Medical Jurisprudence And Toxicology

EVIDENCE OF MISCARRIAGE

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Bisons. If death does not occur, the woman may show signs of chronic
fastro-intestinal disturbances, nervous prostration and chronic ill-health.

EVIDENCE OF MISCARRIAGE

The evidence of miscarriage can be determined by examining the
roman alleged to have miscarried and the material alleged to have been
'xpelled from the uterus.

Examination of the Woman.—(a) Durmg Life.—The signs of recent
lelivery are found. These will depend upon the stage To" which pregnancy
ias advanced, and the time that has elapsed since miscarriage at the time of
he examination. In the earlier months of pregnancy the signs are likely to
lisappear very soon after miscarriage, and the woman should, if possible,
>e medically examined within a very few days after its occurrence. If
septic infection has occurred at the time of miscarriage, the signs would
Dersist for a longer time.

The usual sign in such cases is a bloody discharge from the vagina,
wrhich is relaxed and dilated. On examining the vagrnaPcanal with a
speculum, excoriations, lacerations or wounds of the mucous membrane of
the vagina may be discovered. The os and cervix are patulous, with or
without fissures, tears or lacerations. The uterus may be found enlarged by
bimanual examination or by passing a uterine sound. The enlarged breasts *
and other signs of pregnancy are the valuable points for diagnosis.

(b) After Death.—In addition to the signs of pregnancy and the lesions
caused by general violence, the vaginal canaLshouLd be carefully examined
for the presence of punctures or lacerations, and the marks of inflammation
and corrosion on its mucous memh^-ne The uterus and its appendages

with the vagina attached should then be
carefully dissected out, and laid on the
table for minute inspection. The con-
dition of the os and cervix should be
examined as to the presence or absence
of fissures, lacerations or the existence of
a foreign body. The uterus should then
be cut open, and its increased size, the
attachment of the placenta and tibe
presence of blood clots or of the product
of conception should be noted Tne
ovaries should be examined for the
existence of a corpus luteum. The
alimentary and urinary organs should
also be examined for evidence of irritant
poisoning.

In all cases of criminal miscarriage the
uterus and its appendages with any
foreign matter found in the genital canal,
as well as the stomach, etc. should

always be preserved for chemical analysis, if there is the least suspicion of

a drug having been used locally or internally.

Post-mortem Delivery.—The medical man should bear in mind the
possibility of expulsion of a foetus by the pressure of putrefactive gases
generated in the abdominal cavity some days after the mother's death.

9n March 18, 192*), a Hindu widow, 40 years old, finding that she Jiad
Bant jumped into a well to conceal her sbame. Four days later, the body •
*" *^~ well with a foetus. At tfcte post-mortem examination held by
be body was found to be (feeomposecL The face was bloatec
had become loosened and were coming off. The atxlmen

Fig. 147.—Uterus showing twins
of about 3 months.