which take place in the color of an ecchymosed spot worthy of attention, since they may serve to aid the witness in giving opinion on the probable time at which a contusion has been inflic After a time--commonly in eighteen or twenty-four hours-the blue livid margin of the spot is observed to become lighter; it acquires a vi tint, and before its final disappearance it passes successively thro shades of a green, yellow, and lemon color. During this time the is much increased in extent, but the central portion of the ecchymo that part which received the violence, is always darker than the circ ference.

Contusions on the Dead.-Christison found that blows inflicted o dead body within two hours after death gave rise to appearances on skin similar to those which resulted from blows inflicted on a per: shortly before death The livid discoloration thus produced genera arose from an effusion of the thinnest possible layer of the fluid part the blood on the outer surface of the true skin, but sometimes also fr an effusion of blood into a perceptible stratum of the true skin itself. likewise found that dark fluid blood fight even be effused into the cellu tissue in the seat of the discolorations, so as to blacken or redden 1 membranous partitions of the cells containing the fat; but this last effusi was never extensive. From this, then, it follows that, by trusting external appearances only, contusions made soon after death may be eas confounded with those which have been produced by violence shor before death. If a contusion has been caused some hours before dea there will be swelling of the part, and probably also changes of color the ecchymosed patch, in either of which cases there will be no difficul in forming an opinion. Although ecchymosis, or an appearance simil

EFFECT OF BLOWS ON THE DEAD.

245

to it, may be produced on a body after death, the changes in color are ben met with only under peculiar circumstances, as where the person is boring under general dropsy, and the serum effused beneath the skin may lead to the diffusion of the blood. The most satisfactory mark of stinction between the effects of blows on the living and dead body, in The opinion of Christison, is the following: In a contusion inflicted during fe, the ecchymosed portion of cutis (true skin) is generally dark and much discolored from the infiltration of blood throughout its whole thickess; the skin at the same time is increased in firmness and tenacity. Its is not, however, a uniform consequence of a contusion during life; for a blow may cause effusion of blood beneath the skin without affecting the catis in the manner stated. The state of the skin here described not be produced by a contusion on a dead body; although it is still an open question whether it might not be produced if the contusion were liticted a few minutes after death. As it is, the value of this sign is mewhat limited: it is not always produced on the living,-it might be psibly produced on the recently dead; so that when it does not exist We must look for other differential marks, and when it does exist we ught to satisfy ourselves that the contusion was not inflicted recently after death.

The period at which such injuries cease to resemble each other has not en fixed with any degree of precision; but, as in the case of incised wad-, it would seem that there is little danger of confounding them, when a contusion has not been inflicted on a dead body until after the disappearance of animal heat and the commencement of rigor mortis.

The practical inference from these observations is that discolorations of the skin, caused by blows inflicted soon after death may be sometimes taken for marks of violence on the living body. An instance has been Communicated to the author in which, for the sake of experiment, blows with a stick were inflicted on the recently dead body of a woman, while will warm. The body was afterwards accidentally seen by non-professional persons, who were not aware of the performance of these experiments; and so strong was the impression from the appearances that the deceased had been maltreated during life, that a judicial inquiry was actually instituted, when the circumstances were satisfactorily explained. The fact, therefore, that severe blows after death resemble slight blows during life, is of some importance; there is ecchymosis in each case, and Lo certain method of distinguishing the one from the other.

Is ecchymosis a necessary result of violence?—This medico-legal question has often created great difficulty. It has been repeatedly asserted in courts of law that no severe blow could have been inflicted on the body of a person found dead, in consequence of the absence of ecchymosis or other indication of violence on the part struck; but this assertion is entirely opposed to well-ascertained facts. However true the statement ay be that severe contusions are commonly followed by ecchymosis, it open to numerous exceptions; and unless these are known to a practitioner, his evidence may mislead the court. The presence of ecchymosis is commonly presumptive evidence of the infliction of violence, but its absence does not necessarily negative this presumption.

Cadaveric ecchymoses (lividities) almost invariably show themselves daring the eight or ten hours after death while the body is warm and the bod liquid, varying in extent according to the amount of blood in the boly. These changes are not due to violence before or after death, but to canses about which different views have been advanced by Caspar, Devergie, Ogston, Sir James Paget, Meymott Tidy, and others. The ablest scientific inquiry into their phenomena and causes is that given by Mey

246

ECCHYMOSIS NOT ALWAYS PRODUCED BY BLOWS.

mott Tidy, vol. 1, Phila. Ed., 1882, p. 75 et. seq. The important fact is they constantly occur in dead bodies after death, and that they so cl resemble the ecchymosis produced by bruises upon the living body also after death, as frequently to be mistaken the one for the other.] [After putrefaction has set in, and when the tissues have become and the blood easily diffused, the difficulty of distinguishing the one the other increases.

The table and illustrations given by Tidy, 78-81, well define the di guishing characteristics of each, and illustrate how the skilled obse can discriminate between them. Vid., also "Extravasation of Blood, J. Mitchell Bruce, in Quain's Dictionary of Medicine.]

It was long since remarked by Portal that the spleen had been f ruptured from blows or falls, without any ecchymosis or abrasion of skin appearing in the region struck. This has been also observe respect to ruptures of the stomach, intestines, and urinary bladder, violence directly applied to the abdomen. Portal supposed that mechanical impulse was simply transferred through the supple parietes walls) of the abdomen to the viscera behind, as in the striking of a bla filled with water. Whether this be the true explanation or not, it is certain that the small vessels of the skin often escape rupture fro sudden blow, so that their contents are not effused. A case is repo by Henke, in which a laboring man died some hours after fighting another, and on an inspection of the body the peritoneum was found tensively inflamed, owing to an escape of the contents of the small in tines, which had been ruptured to a considerable extent. There however, no ecchymosis or mark on the skin externally, and the me inspectors were inclined to affirm, contrary in this case to direct evide that no blow could have been struck; but others of greater experi were appealed to, who at once admitted that the laceration of the in tines might have been caused by a blow, even although there was appearance of violence externally. Watson states that a girl, aged n received a smart blow upon the abdomen from a stone. She immedia complained of great pain; collapse ensued, and she died in twenty hours. On inspection there was no mark of injury externally, but ileum (small intestines) was found ruptured, its contents extravasated, the peritoneum extensively inflamed. (On Homicide, p. 187.) Will son met with a case in which a man received a kick on the abdomen f a horse he died in thirty hours from peritonitis. The ileum was fo to have been torn completely across in its lower third. There was the slightest trace of ecchymosis externally-a fact which is the n remarkable since the blow was here struck by a somewhat anguia pointed body, the hoof of a horse. (Med. Gaz., May, 1840. See Guy's Hosp. Rep., 1865, p. 286.) A man who had been run over by omnibus was brought into hospital. The wheel had gone over his cl and abdomen, but on admission no injury was discoverable. On second day peritonitis set in, from which he rapidly sank. The liver the small intestines were found ruptured. (Guy's Hosp. Gaz., 18 Many other cases might be adduced in support of the statement t ecchymosis is not a necessary or constant result of a severe blow or sev bruising violence; but these sufficiently establish the fact. This med legal question frequently arises in cases in which the bladder or live ruptured, as, owing to the general absence of marks of violence, it is of alleged in defence that no blow or kick could have been inflicted on part of the abdomen. It is unnecessary to say that this view is no accordance with facts. (See Ruptures of the Heart, Liver, Spine, Intestines, post.)

EVIDENCE OF THE USE OF A WEAPON.

247

CHAPTER XXIV.

IVIDENCE OF THE USE OF A WEAPON.-CHARACTERS OF WOUNDS CAUSED BY WEAPONS.-INGSED, PUNCTURED, LACERATED, AND CONTUSED WOUNDS.—-STABS AND CUTS.-WHAT ARE WEAPONS?—EXAMINATION OF THE DRESS.-IMPUTED OR SELF-INFLICTED WOUNDS.

Evidence of the Use of a Weapon.-It is not necessary to prove that a weapon has been used for the production of a wound, for the words of the statute are: "Whoever shall, by any means whatsoever, wound or ause any grievous bodily harm to a person," etc.; yet evidence of the use fa weapon in cases of assault may materially affect the amount of punshment awarded on conviction. When, upon the clearest evidence, it is ertain that a weapon has been used, it is not unusual for prisoners to deare that no weapon was employed by them, but that the wound had een occasioned by accidental circumstances. A witness should remember that he is seldom in a position to swear that a particular weapon produced at a trial must have been used by the prisoner; he is only justified a saying that the wound was caused either by it or by one similar to it. Reg. v. Goodale, Norwich Aut. Ass., 1885.) Schwörer relates the following case: A man was stabbed by another in the face, and a knife with the blade entire was brought forward as circumstantial evidence against Lim, the surgeon having stated that the wound had been caused by this knife. The wounded person recovered; but a year afterwards an abscess formed in his face, and the broken point of the real weapon was discharged from it. The wound could not, therefore, have been produced by the Life which was brought forward as evidence against the prisoner at the ral (Lehre von dem Kindermorde.) Although the criminality of an at is not affected by an occurrence of this kind, it is advisable that such stakes should be avoided by the use of proper caution on the part of a witness. (On this question see the case of Renaud, by Boys de Loury, Ann. d'Hyg., 1839, t. 11, p. 170. As to what is a weapon, see Henke, Zeitschrift der S. A., 1844, vol. 1, p. 67.)

Characters of Wounds produced by Weapons.-Let us now suppose Lat no weapon is discovered, and that the opinion of a witness is to be founded only on an examination of a wound. It is right for him to know that, on all criminal trials, considerable importance is attached by the law to the fact of a wound having been caused by the use of a weapon; since this generally implies malice, and in most cases a greater desire to injure the party assailed than the mere employment of manual force. Some Wounds, such as cuts and stabs, at once indicate that they must have been produced by weapons.

1. Incised Wounds.-In incised wounds, the sharpness of the instruBeat may be inferred from the cleanness and regularity with which the ges are cut; in stabs, also, the form and depth of a wound will often dicate the kind of weapon employed. Stabs sometimes have the charers of incised punctures, one or both extremities of the wound being aly cut, according to whether the weapon is single or double-edged. puytren has remarked that such stabs, owing to the elasticity of the apparently smaller than the weapon-a point to be remembered in instituting a comparison between the size of a wound and the instru

248

LACERATED AND CONTUSED WOUNDS.

ment. A lateral motion of the weapon may, however, cause a consi ble enlargement of the wound. (See case Ann. d'Hyg., 1847, t. 1, P. When a stab has traversed the body, the aperture of entrance is comm larger than that of exit; and its edges, contrary to what might be posed, are sometimes everted, owing to the rapid withdrawal of the strument. That facts of this kind should be available as evidence, necessary that the body should be seen soon after the infliction of wound, and before there has been any interference with it.

In general, wounds made by glass or earthenware are characterize their great irregularity and the unevenness of their edges. In Reg Ankers (Warwick Lent Ass., 1845), a clean cut as from a penknife, a two inches long and one deep, was proved to have existed on the pe of the wounded man, who had fallen during a quarrel with the priso Some broken crockery was lying near the spot, and it was alleged in defence that a fall upon this had caused the wound. This allegation quite inconsistent with the clean and even appearance of the edges of wound. The prisoner, in whose possession a penknife had been for was convicted.

2. Punctured Wounds-It is necessary to notice whether the edges a punctured wound are lacerated and irregular, or incised; because it be alleged, in defence, that the wound was produced by a fall on some stance capable of causing an injury somewhat resembling it. In a that occurred to Watson, a deeply-penetrating wound on the gen organs of the deceased, which had evidently caused the woman's de was ascribed, by the prisoners charged with the murder, to her hav fallen on some broken glass; but it was proved that the edges of wound were bounded everywhere by clean incisions, which rendered defence inconsistent, if not impossible. A similar defence has been m on other occasions, where the cases came to trial. In general, wou made by glass or earthenware are characterized by their great irregular and the unevenness of their edges, with portions of the substance in the Cases of this kind show that, as it is not always possible to know wh this sort of defence may be raised, a medical witness should never fail make a minute examination of a wound which is suspected to have b criminally inflicted. These medical difficulties are now for the most p removed by the 24 & 25 Vict., c. 100. This must not, however, lead witness to suppose that a personal injury is not to be carefully examin with a view to the determination of this question.

3. Lacerated and Contused Wounds.-Lacerated wounds do not general present greater difficulty with regard to their origin than th which are incised or punctured. The means which produced the lace tion are commonly well indicated by the appearance of the wound. The injuries are generally the result of accident; they are, however, frequen met with on the bodies of newborn children, in which case they n give rise to a charge of infanticide. If it could be proved that they b arisen from the use of a weapon, and that the weapon fitted the woun these facts would, of course, go far to a conviction on a charge of murd In the case of Montgomery (Omagh Sum. Ass., 1873), it was proved th a bill-hook, found buried in a spot to which the prisoner was seen to g fitted the injuries produced on the skull of the deceased, and this piece evidence served to connect the prisoner and the weapon with the act murder, which took place in a dwelling-house. (See p. 269, post.)

Contused wounds and severe contusions present much greater difficul to a medical jurist. It is not often in his power to say whether a contus wound has resulted from the use of a weapon, from a blow of the fist,