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to be passed from the aorta into the pulmonary artery, but was guarded, on its pulmonary side, by a growth of minute elastic vegetations which, acting completely as a valve in that direction, showed that the permanence of the duct could not have depended, at least during the latter years of life, upon pulmonary obstruction.

(4). The Arterial Duct, Foramen Ovale, and Canalis Venosus may be found uncontracted several days after Birth.In March 1854, Mr. Lee read before the Pathological Society the particulars of the case of a child, in which jaundice commenced immediately after birth. Six days after the separation of the funis, (in which process there was nothing abnormal), slight hæmorrhage made its appearance. The blood was thin and serous, scarcely discolouring the linen, and, when dry, not stiffening it. The bleeding continued for two days, it then stopped, but the child soon afterwards sank. The Umbilical Vein, one Umbilical Artery, the Ductus Venosus, the Ductus Arteriosus, and the Foramen Ovale were all found open. There was no appearance of inflammation in the structures of the umbilical vein. The blood was without coagula, and appeared entirely deficient in fibrin.* There is a large class of these cases, in which children are destroyed, from 6 or 8 to 18 days after birth, by irrepressible hæmorrhage from the umbilical vein. These infants are usually jaundiced, and an excessive degree of cholemia is, of course, adverse to the closure of any of the foetal communications. Mr. Shircore, of Calcutta, lately mentioned to me the particulars of a case in which there appeared to be every reason to believe that the umbilical vein and a considerable portion of the canalis venosus, remained permanently open in a child three or four years old; that is to say, there was a fistulous-looking opening at the umbilicus, into which a probe could be passed

* Association Journal, April 7th 1854, p. 307.

directly backwards for some inches. The parents disliking the appearance of this opening, although it caused no inconvenience, Mr. Shircore readily succeeded in closing its orifice.

Exposure of Young Infants.-This crime is one of great frequency among the Natives, and appears to be a practice of very ancient standing. Tavernier says,-" When a woman is brought to bed, and the child will not take the teat, they carry it out of the village, and putting it in a linen cloth, which they fasten by the four corners to the boughs of a tree, they there leave it, from morning till evening. By this means, the poor infant is exposed to be tormented by the crows, insomuch that there are some who have their eyes picked out of their heads; which is the reason that, in Bengala, you shall see so many of these idolaters that have but one eye, and some that have lost both." [] "In the evening, they fetch the child away, to try whether he will suck the next night; and, if he still refuse the teat, they carry him to the same place next morning, which they do for three days together; after which, if the infant after that refuses to suck, they believe him to be a devil, and throw him into the Ganges. Sometimes some charitable people among the English, Hollanders and Portugals, compassionating the misfortune of those children, will take them away from the tree, and give them good education."

Ward has given the following details, regarding the custom of exposing infants in the northern districts of Bengal, without any reference to Tavernier's account.—“ If an infant refuse the mother's breast, and decline in health, it is said to be under the influence of some malignant spirit. Such a child is sometimes put into a basket and hung up in a tree where this evil spirit is supposed to reside. It is generally destroyed by ants or birds of prey; but sometimes perishes by neglect, though fed and clothed daily. If it

should not be dead at the expiration of three days, the mother receives it home again, and nurses it, but this seldom happens. The late Mr. Thomas, a missionary, once saved and restored to its mother, an infant which had fallen out of a basket at Bholahatee, near Malda, at the moment a jackal was running away with it. As this gentleman and Mr. Carey were afterwards passing under the same tree, they found a basket hanging in the branches containing the skeleton of another infant, who had been devoured by ants."*

The printed Reports are replete with these sad cases, but they need not be cited here, as points of medico-legal difficulty are seldom involved in such inquiries.

INSANITY.

The opinions of Medical men in India are often called for in cases of real or apparent mental aberration of the most involved and difficult nature. If it be sometimes found impossible to bring about unanimity of opinion in three or four of the most eminent men, whose lives have been devoted to the study of Insanity in England, with regard to the sanity or unsoundness of mind of an educated fellow-countryman,f how much more trying must the task be to a young Civil Surgeon, upon whose fiat depends the life or death of a Native, probably from some remote and almost unknown part of the district, in whose mind a perfect chaos of absurd superstitions stands in the place of imagination and religion

*Vol. ii., 3rd Edition, p. 123.

As recently shown in the case of the unfortunate Buranelli, who was hanged upon a sentence which appears to have rested upon the opinion of two medical men, who only saw him once, two months after the perpetration of the fatal deed; while Drs. Connolly, Winslow and Baly, and two Surgeons, expressed it as their solemn and matured opinion that the prisoner was insane at the time he committed the crime.

and whose every turn of thought and expression is strange and foreign; in whom every attempt to question excites an effort to deceive, and in whom the faculties of cunning and simulation exist in their fullest and most active developement. Notwithstanding these difficulties, the printed reports of our Courts show very clearly that dangerous and untenable opinions are rarely given by Medical Officers in cases of this description.-The chief sets of cases which it appears necessary to mention here are the following.

Mental Aberration resulting from the use of Opium and Hemp. -From very early periods, these two poisons have been made to supply the place of fermented liquors, by some of those who pretend to be the strictest abstainers among both Hindus and Mahomedans. Bernier (1655) describes the Rajputs as great takers of opium, and he has sometimes wondered at the quantity he has seen them take: "They accustom themselves to it from their youth. On the day of battle they double the dose; this drug animating them, and making them insensible of danger; insomuch that they cast themselves into the combat like so many furious beasts, not knowing what it is to run away, but dying at the feet of the Raja, when he stands to it." Dr. Fryer, (1672) says: "The plant of which Bang is made, grows like our Hemp, the juice of whose seed, ground in a bowl like mustard seed, and mixed with any other liquor, is that they equivocate with their prophet instead of the grape."

Late in their miserable career, the guujah-smoker and the opium-eater become utterly shattered, alike in mind and body; but I have not met with or heard of any case in which true Insanity has been caused by these practices; the opiumeater sinks into the condition of a hopeless driveller, the gunjah smoker and bang-drinker often remain chronically inebriated, and are sometimes excited to acts of frantic violence, but these states may be readily distinguished from true Insanity. In some rare cases, these pernicious habits,

doubtless, hasten the advent of Insanity in individuals otherwise predisposed. This would certainly much embarrass diagnosis. I doubt, however, whether violent Mania would ever occur in an opium eater; or, if it did, the depressing effects which would result from debarring him from the use of the drug would, almost at once, reduce him to a state of fatuity. A madman who had used gunjah would, probably, continue Insane for months, if merely confined without medical treatment; a few days tranquillity will generally be alone sufficient to restore one who has been over-excited by gunjah to his usual state of mind.

Some observations, made by a writer, in 1798,* bear so importantly upon this subject that they deserve to be quoted here.-"The Indian who Runs a Muck [Amok, Amok,-Kill, Kill!] is always first driven to desperation by some outrage, and always first revenges himself upon those who have done him wrong; they are generally slaves; who indeed are most subject to insults, and least able to obtain legal redress. It has been usual to attribute Mucks to the consequences of the use of opium; but the words of Mr. Stavorinus, who says, that they are occasioned by the swallowing of the opium, or by other means,' seem to confirm the opinion entertained by Marsden, that this should probably rank with the many errors that mankind have been led into by travellers addicted to the marvellous. That these furious quarrels and sanguinary attacks do actually and frequently take place in some parts of the East, cannot be controverted; but it is not equally evident that they proceed from any intoxication, except that of their unruly passions; and many Mucks might, upon scrutiny, be found to be of the nature of one, which Mr. Marsden

* Mr. Wilcocke-Notes to a translation of Stavorinus' Voyage to the East Indies, vol. i., page 293.

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