recent date, and which have served to bring have thus narrowly escaped conviction for medical evidence into disrepute, not only with the lawyers but with the public. conceive it to be the duty, as I have already stated elsewhere,* of the medical adviser of the police, not only to be well acquainted with the jurisprudence of the case he is required to investigate, but "to afford negative as well as positive evidence, and to inform the magistrate, when cases like those under discussion are submitted to his inspection, that the disease which, to use the words" of Dr. Ireland, after the late trials had taken place, "gave rise to the unnatural suspicion of the mother," affords of itself no evidence of attempted violence, but is an affection peculiar to a certain class of children. The magistrates had, I think, in the case of Barber, insufficient evidence to send it for trial, the child having sworn that the crime was committed in a public hall, in the erect position, while her feet were on the ground, and by a man six feet high, who was perfectly free from disease, whereas she (the doctor said) was labouring under gonorrhoea.

a crime which really had not been perpeItrated. . . . It is met with in girls up to six or seven years of age; and children thus affected have been tutored to lay im. putations against innocent persons. This state may commonly be distinguished from the effects of violence by the hymen being entire-the non-dilatation or laceration of the vagina*-the red and inflamed condition of the mucous membrane, and the abundance of the purulent discharge, which is commonly much greater than that which takes place as a result of violence. Capuron mentions two cases in which charges of rape on children were falsely made against innocent persons on account of the existence of a purulent discharge, the nature of which had been mistaken.

"As a summary of these remarks with respect to purulent discharges, we may observe that they should never be admitted as furnishing corroborative evidence of rape, except: 1. When the accused party is labouring under gonorrheal discharge. 2. When the date of its appearance in the child is from the third to the eighth day after the alleged intercourse. 3. When it

child had not previously to the assault any such discharge. It may be said, however, that all these conditions may exist, and yet the prisoner be innocent, for a child may, either through mistake or design, accuse an innocent person." P. 581.

In conclusion, I do not think it necessary to offer any apology to my readers for this lengthened recital, which I have made sole-has been satisfactorily established that the ly upon public grounds, and with a wellfounded hope that it will be the means of causing a stricter investigation into such cases for the future, while it can in nowise assist to clear the guilty where the crime has been absolutely committed, as no doubt it often is. The works on medical juris- Had these tests been applied in the first prudence, both in English and other lan- instance to the five cases brought forward guages, contain the records of many cases in Dublin, they would, in all probability, similar to those which I have described; never have come to trial; but, on the one but, in addition to those already referred hand, the police examiner stated that he to, I would call the attention of my readers formed his opinion irrespective of that of to the following extracts from the work of any other surgeon; and the crown lawyers Dr. Taylor, now the highest authority in and the judges would still have informed this country: "The existence of a purulentus, as the lord chief-justice did with Sir discharge from the vagina has been errone-Astley Cooper's statement, that it was ously adduced as a sign of rape in these only a medical opinion, and not law. young subjects. The parents, or other ignorant persons who examined the child, often look upon this as a positive proof of impure intercourse, and perhaps lay a charge against an innocent person, who may have been observed to take particular no-police adviser swore in his informations tice of the child. Some cases are reported, by which it would appear that individuals

* See letter published in the Freeman's Journal for August 9, 1853.

There is only one other subject which, though scarcely worthy of notice, suggests itself from the foregoing inquiry, but, as it might hereafter form a precedent for law yers, it is worthy of examination. The

that the whole assemblage of symptoms seen in the children, Cosgrave and Del

*Is it possible to dilate a child's vagina without rupture of the hymen?

202

mere,

64

DOMESTIC INTELLIGENCE.

'might result from riding on a

FOREIGN INTELLIGENCE.

Lawrence on the Diseases of the Eyestick." Now, I have searched carefully A new edition of this valuable work, edited through medical and medico legal works, by Dr. I. Hays, with large additions and an and I have also inquired very extensively increased number of illustrations is now among my friends. and I cannot find a sin-ready for publication.

gle instance of a disease resembling infan. tile vaginitis produced by this amusement. -Med. Times and Gaz. Oct. 29, 1853.

MEDICAL NEWS.

DOMESTIC INTELLIGENCE.

Pereira's Elements of Materia Medica and Therapeutics.-We are happy to announce that the second volume of the new and greatly improved edition of this valuable work is nearly ready, and will be pubIlished early in the present month.

Cholera at New Orleans.-New Orleans has had but a brief respite from sickness. Transactions of the American Medical The cholera has succeeded to yellow fever. Association.-We are happy to announce The Board of Health report for the week the publication of the sixth volume of the ending Nov. 28, 211 deaths, of which 129 Transactions of the American Medical As-were from cholera. sociation. It forms a volume of 869 pages,

and is illustrated with 33 plates, most of Death of Dr. Thomas Hobson.-At a spethem beautifully coloured, and upwards of cial meeting of the Northern Medical As60 wood cuts. It may be obtained by re-sociation of Philadelphia, held November mitting five dollars to the treasurer of the Association, Dr. D. F. Condie, Philada.

15, 1853, the following preamble and reso-
lutions were unanimously adopted :-
--

Whereas, It has pleased Almighty God to remove from our midst, to his final home, Dr. THOMAS HOBSON, one of our esteemed and talented associates: Therefore,

Mortality on Board Immigrant Vessels. In our preceding No. p. 187, we called attention to this, and to the importance of Congress requiring emigrant ships to have a surgeon on board. Every emigrant ship that has since arrived in New York, furnishes additional evidence of the necessity for such a requirement. One of the papers states the mortality on board the ships which had arrived during the preceding 48 hours, amounted to 365! The following is the list of ships, with the number of passen-sociation attend the funeral. gers and deaths :

Resolved, That we deeply sympathize with his bereaved family, in this dispensation of Divine Providence; and that the President and Secretary be instructed to convey to them the sincere condolence of this Association for the irreparable loss they have sustained.

Resolved, That the members of this As

Resolved, That the foregoing preamble and resolutions be published in the Medical Examiner and Medical News, and in one of the daily papers.

N. L. HATFIELD. THOS. BOND, Secretary.

FOREIGN INTELLIGENCE.

Death from Chloroform.-Another death from the administration of chloroform has occurred at St. Bartholomew's Hospital. It is proper to state that in that hospital the administration of the agent is always confided to the very able charge of Dr. Black, one of the assistant surgeons; and, as will be presently seen, it adds another to the

many proofs we already possess that no respiratory movements began to be perふ care or foresight can prevent the occasional formed at long intervals, and by slight occurrence of a fatal result from the inha-catching efforts. No time was lost; cold lation of chloroform, and should teach us a water was at once dashed on the thighs, lesson of caution, never to administer this face, and breast, and, the failure in the rearticle but in cases of extreme urgency. spiration becoming shortly complete, Mr. Paget immediately began artificial insufflation of the lungs, by alternately blowing into the nostrils and compressing the chest. Just before commencing this process, Mr. Paget had ascertained, by drawing the tongue forwards and examining the glottis with the finger, that the epiglottis was not

The following history of the case and the autopsy are given in the Med. Times and Gaz (Oct 29, 1853):

"On Thursday afternoon, Oct. 20, it was intended to apply the actual cautery to a sore of cancroid nature in the vagina of a patient named Ann Smith, aged 22 years. She was a stout, florid young woman, for-pressed down. Artificial respiration through merly of dissolute habits, but apparently, with the exception of the local ailment, in perfect health; she had been in the hospital several months, and, about a fortnight previously, had been put under the full and prolonged influence of chloroform, for a like purpose, and without the occurrence of any untoward symptoms whatever. Her pulse was regular, of good power, and average frequency. It had been ordered that she should omit her dinner on the day of the operation, but, as discovered at the post mortem, she had, unknown to the nurses, taken a quantity of food, though not a full meal,

the natural passages having been very efficiently kept up for about ten minutes, the nose appeared to have got clogged, and Mr. Paget accordingly performed tracheotomy, in order to permit of the more free introduction of air into the lungs. A brandy enema was administered, and, within ten minutes of the seizure, galvanism was also put in use, but without any good result ; and, after about three quarters of an hour had been spent in persevering efforts to produce reanimation, they were laid aside as hopeless. It was noticed that, imme. diately after the first alarming symptoms, the pupils were of medium size, neither "The usual form of inhaler was employed contracted nor dilated. All efforts at re-a padded metal cup, fitting over the nose spiration ceased about two minutes after and mouth, and supplied with valves. A the first indications of failure; the pulse, drachm. by measure, was first poured on however, as a very feeble flutter, was felt the sponge, but, as the administration did occasionally for at least two minutes later. not immediately commence, a considerable Thus, then, the facts of the case were part of this was no doubt wasted; after a briefly these: A patient, in profound coma, short inhalation, a second drachm was sup from the administration of an anæsthetic, plied, and subsequently the farther quantity { had, the exhibition of the drug having been of half a drachm. The patient had gone remitted, been suddenly seized with symp. through the usual stages of excitement, etc., toms of failing circulation, followed by the and the last dose was scarcely used, as she speedy suspension of respiratory efforts. sank off, almost immediately after its appli. The pulse had remained perceptible a little cation, into a state of complete insensi-time after the cessation of the latter, and bility, unattended by any alarming symp. had been lost, together with every mani. toms. About five minutes had been occu- festation of vitality, within five minutes of pied in the inhalation, and probably not the first indication of danger. Every effort more than a drachm and a half of the fluid to re-excite the play of the organs essential really inhaled. The apparatus was now to life had been fruitless. In the turgidity removed from the face, and the patient hav- and suffusion of the countenance, there had ing been drawn into the proper position, been some indication of death by asphyxia. Mr. Paget was about to commence the The preceding coma, and the fact that the operation, when Dr. Black, who through- failure of the pulse had been the first symp. out had kept his finger on the pulse, noticed tom exciting attention, each pointed to it to have become extremely feeble and other conclusions. The brain, the heart, fluttering. Almost immediately afterwards, the lungs-in which organ had death comthe patient's countenance was observed to menced? This seemed the important probbe dusky, turgid, and congested, and the lem. Let us now see what evidence the

post-mortem examination furnished for its patient was one to whom chloroform might,

solution.

with the least of apprehension, be adminis. "Autopsy, performed by Mr. Paget, {tered. She was in good health; she had twenty-two hours after death.-The counte- taken it safely before. Then, again, in the nance was still bloated and suffused; the manner of exhibition, every precaution was post mortem rigidity was moderate in de-adopted, and, in the after treatment, all gree, or rather less than usual; there was that science could suggest was persevermuch congestion and lividity of the skin of ingly tried. In our large hospitals, the rethe depending parts of the body; the corpse (quisite skill, assistance, and appliances are was very fat. The thorax was first ex always at hand; and there, if anywhere, an amined, and nothing whatever abnormal immunity from fatal results might be excould be detected in any of its viscera. The pected. It is mournful, indeed, to consider lungs were healthy and crepitant in every that from cases such as the last three or part; their posterior lobes were not more four which it has been our lot to record, congested than is seen in almost every ex- the practical surgeon gains no knowledge amination. The heart, collapsed, but not calculated to authorize the hope that in contracted, and containing a small quantity future the like tragedies will be of less freof fluid blood in each cavity, was of normal quent occurrence." size and proportions in every respect, and its muscular structure, examined by the Death from Chloroform during its Admicroscope, showed no degeneration. Ex-ministration previous to an Operation for cepting that the exterior of the right kidney { Hernia, in University College Hospital. was puckered in places, as if from disease Under the care of Mr. QUAIN.-The proin early life, nothing worthy of note was fession and the public at large are probably observed in the abdominal viscera. The becoming alarmed at the repeated instances brain, its sinuses, ventricles, etc., were all of death brought on by the inhalation of carefully examined, and neither in texture chloroform, and it is for ourselves a melannor quantity of blood was anything ab. choly duty to report these unfortunate normal detected. The spine was not ex- cases. In most of them, the autopsy has amined. In every part inspected the been performed with the greatest care, and heart, great vessels, lungs, vessels within pathologists have endeavoured to discover, the abdomen, those of the scalp, pia mater, in the morbid alterations of the solids and and brain-the blood was universally fluid, fluids, a clue to the sudden cessation of and without the slightest trace of coagulum, life in patients who seek anesthesia in the or even of inspissation. Collected in the inhalations of chloroform. Have these quantity of an ounce or two, and allowed to careful examinations led to the desired restand in an open vessel, it did not coagulate, sult? Are we in possession of rules by nor, in any material degree, change its which we can foresee the danger ere the dark purple colour. Looking then at these nervous pulp has been too completely narfacts, and comparing them with the symp cotized? We are afraid not; and those toms manifest during life, we seem compel-well acquainted with the administration of led to seek in a humoral pathology the cause chloroform will be obliged to confess that of the patient's death. There was no vis-no very marked progress has been made as ceral disease, functional or otherwise, Into the means of averting a fatal result. all probability the blood, poisoned past recovery by the vapour it had received, had died; and ceasing then to afford to any of the organs their natural stimulus, the whole of the vital functions had ceased almost coincidently.

It was thought for a while that a great deal depended on the more or less anæs. thetic practice of the person who adminis ters the chloroform, and much reliance was placed on what are called experienced hands; but this confidence has proved fal"This case, in common with most of lacious, for fatal cases have occurred with those which occur in our metropolitan hos the most practised and scientific chloropitals, has one most especially melancholy formists. The fact probably is, that the aspect a matter, as far as our knowledge whole matter rests, not so much on actual goes, of pure accident, it teaches us nothing pathological changes which may have taken for the future. We need not recapitulate,place in the organs of the patient before he to convince the attentive reader that the inhales chloroform, as on idiosyncrasies.

We are free to admit that this is an unsatisfactory expression, and that the word idiosyncrasy only covers our ignorance; but there nevertheless exists a more or less marked difference in the tendencies of individuals, both as regards healthy nutrition and morbid alterations; add to that the influence of habits and mode of life, and you will have the import of what may be called constitutional peculiarities. Now, it is plain that these peculiarities are extremely difficult of detection; and when we consider that they have, perhaps, more influence on the eventual results of chloroformic inhalations than the presence or absence of fatty heart, it may at once be seen that, in the present state of science and practice, such inhalations must be surrounded with a certain amount of hazard.

patient's habits have been very intemperate. She was intoxicated three days before the strangulation, and did not see any medical man until the morning of her admission.

Mr. Quain was sent for. He arrived about twenty minutes to two in the morning of October 6, and at once decided upon operating. The patient had remained in the bath about three-quarters of an hour, and did not feel particularly faint whilst in it.

Mr. Hillier at once commenced giving chloroform in ward 5, and used a long piece of lint of about the extent of the hand, and folded twice. One drachm of chloroform was then poured on the lint, and applied about one inch from the nose and mouth, the apparatus being gradually approximated, and the face covered with a towel. She inhaled the chloroform as patients generally do, said scarcely anything, and was not excited. The pulse remained very good for two or three minutes, when forty drops of chloroform were poured on the lint and applied as before. Within a minute of this

And yet it seems to be perfectly well known, from experiments upon animals, by what progressive steps chloroform produces the insensibility of the nervous power. Flourens tells us that the anesthetic effects travel from the lobes of the hemispheres to the cerebellum, then to the posterior half{renewal of chloroform, the patient began to and roots of the nerves of sensation in the struggle both with her arms and legs, which spinal marrow, then to the anterior half and she moved about very actively. During roots of the nerves of motion, and lastly to the struggle, Mr. Hillier had hold of her the medulla oblongata and annular protu- right hand, keeping it steady, and trying to berance, or vital knot. The same author feel her pulse; the task was, however, has shown that an animal, subjected to in difficult, owing to the struggles. The lathalations of chloroform, loses first the in-ter became very strong, but, after lasting tellectual faculties, and the power of regu-perhaps a little more than half a minute, lar and well-poised motions; he afterwards they ceased, and immediately stertorous loses feeling, and then the power of motion. breathing commenced. The stertor was At this period, the vital force, hunted, as it very loud and rough, not at all of the comwere, from place to place, becomes concen- Imon kind. Mr. Hillier at once removed trated in the medulla oblongata. This, the lint and towel from the patient's face, then, is the only portion of the encephalon and observed that the pulse had stopped. which resists the anesthetic influence, and She drew several short inspirations, then the animal would soon perish by this last two or three long ones, and ceased to barrier being overcome; for, as M. Flou-breathe. rens says, very plainly, "chloroform takes away pain, but it also takes away life."

Emily R, aged forty years, and a widow, was admitted, October 5, 1853, under the care of Mr. Quain. The patient was suffering from strangulated femoral hernia on the left side, which resisted the taxis with and without the warm bath; she had had severe vomiting, pain at the umbilicus, and constipation of the bowels, for two days before admission. The hernia had been existing for some time past, and a truss had been procured, but there is a doubt whether she wore it regularly. The

Immediately the pulse was felt to be wanting, cold water was dashed on the face; as soon as the breathing stopped, galvanism was also applied within one or two minutes, and she drew distinctly three or four deep breaths after the ordinary respiration had ceased to go on uniformly. No pulse was felt afterwards, but artificial respiration was excited through a wound made into the trachea, and kept up for about half an hour. One of the bystanders stated that the patient's face was convulsed when first exposed. It was slightly livid, the depth of colour increasing pretty rapidly. The pupils