Legal medicine. It is the art of applying the knowledge and the precepts of medicine to different questions of civil, criminal and canon law in order to enlighten or to interpret appropriately.

The art of making reports or relations in justice is only a part of legal medicine, and one can blame those who are narrow minded in it to have substituted an extensive and transcendent science by their nature and their object, the technical exercise of only one of the fields. One defines the reports of medicine : "a public and genuine act, through which doctors and their titled ministers, give testimony, or make the narration in a written document signed by themselves, of everything that their art and their light has made known to them through the examination and the inspection of a subject that presents itself to them, for, to enlighten the judges, in itself to make justice".

This point of view does not embrace all the cases where medicine and her different fields come to the help of the law. The essential object of legislation being the happiness of men, in civil life, in private life, one feels the immensity of the reports which arise between the jurisprudence and the medicine . Knowledge of law and medicine are best when known together, so that it is the same in law as it is in medicine, said Tiraqueau. An axiom in law which is common to all centuries, is to resort to, according to the case, to experts in all subjects to take their opinions. Experts in every art are to be believed (August. Barbosa); and the legislatures themselves have often expressed this opinion as reason of the law or of judgement. Such is the law of the seven months of the state of man: by means of the authority of the learned man Hippocrates.

In shortages of positive evidence which emerge to the magistrate, one consults the doctors and the surgeons to establish by scientific evidence, the existence of a fact which one could only know by this manner. Their decision so becomes the base of judgement and must guarantee certainty and justice. In medicine strictly there is nothing that stands firm but it is established that judgement is greater than testimony. Balde, on the law eadem 2. D. de festis et dilationibus, n. 4

The canon, civil and criminal laws present a mass of cases of this kind and the natural order of subjects seems to require that a dogmatic treatise on medical law contains separately everything that has a connection to canon law, to civil law and to criminal law; but those which are very distinct in jurisprudence are not as much in medicine ; the medical and surgical experts, have the same objects to discuss in the questions of canon law and criminal law and it is less to the order established by the jurisconsults which one must have considered, than to the natural order of subjects.

The reports of medicine with the law were established by the jurists and the doctors of whom the names are respectable. See amongst the jurists, the Emperor Justin. Novell. 3 et Novell. 9; the emperor Leon, nova constitut. Proemia Befold, vinc, carrar, mufoeus, stryke etc and amongst the doctors Amman, Bohn, fort fidelis Caspar a Reies, Strolberger, Zacchia, Bartholin .

Legal medicine has for an object, the life of men, preservation, health, disease, death, different lesions and the faculties of the soul and of the body considered physically: she often decides the questions from whence depend the life, the fortune, the honour or the spiritual health of citizens.

The extreme importance of these inspires a kind of dread for lack of attention in general: we leave to our neighbours the treatment to clear up in the most delicate processes; the authors who deal with legal medicine remain buried amongst each other in the dust of libraries; and without some memorable event which reminds us of the danger of ignorance, one will forget that it is in medicine a kind of study relative to legislation.

One does not teach in any part of France the art of making reports in justice and as it seems to be less important to have the notions on this, than the knowledge of families of animals and of plants, and of analysing foreign curiosities; one demands that young doctors should never be surprised in a cabinet of natural history but not to base oneself on knowledge, of which deprivation can cost the life or honour of citizens.

So many combined reasons excite me to awaken the attention of my counterparts: I am going to trace in this article the analysis of a vast work, leaving time to perfect the enterprise, and I will be lucky, if after having opened an interesting career, my efforts in exciting others is covered. One of these geniuses may be able to make to carry the light everywhere, where they penetrate, to work for the good fortune and the safety of men, in detailing with precision the different objects of which I have been speaking! I think I am in the right of speaking with the famous Bohn, whose field in medicine concerns reports in justice, has not been sufficiently cultivated, nor had consideration (have respect) for its difficulty and to its importance. I will contain in this article, firstly everything which there is of use to know in the history and progress of legal medicine , with note of the best authors whom have dealt with it.

Secondly, the knowledge required to be called an expert in justice.

Thirdly, the qualities necessary in experts.

Fourthly, the different precautions to observe for good reporting.

Fifthly, the different kinds of relations (acquaintances, connections) or reports (connections).

Sixthly, the objects (matters) on which doctors must establish their report and how far their ministrations (aid, service) must spread (extend).

Seventhly, the plan of a treaty of legal medicine which only contains the essential.

Eighthly, the questions to prune or of which discussion is futile or impossible.

The origin and progress of legal medicine. As soon as the knowledge spreads itself in the policed society, their influence will be carried into the laws; several amongst them had only barbaric prejudices for foundations originally, which one had taken for the regulation of justice and injustice, but the men whom enlighten their true interests, have felt that the sublime work of legislation would not be able to be carried to its highest point of perfection, which is by the contribution of all the knowledges. As there are few objects in civil and private life that laws do not rule on, the difficult task of the judge demands to be performed with dignity, preliminary knowledge which by their number exceeds forces of humanity. One shared the work and each can be the judge and minister of the law in the part in which he is able, the particular opinion avowed by the magistrate, is covered by the public sanction and becomes a judgement; one has taken the same precautions to not expose to catastrophic errors of ignorance, the law has demanded that one has resorted to those people approved and truthful artists , and one has had most often the expert jurors.

Such is the origin of legal medicine , born of need like all the arts, she has been for a long time in a state of imperfection which does not allow one to designate it a particular name, she even still appears in her childhood, which sacred and secular history testify that doctors or their ministers have sometimes resorted to in order to decide diverse cases, it is well passed those centuries having that one had to be busy with the treatment of extracting a body of doctrine for these different decisions. All that one finds in antiquity, is confined to the use of authorities by the law, and deductions of imperfect notions which one had in medicine; signs of virginity, those virtues of the male seed, the animation of the foetus of whom the books of the saints talk ( Deuteronomy, Genesis, Exodus ). Egyptian law, which according to the report of Plutarch, was freed of all pain inflicted on pregnant women, demanded their doctors only the obligation of treating the maladies by the method adopted in the canonical books ( Diodore of Sicily ) and some other examples in which they could be helped to multiply, there is other evidence of these imperfections of which I talk.

The Romans were more exact and their laws better reasoned; the caesarean operation was recommended after the death of the pregnant woman, and the examination of wounded cadavers was publicly authorised in order to ease the discovery of crime, they have authentic witnesses for the influence of medicine on their legislation ( See Plutarch, Suétone, Tacitus). Everyone was confined nevertheless to the application of vague knowledge in rare cases or in those which one rarely demands; it was not only at the time of the publication of the criminal ruling of the Emperor Charles the Fifth, that one felt the necessity of a legal medicine which was in the form of a doctrine (Boerner, Kannegiefer). The canons, the decrees often demanded the reports of doctors and of their ministers, causing the jurisconsults to feel their necessity and the use, tradition had made them imperceptible to adopt, and the rulings of the kings published to us by posterity, by Charles the Fifth, who erected this custom in law.

It will remain little to desire in this respect beside legislation, the opinions of experts in medicine became a source of light for judges, but through the consequence of our slowness towards reason, it has not appeared to the experts themselves that they have the contract of obligation to enlighten themselves for the enlightening of others. Vulgar knowledge seemed sufficient: in exercising one part of medicine , one believed oneself to be in a state to solve legal medicine questions with which one was concerned. All supposed that this profession replied with confidence until it was asked; the state of inattention was excused through the rarity of occasions where others' knowledge had been necessary, and the extreme imperfection of reports, necessarily reduced their force in the mind of magistrates.

It is true that legal medicine was founded on the practical and rational principles of medicine in general, but the practitioners well versed in the empirical or historical knowledge of medicine , made with difficulty the philosophical or rational point of view, under which one can consider legal medicine questions, the help of which the study or a particular work is constantly ignored by the mass of doctors and their supports. We will see elsewhere that the history of reports made in the most famous cases prove that it is not sufficient to be a good practitioner to be a good expert or a good judge in legal medicine .

It was especially in Germany and Italy that one cultivated with success this important branch of the art of healing. The more clever, enriched doctors acquired knowledge by a long practice and provide themselves of everything which one can acquire by the study of sciences secondary to medicine , they laid down the first foundations of legal medicine , by publishing different treaties which contained well thought out decisions of the most famous faculties. Such are the treatises of Fortunatus Fidelis de relationibus medicorum, addito judico , 4'Leipic (who published afterwards under the supposed name of Thomas Reinesius, schola jurisconsultorum medica)

Pauli Amann. Irenicum numa pompilii cum Hippocrate 8' Franc. & Leipsic.

Joannis Bohnii de officio medici duplici, clinici nimirum ac forensis. 4' Leipsic.

Pauli Ammann. Medecina critica sive decisoria. 4. Erford.

Mich. Boudewins ventilabrum medico-theologicum. 4' Anvers.

Michaelis Bernard. Valentini corpus juris medicolegale constans pandectis, novellis & authenticis iatrico-forensibus. Fol. Francfort.

Paul. Zacchiae questiones medico-legales. Lugd. Fol.

Caspar a Reies campus elysius jucundarum questionem. Fol. Bruxell.

Roderic a Castro medicus politicus . 4' Hambourg.

More recently still one has seen published the following treatises.

Herman. Frid. Teichmeyer institut medicinae legalis vel forensis. 4'. Iene

Ottomar. Goelicke medicina forensis. 4'.

Mich Alberti System. Juriprendentia medicae . 4'. 6 volumes.

Joannis Francisc. Loew. Theatrum medico-juridicum. 4' Nuremberg.

Hebenstreit anthropologia forensis . 8'. Leipsic.

Frideric. Boerner institut, medicinae legalis. 8' Wirtemberg

Gottieb. Henrici Kannegiesseri, institut. Medicinae legalis. 8' Hall de Magdebourg.

One can join to these general treatises the following specific treatises.

Feldmann de cadavere inspiciendo 4'. Groningue

Bohn de renuntiatione vulnerum lethalium. 8'.

Gottof. Welschii judicium vulnerum lethalium.

And a mass of specific essays on various matters of legal medicine , published in different times.

At the same time that all these works had fixed the attention of the public and proved the necessity of a new genre of study, it would seem to be ignored in France that medicine has connections with legislation; and if one excepts what has been said by Ambroise Paré on the reports of cadavers and the two treatises of Nicolas Blegny and of Devaux on the art of making reports in surgery, we do not have anything with which one can announce that one has been busy with it. These last treatises are only purely shapeless compilations, narrowly limited to the form of reports, and if one sometimes discovers observations founded on the principles of the art, they are nearly always disfigured by absurd superstition or by the most gross errors.

The examination of wounds on the living and on cadavers, is without contradiction the most frequent source of reports which one makes in justice. One has established in France the expert jurors, drawn from the ordinary body of surgeons, because one has assumed that all of them required knowledge for good reporting on a matter that pertains to their profession; and one does not live in order to decide if a wound has been fatal in itself or by accident, it was necessary to know the animal economy on all points of view, and especially which had influence on all the accidents on the principle of life. One has become accustomed to consulting the same experts on the other matters which concerns them less closely, and their decisions are nearly always badly conceived, having disgusted the judges or having left them in a cruel uncertainty.

The use of resorting to surgeons for reports in justice, has made one become accustomed to regard this part of medicine as a simple function attached to the practice of surgery. Only surgeons have written on the art of reporting, and the few jealous doctors to claim that it belongs to them, are perhaps still ignorant of the extreme importance of this field, never siring any effort to enlighten themselves and to come into their rights.

The few advantages that the reports provided, excited magistrates to combinemore often with a doctor to expert surgeons; one waits to see the one enlightening the other; and physical knowledge seemed to have to guide mechanical operations, and to preside over conclusions which one deduced. But the same negligence which prevented doctors from instructing on the reports of their profession with the law, restores this instructive partnership, and the doctor experienced elsewhere, shall be nearly always foreign in a field on which he has never reflected.

It is to these considerations that it is necessary to attribute a little dignity or importance of which legal medicine was playing amongst us; its state of obscurity explains why educated doctors have disregarded dealing in it, and the shortfall of good treaties has often made magistrates to think that they hoped in vain to derive from doctors some light that should have saved them a part of the pain. One can even add that judges less educated than doctors, from the kind of certainty that it is necessary to attribute to medicinal ideas, they evaluate imperfectly the decisions which are presented to them, and are often mislead about the merit of experts.

It matters little to those who only consider the good of humanity to trace the limits which separate two professions which deal with the treatment of healing; the privileges obtained by the surgeons in France, are the praise of those who practice it, they have without doubt good merit of the nation, as she has rewarded them; and they have never brought together purely surgical knowledge, those who have elevated them over the class of simple operators , they will do such as I would like them. This revolution is not far off; several famous surgeons amongst us have made us see that they were equipped of all the secondary knowledge which is suitable for those who deal with the art of healing: one has of all times demanded these knowledge of doctors, that one finishes up with named surgeons for the reports; they should only differ from doctors themselves by the name, and the public will be served usefully.

In the few writings we have on the subject matter of what is in question in this article, it is necessary to distinguish well those memories or particularly the recently published consultations. Messrs Bouvart, Petit, and Louis have shown in some famous cases, that we have been short of only those occasions to do that which our neighbours have done: it has been hoped that those authors would increase their yield in this field; they would be able to serve as a model to others, and the provinces would be able to participate in this respect with resources that one finds scarcely even now in the capital.

Amongst the work cited, those of which one can read or consult with the most fruitfulness, are Zacchia, Valentinus, Albertus, and the specific treaty of Bohn on the reports of wounds. The details which these authors have entered and the observations with which they have enriched their treaties, are of an extreme use in a science in which the main object is to make a just application of known principles. The treaties of Hebenstreit, of Boerner, and of Kannegiesser have their merit without doubt, as one will see below: but they offer difficulty in this application and less possibilities for ideas.

One of the most perfect among these works is that of Zacchia, which has not forgotten anything of use and which has presented everything with method and clarity; but besides that there is much to be pruned or corrected in these questions, he wrote more for the jurisconsults and the judges than for the doctors, he was not anatomical enough for most of the questions that he dealt with and the physical of his time had not acquired the resources that we have in ours.

One can only hide oneself in the times present to the experts who search through the ancient authors to support their opinion or to take in the reasons for decisions in them, often adopted with a marvellously good faith even absurdities which they find. Is it laziness or habit? It is this that I leave to decide.

The knowledge that one must demand in an expert. It is necessary to avoid the excess of some authors who, in detailing the knowledge that is suitable in a doctor named for reports, have finished by demanding the universality of science and demanding everywhere impossible things. But in avoiding exaggeration, it is always evident that among the different fields in medicine, in which practice demands the most varied talents and knowledge, legal medicine is that which is most demanding. The extreme variety of objects on which one has to make reports, demands the necessity of joining a mass of knowledge that one can only acquire by experience helped by geniuses.

‘All the regulations, said M. Verdier, which have established the necessity of reports, are confined to those who have some character; some even have strictly excluded all the others. These dispositions have been particularly stated for the surgeons in the articles 32 of the statutes of surgeons of Paris from 1699 and 27 of those of Versailles: "The reports of persons not approved, will be able to do none itself in justice, without decrees, diplomas, patented letters, privileges, edicts, or other titles to the contrary, which will revoke this effect, and it will be defended by all judges to have regard to this". The law has wished, by this precaution, that one should not have had recourse for the making of reports, in some subject matter it shall be, that to those who have given authentic and juridical evidence of their capacity, in the field of the art or science about which knowledge is necessary for deciding the question.' It is therefore by the nature of the question that it is necessary to judge the knowledge required for treatment, but like the doctor sworn to the exclusive right of making reports on all matters, it follows that he cannot acquit himself from it without reproach if he does not join all that it is essential to know.

The division of medicine strictly speaking, into medicine, surgery, and in pharmacy, established three sorts of artists, whose work is different; but doctors having for the domain, the knowledge of nature, prognostication and the curing of all diseases, of character and of virtue of all the decent abilities with auxiliary sciences which may have driven those which are contained in the art of healing, their ministry extends on all reports that are about nature and that are their object. The other professions must acknowledge in their reports the boundaries that are prescribed to them in their practice, and it is on the experience that each expert has acquired in the profession that he practices, that it is necessary to measure the degree of faith that one attaches to his decision. { See below}. He is helped to feel by these reasons how much it is absurd to pretend, with the author of ‘ The art of making reports in surgery' , that the subject matter and the work of all kinds of reports, is a patrimonial right which belonged to surgeons to doctors themselves: the creation of royal doctors in different places of kingdoms has been the object of remedying abuse in destroying this claim, and everywhere where a similar creation has not been in place, the judge is in the right to name those that the light and the experience indicate to him to be the most decent to fulfil the duties of the law.

The exact knowledge of all the parts of human bodies and the experience of dissections are absolutely indispensable in an expert named to report. It is by the exact knowledge of bone, of their cartilage, of their ligaments, of membranes that conceals them or which connect them, that one can recognise the causes and the sequences of fractures, of dislocations or other accidental lesions or interior of these parts. The muscles, the vessels, the nerves, are also important to know, that is in their number and their disposition, in their volume and in their particular uses. The disposition and volume relative to different viscera, their use in the animal economy and the degree of importance of their functions are the ideas more essential yet; she should connect a different order to these notions which deals with physiology; and this rational use of different organs, which constitute what one calls ‘ physiology' or the physique of animate bodies, must be deduced from positive facts or more strict analogies.

It is necessary therefore that an expert may guarantee himself by the knowledge of the systems in the choice of his opinions; he must only be in his report the follower of truth and so he can not without injustice demand of a man whom extends his views within the circle of his acquaintances, of less will he be guilty from having given for certain what a whole conviction, which was founded on true knowledge, will not have been demonstrated to him. ‘The knowledge of surgical illnesses, said M. Devaux, is absolutely necessary to him for explaining in reports the essence, the signs, the accidents and the prognostic, and the practice is especially necessary to him even more than the theory'. One can in speaking so much of diseases in general, so much internal than external; it is little of it, even the more simple, which is not complicated with accidents which depend on lesions or connection to main organs; the habit of recognising them, judging them and treating them, is a preliminary essential for drawing up reports. It is more by this practice that one puts oneself in a state to determine the order and the time of their recovery to judge whether the previously used help has been administered methodically.

One has perceived in advance the impossibility of good knowledge of the structure and usage of the parts of the animated body in a healthy state and in a state of disease if one is not elsewhere sufficiently provided with physical knowledge which is able to serve as a guide. That one glances over hygiene and the different branches, that one covers the various points of the most accepted or the most common physiology, and one will see that the good and healthy physique is a torch with which the light applies itself to everything between the hands of the wise observer. I am in charge of giving this application of the physical in medicine, the extension exaggerated which so many authors have given to it, I make that it is dangerous to wish all to subjugate to calculation or to the known law of movements and the misleadingness of these authors justifies without doubt the putting aside of others; but I rise up against the absolute ignorance of physical facts, of which the knowledge is a necessary element for treating diseases or for maintaining the health of the healthy. It is not made difficult for me to cite some examples, and the following of this article will put this truth in its evidence.

The particular study of materia medica or of the history and the virtue of simple medications is a part of pharmacology upon which an expert must have dealt with for a long time. Besides the treatment of the diseases which the judge often entrusts to his care, is sometimes called to speak his opinion on the virtue of certain remedies, on their use, their doses, the moment of their exhibition, on their effects on the body, according to the different circumstances, on their indications and counter-indications, the nature of compound medications, their preparation, their choice, their conservation that are within the competence of the pharmacy are still the matters on which the experts have to pronounce. One can not flatter oneself to evaluate well the effect that all this help has on the human body, if one has not looked into these different details and although one associates with doctors most often, among these cases, the artists employed for the preparation of these remedies, are always supposed to summarise with knowledge of the cause, the different points upon which these articles have decided.

A sufficient knowledge of the first elements of chemistry is even more important, if I dare to say it, and one can only attend more to the assistance of the expert-juror who is a chemist. We have learnt lately that good chemistry has been purged from an intelligible muddle by the first founders of this art, it is one of the means the most decent to enlighten the physical that one calls ‘corpuscular' . The exact knowledge and the good preparation of medications is due to chemistry, and it is by analysis which one must, that it is sometimes possible for us to discover the nature of bodies that we seek to know. Poisonous substances drawn from the mineral kingdom, the bad qualities of solid and liquid aliments, are only able to be well known by its assistance; and the expert-juror that the magistrate authorises to this search, find, if he is a chemist, a thousand advantages since all others will be make in them inaction and will presume.

I will not speak of that which is necessary for the doctor being an expert in philosophy, because this expression, of which the meaning is undefined in many respects, it can be badly interpreted, and can seem perhaps too demanding; but it is demonstrated that the freeing of absurd prejudices which have run amongst the people, is a circumstance required for good reporting, it seems to me that no expert is able to merit this title, if they do not carry in their profession this spirit of doubt which banishes fanaticism, and which does not give access to the light of evidence. This being a large service to render to humanity, that from lighting up Medicine by a ray of the true philosophy, which has done so much for progress in the last century and in our, to which all the sciences have such large obligations!

It will not be useless that the expert juror knows the articles of the rulings that concern him, and the judicial form that has a connection to his ministration, in order not to fall into errors or dangerous inconsistencies. One can also sin by omission in legal medicine , and these omissions can be of the greatest importance.

The shortcoming of all this knowledge has often produced legal murder, of which the examples are without number. It is the ignorance that does cherish the marvellous and that does find miracles everywhere. Without running back over times that have preceded us, and in which barbarity is a monument of shame for humanity, we see even in our days credulous absurdities find a place in men the most facts for being educated. There was not a long time since a woman made a doctor of reputation believe that her sister had given birth to a fish (Roederer, ‘essay', published in Petersburg). One believes still in sorcerers in many places in the kingdom, and the heads of the best organised elsewhere, have pain to vouch for contagion for example. A surgeon is not embarrassed in the last place, to certify that a woman is bewitched, having given birth to many frogs. These examples, which are not only ridiculous, have offered bloody scenes in times where the sovereign court was less enlightened; but the subordinate tribunals and the first judges in small places, are often little advanced in the matter of reason; a bad report, a report inconsistent with the determined, can hurt the innocent or leave the guilty unpunished. It is always the presumptuous half-science that gives to the false or to the uncertain the appearance of truth or of the evident. Zacchia reported that two barbers called to examine a body that one had found in the ground of Monticelli, in the ancient country of Sabins, concluded that this man had been strangled by force with hands, or with a cord, or all other similar thing. Since this statement even joined signs of enmity between this person and some other men the judge claimed that it was to these men that it was necessary to attribute the murder of that one of whom one had found the cadaver; his accusation was principally founded on the report of the two barbers. Zacchia, consulted in the second place, proved that among the signs reported by these two ignoramuses there had not been any in it that indicated external violence, and that they were all able to be the effect of a suffocation from internal causes. To these reasons was joined a new consideration of great importance in these circumstances: he recognised then in this country a type of epidemic which killed very quickly and the impression that this disease left on the cadavers of those who died of it, were perfectly similar to those which the two barbers had alleged in their report, and which they believed pointed out an external violence. But why go back so far in order to cite examples of catastrophic effects that are able to be produced by ignorance? Our century presents some memorable enough to us. One takes off with a well in the environs of Maramet, the body of a girl, that one recognised as Elisabeth Sirven, absent for several days from the house of her father. The judge had made address of the report of the cadaver to a doctor and to a surgeon, and one ensured that he found this acquaintance to confer, that it was necessary to address a second to be delivered to the record office. In this one they declared they had found a graze to the hand, the head was weakened, with a little blood clotted towards the neck and a point of water in the stomach; from whence they concluded that one had twisted the neck of this girl, and that she had only been thrown into the well after having been put to death by strangulation. I have proved elsewhere how this report was absurd and that in the account of the facts and in the conclusions that one had deduced from them. I only present here as one of the most sad reminders that ignorance has never produced in favour of prevention.

It is finally the ignorance that makes expert doctors commit deadly errors in their practice, since they are employed by judges to treat the injured or to decide the treatment made by others.

The qualities necessary in experts. These qualities are moral virtues and keep with character and with morals or are the distinctions acquired by ranks or titles. The first are important and are suitable to all men, but more entitled to those who are sometimes disposed to fortune or to life of the same to them. More exactly integrity, impartiality, distrust of oneself, and of ones light, the most obstinate application, and thoughtful attention are the virtues that the expert doctor must possess. He must observe the most large circumspection in their prognostications and in their judgements, and this same prudence becomes necessary to him in all his operations; it was without doubt the unfortunate prevention that blinded the expert named for the report of the cadaver of Elisabeth Sirven, one has written that this doctor believed that the synods of protestants taught the doctrine of parricide: it is necessary to be sensitive to all those who leaving to himself to understand through the spirit of dizziness which sweeps people or which are accessible to fanaticism.

The second type of qualities concern the state or the profession of the expert and the rank or titles of which he must be assumed.

The three classes of artists who share the practice of medicine have a field quite well separated, for which it is possible to be an expert in one part, and perfectly ignorant of the two others, there are only a few doctors of whom the profession supposes the knowledge of the two other branches of their art, and which resembles all that concerns the art of healing for making their way towards the same aim. When one remembers the knowledge required in the expert juror in reports, one sees that the doctor is in the state of those artists that joins them the most often. But as the surgeon and the apothecary are more particularly devoted, the one with operations and with knowledge of the pharmacy, the other of panaceas, incisions, operations and deliveries, it follows that their evidence is necessary everywhere where the question of enlightening is relative to these objects, the practice which is familiar to them, makes them decent to observe well and to describe well, and the doctor who summarises what they have seen and what he has seen himself, legitimately deduces the consequences. It is for this, said M. Santeuil, "that the custom in surgical cases has always been of naming, to make a report, one doctor with two surgeons. These last are as witnesses of the state of the malady and the doctor as judge of the decision principally fix the judgement of the magistrate. It is the custom, said M. Verdier, who has followed in all the well regulated jurisdictions, in consequence of orders and decrees, recounted in the article under the order of 1670 and conforming to this custom in French jurisprudence of only regarding in criminal subject matter reports are only made by surgeons which are informed, that is to say since the notifications of which the judges draw themselves the conclusions, leap to be able to resort to doctors.'

This arrangement, confirmed by the custom and authority by the orders, is decent to warn of the abuse which often arrives in small places, where inexpert surgeons, in whom presumption holds the place of science, interfere in making reports on thousands of items on which they are ignorant. Because, in big cities, it is quite ordinary to find in them that the variety and the understanding of knowledge leaves nothing to be desired, and which are often decent to redress the little experienced and too confident doctors. One finds also in these same cities the apothecaries who rush out from beyond the circle of their pharmaceutical practice, directing their attention and their work on objects of transcendent chemistry which they raise well over what is common to doctors. These artists are the masters of whom the opinion is respectable and must involve the vote, but this resource is not common, and the law must extend his influence over all inhabited places.

In following these principles, one sees the inconvenience that there is to admit without distinction for the making of reports, all men exercising one of the parts of medicine. One distinguishes in effect doctors, surgeons, and apothecaries ranked or avowed by bodies and received masterpieces of those who have only other titles of opinion or habit of practices. All artists received and adopted by a body is supposed to have given sufficient evidence of their capacity, and this presumption can not be suitable to those who are without admission. One sees even in the bodies different classes of artists of whom the capacity is not the same. Surgeons distinguish the masters received by masterpieces or by repeated exams, of which the knowledges are acknowledged to extend on all surgical cases; the others are received on light experience and are principally destined for small places, they are only examined for the form, and the letters which are dispatched to them order to ‘ call a master of the community for giving their advice in the crucial operations, to the pain of a useless person . It is evident, said the same M. Verdier, that such artists do not have the experience required by the law for the drawing up of reports.

The confusion which is recognised in the orders that has not permitted to foresee this difference in the capacity of artists of the same profession; and before the edit of 1692, the titles of the first doctor had permitted to him to make doctors and surgeons reports ‘ in all the good cities and other places of the kingdom, according to whether he was noticed to be good .' He is able to choose indifferently in these places the surgeons ‘ the most capable to assist with reports and visitations of illnesses and injuries '. But the articles 133 of surgeons of Paris of 1699, 66 of those of Versailles of 1719, 83 of those of the provinces of 1730, they carry that ‘ the opening of cadavers can only be made by the masters of the community ’.

The ministration of midwives is more subordinate to more narrow regulations. Their inexperience on all that is not the manoeuvre of delivery, is the reason that they should be able to do their visits only in the presence of doctors and surgeons, they make their report jointly or separately with them, according to whether the decree or the sentence which names them to act in concert or separately. The examples have proved that experience the most long, since she is not enlightened by others, is not put sheltered from the most serious faults. Such is the matron of whom Bohn speaks; she ensured in the presence of this delivery-doctor that a woman was in grief, it was attributed to give birth to a male very alive foetus, they assured that she had felt to perform different movements in the uterus and that she had distinguished the sex. Bohn extracted the child after infinite pains and saw that it was a girl half rotten, dead without doubt for a long time. Such is the example that arrived in Paris in 1665, named by Bourcier , the widow Loudiere, and Marie Garnier , had declared by their report, that there was no mark of pregnancy in a criminal woman who had been executed as a result, and who nevertheless had been found pregnant of three or four months during the dissection of her cadaver: ‘for reason of which these matron jurors were forbidden, decreed, adjourned, and severely blamed, and were scalded by the magistrate, so much that their urgency, that their rashness to decide with too much boldness on uncertain evidence and on which it is necessary to be suitable that the most clever can be mistaken about.' See Pregnancy ( signs of ), supplement.

Besides the quality of the graduated or of the master in one of the professions of medicine, law has even demanded a particular title in the expert named for reports, one sees that this title, in origin, is only one precaution more for assuring one of the choice and of the capacity of the subject. Doctors and royal surgeons, in places where there are some, are put in charge ‘ exclusively by all others ', for all juridical reports. The load of which they covered supposes that one is assured of their sufficiency for the practice; but their right, although exclusive for judicial reports is not removed by other masters in the same profession that one of making reports ‘ denunciations ' by the request of parties ‘ who have not formed action’ , as one can see by the edit of 1692 and by the decree of the parliament of Paris of 10 march 1728.

These charges of doctors and royal surgeons to the nomination of first doctor and first surgeon of the king, in places where there is not a faculty of medicine or a college of surgery, and one feels that if absolutely necessary it is only the reputation and the experience of the subject which decides ones choice. In places where there is a faculty or a college, the charge of royal doctor or juror surgeon is accorded to the body itself, which names those of its members who must answer to all requisitions of the judge, and one can only hide those jobs that are not difficult to being entrusted to the younger or less expert.

There are many qualities which are joint to those of doctors and surgeons, that do not permit them to make a report, which arrive (said the author of the jurisprudence of the medicine in France) ‘all the times that such qualities can make presumed in a doctor or surgeon, the reasons of splitting or favouring those for or against who were making their report, could be a legitimate motive of challenge, such are the doctors or surgeons who would be at the same time advocates or procurers'. A decree of parliament of Provence of 23 May 1677, holds that ‘the juristic procurer was surgeon, able to do in this quality of surgeon, a report of injuries, of causes of which he had accused'. A similar decree of parliament of 11 January 1687, permit to a substitute of fiscal procurer and applicant procurer, was surgeon, to exercise the function of surgeon ‘ to the charge that they were able to deliver any report in justice, for those of whom it was or had been procured, being in the criminal process or those said reports were delivered, being in other civil or criminal process .

The precautions to observe in making a good report. One feels that the nature of the subject of the report determines the number and the kind of precautions that one must observe for doing it well. One can consult about this matter different articles on legal medicine , inserted in this Supplement ; it is nevertheless the essential generalities that find their natural place in this article.

A doctor and a surgeon called in justice in order to make their report on the state of a cadaver, have to decide what is the kind of death which has taken place; they determine in magnification, by the signs which concern them, if it is the person of whom they examine the cadaver who had made an attempt on his own life, or if this attempt was committed by the hands of strangers. Their decision on these two points constitutes quite often the body and the type of offence, and the base of judgement, since the evidence of another person are not peremptory; it is therefore essential to proceed with an extreme caution, and from nothing conclude according to a circumstance, than after being well convinced that there is nothing that draws to invalidate it.

Their first duty is to verify if the cadaver offers no sign of life; if they have the good fortune of seeing it or of presuming it, humanity dictates to them what they must do: help must be administered with precaution and intelligence, according to the nature of the lesions. Ambroise Pare, by a suture and from other ordinary help, brought back to life, in some instances, a lord who, in an attack of a melancholy night, had his throat cut with a razor: the servants accused of his murder, surviving their salvation only on the little of speech that this man had articulated before his death. What satisfaction for the experts, if to the advantage of bringing a man back to life they join those to make light on a doubt which would perhaps have cost the life of an innocent, or which had produced the impunity of a guilty person.

The simple doubt on the remainder of life, although insensible, authorises and imposes the same obligation of multiplying the means for putting the signs of life in a greater evidence; it goes better to employ those needlessly that neglect to make use of them in a case where they are able to be useful.

One has often brought back to life drowned people or the people whom the vapour of sulphur or of carbon have nearly suffocated: these different means are known and are nearly trivial by the multiplicity of work produced in recent times. Air blown into the mouth, closing the nostrils of the body; the warmth of ash, of smoke applied over the body; the irritants introduced to the nose; the throat, by the foundation, the massage, the suction, the blood letting, especially from the jugular veins, are the aids of which the efficacy has been fortunately recognised.

The use of the opening of these veins, in strokes and strangulations, was proved by an observation of Valsalva, that looked entirely pale, after the opening of one of the jugular veins, the face of the cadaver of a woman who had been hung, and who had this opening in a state of extreme paleness; it is true that the fluidity of blood after death favours this discharge, and that one is not able to flatter oneself to meet this circumstance in all cases; but even when one does not evacuate all, it is not indifferent to trying, he always finds a part of blood more or less fluid, and this part evacuated easily the reabsorption of the other. M. Morgagni saw over a woman whom thieves had wished to strangle, whose face was swollen and pale, and the mouth full of foam, one brought her back to life, after having let blood from the arm and from the foot, and having given to her some cordial: one can conclude from this observation, the falsity of this aphorism of Hippocrates, neque is ad vitam redit, qui ex suspendio, spumante ore detractus est.

Secondly. Since death is assured, and that it is necessary to verify the body for making a report, the expert must verify all himself as promptly as it is possible, and especially before the injuries of the air or of putrefaction have caused alterations; he must even have regard for the time since which the person died, and observe with care what can be the effect of delay or of putrefaction, for the distinction of all that is able to depend on other causes. The judges interrogate the doctors to throw light on all that has been reported on the physique of the human body or on medicine strictly speaking, and they have by right of waiting for the most complete explanation from those matters that are not inaccessible to actual knowledge.

The simple lateness in these openings, distorts quite often the indications, which have appeared apparent, having been able to pass for positive. Harvey reported ( Circul. Sang. Exercit. III ) that having opened the chest and pericardium of a hanged man, two hors after his death, he found the first lung full of blood and above all the right lobe of the heart which surpassed the volume of a fist, and which had distended itself that it appeared ready to break; this volume was considerably disparate the following day, the body was perfectly frozen and the blood had penetrated in the neighbouring parts.

The spontaneous alterations which are on cadavers, quite often imitate the effect of caustic or even mechanical causes on the living. One has seen the effusion of blood, becoming corrosive by the stay and the putrefaction, attacking neighbouring parties and producing on them the same effects as poisons that one has swallowed. The bruises or the pressures made on different parts of cadavers, and continued for some time, crumples all the soft parts which they feel, tearing them sometimes, and leaving traces resembling those of blunt instruments applied most violently. The same air releases parts of the cadaver, producing tears or mechanical movements, that an inexpert or less attentive man is able to attribute to causes absolutely foreign.

Thirdly. It is necessary to avoid the use of a probe in the research or the examination of exterior wounds. Observations prove that one has often formed with this instrument false routes, that one has attributed to the nature of the wound, or that one has rendered dangerous those which have been light or easy to heal; Bohn cites the example of an ignorant surgeon who, on finding a wound made in the front by a bullet, cast his instrument to the depth of a finger and did not stop stirring and turning it in all sense, until he had met a solid body, which he believed to be the bullet; that accelerated the death of the injured by the enlarging of the wound, and the forcing of a splinter of bone from the skull into the brain.

Fourthly. The expert must examine scrupulously all which is offered to him by the exterior of the body, as injuries, bruises, pallor, distortions, in a word he must faithfully detail all that has not a place in the natural state; his researches are able to carry him over the choices which can have some connection with the cadaver; such are the instruments or the bodies which have been able to serve to the kind of death which has happened, the position of the places, the hard conditions, sometimes even the illnesses which reign in the country, or the qualities of the air that one breathes in the place of the offence.

Fifthly. He must open the different cavities of the cadaver and attach himself especially to seeing the state of the vital organs. The exterior signs that he was able to perceive must fix the eyes on those signs which they indicated, also an impression of the circulation around the neck, he must determine to verify this part with more attention than all the rest of the body. It is never useless to examine the state of the first tracks, the traces of a poison is often well able to be noted which the other signs can only note in part.

This opening of the body must be made in a convenient place, with precaution, especially since one wishes to discover the depth and direction of wounds, made by pointed and sharp instruments, or those that are made by the bullet of a musket, because of their detours in the tissue of parts.

Sixthly. He must also add the general considerations on the place, the season, the state of the atmosphere, the age of the subject, his sex, his habits (if he has known him alive). See below.

If the cadaver was buried, it is necessary to unearth it, said Feltmann for making the opening ‘otherwise the guilty can only be punished of death in the case where the injured died suddenly after the blow was received'.

The same author reported ( de cadav. Inspiciend .) two conditions quite useless to fulfil, when one pulls a cadaver out of water, firstly to cover the nakedness, secondly to leave the feet to soak in the water from where one has pulled the body; he cites a law of Marguerite de Bourgogne who had also ordered this.

Seventhly. The main articles of the report must be addressed at the place and not from memory, the expert can only speak of that which he has seen by himself and not of the account that has been made to him by assistants or strangers.

If the subject that he examines is living, it is necessary that he marks if he has been required to take himself or if the subject came to find him; in the first case, he must say if he found him lying down or standing up, attending to his business or in the helplessness of being given care there, situated in such and such a fashion.

It is necessary to deduce nothing but the veritable symptoms, without inferring anything from the cries and grief from the illness and from the assistants.

It is necessary to be on guard against the trick with which one counterfeits the true symptoms, like the convulsions, contortions, apparent blackouts, syringed blood, flinging oneself about and furious affections.

Eighthly. If the subject of the report is complicated or demands further reflections, it is necessary, after having noted the essentials at the place, leaving to elapse the least interval possible: if it is a matter of poison, it is necessary to repeat for oneself or make tests on living animals ( see poisons, suppl .); if it is a question of alimens or other unknown substances, making an analysis on oneself, or demanding of a judge that he names other experts well suited to help in this research.

Ninthly. Have regard to all the circumstances in the estimation of dressings, medications, or in the judgement of the method of treatment employed by others.

Assert rarely, either in the prognostics or in the evaluation of the cause and the effects. The mathematical certainty is not the appendage of the art of healing: Celsus said, ‘ nothing in medicine is established for certain, than nothing is certain' . The very great probability is most often the extreme degree to which one can attend.

Brevity, clarity, propriety of words, are more qualities necessary in a report; the scientific words must be explained there in their true sense to be understood by judges. The reports would be unnecessary, said M. Verdier, if the judges were anatomists and doctors.

It is not necessary to combine anything foreign in the report, and so the expert must avoid all displays of erudition that the subject matter does not demand strictly.

One names ordinarily two or three experts, one doctor, the other surgeons, for joining all their medical knowledge which are connected to the question to be consulted, this good use by itself, has inconveniences nevertheless, when one of these experts differ in opinion or encroaches on the report of others. The doctor and the surgeon are equally right to open the cadaver and to observe anatomically, but if the operations of the hand are allotted to the last, it is to the first that the physiological observations relate; the breach of this rule has produced for the art humiliations which must nevertheless only fall on those who have violated it.

One expert only can take the necessary steps; and so the point of physiological discussion before an assembled populace, which believes in your importance with which one explains to them the effects and their causes, which it is made to judge on these subject matters, and at the end who will come to persuade them ( see the report made on Calas, son, under the word ‘Hangings', Suppl .), misfortune to men if never the people call to mind to their tribunal causes of this kind! The precipitation (rash haste) and the enthusiasm that he carries in these decisions, are not combined with the research required.

Tenthly. The reports must be made without connivance and with all the secrecy that merits the facts of which revelation can produce impunity from the crime, or the persecution of the innocent.

In the disputed or difficult cases, when there is discord amongst the experts, the body of offence having been well established, it is necessary to ask the opinion of the famous bodies or faculties, and to address by preference to those who are occupied in these matters, or who combine the means for judging well about it.

So many of the accumulated precautions are not always put to the expert by the shelter of the challenge. The declaration of 16 June 1608 and the decree of the parliament of Paris of 10 March 1728 and others, by ordering that the reports of justice, be made by those who are assistant to this effect, additionally: ‘ in the case that there was not challenge on their part, absent or other legitimate difficulty, for reason of which it has been ordered on differently by the officers of justice '. Verdier, ‘ Jurisprud. Of medicine' .

The different kinds of reports or connections. The ministration of doctors, considered in the reports with the legislation or public order, understand, firstly, the reports, opinions or connections, secondly, the exemptions or certificates of excuse, thirdly, the estimations or judgments.

The reports strictly speaking, that one calls more ‘ judicial reports' , are, as I have already said, public acts, by which doctors and their titled ministers ‘render witness, or are the narration, in a writing signed by themselves, of all that their art and their light have made known to them by the examination of a subject dead or alive, for by throwing light on the judges, does himself in justice'.

It is another kind of report or connection that one can call ‘ political ' or ‘ economic ', it is concerned principally with civil order and has a place when the magistrate or the sovereign demands the opinion of one or of several doctors, or of an entire faculty, on diverse matters generally related to the health or to preservation of the kind. See below.

The first kind of report, or those that one calls ‘ judicial ', is less important than the second, in that it only regards some particulars, but the occasions of making them are so frequent, that there is no doctor who takes to flatter himself about not being called often by the judges, and of whom the lights are often compromised by the difficulty of the cases.

These reports are simply ‘ denouncing ' when they are made by all sorts of avowed doctors or surgeons, on the occasion of some injury or other similar accident, to the same time or soon after, and at the request of the injured or those who are interested for themselves. They are to the contrary of ‘ definitive' or ‘ juridical , when, conforming to orders, they are made and drawn up by those who are put in charge to this effect, or, to their shortcoming, by those that the judge names to office. These definitive reports are the only that are being in justice, and guide the judges in their decisions, ‘and as it is by their means that the injured obtain always the provisions to expense of legal proceedings, medications and alimens, following the content of them, one has named them ‘ provisional ’. For the defender, he is only able to make visits by the consent of asking or by the order of the judge.

The denouncing reports were made by chosen men, and are only of voluntary witnesses, they are always susceptible to suspicion, and only have little authority in justice. It is even by an abuse quite condemnable that the judges of small jurisdictions accord the most often a first provision to the injured on a simple denouncing report, when the information found conforms to the report. The natural right and spirit of the orders, in rejecting all suspicion of admissible proof, order and command, in the evidence of experts in general, that they are called by the judge or by the two parties jointly. In effect, the defender, as the most interested in this report, has the place to presume, if he is not called, to demand that one have chose those who have appeared to him the most well suited to respond to his intentions. The doctor and the ordinary surgeon of illness are interested to the favoured, and the delicacy of conscience is often less powerful than the joint considerations of attachment and the love of gain. One finds elsewhere in the useless person and the reasons of challenge that are found if commonly in these reports, and by consequence in the new discussions, those against visits and the multiplications of expenses which are the continuation of it, from new reasons in rejecting the use.

There is only the free consent of two parties that have chosen the graduated and enlightened experts, who give to the denouncing reports, the force of ‘ definitive ' or ‘ provisional ' reports.

The exemptions or certificates of excuse are, as M. Devaux said, ‘a certificate by writing, given by a doctor or by a surgeon, joint or separately, on the state of particulars, being to their simple requisition, or by the order of justice, tending to make known to all those who are right to take a part of it, the truth of sickly causes that can exempt someone from doing well the things of which they are held, if they are enjoying a perfect health'.

The exemptions are divided politically, juristically, and ecclesiastically.

The first concern the state in general, or the royal houses in particular. The second have the place in the heart of civil or criminal procedures; and the third have for the object of obtaining for the church or for its ministers, the dispenses concerning the practice of offices and duties that she imposes.

The political exemptions which concern the state, according to those who, by their maladies or by their injuries, are not able to attend to military service, to offices, uses and public offices etc. Those which concern the royal houses in particular, exempt someone for the same reasons, of the service of royal houses. These two kinds of exemption devote oneself over the simple denouncing certificates, providing that they are evidence from experts of non suspect reputation, and that each attests only what is of his competence.

The juridical exemptions have place in civil and criminal proceedings, in the view of delaying the judgement of a process of which the instruction or the pursuit requires the presence of parties. This excuse has place only in the decrees of ‘ assigned to be yes ' or of ‘ personal adjournment ', but it does not dispense of the appearing in the ‘ decrees of taking of the body ’ and gives only a delay. For the validity of this exemption all resides in the verbal process of a procuration passed in front of a notary, of whom the accused charges someone: and it is said in the ‘ art 2 of tit XI of the order of 1670, that ‘ his procuration is not received, without the report of a doctor of an approved faculty, which has declared that the accused can not put himself in the way without peril of his life ’ and the doctor must attest by oath, in front of the judge of the place, the truth of his disposition.

Secondly. These judicial exemptions take place when it's a matter of freeing, referring or transferring a prisoner, when the bad air or the awkwardnesses make dying infallible: of this type are the exemptions more for commuting the punishment of a convict, that the incommodities put before the state of serving on the galleys, or of undergoing all other punishment that does not go to death.

Thirdly. These same judicial exemptions have for the object of sparing or of modifying the pain of torture for foible or awkward criminals. See ‘Torture', Suppl.

Fourthly. The pregnancy and confinement of women are another valid reason for exempting them of appearing in person, in order to respond to accusations that are against them.

The ecclesiastical exemptions concern the vocational duties, the observation of canonical laws, like the carrying out of wishes, the recital of breviary, the beneficial duties and fasting or abstinences.

The valuations are of two sorts; one estimates the honour due to a doctor and to his ministers, when this honour is contested, or one evaluates the price of medications and remedies.

These examinations take place when the salaries are contested by the debtors. In this case ‘the judges order that the memoirs contain the visits, operations, dressings, and medications are priced and estimated by the experts who are sometimes named for the duty, but ordinarily of whom the parties agree upon.

It is useless to stop on the right of salary, and the ‘ action that they have in justice' of those who practice medicine and the different branches, against the particulars little recognised or too economical. Doctors are rarely scandalised by such disputes of the court; and it is to good right that one can call the benefit of their profession an ‘ honour ' that he is honest to accept; and that he would be ashamed to ask. The surgeons and the apothecaries are more often using the proceedings of a trial in this effect; and it is especially for the estimation of their memoirs, that the judge calls sometimes an expert to help him.

It is another sort of valuation that one is able to call ‘ judgement' ; it takes place when the experts are required by the judge to decide if a treatment of a malady or an operation of surgery and of dressings, have been made according to the rules of the art.

This delicate matter demands all possible prudence; and the expert who decides on the goodness of a treatment must be in possession of the most great light. See below ‘ the article on mistakes of men of the art '.

The subjects (objects) on which the doctors have reports to make and up to where their ministry spreads. Life, health, maladies, death, different lesions, faculties of the mind and the body considered physically are, as I have already said, the subjects that connect medicine with jurisprudence. If medicine, considered under its true point of view, can be called the ‘ science of nature' , it follows that she must be constantly united to the theory and practice of the law, of which the essential object is regulating man according to the principles of natural right, but the bounds of the human mind do not permit him to embrace a plan of a similar range. Medicine, or the art of healing or preserving, demands varied knowledge, of which the manifold variety hardly leaves to those who practice it, of other times that those who it is necessary for taking a superficial idea. The artist makes some steps in this career, throwing light by the principles that his experience suggests to him, the rest is left to chance, of which the step is unknown, or at the very most lighted up by foible, which the doctors have called ‘ nature'. The thread of experiences does not spread very far: one has substituted for the chain of principles that are often lacking in medicine, the precious ‘ observation’, and sometimes the analogy has been deduced severely, but it only appears to some privileged geniuses of enterprise to move the bounds.

These little resources that doctors have for attaining certainty that gives the full conviction, only permits them rarely to confirm on the subjects that do not fall under the senses; it is also only in the smaller class of subjects that their ministry becomes truly useful or legislative.

It suffices to remember the different types of reports of which I have spoken, for concluding that there is a mass of cases in which they are applicable. But one sees at first sight the impossibility of making a dogmatic treaty that embraces everything, in assigning to each object the degree of importance, that is suitable to it. It is for these particular cases that one can make the application of the principles of which expose it to be obscure or unintelligible without this help; elsewhere, in the majority of circumstances, a decision once adopted, has not force of the law in the future, because the circumstances and reasons of interest are not always the same.

Among the questions of medicine relative to jurisprudence, it is some, as one has seen above, that gives place to judicial reports, and others to the political or economic reports.

In the first class are the examinations.

The perfect or imperfect foetuses, the monsters, the runts, their baptisms. See ‘Abortions', ‘Monsters', ‘Baptisms’, ( legal medicine ) in this supplement .

Abortion and its causes. See ‘Abortions' ( legal medicine ) in this supplement.

Caesarean operations. See ‘Caesarean operations' ( legal medicine ) in this supplement.

The late and early births.

The cause of the right of the eldest in twins.

Infanticide. See ‘Infanticide' ( legal medicine ), in this supplement.

The signs of pregnancy. See ‘Pregnancy' ( legal medicine ) in this supplement.

Impotence, sterility and other causes of divorce or of the separation of bodies. See ‘Impotence' ( legal medicine ) in this supplement.

Rape, virginity and its signs.

The ages of life. See ‘ages' ( legal medicine ) in this supplement.

General maladies, particular or organic, true or simulated.

Wounds, deformities, mutilations, poisons. See ‘Wounds', ‘Poisons' ( legal medicine ) in this supplement.

Death, its causes, its signs . See ‘Deaths' ( legal medicine ) in this supplement .

The effects of torture. See ‘Torture' ( legal medicine ) in this supplement.

Miracles, the young, dispensations etc

Maladies and healings supernatural, the ecstasy, etc

The incorruptibility of cadavers, their causes.

The shortcomings in the treatment of maladies or in the practice of one of the parties of medicine.

In the class of political questions or relations to civil order, are the general considerations on the education of the physique of children, especially in the public houses, like orphanages (hospitals of found children), etc.

The examination of wet nurses, inoculation. See ‘Inoculation' ( legal medicine ) in this supplement.

The effects of polluted air on the body.

The influence of states (moods) or professions on health.

Alimens, their nature, their choice, the examination of usual flour, grains and plants; the examination of water, falsified or spoiled wines, fresh, salted meats, etc.

The consideration of clothes, their form, their drawbacks, etc.

Habitations, their aspect, etc, prisons, barracks, hospitals, camps etc, the effect of the closeness of ponds, of marches, of smoke, of butchers, of tombs or cemeteries, the manufacture of starch, tanneries of some other arts, etc.

The exploitation of mines, minerals.

The great operations in the cases that one believes desperate, the new or doubtful remedies, the trials in medicine.

If one remembers the different knowledge that is suitable in the expert doctor, and the precautions that one must observe in the reports, one will see what is the extent of his ministry, and what are the lights that the judge is in the right to expect of him. In the judicial reports, one only demands enlightening foundations in order to establish the facts, or the consequent reasons for destroying suspicions. The witness of sense deserve the first place: the doctor, accustomed to observations of nature, sees better than the common, when it concerns living bodies. But is it only the witness of sense that it is necessary to confine the methods of which he arranges. Not without doubt; the mind of observation and of reflection; have been applied to facts of nature by several illustrious doctors; the useful discoveries of which they have enriched us by this method alone, laying down well clearly beyond which their ministrations extend, if the judge has the right, in executing the law, of researching the spirit of it, if he penetrates sometimes in the mind of the accused for discovering the intention and the detours, it is without doubt permitted to the expert, who does not quit his subject, to summarise the things that he observes and to deduce the natural conclusions about it. That he speaks of facts and of known principles; that he throws light on other facts as soon as he abandons the common route; in a word, that he is logical and that he resents doubting, he will always make his place. The expert can be mistaken with the witness only when he lays down what he has seen; but when using of his light, he appreciates the signs and goes back to a knowledge of causes, he becomes the judge himself. ( See ‘suicide', Supplement ). I admit that the necessity of most experts to put the boundaries straight to a degree of credibility that one accords them; the judge must often guarantee the inconsistency that one finds so commonly in the reports; but the faults of the artist leaves much to all his energy to the art. In applying oneself to choose among men, and especially in the large towns, one will finish by finding the resource of which one lacks, and the good minds directed towards a useful and large subject, extending our views and our methods.

The plan of a treatise of legal medicine. A treatise of legal medicine which contains with detail all the cases where the opinion of doctors become useful or appears to be it, is without doubt a respectable work: we have in several of this type, of which the merit is known, and that one consults when the occasion arises: but if one finds it with pleasure in these works the spirit of research which lights up, one sees them also by that unfortunate credulity that ignorance and superstition produces in previous centuries. The habit of dogmatising, defining, explaining, being contagious; one was only wanting it by words, and neglected experience appeared secondary to the art of constructing theories. One is embarrassed to confess the impossibility to know the manner of which nature connects its operations, of not seeing clearly the liaison of effects and of causes. Never could the human mind handle such advancements, nor could anything stop it, and the imagination holds the place of logic. Some knowledge we have learnt to doubt more, and this useful revolution has produced positive notions that one was ignorant of; and has dissipated the falsities that time had consecrated.

We do not have refined treaties, they are all incomplete, although doctors have published in our days specific works, marked at the corner of this philosophy, which only admits good evidence or the most severe analogies, they have not said all, and one consults too often, in shortages, those who have not had the time or the talent of seeing so well.

It is more an obstacle of another kind; one rests on the ancients for discussing the facts and the probabilities of difficult evidence; one respects as far as their errors, that a physique more healthy and less vague, demonstrates to be multiplied; it is only a matter of knowing to compile, and only the weight of authority balances reason and sometimes prevails on the evidence. The enlightened experts, of whom the knowledge is not subjected to this yoke, have sometimes dared in specific memoirs, to rise against this abuse; they have been combated by other doctors less philosophical; one has made it a crime to think by oneself, as if it was not allowed to all men to consult nature and by sometimes drawing out useful truth. The uncertainty of judges is increased by these opinions; it should be necessary for a doctor to decide between the two parts, and one should abandon to chance a decision that would interest the fortune or the life of citizens.

So many drawbacks and some catastrophic events, have announced the extreme usefulness of the work of legal medicine , which by embracing all the subjects on which doctors make reports in justice, established only by other principles those who confessed by good observation or by experience, which strictly appreciates our positive knowledge and distinguishes them from conjectures; who present in a word the picture of facts and those of opinions; but this work is the work of time, and especially those of considered experience without prejudice. Enough centuries have not elapsed and too few men are engaged this subject, for it to be possible to substitute an edifice equally supported by all parties, to those of whom I have proved the little of solidity. I feel that I have not much to say and that I put the most often the reasoned doubt in the place of dogma: but one can only approach the truth through successive steps.

It appears to me useful in a treaty of legal medicine of considering man in reports; primarily with natural law, secondly with civil law, thirdly with religious law. If he finds himself between this variety of reports, or between the laws which arise from them, striking contradictions, it is not to the doctor to reconcile them, but it is advisable for him to put them in evidence.

Firstly, the essential object of medicine is healing or preserving; but the imperfection of his art often puts him in the case of using violent means that seem to attack the laws of nature. Beyond the incipient the questions follow:

Is it allowed to try a new or unknown remedy? In which case? On which subjects?

Can one practice certain surgical operations, such as amputations etc in the cases where they are not absolutely necessary? Does the free will (wish) of the sick suffice to excuse the surgeon? Must the reluctance of the ill alone prevent the practice, when it will evidently be useful? Does the caesarean operation conform to the laws of nature? Is the practice of inoculation also advantageous to men simply subject to natural law, which is in a state in which the civil laws favour the population?

Can it be permitted to use abortive remedies in the case where a malformed pregnant woman is evidently in danger of death? Can one in these circumstances kill a foetus in the womb of his mother for its following extraction in pieces?

Does the fear of contagion authorise one to kill the unfortunate who are able to communicate it?

Can the doctor be forced to run the risk of a fatal epidemic in the view of helping those similar?

Can one reasonably order a doctor or a surgeon to treat all the sick of the same disease, according to a determined method, for if good and if salutary that this method seems?

Would there be less inconvenience to leave the treatment of the arbitrariness of medicine?

Is a doctor guilty for having remained in inaction during a fatal illness, under the pretext that he is waiting for the effort of nature, etc?

Secondly, the ministry of a doctor has connections still more close to civil law. I have treated above the main subjects connected to criminal and political law: it matters little elsewhere that in treating these questions, one subjects them to the stiff march that have introduced scholars. The clarity in the exposition makes here the first merit, and as one has always in view life, health, functions of organs and death, these different questions lighten up and explain one by the other. The object of medicine in criminal cases is established. Firstly, the body of offence by the evident signs that his profession puts him in the state to discern; secondly, of researching the cause of it, and determining by the form and the circumstances of lesions, their seat of authority and their reports, if they have been made naturally, by chance or by design. Thirdly, if among the different signs that establish the body of offence, it is by that being independent the one from the other, and that one cannot draw reports to the same cases. Thus a man already maltreated by blows can be seized by a fatal stroke. A woman who comes to abort can only have been upset etc. Bile spilt in a violent attack of colic, can produce on the intestines all the signs of poison. Fourthly, if the body of offence is only caused by the simple omission of precautions that would have been able to inform. Fifthly, if there was the impossibility of observing these precautions. See ‘infanticide', ‘abortion', Supplement.

In civil cases, like impotence, sterility, pregnancy, legitimacy etc, the report of the doctor is founded on the examination of subjects or on the dogmas supported by the observations of all the centuries. It is especially in these questions that medicine is the judge; but it is also in these same questions that one must challenge these lights.

Society or public order also asks the doctor on economic subjects, and it is only experience in the profession, or varied knowledge of which one is in possession, which puts him in the state of filling these views. See above.

These different subjects seem to me to present a natural division in three classes; the first contains questions of criminal right, the second those of civil right, and the third those of political or economic right.

Thirdly, the canons or the religious laws impose to men the duties of another kind; civil justice in guaranteeing observation, and the ecclesiastical tribunals judge jointly with the tribunal of justice, the offences which have reported there. The ministry of a physician is often necessary in this research. Firstly, the needs and the disabilities of human nature are sometimes incompatible with certain duties. Secondly, it is dangerous for the same interest of religion, that one reports on those supernatural causes which are in the order of nature and conform to purely physical laws. Thirdly, the dignity and the necessity of sacraments demand in their administration certain precautions on the part of the doctor and the deliverers. The time of the animation of the foetus, the distinction of monsters with human foetuses for the administration of baptism, are the questions which concern equally doctors and the ecclesiastical tribunals. ( see ‘baptisms', ‘monsters', ‘abortions’). The cases of divorce are sometimes cited before these same tribunals, and in the times of fantasy and error, they have been sought in condemnation as sorcerers and possessing unfortunate idiots who had only sinned by fault of reason. ( See the following article). The heart of Rome has sometimes required the physicians or doctors to declare if events, extraordinary healings, have been able to depend on universal and known laws, or if it was necessary to attribute them to supernatural causes; this decision which has established or made disappear the miracle, became a public act in the beatification of the holy and of saints and served as criteria of truth in subjects which the thoughtless zealous never fail to magnify or to disfigure. It seems that one has felt that, at the same time that the physicians were not seeing the chain which connects an effect with general causes, it was not necessary to hurry hastily to attribute to celestial causes, because a physician can be mistaken, and does not know everything. It is therefore to avoid an error of another kind that one has ceased to assume his ministry; he is in effect indecent to suppose that one had never been able to dread the learned eye in the subjects that one delivers to the public oneself.

The diseases that one has called supernatural, and which are of our days in the order of nature; the raptures, the long prolonged youth, the hysteric and convulsive affections, we remember the errors of our fathers and we learn that it is rarely necessary to believe in prodigies. The good Zacchia did not believe that it was possible to preserve a cadaver for a long time in the freshness without the intervention of the demon, unless God expressly permitted this event against nature, to edify his people, in making a discovery of a saint. It did not seem that Ruysch and such other anatomists assumed devilish help for ornating their cabinets. One contented oneself to admire the artist: man is consoled of his foibles in seeing his progress and he dares yet to hope for more.

The exemptions for the young, the abstinence of meat and certain religious duties, also concern medicine , when they can be justified by disabilities or other similar reasons. It is also the case where the doctor is consulted on the compatibility of constitutions with certain religious states, like those of the recluse or cloistered; one has even been asked if it is the constitutions for which continence was impossible. All these questions which belong in the natural order of right of doctors, are however subordinate to casuists, which it belongs to reconcile, so much that it is by them, the foibles of humanity, with the rigor of the state of religion. But as the zealous and the pious have not freed anybody from the disabilities of the human kind, and that on the contrary they are often aggravated about it, it follows that a doctor violates his duties or the subject of his art, if he hides the consequences of these disabilities, or if he does not propose the help that his experience suggests to him: these means are not equally practical, and it is to suggest them that one can confine the ministry of the doctor, whereas the discussion and the judgement are referred to MM. The bishops.

The state of the doctor and of the surgeon demands them another obligation to warn the sick in danger of death, or their relations, for the administration of sacraments, constitutions, bulls, councils, the declaration of the king of 1712, and that of 1724, expressly mentioned this duty; but it is even better suitable by the doctor whom ministers it to confine himself to the relief of the sick, (if he is suffering from a fatal illness anyway), of not giving this opinion to those assistants or ministers of the church, for providing it themselves and sparing the almost always timid and frightened dying the trouble of hearing pronounced a decree of death by those whom he has entrusted his life.

This plan of which I come to make the exposition, seems to me to embrace the most large number of reports which find themselves between medicine and the law of all kinds; my unique subject in this article has been to present the system or the picture of medical knowledge relative to the law, and it is especially for the doctors and for the surgeons that I have done it. It helped to sense that the reports of the law with medicine can be considered under another aspect which is concerned more closely with the jurisconsults and the judges; the result of these reports constitute what one calls jurisprudence of medicine: a work of detail, fortunately undertaken and finished by M. Verdier, doctor in medicine and advocate in the heart of parliament of Paris.

Questions to prune. The progress of knowledge and some little of philosophy have banished the absurd barbarity which sat in the past on the first tribunals of justice: one sees more rarely these scenes bloody, or humiliating for the reason, but the laws that have authorised them still remain in our codes, and serve sometimes as an excuse to new atrocities. It is easy to prove by recent examples, that one has rested on these absurd laws to authorise injustices: the voice of reason is more foible in some tribunals and the particular magistrate that was preoccupied with ignorance and timidity, confident by the shadow of these laws, suffocated without remorse the cry of his conscience and those of humanity. We hold the veil on these distressing matters and we make the vows for the progress of light; men are barbaric by instinct since they are not enlightened.

I excuse myself from joining to the plan that I come to set out, a mass of other puerile or absurd questions of which all the authors of legal medicine have swollen their collections. If one was not irritated by the following catastrophes, which have had their opinions, one cannot have missed to admire the extreme patience with which they have compiled the unintelligible absurdities, and the air of importance with which they have put on. We trace succinctly some of those questions which are no longer cited by them, they recall to our nephews by what degrees it was necessary for us to pass to arrive at the point where we are.

One has sometimes questioned doctors on the resemblance or dissimilarity of children with their fathers. In starting from the principle that the feminine subject matter conserves the form that she had experienced, one concludes about it that it would be necessary that a child necessarily resembled its father. The ancient doctrine that treated all dogmatically assured sometimes that the man gave the form, and the woman the matter; she assured in other times the contrary, and the insane had given facts that were only able to dissuade after a long continuation of centuries. It was necessary that an exact logic demonstrated the actual impossibility of solving this problem. One ignores as far as the elements of this question; the most thick veil covers all that have reported it; and all the same one can hope one day of discovering a corner in this mysterious veil, one is still fixed by the millions of various forms or unforeseen accidents.

It is absurd to wish to establish adultery on proof of this kind few husbands have the place to be considering the fidelity of their wives, and the chance resemblances has too often troubled the peace of families.

It is by guesses less founded on what was believed to be able to be determined which are those that, subjected in some cases even to death, have survived in others. The right of heritage was established and regulated by the law, rending sometimes this knowledge useful, and since by peculiar circumstances no eyewitness can be deposed to this effect, one consults doctors to supply to this shortcoming through the deductive probabilities of their art. Mother and child, husband and wife, father and his son are dying by the same case, what are those of two that one must presume to be the death of the last? One sees that the cause of death which can be very varied, can also be through a mass of unassignable circumstances, to have unequally acted on one or on the other. The age, sex, temperament, the particular vigour of the subject, are not the only objects to consider in this question. An entire family can be buried under the ruins of a house, they can be submerged, suffocated by suffocating vapours, by lightning, by a fire, removed by the plague in an isolated house, by the fire of an enemy conqueror, by a poison. All these cases if disparate cannot be justly evaluated in their effects, that by a competition of knowledge on which one is absolutely devoid of in the case upon which he acts. It wants much more to leave the law to act blind, and to rule without reason, than to pretend at the wrong moment to throw light on vague conjectures. The law of which equity is not evident, is of a less dangerous example than the false explication that one is able to give.

The trials of fire, cold water, boiling water etc which ancient barbarians have given us the important name ‘ judgments of God' , have also demanded sometimes the witness of doctors. These times of superstitious delirium are inconceivable for the century where we live; the only natural light demonstrates the absurdity of these practices by more crude spirits and it is necessary all the respect that is due to the history to persuade the possibility of this delirium.

The haemorrhage of cadavers in the presence of those who one suspects guilty of murder, has also exercised the mind of the authors of legal medicine . It is with a marvellous good-heartedness that the most distinguished had discussed between themselves the certainty of this sign, their books swarm with that one assures are authentic, one cites of the law, the uses, the authorities, one interests in this cause the dignity of the first and the most grand historians, in a word all that the tradition offers of more respectable and more important, is put to contribution. Hundeshagen cites the case that he said (having arrived in Ratisbonne in 1630, in the presence of the emperor and the states of the empire) of a Jew who had massacred the son of a merchant of Frankfurt, and who, put in the presence of the body, freely confessed his crime to the view of blood which exited in abundance. The bloody jurisprudence of these times of ignorance, had for a base all the superstitious prejudices, and the only name of the divinity that one interested in these cases, served as a coat to all injustices. It is everywhere that it is necessary to explain how the light pierced if late among men; it was nearly in shaking of fear that one avowed sometimes that the most ordinary causes could be imposing on an event that one regarded as divine. It is even odd that Germany has been the main theatre of these scenes, and that the infinite number of jurisconsults that she has produced, have only served to retard to this regard the progress towards reason.

The examination of philtres, the so-called possessions, the evil spells, the magic spells have made at one time a part of the appendage of doctors: one established them judges between what is natural and what is against nature or unusual; all that which appeared extraordinary to them, of which they could not see the cause, that which resisted to their aid, were accused of prodigy and were referred as such to the magistrate and to the public; and it was not necessary to believe that these experts were already quite ignorant, taking the pain to assure one of the evidence through the witness of their senses; nearly always they were preoccupied by opinion or prejudice; they were swept away by popular rumour, and their main efforts were confined to giving an air of verity or of consistency to judgment anticipated by the multitude. One must nevertheless confess that this deplorable state of our legislation has only been dissipated by assumed knowledge, in the continuation of these same doctors. I say more, since even the legislators, the tribunals of justice and the nations appeared to become foul in the most profound errors, medicine counted amongst its followers enlightened and humane geniuses who have endeavoured to dissipate the darkness.

It is useless to remember the accusations of sorcery, of magic, the knots tying down, the recoveries through words, and other similar stupidities which are not even worthy of occupying children. I degrade the dignity of this work, if I seriously propose the reasons against the tangible absurdities.

One must rank in this class the signs of virginity or of pregnancy, or even diverse illnesses that imbecilic charlatans have claimed to know by the inspection of urine, by the qualities of blood etc, such is also the discussion of the possibility of rape of a woman or robust girl by a sole man; the public congress; the signs or indications which one resorted to in order to establish pederasty, bestiality and some other questions of this nature, on which one no longer consults doctors.

It is to the shame of our century and of reason that one is still authorised to seriously refute the amulets, bracelets, bags, belts etc, employed in our days for the healing of illnesses. The collections of medications, and of formulas, the treaties of illnesses and materia medica the most esteemed are filled of vain pretensions on the efficacy of certain substances carried in the pocket, sewn into clothes, gathered in certain times and certain hours etc. The judicious laws which have dealt severely with the illusory arts of the soothsayer, the superstitions, the cabalists, are a rampart for reason against the efforts of prejudices, but this rampart is still well foible, and our reason has advanced too little. The amulets, the bags perpetuate, the multitude who adopt them feed on the credulity and love of the marvellous, and the government that tolerates them or authorises them, is in contradiction with itself. It is sad for men who contemplate all the progress of the nations in the same gaze to find beside the sublime efforts of geniuses, of philosophy and of the arts, the contrast of ignorance and of gross credulity.

( This article is by Mr. La Fosse, doctor in medicine of the faculty of Montpellier ).