ordinary interest, both as bearing on this point, as well as in its relations to legal medicine.

In the early part of these observations, I stated that a knowledge of such subjects as we were then about to consider, namely, certain conditions of intra-uterine existence, whether arising from accidental injuries, or pathological lesions, might occasionally become of paramount importance; as such alterations might readily assume highly influential relations both with our social happiness, and even with the administration of justice: in illustration of this statement, I wish now to offer a few observations. Disease in its own system, defective organization, or abnormal conditions of its envelopes and appendages, such as have been already noticed in former chapters of this book (see pp. 142, 313), may so impede the development of the foetus, and ultimately extinguish its life, that it may be born presenting characters belonging to a period of intra-uterine existence not more than half its real age and hence, under peculiar circumstances, a character of spotless purity may be tarnished, and branded with disgrace and shame, and a long train of unmerited evils may invade a home where all was peace before; and thus it may happen: a husband goes abroad, leaving his wife a short time pregnant; some two or three months afterwards, some morbid lesion attacks the foetus or its envelopes, a suitable supply of healthy nutrition is denied it, and it ceases to grow and to live; but it is not decomposed, and is retained till the end of five or six months (during all which time the husband is away), and is then expelled, presenting a development corresponding to not more than half that period; suspicion is readily aroused; a medical opinion is sought for, and if that opinion be incautiously given, guided by the amount of development alone, and without sufficient examination into, and appreciation of the influence of morbid causes, it would be diffi cult to overstate the amount of domestic misery and disunion that may ensue. I here describe what I have more than once witnessed. (See p. 314.)

This is very deplorable; but far worse might happen; certain accidents may occur to, and injuries be sustained by the child in utero, whether produced by external agencies, or simply resulting from spontaneous pathological alteration, the evidences of which at birth, might suggest so forcibly the idea of intentional violence

offered to it, that if we were not previously acquainted with such facts as we are here considering, our unassisted judgment would refuse its assent to the belief, that some of these conditions could arise from mere accidental causes; and we would be almost irresistibly led to the conclusion, that premeditated injury bad been inflicted on the child; when, in reality, nothing of the sort had ever been even thought of; and thus might we unjustly and cruelly imperil the life of one entirely innocent of the crime imputed to her.

Every accoucheur is aware, that in very many cases indeed, the new-born child presents a tumor on the head, such as might result from a blow, or other intentional violence offered to it after birth; but which is really only the effect of pressure sustained during parturition; and in general, its size is proportioned to the difficulty of the labour, and the consequent amount of pressure undergone; occasionally, however, this tumor appears after an easy labor, and sometimes not for a day or two after birth.

The same causes which give rise to the formation of the bloody tumors just noticed, have not unfrequently produced fractures or depressions in the flat bones of the cranium, especially in the parietals; more particularly in cases of contracted pelvis, where the promontory of the sacrum projects considerably inwards; though I have known such accidents happen without the concurrence of any such state of the pelvis; but from the interposition of an arm between the head and the bony wall of the pelvis, and sometimes without any obvious cause, as in Case XLIV.

CASE XLIII.-Siebold has reported a case in his journal, in which the labor was painful and tedious, and the child was born dead; a large bloody tumor was found over the right parietal bone; and on exposing the bone, it was traversed by three distinct fissures passing in different directions; no instruments had been used.' But these injuries of the cranial bones may occur not only independently of contracted pelvis, but even of slow or difficult labor.

CASE XLIV.-I, some years since, attended a lady in her second labor, and, after about three hours from its commencement, she gave birth to a healthy boy; but with a depression in

See Med. Chir. Rev., No. 37, July, 1833, p. 211.

the left temporal bone, which would readily have contained an almond in its shell; by degrees, the depression disappeared, and at the end of a few months, no trace of it remained; the lady's first labor was easy, as were also those that succeeded the birth of this child, and no such injury was observable in any other of the children.

CASE XLV.-More recently, I was informed by Dr. Mulock, of a case in which, on the subsidence of a cranial tumor, a spicula of bone was felt distinctly projecting under the integuments; the labor had been slow, but natural. Instances of injury to the cranial bones before birth have been recorded by Osiander, W. J. Schmitt, Schnuhr, d'Outrepont, and Graetzer:1 and still more recently, three well-marked cases, in which several fractures were found under bloody tumors, were published by Drs. Flugel and Schilling. When these injuries of the foetal head were first observed, they were attributed to violence, by Haller, Rosa, and others, the error of which opinion was first perceived by Roederer and Baudelocque; and it is needless to say how important is the distinction, especially in a medico-legal point of view.

CASE XLVI.-A few years since, a case occurred in England which appears to me of unparalleled interest and importance, in many points of view; but especially as regards the administration of criminal law. A lady, Mrs. B., when seven and a half months pregnant, in going down stairs, trod upon a cat; to save herself from falling, she made a violent effort, and sprang down the flight of stairs, receiving, of course, a severe shock, which produced faintness; and next day, a slight sanguineous discharge, per vaginam, showed that some internal injury had been sustained; however, she soon recovered her usual health and spirits. Six weeks afterwards, she gave birth to a healthy male child, with an extensive open wound across its back, and down the arm, to within an inch of the elbow. Now what could have made this wound or rent. The severity of the labor?-no, for it was unusually easy. Was it caused by the doctor?-no, for there had been no interference whatever; but one existing fact

1 Vide op. jam cit., capp. 61, 62.

2 Brit. and For. Med.-Chir. Rev., April, 1852, p. 558.

See Med.-Chir. Trans., vol. xxxii. p. 59, where the case is related by Mr. J. D. Jones.

showed, beyond all controversy, that the wound must have been made some time before birth; for a large proportion, fully a third, of it was already healed, and the rest of it had a healthy, granulating surface, like a wound healing in the usual manner. After birth, the healing proceeded most favorably, and in about five weeks, no other sign remained than a large cicatrix.

That this wound occurred at the time of the mother's accident on the stairs, six weeks before her delivery, seems almost evident; though the exact mode of its production is a problem, by no means easy of solution: but this does not so much concern us at present, as the fact, of which there is no doubt, that a child was born with a large open wound on its body, part of which was healed; showing that it must have occurred within the uterus some time before. (See fig. 46.)

Now in the case of this married lady, with her child alive and well, no suspicion unfavorable to her could arise, or be enter

tained for a moment; but let us suppose such an occurrence to take place under other circumstances. A friendless unmarried female is likely to be a mother, and anxious, to the last moment, to hide her shame from the scorn and reproach of the world,

where so many act as if they thought that their zeal for morals is best shown by their forgetfulness of Christian charity; she keeps her secret and her sorrow to herself, and perhaps makes no preparation; and all these things are against her; let us suppose, then, that under such circumstances, there happens to her the same accident that occurred to Mrs. B., and that soon afterwards, perhaps that night, or the next, alone, without any friendly hand to aid her in her hour of trial, or any human witness to testify in her favor, she gives birth to a dead child, or one which dies soon after with a long wound or gash across its body, as in Mrs. B.'s child, but in this case, quite fresh, and showing no evidence of healing.

Is it not in the highest degree probable, nay, is it not almost certain, that, under such circumstances, the death of this child would be attributed to the wound, and the wound be regarded as the work of the hapless mother's hand?

In vain might the wretched woman declare that the child was born so wounded; who would believe her?

Were we not in possession of such a fact as that we have just been considering, few could bring themselves to believe or acknowledge the possibility of such a wound having been produced within the womb by accidental causes; and yet, it is an undoubted fact, and not half so wonderful as the process of spontaneous amputation; but one shudders at the thought of what might be the consequences of such a disbelief to the wretched mother; perhaps an ignominious death for a crime which she never committed, nor even thought of.

Almost the same observations would apply to those cases in which fractures of the skull, with bloody tumors from natural causes, have been found in new-born children.

The following singular case, very recently brought under my observation, although differing widely in its pathological characters from the one just described, has, notwithstanding, several points of relation therewith, presenting a lesion, whose conditions so closely resemble those which would result from intentional violence, that, under doubtful circumstances, and without a sufficiently accurate investigation, they might be but too readily mistaken for, or confounded therewith; or, at least, entail on the attendant practitioner unmerited obloquy, as having, by mis.