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Full text of "Medical Jurisprudence And Toxicology"

WAS THE  CHILD BOKK  ALIVE ?                                         349

respond to the hydrostatic test. Dr. Dilworth, who examined the body, stated that but
for the evidence heard by him at the inquest he would have no hesitation in affirming that
the child had been still-born and had never breathed. He suggested that the child had
lived a few hours by what little seration the blood received through the mucous membrane
of the trachea and larger bronchi.—Brit. Med. Jour., Dec. 1, 1900, p. 1567.

2. A married woman, the mother of a family, was delivered of a seven months'
child. The infant was washed and dressed j it did not cry, but the nurse said " it made
a moaning noise". It lived a little over seven hours. An inquest was held, and at the
autopsy the lungs were found collapsed and had all the appearance of those of a child
who had never breathed. There were no developed air cells or vermilion spots. The
lungs sank in water. They were then cut up into small pieces and every piece went
to the bottom immediately it was thrown into the vessel. There was no doubt that the
infant had lived and breathed, though probably very feebly, for seven hours.—Charles
Bandolph, Ibid., Jan. 19, 1901, p. 146.

2.   The unexpanded lungs may float from—

(a)   The Presence  of Putrefactive Gases.—For the putrefactive gases
to be the possible cause of floating the lungs, there should be distinct signs
of decomposition of the body as well as of the lungs.   The putrefied lungs
are soft and greenish in colour, and the putrefactive gases collect under the
pleurae and in the connective tissue in the form of air bubbles of different
sizes, which can be squeezed from place to place, and can be expelled on the
application of pressure after cutting the lungs into pieces, so that they will
sink when placed in water, whereas the air due to the establishment of
respiration cannot be expelled from the air vesicles after the application of
pressure, unless the force is so  great as to disintegrate the lung tissue.
However, the medical jurist should never venture an opinion, if the lungs
are too far advanced in putrefaction.

(b)  Artificial Inflation.—The  foetal lungs may  be  artificially  inflated
by blowing air through a tube, catheter or cannula passed into the trachea,
by the mouth to mouth method or by Schultze's method (swinging the body)
of resuscitation.    Artificial inflation of the lungs in a newly-born infant is an
extremely difficult matter.   The lungs may be inflated partially but cannot
be distended completely, even when artificial respiration is performed by a
trained person.   In such cases the stomach is certain to be filled with air,
while it is airless in still-born infants.   Miron Hajkis9 has also shown from
radiographic investigations that mouth to mouth insufflation in a still-born
infant immediately after birth causes air to enter the stomach but never the
intestine, while air is never present in the stomach or intestine of still-born
infants.

The possibility of inflating the lungs artificially in criminal cases should
never be countenanced, as inflation can only be practised by the medical
attendant or by the mother to save the child, but one who wants to destroy
a newly-born infant will try to prevent respiration rather than induce
artificial inflation of the lungs.

In conclusion, the medical officer is justified in affirming that the child '
had lived during and after its birth if lie finds the following appearances on
post-mortem examination of the body of a newly-born infant: —

(1)  A full-term  mature  foetus  judged   from  its  length,   weight   and
other  characteristics,   especially  the  centres  of  ossification  in  the  lower
epiphysis 6f the femur and in the tarsal cuboid bone.   The centre of ossifi-
cation in the upper end of the tibia is usually found at full-term or shortly
after full-term.

(2)  The diaphragm standing at the sixth or seventh rib.

(3)  The lungs occupying more or less the thoracic cavity and
a portion of the heart and thymus gland.

-----------------------------

9.   Lancet, July 21, 1934* p. 134.