Page:Encyclopædia Britannica, Ninth Edition, v. 15.djvu/811

Rh MEDICAL JURISPRUDENCE 779 6. Pregnancy. This subject presents one of the widest fields for medico-legal evidence. The limits of age between which it is possible, the limits of utero-gestation, and the signs of pregnancy may all in turn be the subjects of investigation. The limits of age between which pregnancy is possible are usually fixed by the appearance and cessation of the monthly flow ; and these ordinarily begin about fourteen and cease at forty-five years of age. Exceptionally they appear as early as the tenth year, and may not cease till the end of the fifth decade of life. Cases, however, have occurred where a woman has conceived before menstru ating ; and a few doubtful cases of conception are recorded in women upwards of fifty, or even sixty, years of age. The general fact of pregnancy being limited by the age of puberty on the one hand and the cessation of the monthly flow or fifty years as the extreme limit of age must be accepted as the safest guide in practice. The limits of utero-gestation are not in England fixed by legislation. The French code fixes the extreme limit of three hundred days. The ordinary period is forty weeks and a half, or two hundred and eighty-three days from the cessation of the last monthly flux. The limit of three hundred days, as fixed by the French code, is perhaps never exceeded, if ever reached. The uncertainty of females in fixing the exact date of conception has given rise to the discrepant opinions of physiologists on the subject. It is well known, however, that among the higher animals the period is not a precise one ; and impregnation and conception are doubtless not necessarily coincident. The signs of pregnancy are of the utmost importance to the medical jurist. He may be called upon to pronounce upon the virtue of a female, to sustain or rebut a plea for divorce, to determine whether a capital sentence shall be carried out, or to determine whether it is probable that an heir will be born to an estate. Should he err in his judg ment and mistakes are very possible in the earlier months of utero-gestation he may commit a grievous wrong. Medical jurists are in the habit of classifying the signs of pregnancy as uncertain or certain ; it is the former which are most regarded by the public, but the latter are alone of probative value to the jurist. The usual and uncertain signs are the cessation of the monthly flow, nausea, sick ness, a darkening of the areola and the formation of a secondary areola around the nipple, enlargement of the breasts, increased size of the abdomen, the formation of a tumour in the womb, quickening, and the motions of the fcetus. There are also other minor signs of less importance. The certain signs are the uterine souffle, which is a peculiar soft sound heard over the abdomen, and synchronous with the maternal pulse ; ballottement, or the examination for a floating tumour in the abdomen between the fifth and eighth months of pregnancy ; and the pulsations of the foetal heart, heard by means of the stethoscope. These pulsations are much quicker than, and not synchronous with, the maternal pulse. This is the only indubitable sign of pregnancy. It is inapplicable before the fourth month of gestation. 7. Parturition. The imminence of the process of par turition is of comparatively little interest to the medical jurist; but the signs of recent delivery are all-important. These signs are the bruised, swollen, and lacerated state of the external genitals, relaxation and dilatation of the vagina and womb, the existence of a peculiar vaginal dis charge known as the lochia, a relaxed and fissured condition of the abdominal walls, a peculiar aspect of the countenance, and the distended state of the breasts due to the secretion of milk. The Ipchial discharge is the most characteristic sign. All the signs may disappear within ten days of delivery, though this is not usual. Connected with parturition, the question of viability of the child is not unimportant. After the intra-uterine age of seven months is reached a child is certainly viable. The period at which the foetus becomes viable cannot be stated with certainty ; but five calendar months, or one hundred and fifty days, is perhaps the nearest approximation which can be made. The viability of a child is judged by its size and weight, its general state of development, the state of the skin, hair, and nails, its strength or feebleness, the ability to cry, and its power of taking maternal nourish ment. The question of viability has important bearings upon the crime of infanticide, and the succession to property. The subject of superfoetation, or the possibility of two conceptions having occurred resulting in the birth of twins with a considerable intervening interval, is a very obscure one, and has given rise to much controversy, its existence being affirmed by some medical jurists, and denied by others. There is much, however (e.g., the existence of a double or bifid womb), to countenance the view that a double conception is possible. In the curious case of a man marrying a woman having possession of an estate of inheritance, and by her having issue born alive and capable of inheriting her estate, the man on the death of his wife holds her lands for life as a tenant by the &quot;curtesy&quot; of England. Here the meaning of &quot; born alive &quot; is different from the meaning of the same expression as used respecting infanticide. In questions of tenancy by the curtesy it has been decided that any kind of motion of the child, as a twitching and tremulous motion of the lips, is sufficient evidence of live-birth. As regards infanticide, proof of a conclusive separate existence of the child is demanded before live-birth is admitted. 8. Monsters and Hermaphrodites. To destroy any living human birth, however unlike a human creature it may be, is to commit a crime. Blackstone states that a mon ster which hath not the shape of mankind hath no inherit able blood ; but the law has not defined a monster, nor what constitutes a human form. The same author states that if, in spite of deformity, the product of birth has human shape, it may be an heir. Hermaphrodites are beings with malformations of the sexual organs, simulating a double sex. Physiologists do not admit, however, the existence of true hermaphrodites with double perfect organs, capable of performing the functions of both sexes. 9. Paternity and Affiliation. These are often matters of great doubt. A considerable time may elapse between the absence or death of a father and the birth of his reputed child. As has already been said, three hundred days is the utmost limit to which physiologists would extend the period of utero-gestation. This subject in- volves questions respecting children born during a second marriage of the mother, posthumous children, bastardy, and alleged cases of posthumous children. 10. Presumjnion of Survivorship. When two or more persons perish by a common accident, when a mother and her new-born child are found dead, and in a few analogous cases, important civil rights may depend upon the question which lived the longest; and great ingenuity has been displayed in elucidating the disputes which have arisen in the law courts in such cases. 11. Maladies Exempting from Discharge of Public Duties frequently demand the attention of the medical man. He may be called upon to decide whether a man is able to undertake military or naval service, to act as a juryman without serious risk to life or health, or to attend as a witness at a trial. An endeavour to give a fearless and honest certificate should animate the medical man in the discharge of this delicate duty. 12. Feigned and Simidated Diseases often require much