Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
It is by no means easy to answer the question whether an alleged
abortion has really taken place or not. The signs of recent delivery
are in most cases absent, for the woman can better hide her condition
during the earlier than during the later months of utero-gestation;
consequently suspicion may not have been aroused against her for some
weeks or months after the event. The history of the case, with other
attendant circumstances--milk in the breasts, change in the colour of
the areola round the nipples, severe flooding, absence of the hymen,
injuries to the os uteri, transverse condition of the os uteri in
contradistinction to its circular form after delivery, &c.--will, in
most cases, assist in forming a correct diagnosis; but it must be again
repeated that few of the signs applicable to delivery at the full time
are here available.
In all doubtful cases--
1. Examine into the general and present state of the
health of the woman.
2. Find out if there are any reasons which would
occasion a pretext to use drugs which are not usually
given to women during pregnancy.
3. Learn if menstruation is regular and easy, or if
the woman is in the habitual use of emmenagogues, for,
if so accustomed, she may have used them ignorant of
pregnancy.
4. If a woman ascribes her abortion to a fall, to an
accident, or to violence used against her, carefully
examine into the nature of these.
5. Examine into the general causes of abortion, and
also inspect the expelled substances.
Where death is supposed to have followed the use of abortives, the
alimentary canal must be examined for the signs of the action of
irritants, or the presence of disease in the internal organs; but when
death has resulted from an attempt to procure abortion by instrumental
means, the neck of the womb is most frequently found covered by a
number of small more or less irregular wounds, which may penetrate into
the womb or lose themselves in the walls of the organ. Their course
is indicated by infiltration, or a small extravasation of coagulated
blood, the exact condition of which must, if possible, be ascertained,
so as to decide when the wound was inflicted.
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