MEDICO-LEGAL AUTOPSIES.

BY

H. P. LOOMIS, A.M., M.D.,

Professor of Pathology in the University of the City of New York; Visiting Physician and Curator to Bellevue Hospital, New York; Pathologist to the

Board of Health, New York City; President New

York Pathological Society, etc., etc.

AUTOPSIES.

A MEDICAL examiner before proceeding with an autopsy, especially if called before the body has been removed from the place where it was found, should carefully note certain facts. These should be entered by himself or an assistant with great care, in a note-book, as this book can be introduced as evidence in any trial. A satisfactory way is to dictate to the assistant as the examination proceeds, and at the conclusion the assistant reads the notes taken, and the examiner verifies them.

SURROUNDING OBJECTS-POSITION OF THE BODY.

These should be first noted. The character of the soil; the condition of the ground, and whether it shows footprints; if so, their direction; the evidence of any struggle; the presence of any weapon; and finally, the exact position in which the body lies, especially the position of the hands and feet. This is important, for the body may be found in a position which the deceased could not have assumed on the supposition of the wound or injury having been accidental or homicidal. If possible a photograph should be taken of the body in the exact position in which it is found. If it is absolutely necessary to remove the body, it should be done with great care, keeping the body in as horizontal a position as possible.

The character of the surrounding soil should be noted. This is of special importance when the body to be examined has been exhumed for the question of preservation of the body and the ability to recognize pathological changes may be brought up at a trial. This was an important point raised in the Buchanan case (New York, 1893).

body be found in the water, examine the character of the water and the temperature, and if found near the shore, the character of shore and bottom.

Blood. The situation of blood-stains, and their number and extent, on clothing or surrounding objects should be noted.

This will often show whether a struggle has taken place after receiving the fatal wound, and is also of medico-legal importance if made at the time the body is found, for it may be so situated as to show that the body has been interfered with after death.

Again, spots of blood found upon articles of clothing or upon surrounding objects should be noted as to their form and direction, for they may serve to furnish an indication of the position of the person with respect to them when the wound was inflicted. For example, if the spot was oval, the presumption is that the person was placed obliquely with respect to the stain while the hemorrhage was occurring. The force with which the blood was thrown out will in some measure be indicated by the obliquity or length of the spot. The amount of blood will also often indicate whether the person has died suddenly, the exact spot where death occurred, whether a struggle took place, and will also preclude the possibility of a person moving after receiving the fatal injury. When we examine a body, especially when found in a room, care must be taken not to be misled by the accidental diffusion of blood by persons going in and out, or touching the body (see BOOD-STAINS, Vol. II.).

Clothing. The examination of the clothing should be thorough. A description of each article should be noted, and the order in which it is removed; for often it is important to prove that the garments were worn by or belonged to the deceased. If any blood is on the clothing, note whether the blood is in large patches, or whether it is sprinkled over the garment: the amount of the blood and what garments are stained by it. Note and examine whether the blood has flowed down the front of the clothing, whether it has soaked the inner garments, or again, whether it has collected along the back; for these appearances will sometimes demonstrate whether a wound was inflicted while the person was sitting, standing, or lying down. For example, if the throat is cut while the person is lying down, the blood will be found on each side of the neck along the back and not down the front of the body. Few suicides cut their throats in a recumbent position, and this distribution of the blood may serve to distinguish a suicidal from a homicidal wound.

The condition of the clothing may also serve to show whether there has been any struggle, and the presence of dry spots or mud on it may sometimes serve to connect an accused person with an act of murder. This is well illustrated in the case of Reg. v. Snipe, reported in Beck's "Medical Jurisprudence," where evidence was adduced to show that some spots of mud on the boots and clothing of the prisoner, when examined microscopically, contained infusoria, shells, and some rare aquatic vegetables. The mud of the ditch close to where the body was found, as also the mud on the clothing of the dead. body, presented the same microscopical appearances. The medical expert who gave this evidence swore that in his opinion the mud spots on the body and on the prisoner's boots were derived from the same ditch, for the mud of all the other ditches in the locality was found, on microscopical examination, to be different. The well-known case which occurred in New York a few years ago, known as the "Shakespeare case," furnishes an example of the importance of carefully examining all stains on the clothing found on bodies.

If there are several stabs or cuts on the body involving the dress, it should be noted whether they are blood-stained, and if so, whether the stain is on the inside or outside of the garments, for sometimes in simulated personal injury a stain of blood may be inadvertently applied to the outside of the dress, as in wiping a weapon.

Weapons. If a weapon is found, the character of the weapon and its exact position should be noted. This is frequently of importance in telling whether a person has died from an accidental or self-inflicted wound. In a case where death occurs immediately or within a few minutes, the weapon is found near the body, or often so tightly grasped in the hand that it can be with difficulty removed. If the weapon is found near the body it should be noted on which side and at what distance, and it must be questioned whether it could have fallen on the spot or been thrown there by the deceased. It is compatible with suicide that the weapon should be found at some distance from the body. An instance has been recorded where an individual was discovered in bed with his throat cut, and the bloody razor was found closed and in the pocket of the deceased. If a weapon cannot be discovered, or is concealed,