Medical Jurisprudence, Volume 3 (of 3)Paris, John Ayrton
Science
Medical Jurisprudence, Volume 3 (of 3)
Paris, John Ayrton
Medical laws and legislation -- Great Britain
head, and to the circumstances above mentioned, it will not be difficult
to establish a just diagnosis upon these occasions. Before cutting into
the brain, we should observe whether the convolutions are furrowed as
usual, for when much fluid is contained in the ventricles, as in
hydrocephalus, the _sulci_ are more or less obliterated. Such a change,
therefore, will offer a precaution to the anatomist, to proceed slowly
in his dissection, so that the accumulated fluid may not escape. Where a
person has been suddenly killed, while in a state of health, the
ventricles will, on examination, appear merely lubricated with a fluid;
but in cases where the patient has died after protracted disease, more
or less serum will be found in these cavities. In our examination of the
substance of the brain, we ought to notice its consistence and tenacity,
for in many recorded cases, a _part_ of the medullary mass has been
found so morbidly soft as to have assumed nearly the consistence of
custard; and it has been said to have occurred in cases of fatuity; it
seems, however, more correct to consider it as the effects of
inflammation: the phenomenon must be carefully distinguished from that
natural deliquescence which the _whole_ of the brain undergoes after
death, when in an incipient stage of putrefaction. In some instances,
the texture of the brain has been found tougher than is natural, and
even to have been dry and friable. (_See our observations upon the brain
in cases of mania_, _vol._ i, _p._ 327.) Scrophulous and encysted
tumours, hydatids, abscesses, and extravasated blood, may also occur,
and its cavities may be distended with fluid. The state of the larger
blood-vessels should be attentively inspected, for in persons advanced
in life there appears to be a strong disposition to disease in the
internal carotid and basilary arteries. The great importance of minutely
inspecting every part of the brain cannot be too frequently, or too
forcibly urged, in cases of forensic inquiry. The instances already
recorded (_page_ 16) are sufficient to sanction this assertion; and to
these, we may add the following illustration which is to be found in the
article _Cas Rares_ of the _Dictionnaire des Sciences Medicales_, by _M.
Fournier_, who was called upon for his opinion in a case of alleged
murder at Brussels.[27] The deceased had quarrelled with another man,
some blows had been interchanged, and he had died a fortnight
afterwards, emaciated and completely exhausted. Two of the lowest order
of practitioners in France, officiers de Santé, as they are called,
inspected the body, and pronounced that death had taken place in
consequence of the blows. _M. Fournier_ discovered an extensive
suppuration in the brain, with a very carious state of the inner surface
of the cranium, and learnt that the deceased had been afflicted with
head-aches for twenty years. He therefore declared it to be his opinion,
that the man had died of a disease of long standing. In this opinion we
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