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Full text of "Medical Jurisprudence And Toxicology"

300:                                                MEDICAL JURISPHTTDENCE

The" corpus luteum used to be regarded as a positive sign of pregnancy,
but it has now no forensic value, inasmuch as it is seen as a result of over-
congestion, as in fibroid tumours and other pathological conditions. It has,
also been found in the ovaries of women who were neither pregnant nor
menstruating. Moreover, pregnancy has occurred without the formation of
a corpus luteum.

DELIVERY

The cases in which the medical jurist is required to ascertain whether
a woman has been delivered or not are those of abortion, infanticide,
concealment of birth, feigned delivery, contested legitimacy, and libel actions
of disputed chastity.

SIGNS OF DELIVERY

These signs are discussed under the following four headings : —
I.    Signs of recent delivery in the living.
II.   Signs of recent delivery in the dead.
HI.   Signs of remote delivery in the living.
IV.   Signs of remote delivery in the dead.

I.   SIGNS OF RECENT DELIVERY IN THE LIVING
The signs of recent delivery at full term are—

1.    Appearance of  General Indisposition.—For the first two  or three
days after delivery the woman wears a languished look with the sunken eyes
having a dusky  pigmentation about  the  lower  eyelids,  and has  a  slight
increase in the pulse and temperature.   These signs may be absent in strong
women, or may be found in any other illness or at the time of the monthly
course.   The intermittent contractions of the uterus are usually present for
the first four or five days.   These are termed after-pains when they are
vigorous and painful.

2.    Breasts.—The breasts are full, firm, knotty and enlarged, and contain
colostrum or milk.   The areolae are dark and the nipples turgicl

3.    Abdomen.—The abdomen is slightly full, but more often lax and
flabby.   The skin is wrinkled and shows the linese albicantes, which are
pinkish in the beginning, but subsequently become white in colour.

4.   Uterus.—Just after delivery the uterus relaxes, and may be felt as a
flabby mass extending to the umbilicus a few hours after delivery.   It then
diminishes in size, and is felt like a hard cricket ball for about two or three
days in the lower part of the abdomen above the symphysis pubis, but its
fundus can be felt just above or behind the symphysis pubis up to the
fourteenth day.

5.   Vagina.—The labia are tender,  swollen and bruised or lacerated.
The vagina is smooth, relaxed and dilated, and may show recent tears.   The
fourchette is usually ruptured, and the perinaeum is sometimes lacerated.

6.    Cervix.—The cervix is soft and patulous, and its edges are torn or
lacerated transversely.   The internal  os begins  to   plose  during  the  first
twenty-four  hours.   The  external  os  is  soft  and  patent,   admitting  two
fingers for a few days.   It admits with difficulty one finger at the end of a
week, and closes in two weeks,

7.   Lochia.—35te lochia is a  discharge from  the uterus  and  vagina,
lasting for the first two or Iliree wed^s stfter delivery.   It has a -gecu&ar,

disagreeable odour.   Bating the first three or four days the discharge