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Full text of "Medical Jurisprudence And Toxicology"

282                                                 MEDICAL JURISPRUDENCE

MUSCLES

Contusions and sprains of the muscles may occur from a blow or from
a fall. They are generally simple in nature, but an abscess may form in the
contused part of the muscle, or paralysis and subsequent atrophy of the
muscles may occur if the nerve supplying these muscles is damaged.
Similarly, a person may become lame from a sprain of the gastrocnemius
and soleus owing to their contraction.

Laceration and crushing of the muscles due to a heavy cart or a railway
or machinery accident may necessitate the amputation of a limb, or may
cause death indirectly from gangrene or tetanus.

Sometimes, it so happens that owing to its elasticity, the skin, especially
of the chest and abdomen, remains intact, but the underlying muscles are
torn by kicks, blunt weapons or street accidents causing protrusion of a
portion of a viscus behind the skin.

In a carriage accident a boy, aged 11 years, sustained injuries in his chest by the
front end of a pole of an ekka hitting him on the right side. On examination there was
no mark of external injury on the chest, but a portion of the lung was found protruding
through the torn muscles in the fourth intercostal space of the right side of the chest.

A woman, aged 60 years, was struck in the abdomen by a bullock with his head,
and died 3 days later. At the autopsy the abdominal wall was found intact without
any external mark of injury, but a piece of the omentum was found protruding behind
the skin through a tear 1J" X 1", of the abdominal muscles on the right side in the
upper part. There was also a tear in the small intestine towards its lower part on the
right side.

BONES

Contusion of a bone and of its periosteum due to a blow or a fall is a
simple injury, and in ordinary circumstances subsides in a few days, though
acute infective periostitis or necrosis may occur in the case of debilitated,
syphilitic or rheumatic people.

Fractures of bones may occur from blows, falls or muscular contraction.
A case occurred in which a healthy man fractured his humerus by muscular
exertion in throwing a cricket ball.

Fractures are not ordinarily dangerous, unless they are compound,
when death may occur from loss of blood, if a big vessel is wounded by the
split end of a fractured bone, or from fat embolism, septicaemia, gangrene
or tetanus.

In children and young persons the bones are tough and elastic, hence
a green-stick or partial fracture occurs more frequently; while in old people
the bones, being brittle owing to the increase of their inorganic constituents,
are easily fractured even with very slight violence. The bones are more
fragile- in certain diseases, such as syphilis, arthritis, osteomalacia, rickets,
sarcoma, cancer, scurvy and those nervous diseases which produce trophic
changes.

There is a peculiar brittle condition of the bones, called -fragilitas
ossutm, in which fracture may occur from a trivial trauma or a slight
exertion, such as a misstep in walking or moving around in bed. This con-
dition is hereditary and found in persons apparently in good health. It is
also found in people suffering from locomotor ataxy, syringomyelia, and
general paralysis of the insane, and in workers in phosphorus.

In criminal cases the defence often admits the fracture of a bone, but
raises the plea that it was due to an accident and not to direct violence. A
fracture caused by direct violence can be judged from its position and the
presence of a bruise or wound of the skin or subjacent tissues accompanying
the fracture. It shoiild, however, be noted that in some cases no bruise or