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
=Appearances showing that a New-Born Child has breathed.=--1. Walls
of the Chest.--“The vaulting of the thorax is not of the slightest
diagnostic value.” Casper quotes from Elsässer the following remarks:
“It is irrefutable that the variations in the circumference of the
thorax (and, of course, in its diameters) are so considerable that no
certain normal mean for a thorax that has breathed, and for one that
has not breathed, can be laid down. In most cases the measurements
of the thorax are incapable of determining whether the lungs contain
air or not. The reasons for these variations is, without doubt, to be
referred to the congenital differences in the volume of the osseous
thorax; partly, also, to the thickness of the soft parts, particularly
of the subcutaneous fat and the thoracic muscles; partly, also, to the
differences in the degree and amount of the dilatation of the thorax by
respiration, with which the distension of the lungs also corresponds,”
&c.
2. Diaphragm.--The position of the diaphragm may be considered as a
good diagnostic sign; for it is found that, in children born dead,
the highest point of the concavity is between the fourth and fifth
ribs, whereas in those born alive it is between the fifth and sixth.
The position of the diaphragm may be affected by the gases produced
during putrefaction, and also, in children who have _breathed_, from
distension of the stomach and intestines with gas.
3. Stomach and Intestines.--With regard to the stomach, Tardieu has
suggested that the presence of air-bubbles in the glairy mucus usually
found in that organ is a sign of live birth, as it can only have arisen
from the swallowing of saliva and mucus, aerated by repeated attempts
at respiration, probably lasting from five to fifteen minutes. Air
in the duodenum is strong evidence of live birth. Breslau of Prague,
who has further investigated this subject, states that, in children
born dead, or who have undergone prolonged intra-uterine putrefaction,
there is never any accumulation of gas in the stomach or intestines,
and that the presence of gas in these organs is contemporaneous
with respiration, and is independent of the ingestion of food.
The intestines of newly-born children do not float in water, but
rapidly sink in that fluid. As respiration proceeds, the coils of the
intestines become distended with gas.
4. Kidneys and Bladder.--The presence of crystals of uric acid in the
pelvis of the kidneys and even in the bladder has been suggested as
a sign of live birth. Uric acid infarction, as it has been called,
usually occurs in from two to ten days after birth, at a period when
there are more important signs of live birth than this, even if
infarction did not occur, as it does, in still-born infants.
5. Lungs.
(_a_) _Size._--In the fœtus, prior to respiration, the lungs do not
fill the cavity of the chest, and the left lung is never found even
partially covering the heart.
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