EXAMINATION OF THE OVUM.

509

is from five to six inches long, and weighs from two to three ounces; at the fifth month it measures from six to seven inches, and weighs from five to seven ounces; and at the sixth month its length is from eight to ten inches, and its weight is about a pound. (For the characters of the child beyond this period, see Infanticide, post.) The great difficulty will Consist in determining the nature of the supposed ovum or embryo between the second and third months. In making the examination the ovum should be placed in water, and all clots gently washed away from the membranous coverings or removed by some blunt instrument. Alcohol may be used as a substitute for water after the blood has been removed. If the embryo cannot be found, the decidua and chorion or portions of them may be recognized the former by its forming the outer investment with its smooth internal and rough external or uterine surface; the latter by the villous or shaggy appearance of that portion of it which would have become the placenta. Between the third and fourth months the foetus may be commonly identified without much difficulty. The ovum in many instances escapes first, leaving the decidua behind. This comes away after a time, but it is important to remember that in some states of the virgin decidua-like structures are thrown off from the uterine mucous membrane, which, when examined by the microscope, resemble the true decidua. Both are constituted of the innermost portion of the uterine mucous membrane, and contain all its elements. Keiller (Edin. Med. Jour., 1865, ii. p. 82) and Bell (ibid., p. 120) have called attention to the fact that an erroneous medical opinion on the date of pregnancy may be formed by trusting too much to the appearance of the ovular membranes. The ovum or fœtus may die and the membranes afterwards continue to grow, thus giving the appearance of a more remote date to pregnancy. An examination of the embryo alone can give any satisfactory results on this point. The membranes may be also enlarged as the result of dropsical accumulation, and this may be set down to pregnancy of some duration, when it may not actually have extended beyond the second or third month.

A mole is the result of conception, the fœtus having died in consequence of the effusion of blood into the decidua and the various membranes, and, should a placenta exist, into its structure. The symptoms accompanying a mole resemble those of pregnancy; and the appearances produced by its expulsion are not to be distinguished from those attending the abortion of a foetus at an early period of gestation. The only means of distinction would be derived from an examination of the expelled matters. The local efects produced on the organs of generation by the expulsion of these bodies are by no means so great as those arising from delivery at the full period. When from some accident the foetus dies at any time before the complete formation of the placenta, the villi of the chorion, instead of completely dying, grow imperfectly; whilst serous fluid is effused within, and the part is distended into a globular form. This is called a vesicular mole. In the early stage of pregnancy a decidual covering will always be found more or less complete around this mole; but if the size of the mass be great, then, although present, it will be less observable, being spread over a larger surface. A corpus luteum will also be found, but not so perfectly formed as in normal pregnancy. The ordinary symptoms of pregnancy accompany this state, although in all forms of mole-pregnancy it is either imperfectly marked or it only proceeds to a certain point. (See case Obst. Rec., vol. i. p. 21.) It is also to be remembered that the effects produced by the expulsion of a mole are very similar to those of an abortion. These facts may have an important bearing in medico-legal practice.

510

CONCEALMENT OF BIRTH.

Concealment of Birth.-Medical evidence respecting delivery is required in two cases: first, when the birth of a child is wilfully concealed; and second, when the contents of the womb have been prematurely expelled by criminal means. The concealment of pregnancy is no offence in the English law; but the concealment of delivery or of the birth of a child is a misdemeanor by the 24 and 25 Vict., c. 100, sec. 60, the words of which are to the following effect: "If any woman shall be delivered of a child, every person who shall by any secret disposition of the dead body of the said child, whether such child died before, at, or after its birth, endeavor to conceal the birth thereof, shall be guilty of a misdemeanor." Willes, J., remarked upon the statute that women tried on this charge are punished, not for concealment of birth, but concealment of the body-a distinction which not only increases the difficulty of obtaining evidence, but excites hope in the criminal that, if she can finally do away with the body, she may be free of the law. Various interpretations have been put upon the terms "concealment" or "secret disposition" of the body. This part of the evidence does not affect a medical witness, unless he himself has found the dead body or was present when it was found. It will rest with the judge to determine whether the body has been so disposed of as to constitute a misdemeanor. (Reg. v. Clarke, Chelmsford Sum. Ass., 1864.)

[In the American States the statute laws make it a criminal offence to conceal the birth of a child. They vary to such an extent that the only safe rule to adopt is, that each case must be considered and construed under the law existing where the offence was committed. The courts in all cases construe these statutes with great strictness. In some of the American States the statutes require that it must appear that the child was born alive, and that if the child was stillborn there could be no crime: Desty Am. Crim. Law, § 90, citing State v. Kirby, 57 Me. 30; State v. Jones, 4 Hawks. (N. Car.) 350; State v. Love, 1 Bay (S. Car.), 167; Douglass v. Com., 8 Watts (Pa.), 538.

It has been said of all these statutes: "That they make heavily punishable what of itself is nearly or quite innocent, simply because of its tendency toward an unproved wrong. Hence the interpretation is always specially strict:" Amer. and English Encycl. of Law, vol. 3, p. 416.]

Medical men must be here cautioned, as in some other crimes committed by women, that they have no legal right, except by the consent of the woman, to examine her person in order to ascertain whether she has been recently delivered or not. According to English law, no person is bound to furnish evidence against himself or herself. A medical man who neglects this rule may find himself charged with an indecent assault, and be sued for damages. [The rule is different in the American States or many of them. A physician who attended the mother would not be permitted to disclose any fact coming to his knowledge while attending her in his professional capacity. The statutes of New York and many American States make all such knowledge privileged, and the physician is prohibited from testifying regarding it.] In Agnew v. Jobson and others (Newcastle Lent Ass., 1877), the plaintiff was suspected of concealing the birth of her illegitimate child, of which she was afterwards convicted. An inspector of police, wishing to have evidence of her physical condition, gave to Mackay authority to examine the plaintiff's person. Having some doubt about the legality of the proceeding, he applied to the defendant Jobson, a magistrate, who gave him a written order for the purpose. Jobson, Mackay, and another were sued for damages for an indecent assault. The evidence made it clear that the girl did not give her consent,

DEFINITION OF A "CHILD."

511

at her alarm prevented her from resisting. The judge summed up, and The jury returned a verdict for the plaintiff, with 501. damages. (Brit. Med. Jour., 1877, i. p. 336.) A medical man may, however, examine the lothes of the accused, as well as the body of the child, if they are handed to him by the police for this purpose.

This is an offence of which women charged with child-murder are comonly convicted in England; while the Scotch law punishes women for The concealment of pregnancy if the child be dead or amissing. (Alison's Crim. Law, p. 153.) The medical evidence on trials for this misdemeanor in Scotland is exclusively derived from an examination of the mother; and thus much will depend upon the time at which this is made. With gard to the child, its body need not even be produced, provided there be atisfactory evidence of its death; the body may have been secretly buried or burnt, and in the latter case it may be necessary to examine the bones or ashes.

of the statute.

According to the English statute, the child must be dead-the concealent of the birth of a living child not being any offence unless it should Lappen to die before its birth was made known. In the case of Reg. v. Woodman (Kingston Lent Ass., 1845), the woman was acquitted because the child was living when concealed. Chitty says that, in order to onstitute the offence, the child must have advanced to the end of the seventh month (Med. Jur. p. 412); but it is to be presumed that the conalment of the birth of a dead child at the sixth, or under the seventh Lonth, would be as much an infringement of the statute as if it were Lore advanced. The concealment of the aborted but undeveloped ovum or embryo, of a monster-i. e. a child without human shape, à mole, or her morbid growth-would not probably be considered a contravention We are not aware that there has been any judicial decision this point. Lane communicated to the Med. Times (Aug. 1845) a e in which a charge of concealed birth was dismissed, because the conalment referred to a child born at the eighth month in its membranes. The woman stated that she did not consider it to be a child. The case, eing entirely new, should have been sent for trial; for a magisterial desion can furnish no precedent on a question of this kind. This woman ast have been delivered of a child, foetus, or embryo, or of course there Would have been no pretence for the charge. That a child may be thus Born and removed from the membranes alive is a fact established by experience. Brunton reported to the Obstetrical Society a case in which the entire ovum was expelled at the seventh month of gestation, and the tid was rescued alive, although born fifteen minutes before being taken nt of the membranes. (Med. Times and Gaz., 1871, i. 412.) In another ase of sudden delivery the child in its membranes with the placenta was charged into a bucket. It was not rescued in time to save life. (Amer. Jr. Med. Sci., April, 1870, p. 430.)

It is difficult to suggest a proper legal definition of a “child." From Se observations made by a Recorder of London, there appears to be uncertainty on this point.. In reference to the case of Reg. v. Knight C. C. C., Oct. 1865), where a woman was charged with concealment of th, the prisoner admitted to a policeman that she had been delivered of Something" (not forthcoming). "Now, was she delivered of a child, d had she disposed of the body in such a way as to conceal the fact of having been so delivered? Then what was a child?'-for those Were the words used in the statute. He felt himself a little debarred from pressing his own opinion in reply to this question, because two of the dges had given decisions directly contrary the one to the other upon

512

DEFINITION OF A "CHILD."

this subject. One of them said it was not a child unless it had attained that state in which it could live, supposing it had been born alive. If it had attained that state, then he was of opinion that it was a child. The other judge said that this was not his idea of a child; but that if it bad the outward form of a child, it was a child according to the statute. The one contended that it ought to have attained to a state in which it had a capability of living (viability); and the other that at any rate it should have the outward form of a child. Was there any proof of this kind here? The prisoner herself said she did not know whether she had been in the family way for three months. Taking the widest view of the judgesHad what was born in this case the outward form of a child? If it had not, then the prisoner was not guilty of the offence charged against her." The proposed new Criminal Code contained this provision (section 146): "No foetus shall be deemed to be a child within the meaning of this sec tion which had not, when born, reached the period at which it might have been born alive." This, as it will be seen under Infanticide, is not a fixed period, but no doubt the earliest period at which a child has been known to come into the world living would be taken as the limit.

It will be perceived that it is not material here, as in a case of alleged infanticide, to prove when the child died—whether before, during, or after its birth; and thus those subtleties and technicalities which are met with in cases of child-murder are avoided. In regard to proof of concealment, and what constitutes it, these are essentially legal points; but a medical practitioner may sometimes benefit an accused person if he can prove that the woman had made application to him on the subject of her pregnancy and delivery. The law is especially lenient under such circumstances. A very strict interpretation appears to be put upon this term concealment. There must be a "secret disposition" of the dead body. The medical witness may even have to deal, not with the body, but with the remains in a mutilated state or burnt. He must be able to prove that they really are human remains. In one case (Cornwall Sum. Ass., 1871), the prisoner, a married woman, was charged with the murder of her illegitimate child. The body was found mutilated, and partly burnt. The woman had concealed the mutilated body of the child, and had tried to get rid of it by burning. She said the burnt bones found and some blood on a rug were those of a fowl. It was proved, however, that they were the bones of a child and that the blood was not that of a fowl.

Questions connected with concealment of birth do not fall under the jurisdiction of a coroner; the medical evidence is therefore required by a magistrate.

ABORTION-NATURAL CAUSES.

513

CRIMINAL ABORTION.

CHAPTER XLVI.

ABORTION FROM NATURAL CAUSES.-CRIMINAL CAUSES.-MECHANICAL MEANS.-MEDICINAL SUBSTANCES. SIGNS OF ABORTION.-SPECIFIC ABORTIVES.-LOCAL APPLICATIONS.PFIGNED ABORTION.-MEANING OF THE WORD "NOXIOUS" AS APPLIED TO DRUGS.-ON INPUCING PREMATURE LABOR.-PROOF OF PREGNANCY NOT NECESSARY.-ABORTION OF MONSTERS.-MOLES AND HYDATIDS.

By abortion is commonly understood, in medicine, the expulsion of the contents of the womb before the sixth month of gestation. If the expulsion takes place between the sixth and ninth months, the woman is said to have a premature labor. The law makes no distinction of this kind, but the term "abortion" is applied to the expulsion of the fœtus at any period of pregnancy before the term of gestation is completed; and in this sense it is synonymous with the popular term miscarriage. Criminal abortion is incorrectly thought to be rarely attempted before the third month; it is now very common to perform it before the second month, because then a woman begins for the first time to acquire a certainty of her pregnancy. The causes of abortion may be either natural or violent. The latter only fall under the cognizance of the law; but a medical witness hould be well acquainted with the causes which are called natural, in contradistinction to others which depend on the application of violence. These natural causes are sometimes very obscure, and the real cause is thus often overlooked. They are so frequent, that-according to Whitehead's observation-of 2000 pregnancies, one in seven terminated in abortion. These causes are commonly ascribable to peculiarities in the female system, to the presence of uterine or other diseases, or to some shock sustained by a woman during pregnancy. Any diseases which strongly affect the womb or general system of a woman may give rise to abortion. An attack of smallpox has been known to produce it; and it has been suggested by Acton that the presence of constitutional syphilis in the father is not only a cause of infection in the offspring, but of repeated abortions in the woman. (Lond. Med. Gaz., vol. xxxvi. p. 164; Ramsbotham's Obst. Med., p. 655.) These facts deserve attention, when it is proved that a woman has really aborted, and an attempt is unjustly made to fix an alleged act of criminality on another. For further information on the numerous natural and accidental causes which may give rise to abortion, the reader may consult the work of Whitehead (On Abortion and Sterility, p. 252); and, for the effects of undue lactation and diseases of the placenta in causing abortion, the Med. Times and Gaz, 1852, ii. p. 580, and 1853, i. p. 302. In considering the operations of these causes, it is proper to bear in mind that, during pregnancy, the Womb is subject to a natural periodical excitement corresponding to what Would have been the menstrual periods dating from the last cessation. Hence comparatively trivial causes operating at these periods may lead to