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Full text of "Medical Jurisprudence And Toxicology"

52                                               MEDICAL  JURISPRUDENCE

family  with  supernumerary  digits   in  which,  the   deformity   skips   two   generations  to
reappear in orife member of the third and in five of the fourth.58

Acquired deformities, such as malunited and ununited fractures of the
bones of extremities, are the results of previous injuries.

The body of Livingstone, the great African traveller, was recognised by the un-
united oblique fracture of the humerus exactly in the region of the attachment of the
deltoid to the bone.

9.   SCARS

A scar or a cicatrix is a fibrous tissue covered by epithelium formed as
a result of the healing process of a wound or injury in which there has been
a breach of continuity of substance. It has no hair follicles or sweat-glands,
but it is slightly vascular owing to the presence of a few capillaries.

Character of Scars.—A scar generally assumes the shape of the wound
causing it. A scar resulting from an incised wound which has healed by
first intention, is usually linear and straight. If it has healed by the forma-
tion of granulation tissue, the resulting scar will then be wider and thicker
in the centre than at the periphery. But a scar following an incised wound
in the axilla or upon the genitals may be irregular on account of the loose
folds of the skin. Such a scar may also be smaller than the original wound.

Broad and irregular scars are caused by lacerated wounds. Large
irregular scars accompanied very often by keloid patches are the results of
extensive burns and scalds. Scars resulting from bullet wounds are gene-
rally irregular in shape and larger than the bullet, and are usually sur-
rounded by the grains of unburnt gunpowder, if the weapon was discharged
within a few inches of the body. While they are depressed, disc-
shaped, adherent in the centre and smaller than the bullet, if discharged from
a distance. The scar of the wound of entrance is, as a rule, smaller than
that of the wound of exit. Doubtful cases should always be examined by
X-Rays in order to determine the presence or absence of shots embedded
in the underlying tissues or of injuries to the underlying bones.

In January 1924, the District Magistrate of Gonda referred to me a case in which
one Bisheshwar Singh was suspected of having taken part in a dacoity that took place
three years ago, and was consequently injured in the thighs by the discharge of fire-
arms. On examination I found several rounded nodular and depressed scars on the
front of the thighs resulting probably from gun-shot wounds. Skiagrams that were taken
in the X-Ray Department of the King George's Hospital, Lucknow, showed several
shots embedded in the soft tissues of the thighs. The man was prosecuted and sentenced
to a term of imprisonment for the offence of committing dacoity.

Scars from wounds, produced by stabbing instruments are triangular in
shape, smaller in size than the Hade of the weapon, and are less depressed
than the scars of gunshot wounds.. Scars resulting from leech-bites' are
triradiate. Scars due to syphilitic and tuberculosis ulcers are irregular and
thick in parts, while those due to Vaccination and small-pox are pitted.

Appearance of Scars.—A scar appears in- four or five days when a wound
heals under a scab as in the case of a superficial cut on a finger or a shave-
cut on the chin or cheek. In the case of a clean aseptic wound which is
caused by a surgical operation, and heals by first intention, the scar usually
appears in a fortnight, while in a suppurating wound it appears from two
weeks to three months, or more.

Disappearance of Scars.—Scars resulting from wounds and skin diseases
which involve the whole thickness of the skin are always permanent, but
superficial linear scars involving only the epidermis or cuticle layer of the
skin may disappear in the course of a few years. It is not possible to remove
a scar successfully but its size and shape can be altered by an operative

58.   Ibid., May 28, 1904, p. 1254.