INTRODUCTION.

THE terms FORENSIC MEDICINE, LEGAL MEDICINE, and MEDICAL JURISPRUDENCE have heretofore been used interchangeably to apply to those branches of state medicine and of jurisprudence which have to deal with the applications of medical knowledge to the elucidation of questions of fact in courts of law, and with the legal regulation of the practice of medicine.

MEDICO-LEGAL SCIENCE therefore includes all subjects concerning which members of the legal and medical professions may seek information of one another, each acting in his professional capacity. It consists of two distinct branches: that treating of medical law, to which the designation of MEDICAL JURISPRUDENCE properly applies; and that relating to the application of medical, surgical, or obstetrical knowledge to the purposes of legal trials, FORENSIC MEDICINE.1

The term STATE MEDICINE, which is sometimes erroneously used as synonymous with forensic medicine, properly applies to a more extended field of medical inquiry; i.e., to all applications of medical knowledge to the public welfare. State medicine, therefore, while excluding medical jurisprudence, includes, besides forensic medicine, public hygiene, medical ethics, medical education, and military and naval medicine.

TOXICOLOGY, the science of poisons, may be divided into

'The distinction made in the text and in the title of this work is not new. Zacchias, early in the eighteenth century, recognized it in the two prefaces to his book, one to the "lector medicus," the other to the "lector legumperitus" ("Quæst. Med. Leg.," Ed. Venet., 1727, fol.). In a note to the introduction of the -Medical Jurisprudence" of Dr. Paris and Mr. Fonblanque (the first work produced by joint authorship of a physician and a lawyer, in 1823) is the following (p. i.): "Some authors have objected to the term Medical Jurisprudence, as implying a knowledge of the laws relating to

medical topics, rather than an acquaintance with the medical science necessary for the elucidation of legal subjects. As it is our peculiar object to unite the sciences and to show their mutual relevance, the title becomes most applicable to this, although it may have been improperly affixed to former works." The title of one of two existing French works in whose authorship a lawyer is associated is: "Traité de Médecine légale, de Jurisprudence médicale et de Toxicologie," par Le Grand du Saulle, Geo. Berryer et Gab. Pouchet, 2d ed., 8vo, Paris, 1886.

medica. toxicology, whose object is the prevention or cure of all forms of poisoning, and forensic toxicology, whose aim is the detection of criminal poisoning. In its last-named relation toxicology differs from forensic medicine in one important particular. In all cases other than those of poisoning in which questions involving medical knowledge arise, the answers are entirely within the functions of the physician, the surgeon, or the obstetrician, but the problems of forensic toxicology require for their solution the further aid of the chemist and the pharmacologist.

Forensic medicine is an applied science, partly legal, partly medical, calling for information and investigation in widely divergent lines, and becoming more minutely ramified with the progressive advances in medical knowledge and in those sciences of which medicine is itself an application. Its development has been dependent partly upon the slow though progressive tendency of medicine from the condition of an empirical art toward that of an exact science, and partly upon the more rapid and more advanced development of criminal jurisprudence. Medical jurisprudence had reached a high development during the early history of the Roman Empire, and at a period long anterior to the first recognition of forensic medicine.

Although the literature of modern medico-legal science is very largely written from the medical point of view and by physicians, its earlier history is to be found in fragmentary form, partly in medical literature, but principally in the writings of historians, in the earlier criminal codes, and in the early records of legal proceedings.

In the earliest historical periods the functions now exercised by the priest, the lawyer, and the physician were performed by the same person, who, presumably, made use of what medical knowledge he possessed in the exercise of his legal functions. Among the Egyptians at a very early period it is certain that medical questions of fact were considered in legal proceedings, and that the practice of medicine was subject to legal regulation. According to Diodorus,' "when a pregnant woman was condemned to death, the sentence was not executed until after she was delivered." The same author tells us that "the physicians

2

I., ii., 82; transl., i., 165.

regulated the treatment of the sick according to written precepts, collected and transmitted by the most celebrated of their predecessors. If, in following exactly these precepts which are contained in the sacred books, they did not succeed in curing the sick, they could not be reproached, nor could they be prosecuted at law; but if they have proceeded contrary to the text of the books, they are tried, and may be condemned to death, the legislator supposing that but few persons will ever be found capable of improving a curative method preserved during so long a succession of years and adopted by the most expert masters of the art." With the system of legal trial in use among the Egyptians' it is difficult to imagine that the question of the existence of pregnancy in the one case, or of malpractice in the other, would not be the subject of contest, and, if contested, determined without the testimony of obstetricians or of physicians.'

Medical knowledge among the Hindoos was further advanced than among the Egyptians. In the Rig Veda (about 1500 B.C.) occur a few medical references, among which is the statement that the duration of pregnancy is ten (lunar) months.

The earliest purely medical Sanskrit texts are the Ayur Vedas of Châraka and Sûsruta, which were probably written about 600 B.C., but which are undoubtedly compilations of information which had been handed down during many centuries before that time. In each of these is a section devoted to poisons and their antidotes (Kalpa), in which it is written that a knowledge of poisons and antidotes is necessary to the physician "because the enemies of the Rajah, bad women, and ungrateful servants sometimes mix poison with the food." Full directions are also given for the recognition of a person who gives poison, and to differentiate the poisons themselves, whose number, from all the kingdoms of nature, is legion. The age at which women may marry is

L. c., I., ii., 75, 76; transl., i., 152.

The "Papyros Ebers," in the University of Leipzig, the most ancient medical text known, was written about 1550 B. C., and is probably one of the books referred to by Diodorus. It contains no statement bearing upon our subject. It is, however, simply a collection of de

fixed at twelve years, while men

scriptions of remedies, and their uses, including the incantations to be used with them. (See "Papyros Ebers," H. Joachim, Berlin, 1890.) The same is true of the Berlin and Leyden papyri. The Bibl. Nat. (Tf. 2) possesses a Chinese manuscript on legal medicine. The catalogue does not, however, state to what period it belongs.

may not marry before twenty-five. The duration of pregnancy is given as between nine and twelve lunar months, the average being ten. The practice of medicine is restricted to certain castes, and requires the sanction of the Rajah, and the method of education of medical students is prescribed.'

It is singular that the Greeks were apparently destitute of any knowledge of legal medicine. Although medicine and jurisprudence were highly developed among them, allusions to any connection between the two are of very rare occurrence and uncertain.

The Hippocratic writings (ca. 420 B.C.) contain many facts which are of medico-legal interest: the possibility of superfoetation was recognized; the average duration of pregnancy was known, and the viability of children born before term was discussed,' the relative fatality of wounds affecting different parts of the body was considered,' and the Hippocratic oath makes the physician swear that he "will not administer or advise the use of poison, nor contribute to an abortion." The position of the physician in Greek communities was an exalted one. No slave or woman might be taught medicine," although later free-born women were permitted to practise in their native places. Homer also refers to physicians as men of learning and of distinction. The Greek physician was therefore in a position, both from his information and from his standing in the community, to aid in the administration of justice.

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The Greeks were also extremely litigious and possessed a code of criminal procedure which was elaborate, and in many respects resembled those now in use in England and the United · States. The writings of the Greek orators, Demosthenes, Æschines, Lysias, Antiphon, Isocrates, etc., which have come down to us substantiate the claim of Elian that "to Athens mankind

For an account of early Indian medicine, see Th. A. Wise. "Review of the Hist. of Med.," Lond., 1867, i., 272 et passim: "Hindu System of Medicine," 1845, by the same author: Haeser, "Lehrb. d. Gesch. d. Med., " 3. ed., i., 5–40.

Hippocr."De Superfotatione," ed. Littré, viii., 472.

3 Hippocr.: "De Septimestri partu;" Ibid., "De Octimestri

partu,' " ed. Littré, viii., 432, 436, 452.

4"Aphorismi," vi., 18, 24; "De Morbis," ed. Littré, vi., 144.

Petit, S.: "Leges Atticæ," Lugd. Bat., 1742, lib. iii., tit. 8.

6 "Od.," iv., 229; xvii., 384.

* For an excellent account of Attic criminal procedure, see Kennedy, C. R. "Demosthenes' Orations," ed. Bohn, iii., 326-372.