presumption that his examiner is necessarily less informed than himself on medico-legal subjects.

I know of no modern trial which more strikingly shows the necessity for a close attention being paid to the study of medical jurisprudence than this; and I shall here read from a pamphlet some parts of the evidence, in order that you may judge for yourselves what may be expected from you when you are required to act as medical witnesses.

In this case a woman was charged with having poisoned her husband with arsenic. No poison was found in the body, and the symptoms and appearances were referred by some of the medical witnesses to natural causes-by others to the effects of arsenic. Mr. Dyson, surgeon, of Manchester, is under examination for the prosecution, and

states:

"I have inspected six cases of poisoning by arsenic, and the appearances in this were very distinct and marked, only more severe than I have before seen. The absence of the arsenic may be accounted for by its having been evacuated by vomiting, or purging, or by its having been absorbed into the system. I think it might be thus got rid of in three days and nights. It might have required a week or two, or more, to carry off all traces from the flesh. The JUDGE: If a piece of flesh were cut off, supposing arsenic to have been absorbed, could it not be discovered by submitting the flesh to chemical analysis?-WITNESS : The French chemists have discovered it in flesh; but I was not aware of it when I made the examination.-By Mr. WILKINS: The arsenic might have been carried off by insensible perspiration, and other means in progress for its elimination, in the course of two or three days.-The JUDGE: Would all traces of arsenic be likely to be carried away if taken at six o'clock on Friday night if the person died on Monday evening?— WITNESS: All from the stomach and bowels.-The JUDGE: But from the flesh? WITNESS: I cannot tell.-The JUDGE : Was the flesh examined? WITNESS: No, my Lord.-The JUDGE: That was a pity! -By Mr. WILKINS: Had read Christison and Orfila, and my reading, as well as my experience, confirmed these opinions."

"Arsenic is soluble to the extent of 77 parts in 1000 of hot water. I account for its disappearance from its having been given

in solution. In the six cases I have examined, arsenic was found, but in every case the arsenic was given in substance, the quantity varied from a quarter of an ounce to an ounce. Thirty grains would be enough to kill an adult. [This reply was probably made as a mere affirmative answer to a question, since a much smaller quantity

than thirty grains has destroyed life.]—Mr. POLLOCK: But how much of thirty grains would six or seven spoonfuls of milk porridge dissolve? WITNESS; The whole of it!-Mr. POLLOCK: Dissolve, not suspend? WITNESS: It will, if hot, dissolve as much, or more. It will dissolve as much again in hot as in cold milk. I take the data of chemists. The medicines given would promote its removal by rendering the arsenic more soluble by forming arsenite of potash and ammonia.-Mr. POLLOCK: But would they have that effect if given with lemon-juice? WITNESS: It would depend upon the affinity of the acids for the alkalis. Mr. POLLOCK: And which has the stronger affinity? WITNESS: I do not know ! There was destruction of the mucous coat of those parts which natural disease seldom affects. The jejunum is rarely affected in natural disease; in this case it was much affected: there was softening of the mucous membrane. Inflammatory patches might occur from natural disease in the stomach, but not in the jejunum. The extent of the diseased appearances depends upon the time of death from the time of taking the poison; when life is protracted arsenic produces more extensive local effects than natural diseese. I noticed the spots of extravasated blood at the inspection, and would have mentioned them at the inquest, but was requested not to give the par ticulars; they are mentioned in the report written a week after the inspection. The JUDGE: Not written at the time? WITNESS: No, my Lord, a week after. Arsenic boiled in milk does not perceptibly alter its taste. It has not an acrid taste in the mouth, but if swallowed, as soon as it passed the gullet, a sense of heat would be felt."

The chemical evidence is also worthy of your notice. Mr. John Davies states, "I have studied chemistry a great many years. Received the contents of the stomach from Mr. Harrison (who was examined yesterday), and separated them. Carefully analyzed them, and also some porridge* given to me by Mr. Beswick. After the most accurate investigation, having subjected the contents of the stomach and intestines, both separately and conjointly, not only to four or five different tests, but also applied those expedients for the reduction of the metal which would be decisive if the metal had been present, I found no poison whatever. There were no traces of arsenic whatever. I applied the sulphuretted hydrogen test, nitrate of silver, Marsh's test, and the reduction by

* This porridge was, I believe, some which was found in a broken basin in the midden, and is supposed to be that which the prisoner threw away, belleving it to be the cause of her husband's illness; but this is doubtful.

from entering upon the study. It is assuredly beyond the mental power of any individual, that he should be at the same time profoundly versed in all the principles of medicine and jurisprudence, and that he should be able to answer all possible questions, and encounter and remove all medical difficulties, that may occur at a criminal trial. All that the law expects from a practitioner is a fair average knowledge not merely of his profession, but of what falls more peculiarly under the province of a medical witness. There can be no doubt that the more perfectly a man has made himself master of his profession, the better will he be fitted to follow the principles and appreciate the value of medical jurisprudence; but he must divest himself of the notion, that these principles can be spontaneously acquired, or that they are necessarily derived from the study of those isolated branches of medicine upon which medical jurisprudence professes to be based. The materials for the medical jurist undoubtedly exist in these sciences: but they require to be assorted, selected, and moulded into shape, before they can be applied to any useful purpose.

A man may be an excellent practical physician or surgeon, and yet find himself deficient when called upon to act as a medical witness. There was no doubt that the celebrated John Hunter stood in his time at the very head of his profession, and that none could have profited more by industry and experience. If sound professional knowledge could have qualified any man to act as a medical witness, we might assuredly be justified in pointing to him as an example; and yet this great man, when summoned to give evidence on a memorable trial for poisoning, which occurred in 1781, was obliged to confess, that he was unable to give any satisfactory answers to the questions put to him. With that candour which exists in all great minds, he admitted his deficiences; and he regretted to the latest period of his life that he had relied exclusively upon his professional knowledge. In his time medical jurisprudence was unknown; but the want of it was clearly perceived. It was then obvious that a peculiar kind of experience was required to fit a man to act as a witness in a Court of Law:-that many loose principles existed in medicine, surgery, and chemistry, the fallacies of which were quite unimportant so far as they related to medical practice, but which required to be closely sifted and thoroughly examined before they could be received as evidence in law. Medical men were apt to confound what was mere matter of belief with proof. In a Court of Law, however, the difference was soon made apparent: and out of this, ultimately arose the necessity for the creation

of a distinct branch of study in which all medical facts and principles capable of serving as evidence, should be developed and explained. Such, then, was the origin of the science of medical jurisprudence.

As it is proposed in these lectures to give the general applications of the principles of medical jurisprudence, it appears advisable, in teaching the science, to be guided by the relative value in a practical view of the subjects to be considered. It would be useless for me to occupy your time in the present course, by entering into long discussions on speculative matters, that may never come before you in practice. It is, I conceive, at least more reasonable to direct your attention especially to cases which are of daily, nay of almost hourly, occurrence.

Medical jurists are unfortunately by no means agreed upon the exact boundaries of their science. Some go so far as to include forgery and coining, among the subjects to which a medical practitioner must attend ; while one German writer, Professor Most, even introduces the government and regulation of Temperance Societies, as subjects requiring the attention of a medical jurist. There can be no doubt that a tendency at present exists rather to carry the science beyond its fair limits than to confine it within its proper boundary. A course of medical jurisprudence is not to be made up of the substance of every other science, but rather of selected parts of each; and the best rule to be adopted by a teacher appears to me to be that of observing what subjects most frequently present themselves for medical investigation before our public tribunals. These, when properly treated, will assuredly furnish an ample field for practical instruction. I have also here to consider what may more particularly concern the duties of a general practitioner of medicine.

The results of some years' observation enable me to state, that murder by poisoning, murder and manslaughter by wounding, together with infanticide, constitute the great majority of the cases which came before the criminal tribunals of this country. It is therefore chiefly to these subjects that the student has to apply the medical knowledge which he has already acquired.

This table may be taken as furnishing an average estimate of the relative frequency of occurrence of medico-legal cases.

acquaintance with the various branches of medical study. Anatomy, medicine, pathology, and chemistry, are here absolutely demanded of a practitioner, for it is upon these sciences that toxicology is based. There is great reason to suspect that in spite of the many improvements in this branch of science the crime of poisoning is more frequent than it is supposed to be; and that under the present system of conducting coroners' inquests, i. e. of leaving in many cases the necessity for the inspection of a body to be determined by those who are in general wholly unacquainted with the principles of medicine, many individuals whose deaths are pronounced by the verdicts to be natural, are hurried to the grave by poison. This will be easily com. prehended, when the difficulty of detecting these cases is explained; the symptoms are often equivocal, and as a post-mortem examination is not invariably required, such cases must necessarily escape detection. The great error in the system appears to me to be that the inspection of a body is not ordered, unless there be a strong suspicion of the cause of death; when, in point of fact, in all secret cases of poisoning, the true source of evidence is the careful examination of the body itself, and unless there be a strong suspicion that the death was not natural, it is difficult to understand why any inquest whatever should be held. That this is no exaggerated statement will, I think, be apparent to you, when it is considered, that exhumations of the dead have of late years taken place after the lapse of weeks, months, and sometimes of years; and on inspection, poison has been found in the stomachs of the deceased, when at the inquest they had been pronounced to have died from natural causes. We shall, however, have an opportunity of entering into this question more fully in treating of Toxicology.

In concluding the lecture, I have to call your attention to the establishment, in connexion with these lectures, of a Class of Practical Toxicology. From the experiments performed in the general lectures on the analysis of poisons, it is evidently impossible that a student can acquire more than a fleeting knowledge of the effects of tests and reagents. The taking of notes may assist the memory, but the results cannot be permanently impressed on the mind without direct personal experience. Besides, during the performance of the experiments in lec. tures, doubts and difficulties may occur to him, which he cannot, at the time, have solved and which probably before the conclusion of the lecture, escape from him altogether. These evils, inseparabie from the present prescribed mode of teaching, in which the amount of knowledge is unfortunately made to depend on the precise num

ber of lectures at which attendance is given, can, it appears to me, be removed only by the adoption of a systematie course of practical instruction, in which the reason for an experiment, and the results of it, are clearly brought before the mind at the time of its performance.

Let

If you agree with me in this view, I am satisfied that when you are engaged in practice, you will not be placed, under what we must consider in the present day, the disgraceful necessity of employing some "analytical chemist," at a distance, to undertake the analysis of a suspected poisonous substance. There may be complex cases in which the assistance of others will be required, but these are only of an exceptional nature. it be remembered that on a trial for murder by poison, a question invariably put to a witness, is, whether he has ever been accustomed to the analysis of poisons; and there are some trials on record, in which legal convictions could not take place, simply because the witness had never attempted an analysis before that particular occasion. With such an admission, wrung from the witness by a cross-examination, a jury is, in general, most unwilling to rely upon the chemical evidence.

It is unfortunate that the beneficial effects of a course of this description are seldom sufficiently appreciated by those actually engaged in completing their studies. A student is apt to remain satisfied with the reflection, that there is already enough to occupy mind and body in keeping to the line marked out by the regulations of the Hall and College. It is proper, however, to observe, that, even under these regulations, a pupil is always presumed to acquire that knowledge of the subject of toxicology, which it is not possible for him to obtain, without making some addition to the legalised curriculum of study.

The necessity for this addition, in the shape of practical toxicology, has been long felt by those who have passed their examinations, and established themselves in practice.

They have found, when too late, that they had neglected a most useful branch of practical chemistry; and one which, unless it be acquired during the period of study, is lost for ever to a practitioner. The cares and anxieties of practice, and the want of any opportunity for proper experimental illustrations, are a sufficient bar to this subject being prosecuted with any success in after life. There can be no doubt that very heavy labour is thrown on the medical student of the present day; but the question is here one of necessity rather than of inclination.

By industrious habits the whole of these difficulties are removed. This is the great secret of success. When we look into the lives of all those, who, from comparative

obscurity, have raised themselves to the highest ranks of the profession, we find that there is one, and only one, point, in which they have uniformly agreed, namely, that of manifesting untiring industry in the pursuit of professional knowledge.

In reference to the number of subjects, to the study of which a medical student is now compelled to devote himself, I do not know that I can do better than quote to you in conclusion some remarks lately made by Dr. Hare, of Philadelphia:-

"In proportion as the qualifications requisite to a medical degree are difficult of acquisition, and elevated in their nature, so will be the standing of those on whom it may be bestowed. As there is no royal way of becoming a mathematician, so there is no easy mode of becoming a skilful, learned, and eminent practitioner. Fame can only exist at heights inaccessible to ignorance, indolence, and imbecility. The paths which lead to her abode are rugged, steep, and circuitous. All who seek that pinnacle by the highways of sloth and pleasure will inevitably find themselves lost in the shades of ignoble obscurity."

DIAGNOSIS OF CANCER OF THE CERVIX UTERI.

M. LISFRANC, whose experience is very great, and whose opinions are of so much importance in this matter. published, in the Gazette Médicale, the following differential signs.

1. Simple engorgement is softer, and its surface is more even to the touch, than scirrhus, which presents prominences and inequalities.

2. In scirrhus, the mucous membrane of the neck is of a dull white colour, which, according to this celebrated practitioner, is not the case in simple engorgement.

3. Scirrhus is developed more slowly; for example, when an engorgement dates from one or two months only, and especially when it follows abortion, ordinary labour, or sudden suppression of the menstruæ, we infer, says M. Lisfranc, that it is not of a scirrhous nature.

4. Finally, simple engorgement requires a treatment of a month or six weeks, whilst scirrhus is much longer in recovering. We will add to the characters of scirrhus, mentioned by the able surgeon of La Pitie, that engorgement is generally less sensible, less active, and more circumscribed, than simple induration; we shall also add, that its formation is not accompanied by such marked symptoms, nor does it produce at the outset such troublesome symptoms or such wellmarked general phenomena. Finally, let us say that, under the influence of bleeding, strict diet, repose, antiphlogistics, and re

solvents, simplengorgement of the uterus usually diminishes with great rapidity, which never occurs in scirrhus degeneration, even at the beginning.-Colombat on the Diseases of Females. Meig's Translation.

NEW KIND OF FINE INJECTION.

In

IT has always been a matter of difficulty to make a successful injection of the kidney, through the ureter, and with the ordinary fluids of injection this cannot be effected. The plan of double injection, recently proposed and adopted on the continent, and used with so much success by Mr. Bowman in his investigations on the minute anatomy of the kidney, was a great improvement; and the principle of it has been still further improved upon lately by Dr. Gerlach. stead of injecting the two fluids one after the other, and allowing the precipitate which results from the chemical reaction of the two solutions on coming into contact with each other, to take place within the urinary tubule (or other parts into which they may have been injected), he forms the precipitate at once by mixing the two fluids together before injecting them. The salts which he and others most commonly use in the double injection are, the bichromate of potash and the acetate of lead, which when in solution and mixed together give rise to a fine yellow precipitate of chromate of lead. By dissolving these two salts separately in a moderately strong solution of gelatine, and then mixing them together, Dr. Gerlach states, that a thin yellow fluid is obtained, throughout which the particles of the precipitated chromate of lead are held equally diffused by means of the gelatine, and have no tendency to sink to the bottom: the extreme thinness of the fluid ellows of its being used for very fine injections, and thus obviates the necessity of making a double injection by means of it Dr. Gerlach has succeeded in injecting the capsules of the Malpighian bodies through the uriniferous tubes; thus proving the ac uracy of Bowman's statement, that there is a direct continuity of the capsules with the uriniferous tubes. Two other advantages possessed by this injection fluid are, that it does not require a high temperature for its fluidity, and when injected takes a tolerably long time to cool and set: this latter condition renders it especially adapted to the injection of the excretory canals of glands, where success depends in great measure on the care and particularly the slowness with which the injection is performed. Dr. Gerlach recommends also, especially for ordinary pur poses of injection, a solution of gelatine, to which is added a small quantity of very finely powdered carmine, just enough to colour it. Müller's Archiv. Heft. 4, 1815.