Medical jurisprudence / by Alfred S. Taylor.

  • Taylor, Alfred Swaine, 1806-1880.
Date:
1850
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Licence: Public Domain Mark

Credit: Medical jurisprudence / by Alfred S. Taylor. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    to the skin. Strong muscular exertion—the act of vomiting, and many other conditions, may give rise to a rupture of the minute vessels, and to an effusion of blood in parts which have been stretched or compressed. I have known it to have been produced to a great extent around the knee, from the stretching of the liga- mentum patellar in an individual who was trying to save himself from suddenly falling forwards with his knee bent under him. Such cases are commonly re- cognized by there being no mark of mechanical injury about the part:—the skin is smooth and unabraded. It is of importance to know that violence inflicted on a living body, may not show itself under the form of ecchymosis until after death. A case of this kind was communicated to me by Mr. J. Stevenson. A man received from behind several kicks on the lower part of the abdomen, which caused a rupture of the bladder, and death by peritonitis. He died in about thirty-five hours : but there was no ecchymosis in the seat of the blows, i. c. the pubic and lumbar regions, until after death. Dr. Ilinze met with a case of suicidal hanging, in which it was observed that ecchymosis appeared in the course of the cord only after death. (See Hanging, post.) It has been remarked by Devergie that ecchymoses are often concealed on the bodies of the drowned, when first removed from water, owing to the sodden state of the skin; and they may become apparent only after the body has been exposed for some days. A medical jurist must guard against tlie error of supposing that when a blow has been inflicted on a living person, it is necessary that the individual who is maltreated, should survive for a certain period in order that ecchymosis should be produced. Among numerous instances proving the contrary, the case of the Duchess of Pra siin (August, 1847) may be mentioned. This lady was assassinated by her husband, having been attacked while asleep in bed. The number of wounds on her person (thirty) showed that there had been a mortal struggle, which, however, could not have lasted more than half an hour. Yet, on inspection, there were the marks of numerous ecchy- moses, which had resulted from the violent use of a bruising instrument. (Ann. d'llyg. 1847, ii. 377.) Changes of Color.—The changes which sometimes take place in the color of an ecchymosed spot, are worthy of the attention of a medical jurist, since they will serve to aid him in giving an opinion as to the probable time at which a contusion has been inflicted. After a certain period, commonly in eighteen or twenty-four hours, the blue or livid margin of the spot is observed to become lighter; it acquires a violet tint, and before its final disappearance, it passes suc- cessively through shades of a green, yellow, and lemon color. During this time, the spot becomes much increased in extent, but the central portion of the ecchy- mosis is always darker than the circumference. These changes have been referred by Chaussier and others to the gradual dilution of the serous portion of the extravasated blood by the fluid of the cellular membrane, and its slow and uni- form dispersion throughout the cells. The color is finally entirely removed by . the absorption of the extravasated blood. The extent and situation of the ecchy- mosis, the degree of violence by which it has been produced, as well as the age and state of health of the person, are so many circumstances which may influence the progress of these phenomena. Thus an ecchymosis is longer in disappearing in the old than in the young. Mr. Watson, of Edinburgh, found extravasated blood in an ecchymosis in an old person, five weeks after the receipt of the injury. Where the cellular membrane is dense, the ecchymosis, cseteris paribus, is not so rapidly formed; nor, when formed, do the above changes take place in it so speedily, as where the blood is effused into a loose portion of membrane, like that surrounding the eye or existing in the scrotum. In some instances an ecchy- mosis has been observed to disappear without undergoing these changes of color at its margin. On examining an ecchymosed portion of skin which has suffered from a severe contusion, we find that the discoloration affects more or less the