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 _medical 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,[2] “when a pregnant woman was condemned to death, the sentence was not executed until after she was delivered.” The same author tells us[3] that “the physicians 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[4] 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.[5] 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 fixed at twelve years, while men 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.[6] 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 superfœtation was recognized;[7] the average duration of pregnancy was known, and the viability of children born before term was discussed,[8] the relative fatality of wounds affecting different parts of the body was considered,[9] 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,[10] 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.[11] 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. 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.[12] The writings of the Greek orators, Demosthenes, Æschines, Lysias, Antiphon, Isocrates, etc., which have come down to us substantiate the claim of Ælian that “to Athens mankind is indebted for the olive, the fig, and the administration of justice.”[13] The writings of the Greek physicians contain no reference to any legal application of their knowledge, and certain passages in the writings of the orators seem to indicate that, while a physician was called to inspect and treat a wounded person, the testimony as to the patient’s condition was given in court by others. Thus in the case against Euergos and Mnesibulus, in which an old woman had died some days after an assault, Demosthenes[14] states that he notified the accused to bring a surgeon and cure the woman; but that as they did not do so, he himself brought his own surgeon and showed him her condition in the presence of witnesses. Upon hearing from the surgeon that the woman was in a hopeless condition, he again explained her state to the accused and required them to find medical aid. Finally, on the sixth day after the assault the woman died. He further asserts that these statements would be proved by the depositions.[15] The third Tetralogy of Antiphon[16] (B.C. 480) relates to a case in which the defence was essentially the same as that which was the subject of a vast amount of medical expert testimony in a celebrated trial for murder in New York not many years ago. A person wounds another, who dies some days afterward. The assailant is accused of murder and sets up the defence that the deceased perished, not from the wounds inflicted, but in consequence of unskilful treatment by the physicians. In neither of these cases is any mention made of physicians having been called upon for testimony; indeed, the statements would lead to the inference that they were not. In another case in which a poor and sick citizen is accused of malingering to obtain the customary pecuniary aid from the State, Lysias[17] summons no medical evidence but relies entirely upon a statement of his client’s case.[18] Medical legislation was not more advanced during the ascendancy of the Roman Empire, although medical science was greatly developed, principally by the labors of Celsus, and of Galen and other Greek physicians. A few cases are mentioned by the historians which would seem to indicate a closer connection between law and medicine than had existed among the Greeks, but they refer rather to the custom of exposing the bodies of those who had died by violent means to public view, in order that any one might express his opinion as to the cause of death, than to any appeal to medical science in the administration of justice. Thus Suetonius[19] says that the physician Antistius examined the dead body of Julius Cæsar (B.C. 44), and declared that of all the wounds only that received in the breast was mortal. Pliny[20] cites an early instance of contested interpretation of post-mortem appearances in the case of Germanicus, who died A.D. 19, by the action of poison, said the enemies of Piso, because the heart did not burn. The friends of Piso, while admitting the fact of non-consumption, attributed it to the deceased having had heart disease. The same author[21] quotes Masurius as having declared a child born after thirteen (lunar) months to be legitimate, in an action for the possession of property, on the ground that no certain period of gestation was fixed. The Emperor Hadrian (A.D. 117-138), according to Gellius, sought medical information in a similar case, and decreed the legitimacy of a child born in the eleventh (lunar) month, “after having considered the opinions of ancient philosophers and physicians.”[22] Although the Justinian collections, the “Codex” (A.D. 529), the “Institutes” (A.D. 533), the “Digests,” or “Pandects” (A.D. 534), and the “Novels” (A.D. 535-564), prepared by the best legal talent of the age, under the direction of Tribonian, do not provide for the summoning of physicians as witnesses; they contain an expression which indicates that at that time the true function of the medical expert was more correctly appreciated than it is to-day. His function was stated to be judicial rather than that of a witness.[23] There is also a provision that in cases of contested pregnancy, midwives (who were considered as belonging to the medical profession) should, after examination of the woman, determine whether or no pregnancy exist, and that their determination should be final. The practice of medicine, surgery, and midwifery was regulated. Those desiring to practise must have been found competent by an examination. The number of physicians in each town was limited. They were divided into classes, and were subject to the government of the Archiatri. Penalties were imposed upon those guilty of malpractice or of poisoning. The Justinian enactments contain abundant internal evidence of having been framed in the light of medical knowledge. They contain provisions relating to sterility and impotence, rape, disputed pregnancy, legitimacy, diseased mental conditions, presumption of survivorship, poisoning, etc., which indicate that the medical knowledge of the time was fully utilized in their construction.[24] The Germanic peoples at about the same period possessed codes in which traces of a rudimentary medical jurisprudence existed. The most ancient of these was the Salic law (A.D. 422), in which the penalties to be paid for wounds of different kinds are fixed. The Ripuarian law, of somewhat later date, takes cognizance of the crime of poisoning. The laws of the Bavarians, Burgundians, Frisians, Thuringians, and Visigoths contain practically nothing of medico-legal interest. The Lex Alamannorum has numerous provisions relating to wounds, and expressly provides that the gravity of the injury shall be determined by a physician.[25] During the period of about a thousand years, intervening between the Justinian and Caroline (_vide infra_) codes, the advancement of medicine and jurisprudence suffered almost complete arrest. The guilt or innocence of an accused person was determined rather by his own confession under torture, or by “the judgment of God” as shown by ordeal or by judicial combat, than by testimony either expert or of fact. Even during the night of the Middle Ages, instances are recorded in which the opinions of physicians were sought to determine questions of fact in judicial proceedings. In the duchy of Normandy, in 1207-45, the laws provided for the examination of those claiming to be sick (to evade military service or appeal to judicial duel), of persons killed, and of women.[26] In a decretal of Innocent III., in 1209, the question whether a certain wound was mortal was determined by physicians.[27] There is extant in the statutes of the city of Bologna, under date of 1249, an entry to the effect that Hugo di Lucca had been assigned the duty, when called upon by the podesta, and after having been sworn, to furnish a true report in legal cases.[28] In the kingdom of Jerusalem (_ca._ 1250) a person claiming exemption from trial by battle because of sickness or of wounds was visited by a physician (_fisicien au miége_) and a surgeon (_sérorgien_), who examined him and made oath as to his condition.[29] Sworn surgeons to the king are also mentioned in letters patent of Philippe le Hardi in 1278, of Philippe le Bel in 1311, and of Jean II. in 1352.[30] That of Philippe le Bel refers to Jean Pitardi as one of “his well-beloved sworn surgeons in his Chastelet of Paris,” whose functions are partly indicated by the extracts from the registers given below. The registers of the Châtelet at Paris from 1389 to 1392 record several instances in which medical aid was rendered in judicial proceedings. Under date of March 22d, 1389-90, “Maître Jehan Le Conte, sworn surgeon to the king our sire,” reports to Maître Jehan Truquam, lieutenant to the provost, that “upon that day in the morning one Rotisseur had gone from life unto death in consequence of the wounds which he had received on the Monday evening preceding.”[31] Under date of July 22d, 1390, is an account of the examination of one Jehan le Porchier, accused of intent to poison the king (Charles VI.), in which there is reference to a very early instance of toxicological expert evidence. In the wallet of the accused certain herbs were found. The account proceeds: “Richart de Bules, herbalist, was summoned, to him the above-mentioned herbs were shown, and he was commanded that he should examine them and consider well and duly, reporting the truth of what he should find. The said Richart, after having examined them with great diligence, reported that in the box in which these herbs were he had found six leaves, namely: one leaf of _jacia nigra_, and one of round plantain, called in Latin _plantago minor_, and four of sow-thistle (_lasseron_), called in Latin _rosti poterugni_, and says that the leaf of _jatria nigra_ is poisonous, but that in the others there is no poison known to the deponent.”[32] On August 12th, 1390, “Jehan Le Conte and Jehan Le Grant, sworn surgeons of our sire the king,” are present at the torture of a prisoner, but for what purpose does not appear. In another case the same Jehan Le Conte testified that a wound in the head of a deceased person was made with an axe.[33] At a later period in Italy, the infliction of “the question” took place under medical supervision. Zacchias devotes a chapter, _De Tormentis et Pœnis_,[34] to the consideration of the different methods of torture, the degrees of pain and danger attending each, and the conditions of age, sex, and health which render its application inadmissible.[35] During this period, as indeed from the earliest times, the practice of medicine was regulated by law. Thus a law of King Roger of Sicily (1129-54) punished those who practised medicine without authority with imprisonment and confiscation of goods; and an edict of Frederick II. (1215-46) imposed like penalties upon those who presumed to practise except after graduation at the school of Salernum.[36] Medico-legal science was formed in the middle of the sixteenth century by a simultaneous awakening of jurists and physicians to the importance of the subject. It was in Germany that expert medical testimony was first legally recognized. In 1507, George, Bishop of Bamberg, proclaimed a criminal code in his domains. This was subsequently adopted by other German states, and finally was the model upon which the _Caroline Code_, the first general criminal code applying to the whole empire, was framed and proclaimed at the Diet of Ratisbon in 1532.[37] These codes, particularly the Caroline, distinctly provide for utilizing the testimony of physicians. Wounds are to be examined by surgeons who are “to be used as witnesses;”[38] and in case of death one or more surgeons are to “examine the dead body carefully before burial.”[39] They also contain provisions for the examination of women in cases of contested delivery, or suspected infanticide;[40] for the regulation of the sale of poisons;[41] for the detection and punishment of malpractice;[42] and for examination into the mental condition in cases of suicide and of crime.[43] An early work on the practice of criminal law, based on the Caroline Code, was published by the Flemish jurist, Josse de Damhouder, in 1554. It contains a chapter treating of the lethality of wounds, which should be determined by expert physicians and surgeons,[44] and describes the course which is to be pursued in the judicial examination of dead bodies. This is probably the earliest printed book (other than the laws themselves) containing reference to medico-legal examinations,[45] and antedates the writings of physicians upon the subject. Although it was only in 1670 that the Ordinances of Louis XIV. gave to France a uniform criminal code, medico-legal reports were made by physicians and surgeons to the courts more than a century before. Indeed, the earliest medico-legal work written by a physician[46] is the 27th book of the Œuvres d’Ambroise Paré, first printed in 1575, in which he directs the forms in which judicial reports shall be made in various medico-legal cases.[47] During the remainder of the sixteenth century France produced but three treatises on medico-legal subjects.[48] One of these, written by the jurist A. Hotman, distinctly mentions the employment of physicians to determine questions of fact. In Italy works on medical jurisprudence were published at the close of the sixteenth and beginning of the seventeenth century. The earliest of these was a chapter of Codronchius, treating of the “method of testifying in medical cases,” in 1597.[49] At about the same time, but certainly later, appeared the work of Fortunatus Fidelis, to whom the honor of being the first writer on medical jurisprudence is given by many.[50] The great work of Paulus Zacchias, physician to Pope Innocent X., was first printed at Rome, 1621-35. This medico-legal classic contains in the first two volumes the “_Quæstiones_” and in the third the decisions of the Roman Rota. It treats of every branch of medico-legal science, and discusses physiological questions of legal interest, besides dealing with questions such as the infliction of torture and miracles.[51] Although the “Quæstiones Medico-legales” of Zacchias was the first systematic work upon medical jurisprudence, his countrymen in succeeding centuries have contributed but little to this science. It is only during the latter part of the present century that Italians have again become prominent in medico-legal literature. In France legal medicine progressed but little from the time of Paré to the latter part of the eighteenth century. Several treatises appeared, being chiefly upon legitimacy and kindred subjects,[52] with a few treating of reports, signs of death, etc.[53] Toward the end of the eighteenth century the labors of Louis, Petit, Chaussier, and Fodéré elevated legal medicine to the rank of a science. The investigations of Louis (Ant. L.) were numerous and important in this as in other subjects,[54] and the “_causes célébres_” contain reports of many trials in which he threw light upon doubtful medical questions.[55] Antoine Petit, a contemporary of Louis, contributed an extensive work on the duration of pregnancy as affecting legitimacy.[56] Somewhat later Fr. B. Chaussier, between 1785 and 1828, published at Dijon a number of treatises on infanticide, viability, surgical malpractice, etc.[57] Fodéré, a Savoyard, was the first to publish a systematic treatise on medical jurisprudence in France, which was first printed in 1798 and in a much enlarged form in 1813.[58] This last edition is an exhaustive treatise upon all branches of legal medicine and public hygiene, and won for its author the appointment as Professor of Forensic Medicine in the University of Strassburg. At about the same period appeared the works of Mahon[59] and of Belloc,[60] both of which went through three editions in ten years, and those of Biessy.[61] The most industrious and original of French professors of legal medicine was Orfila. A native of Minorca, he graduated in medicine at Paris in 1811, and devoting himself to chemical and toxicological investigations, published the first edition of his “Traité des Poisons” in 1814. This work, which may be regarded as the foundation of experimental and forensic toxicology, went through five editions to 1852, and was translated into several foreign languages. The first edition of his “Leçons de Médecine légale” appeared in 1821, and the fourth in 1848. Besides these Orfila published a work on the treatment of asphyxia and a great number of papers on medico-legal subjects, principally in the _Annales d’Hygiène_, of which he was one of the founders with Andral, Esquirol, Leuret, and Devergie. Orfila occupied the chair of chemistry and medical jurisprudence in the University of Paris for upward of thirty years, and was employed as expert in innumerable cases before the courts. Contemporaneous with Orfila, and almost as prominent, was Devergie, the first edition of whose “Médecine légale,” in three volumes, appeared in 1836, and the third in 1852. In 1820 the first edition of the Manual of Briand and Brosson was published. This work, the tenth edition of which was published in 1879, is the first in which a jurist was associated with a physician in the authorship,[62] and is one of five of which one of the authors is a lawyer.[63] Special treatises on the medico-legal relations of insanity were published by Georget (1821), Falvet (1828), Esquirol (1838), and Marc (1840), and on midwifery by Capuron (1821). Tardieu, Professor of Legal Medicine in the University of Paris (1861-79), published a most important series of monographs on hygienic and medico-legal subjects,[64] besides many papers, principally in the _Annales d’Hygiène_, _etc._, and testified before the courts in many “_causes célébres_.” The first work of medico-legal interest to appear in Germany was the “Medicus-Politicus” of Rodericus à Castro, a Portuguese Jew living in Hamburg, printed in 1614, which deals principally with medical ethics and the relations of physicians, but contains chapters on simulated diseases, poisoning, wounds, drowning, and virginity.[65] It was only toward the end of the seventeenth century that the subject was scientifically treated, and during the latter part of the seventeenth century and the beginning of the eighteenth great progress was made in the development of forensic medicine in Germany. Johannes Bohn, one of the originators of the experimental method of investigation in physiological chemistry and physics, at the University of Leipzig, was also one of the earliest German contributors to the literature of legal medicine. Besides smaller works he published two noteworthy treatises: in 1689 a work on the examination of wounds and the distinction between ante-mortem and post-mortem wounds, and between death by injury, strangulation, and drowning.[66] In 1704 a work giving rules for the conduct of physicians in attending the sick and in giving evidence in the courts.[67] At about the same period M. B. Valentini, professor in the University of Giessen, published three important works, containing collections of medico-legal cases, and of the opinions and decisions of previous writers.[68] Another extensive collection of cases and decisions was published in 1706 by J. F. Zittmann, from a MS. left by Professor C. J. Lange, of the University of Leipzig;[69] and still another by J. S. Hasenest[70] appeared in 1755. During the latter part of the eighteenth century, the Germans cultivated legal medicine assiduously, and a great number of works upon the subject were published. Among these may be mentioned those of M. Alberti, professor at the University of Halle;[71] H. F. Teichmeyer, of the University of Jena;[72] A. O. Gölicke, of the universities of Halle and Duisburg, who was the first to prepare a bibliography of the subject;[73] J. F. Fasel (Faselius), professor at Jena;[74] J. E. Hebenstreit and C. S. Ludwig, professors at Leipzig;[75] C. F. Daniel, of Halle;[76] J. D. Metzger, professor at Königsberg, the author of a number of works, one of which, a compendium, was translated into several other languages;[77] J. V. Müller, of Frankfurt;[78] J. C. T. Schlegel, who collected a series of more than forty dissertations by various writers;[79] M. M. Sikora, of Prague;[80] J. J. von Plenck, professor in Vienna, who published a work on forensic medicine and one on toxicology;[81] K. F. Uden, subsequently professor in St. Petersburg, who was the first to publish a periodical journal devoted to legal medicine, which was afterward continued by J. F. Pyl at Stendal;[82] and J. C. Fahner.[83] At this period compends for students were published in Germany, which indicate by their number the extent to which this science was the subject of study. Among these those of Ludwig (1765), Kannegieser (1768), von Plenck (1781), Frenzel (1791), Loder (1791), Amemann (1793), Metzger (1800), and Roose may be mentioned. The Germans of the present century have maintained the pre-eminence in legal medicine achieved by their forefathers. Among a great number of investigators and writers a few may be mentioned: C. F. L. Wildberg, professor at Rostock, was a most prolific writer, edited a journal devoted to state medicine, and contributed a valuable bibliography of the subject;[84] A. F. Hecker, professor at Erfurth and afterward at Berlin, and J. H. Kopp each edited and contributed extensively to a medico-legal journal.[85] A much more important periodical was established in 1821 by Adolph Henke, professor in Berlin, and was continuously published until 1864. Henke also wrote a great number of articles and a text-book on legal medicine.[86] Jos. Bernt, professor at Vienna, published a collection of cases, a systematic treatise, and a number of monographs,[87] as well as the MS. work left by his predecessor in the chair, F. B. Vietz. A handbook containing an excellent history of medico-legal science was published by L. J. C. Mende, professor at Griefswald,[88] who also contributed a number of monographs, chiefly on obstetrical subjects. K. W. N. Wagner contributed but little to the literature of the subject, but it was chiefly by his efforts, while professor in the University of Berlin, that a department for instruction in state medicine was established there in 1832. A. H. Nicolai, also professor at Berlin, published a handbook[89] besides numerous articles in the journals. F. J. Siebenhaar published an encyclopædia of legal medicine, and in 1842 established a journal devoted to state medicine, which in its continuations was published until 1872.[90] J. B. Friedreich, professor at Erlangen, after editing a journal devoted to state medicine from 1844 to 1849, established one of the most important of current medico-legal periodicals in 1850,[91] to both of which he was a frequent contributor until his death in 1862. Ludwig Choulant, professor at Dresden, and more widely known as the author of important contributions to the history of medicine, published two series of reports of medico-legal investigations.[92] The foremost forensic physician of this period in Germany was unquestionably John Ludwig Casper, professor in the University of Berlin and “forensic physician” (gerichtlicher Physicus) to that city, who greatly extended the department established in the university under Wagner. He made innumerable investigations, some of which are preserved in several collections of cases,[93] others in his classic Handbook,[94] and still others in the periodical which he established in 1852, and which is now the most important current medico-legal journal.[95] It is necessary in this place to make mention of one work by living authors, as its appearance marked a new departure in medico-legal literature, and as in it the fact that forensic medicine extends over so wide a field of inquiry as to require treatment at the hands of specialists was first recognized. To Josef von Maschka, professor in the University of Prague, the credit is due of having been the first to produce, with the collaboration of twenty-two colleagues, a truly systematic work on modern forensic medicine.[96] English works upon this subject did not exist prior to the present century,[97] although physicians were employed by the courts to determine medical questions of fact at a much earlier date. Paris and Fonblanque, in the third Appendix of their “Medical Jurisprudence,” give the text of reports by the Colleges of Physicians of London and of Edinburgh concerning the cause of death as early as 1632 and 1687 respectively.[98] Lectures on medical jurisprudence were given at the University of Edinburgh by A. Duncan, Sr., at least as early as 1792.[99] The title of Professor of Medical Jurisprudence in a British university was conferred for the first time, however, upon A. Duncan, Jr., at the University of Edinburgh in 1806.[100] The first English work on medical jurisprudence worthy of consideration is the medical classic known as Percival’s “Medical Ethics.” This was first published in 1803, and contains in its fourth chapter an admirable epitome of legal medicine.[101] A more elaborate work, based very largely, however, upon the writings of continental authors, was published by G. E. Male in 1816.[102] In 1821 Professor John Gordon Smith published the first systematic treatise on forensic medicine,[103] and was one of the first in Great Britain to show the importance of the subject. Two years later, in 1823, appeared the elaborate and scholarly work of Dr. Paris and Mr. Fonblanque, the first in the English language in whose authorship members of the medical and legal professions were associated.[104] In 1831, Prof. Michael Ryan published the first edition of his “Manual of Medical Jurisprudence” from the memoranda of his lectures on the subject in the Westminster School of Medicine.[105] A similar work was published by Professor T. S. Traill, of the University of Edinburgh, in 1836.[106] The awakened interest in medico-legal subjects among the medical profession during the decade 1830-40 is evidenced by the publication in the medical journals of the lectures of A. Amos, in 1830-31; of A. T. Thomson, at the London University, in 1834-35; of H. Graham, at Westminster Hospital, in 1835; of W. Cummin, at the Aldersgate Street School, in 1836-37; and of T. Southwood Smith, at the Webb Street Theatre of Anatomy, in 1837-38.[107] Among the noteworthy contributions to the science previous to 1850 are the writings of Dease (1808), Haslam (1817),[108] Christison, the successor of Professor Duncan in the University of Edinburgh, and best known as a toxicologist, Forsyth (1829),[109] Chitty (1834),[110] Watson (1837),[111] Brady (1839),[112] Skae (1840),[113] Pagan (1840),[114] and Sampson (1841).[115] In 1836, Dr. Alfred Swaine Taylor (b. 1806, d. 1880), the first Professor of Medical Jurisprudence in Guy’s Hospital, published his “Elements of Medical Jurisprudence.” This, the most important work upon the subject in the English language, is now in its twelfth English and eleventh American edition. During forty years of devotion to forensic medicine Dr. Taylor also contributed other important works and numerous papers, published for the most part in the Reports of Guy’s Hospital.[116] In 1844, Dr. Wm. A. Guy, Professor of Forensic Medicine in King’s College, published the first edition of his excellent work.[117] In 1858, Fr. Ogston, Professor of Medical Jurisprudence in the University of Aberdeen, published a syllabus and subsequently (1878) a complete report of his lectures.[118] In 1882, C. M. Tidy, Professor of Chemistry and Forensic Medicine in the London Hospital, who had previously (1877) been associated with W. B. Woodman in the authorship of a valuable handbook, began the publication of a more extended work, which was interrupted by his death in 1892.[119] The first Spanish work on legal medicine was that of Juan Fernandez del Valles, printed in 1796-97.[120] No further contribution to medico-legal literature was furnished by Spain until the appearance in 1834 of the work of Peiro and Rodrigo, which went through four editions in ten years.[121] Ten years later, in 1844, Pedro Mata, Professor of Legal Medicine and Toxicology at Madrid, published the first edition of a work, which in the development of its subsequent editions, has become the most important on the subject in the Spanish language.[122] The first Portuguese medico-legal treatise was that of Jose Ferreira Borjes, first printed at Paris in 1832.[123] A posthumously published report of the lectures of Albrecht von Haller was the earliest Swiss work on forensic medicine.[124] In Sweden the earliest medico-legal publication was a comprehensive treatise by Jonas Kiernander, in 1776,[125] which was followed in 1783 by a translation of Hebenstreit, by R. Martin. The voluminous writings of the brothers Wistrand (A. T. and A. H.), including a handbook, were published at Stockholm, between 1836 and 1871. Between 1846 and 1873, several articles upon medico-legal subjects were published at Helsingfors, in Finland, by E. J. Bonsdorff, O. E. Dahl, and J. A. Estlander. In 1838 Skielderup[126] published his lectures on legal medicine, delivered at Christiania, and Orlamundt[127] published a handbook at Copenhagen in 1843. The earliest recognition of medico-legal science in Russia was in the lectures of Balk,[128] begun in 1802 at the then newly founded University of Dorpat. Although dissertations upon subjects of medico-legal interest were published at the University of Leyden as early as the middle of the seventeenth century,[129] and the works of Pineau,[130] Zacchias,[131] Ludwig,[132] von Plenk,[133] and Metzger[134] were printed in Holland, either in Latin or in the vernacular, no original systematic work on legal medicine in the Dutch language has yet appeared. The only Belgian contribution to the literature of forensic medicine, other than articles in the journals, is a text-book by A. Dambre, first published at Ghent in 1859.[135] Two medico-legal works have been printed in the Japanese language, one a report of the lectures of Professor Ernst Tiegel, at the University of Tokio,[136] the other a treatise by Katayama.[137] In the United States the development of forensic medicine has kept pace with that in the mother country. In an introductory address delivered at the University of Pennsylvania in 1810, the distinguished Dr. Benjamin Rush dwelt eloquently upon the importance of the subject.[138] In 1813, Dr. James S. Stringham was appointed Professor of Medical Jurisprudence in the College of Physicians and Surgeons of New York, and a syllabus of his lectures was published in the following year.[139] At the same period (1812-13) Dr. Charles Caldwell delivered a course of lectures on medical jurisprudence in the University of Pennsylvania.[140] In 1815, Dr. T. R. Beck was appointed Lecturer on Medical Jurisprudence in the College of Physicians and Surgeons of the Western District of the State of New York; and soon after Dr. Walter Charming was appointed Professor of Midwifery and Medical Jurisprudence in Harvard University. In 1823, Dr. Williams, in the Berkshire Medical Institute, and Dr. Hale, of Boston, each lectured upon the subject.[141] In 1819, Dr. Thomas Cooper, formerly a judge in Pennsylvania, and at that time Professor of Chemistry and Mineralogy in the University of Pennsylvania, reprinted, with notes and additions, the English works of Farr, Dease, Male, and Haslam.[142] The works of Ryan, Chitty, Traill, and Guy were also reprinted in this country shortly after their publication in England. In 1823, Dr. Theodric Romeyn Beck published at Albany the first edition of a treatise as admirable for scholarly elegance of diction as for profound scientific research. This remarkable work, _facile princeps_ among English works on legal medicine, has had twelve American and English editions, and has been translated into German and Swedish.[143] Papers upon medico-legal subjects or reports of lectures were published by J. W. Francis,[144] J. Webster,[145] R. E. Griffith,[146] R. Dunglison,[147] J. Bell,[148] and S. W. Williams[149] between 1823 and 1835. In 1840, Amos Dean, Professor of Medical Jurisprudence at the Albany Medical College, published a medico-legal work, followed by another in 1854, which with the later work of Elwell are the only treatises on forensic medicine upon the title-pages of which no physician’s name appears.[150] Numerous papers and tracts upon medico-legal subjects were published by J. J. Allen, T. D. Mitchell, H. Howard, D. H. Storer, J. S. Sprague, J. S. Mulford, J. F. Townsend, and A. K. Taylor between 1840 and 1855. In the latter year appeared the first edition of the admirable work of Francis Wharton and Dr. Moreton Stillé, the first American product of the collaboration of members of the two professions, now in its fourth edition.[151] Between 1855 and 1860 no systematic treatises on legal medicine were published, although the medical journals contained numerous articles bearing upon the subject. In 1860 the first edition of a treatise written from the legal aspect was published by J. J. Elwell.[152] In 1869 Dr. J. Ordronaux, recently deceased, widely known as a teacher of legal medicine and a graduate in law as well as in medicine, published a treatise which has been extensively used as a text-book.[153] At the present time the great number and variety of articles published in the medical and legal journals, bearing upon every branch of forensic medicine and of medical jurisprudence, and written for the most part by specialists, is evidence of the assiduity with which the science is cultivated. The wide appreciation of the importance of medico-legal science in the United States is also indicated by the fact that at the present time there are but few medical schools in which the subject is not taught. To ascertain the extent of medico-legal instruction at the present time, a circular of inquiry was sent to the deans of 124 medical schools and of 56 law schools in the United States and British provinces. Answers were received from 103 medical colleges. Of these only 3 are without a teacher of “medical jurisprudence.” In 38 the teacher is a physician, in 50 he is a lawyer, in 5 he is a graduate in both professions, and 3 have two teachers, one a lawyer, the other a physician. The average number of lectures given is 21, and the average in those schools in which the teacher is a lawyer, and therefore presumably teaches only medical jurisprudence, is 15. The medico-legal relations of their subjects are taught in their lectures by the neurologist in 62 schools, by the surgeon in 66, by the obstetrician in 69, and by the chemist (toxicology) in 91. It appears from these reports that not only is the importance of medico-legal science appreciated, but that in the majority of our medical schools the distinction between medical jurisprudence and forensic medicine is recognized in the fact that the instructor is a lawyer, who presumably teaches medical jurisprudence, while the different branches of forensic medicine and toxicology are taught by the specialists most competent to deal with them. Every practising physician requires thorough instruction in medical jurisprudence, which, being strictly legal, is best taught by one whose profession is the law. The general practitioner only requires so much knowledge of the different branches of forensic medicine as will enable him to intelligently fulfil his obligations in such medico-legal cases as will be forced upon him as results of his ordinary practice. He can become a medical expert only by a particular study of and a large experience in some particular branch of the subject. In our law schools the teaching of medico-legal science is not as general as in schools of medicine. Of 35 law schools, only 10 have professors of medical jurisprudence. Of these 6 are lawyers, 1 is a physician, 2 are graduates in both professions, and 1 is a doctor of divinity. In this work the existence of specialists in the various branches of medico-legal science has been recognized for the first time in a treatise in the English language. Each branch has been assigned to a specialist in that subject, or at least to one who has made it a particular study. In the arrangement of the matter, the primary division into the three sciences of medical jurisprudence, forensic medicine, and toxicology has been adopted. The division of pure medical jurisprudence is contained in the present volume, while the legal aspects of neurology, obstetrics, etc., will be treated of in future volumes along with the subjects to which they relate. In the division of forensic medicine the classification of Casper has been followed: _i.e._, _Thanatological_; including those branches in which the subject of inquiry is a dead body (contained in the present volume). _Bio-thanatological_; relating to questions concerning both dead bodies and living persons (in the second volume). _Biological_; relating to living persons (in the second and third volumes). The applications of the microscope to forensic medicine will be treated of in the second volume. The fourth volume will contain the division relating to toxicology. R. A. W. MEDICAL JURISPRUDENCE. THE LEGAL RELATIONS OF PHYSICIANS AND SURGEONS, INCLUDING THEIR ACQUIREMENT OF THE RIGHT TO PRACTISE MEDICINE AND SURGERY; THEIR LEGAL DUTIES AND OBLIGATIONS; THEIR RIGHT TO COMPENSATION; THEIR PRIVILEGES AND DUTIES WHEN SUMMONED AS WITNESSES IN COURTS OF JUSTICE, AND THEIR LIABILITY FOR MALPRACTICE. BY TRACY C. BECKER, A.B., LL.B., _Counsellor-at-Law; Professor of Criminal Law and Medical Jurisprudence in the Law Department of the University of Buffalo; Chairman Executive Committee New York State Bar Association, etc._ LEGAL STATUS OF PHYSICIANS.