128. Taches de Tardieu. The signs that Tardieu considers as characteristic of suffocation, called "taches de Tardieu," and that make the difference between his statistics and those of Brouardel and others, are the subpleural and subpericardial ecchymoses, and the similar spots under the pericranium, which are not to be confounded with the ecchymoses of the hemorrhagic diseases,-purpura and severe eruptive fevers. The ecchymoses of disease are irregular, large, diffuse areas of fluid blood, generally violet-colored, and the conditions under which they have been formed have their peculiar symptoms. The subpleural ecchymoses of Tardieu, found in these cases of suffocation, he describes as follows:65 "One sees on the surface of the lungs small, punctate spots, very regularly rounded, of a very dark red, almost black color, of which the size varies in the new born from that of the head of a pin to that of a hemp seed. The spots are scattered under the pleura in variable numbers, sometimes reduced to five or six, sometimes thirty or forty; in certain cases so numerous that the lungs have the appearance of granite. Sometimes they are united and agglomerated so as to give the appearance of marbling. But in all cases they are exactly circumscribed and distinct against the general background of the lungs. Their location is not less irreg ular than their number; however, they are found most often at the root of the lung, at its base, and at the edge of the inferior border. These punctate spots are formed by little bloody effusions, little ecchymotic droplets under the pleura, arising from the rupture of the superficial vessels of the lungs. I have found these subpleural ecchymoses distinct on the lungs of a newborn infant whose body had lain for ten months in a privy. those found under the pleura, one finds ecchymotic spots almost constantly under the pericardium, principally at the origin of the great vessels."

Just like

In opposition to the experience of Tardieu, Brouardel66 has found subpleural and subpericardial ecchymoses in cases of difficult labor, in cerebral disturbances, convulsions, and in cases of compression of the head. Moreover, he says that they may be absent in cases in which the woman declares that she has suffocated the infant. Therefore he considers them characteristic of suffocation only when they are corroborated by the external evidence. He cites the case of a fetus examined by Casper, found unborn at the eighth month in a woman who was hanged, in which these subpleural ecchymoses were

Tardieu, p. 104.

"Brouardel, p. 78.

present. Philippon," in his thesis on "Infanticide by Strangulation," quotes Legroux as saying that, while making certain reservations, it is safe to say that in young individuals very numerous subpleural ecchymoses indicate suffocation; somewhat less numerous ones, strangulation; and still less numerous ecchymoses indicate hanging.

The evidence, then, of death from suffocation, must rest upon the external signs in addition to these subpleural ecchymoses as the conservative proof of the crime. Following Brouardel's evidence may lead to the nonconviction of a certain number of infanticides, according to the evidence of Tardieu; but there will be no doubt as to the cases convicted.

129. Strangulation.-Death by strangulation not infrequently oc curs with suffocation or with fracture of the cranium. If the strangulation is done with the hand, there are the marks of the finger nails on the neck, as described in the consideration of the external signs of suffocation. If the strangulation is done by a string, cord, apron string, stocking, or some other band (most frequently taken from the dress of the mother), there may be marks of the constricting band on the neck, as in the adult;68 but, as the skin of the infant is very delicate, the marks of excoriation would be more evident, though the force required to strangle the infant is only slight. Not infrequently the cord used had been left in place on the neck of the child, and is found at autopsy. The mark is more distinct in proportion to the smallness of the cord and the roughness of its surface. The mark of the cord is the characteristic brown discoloration, not associated with any dif fuse ecchymosis. It must be distinguished from the line left by the furrow in the skin, which is found if the child lies with the neck sharply bent. The line left by this skin furrow is more marked in fat children, occurs usually only on the front of the neck, and is a white streak, bordered by two violet ones. Such a mark disappears in a few hours if the cadaver is left lying flat and straight on the table.

Strangulation by the umbilical cord has also been recorded; not the accidental occurrence when the cord is around the neck of the child at birth, but where it has evidently been applied after birth. The differentiation between the two conditions is difficult, but Brouardel considers that if air has entered the lungs or stomach the child must

"Thèse, Lyon, 1895, p. 30.

"See §§ 348 and 358, on violent deaths.

first have had an opportunity to breathe, and therefore have been born alive; while if no air can be shown in the lungs, the case should be considered as one of the not infrequent deaths during labor.

130. General signs of strangulation.- The general signs of strangulation are similar to those of suffocation. There are the subpleural and subpericardial ecchymoses, and the subperiosteal ecchymoses on the cranium, the taches de Tardieu. There are often apoplectic nodes in the lungs, and more often than in suffocation, small areas of pulmonary emphysema. Then the bronchi contain the same bloodstained frothy mucus, and more often than in suffocation there are submucous ecchymoses in the trachea and bronchi. Bloody, frothy mucus may be swallowed during the death struggle, and be found in the stomach. Unlike the adult, fracture of the cartilages of the larynx is a very rare or undescribed occurrence, because here the cartilages are so soft and pliable.69 Occasionally there are intramuscular ecchymoses in the neck and upper parts of the thorax, especially in the pectorals, sternomastoid and sternohyoid. Philippon considers rupture of the internal coat of the carotid arteries in the neck as characteristic of strangulation by a cord; and he cites in this connection cases from Vibert and Lacassagne. The condition of the heart is not characteristic.

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131. Submersion in water.-Death by submersion of the infant in water is less frequent than the attempt to dispose of the dead body of the child by throwing into the water. The evidence that the infant was drowned is like that of the adult,70-the water found in the lungs and stomach, the general fluidity of the blood, et cetera. If the water contains the dejections of the mother or child, they may also be found in the lungs. Brouardel 1 reports some very interesting experiments made on dogs, in which it was found that if a pregnant bitch was made to whelp under water, the pups would live sometimes as long as three quarters of an hour, while the mother would die in four or five minutes. He estimates that the human infant may live twenty to thirty minutes, and cites the instance of a woman who was delivered in a tub of water, where the child lived about that length of time.

132. Submersion in privy.- Submersion of the infant in the fluids. of the water-closet may also be considered in this connection. Here again the differentiation must be made between the cases where the infant is thrown into the sewer to dispose of the body after death, and

the cases where the infant is put into the closet living, either with the intent of killing the child, or by reason of being accidentally born there, the woman mistaking her labor pains for those of need to evacuate the bowels. The question as to whether the infant was alive or dead at the time that it was introduced into the closet depends, as in the case of drowning, on the substances respired. If the child was put living into the closet the fecal matter would be found in the pharynx and stomach; in the larynx, small bronchioles and air vesicles; and possibly in the middle ear. The identification of the fecal matter in the lungs may be demonstrated by expressing from the cut section of the lung the little candles of fecal matter, like those of muco-pus, expressed in the case of bronchitis. The composition of the candle would be easily identified under the microscope.

The question as to whether the child was accidentally born into the water-closet or was intentionally put there may not be so easy to determine. In the first place the possibility of the occurrence must be considered. The confusion of the two sensations is undoubtedly possible, but it is not so easy to conceive of the birth of the child with the woman in the sitting posture. Tardieu 72 considers it scarcely possible for the woman to remain seated during the entire delivery. Either she must be squatting, or she would have to straighten out in order to keep the infant from striking the border of the hole. If she straightened out the infant would be born on the floor, and not into the closet trap, while if the woman was squatting the child might be born into the closet. Hence, before admitting the possibility of the accident, the exact position of the woman and the arrangements of the closet should be taken into consideration. Again, for such an accident to occur the labor must be considered to progress considerably more rapidly than is ordinarily the case, and at a rate that is very exceptional in the case of a primipara, in whom the infanticides are not infrequent. Moreover, for the infant to fall beyond recovery, either the placenta must be born immediately after the child, a very infrequent occurrence, or the cord must be ruptured, which is more likely. In the latter case the end of the cord gives evidence that at least it was not cut, by its irregular end, and the retraction of the blood vessels, as distinguished from the even end and comparatively prominent vessels of the cut cord.

133. Fracture of skull.- Infanticide by fracture of the skull is the next most frequent method to that of suffocation. It is to be distin"Tardieu, p. 166.

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If

guished from the fractures of the cranium due to deformity of the pelvis, pressure of the forceps, and precipitate labor.73 In the intentional fractures the woman is not, as a rule, satisfied with a single blow on the head, but repeats the blows till the head becomes a mere bag of fragments of bones. A single blow of a sabot, according to Brouardel, produces ten or twelve pieces; while the accidental fractures, as a rule, produce a single fracture or depression. Then these infanticide fractures are, as a rule, associated with more or less excoriation of the skin and scalp, and in the vicinity of the fractures there is an exudation of blood which may or may not be clotted. the fractures are produced by projecting the head against the wall, the fracture may involve any part of the skull, and as a rule several bones at a time are involved on the same side of the head. If the fracture is due to a blow, there will be not only a fracture of the bones at the point where the blow was given, but also on the other side of the skull, at the diametrically opposed point. As to whether the fractures occurred before or after death, Tardieu 75 held that the presence of blood clot at the site of fracture was evidence that the death occurred subsequent to the fracture. Brouardel, on the other hand, does not consider this proof of the fracture during life, for he says that he has found the same in fractures occurring after death. That the floating of the lungs should not, in such cases, be taken as the only evidence on which to base the life of the child, is well illustrated by a case cited, described by Bellot," of a double infanticide, where the woman was delivered of twins, and immediately after their birth, as evidenced by the autopsy, and admitted by the woman, crushed the heads of both children with a wooden shoe. The one had had time to breathe, but the other failed to give a positive docimasia pulmonum; yet the cranial lesions of the two were the same, including the blood clots at the site of the fractures.

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134. Wounds and mutilation.- Wounds and mutilation of the body are also at times the cause of death of the infant. The wounds are usually multiple, and made by the mother with any instrument at hand, knives, scissors, pins, et cetera. In one case over forty wounds were counted in the pericardium and abdomen of the infant, and others existed in other parts of the body. Large needles, by entering big vessels, may cause death by hemorrhage without much ex