His present Majesty has afforded an early instance of his regard for our principal medical corporation, by an act of favour no less important to the institution, than honourable to the learned and distinguished physician who presides over its rights and interests, as will appear by the following
“The KingdesiresSir Henry Halford, as President of the Royal College of Physicians, to announce to the College assembled, that it is the King’s pleasure in future, that the President for the time being, should always hold the office of Physician in Ordinary to His Majesty. The King has great pleasure in making this communication during Sir Henry’sPresidency, from the sincere regard He entertains for him, and the very high estimation in which He holds his character and abilities.
“Signed. G. R.
“Carlton House,Jan. 18th, 1822.â€
“Carlton House,Jan. 18th, 1822.â€
“Carlton House,Jan. 18th, 1822.â€
“Carlton House,
Jan. 18th, 1822.â€
To which the College voted the following Address.
To which the College voted the following Address.
To which the College voted the following Address.
‘TO THE KING’S MOST EXCELLENT MAJESTY.
‘Sire,
‘We, the President, Elects, and Fellows of the Royal College of Physicians, humbly approach your Majesty with our most grateful acknowledgments for the mark of Royal favour with which your Majesty has been pleased to distinguish us by an order written and signed by your Royal hand, addressed toSir Henry Halford, Bart. our President, commanding him to declare to the College assembled your Majesty’s Royal will and pleasure that every future President of the College of Physicians, for the time being, shall hold the office of one of your Majesty’s Physicians in Ordinary.
‘We associate,Sire, with this mark of your Royal kindness the pleasing remembrance of the circumstances of our original foundation by your Majesty’s illustrious predecessor KingHenrythe VIII, and dare to presume from so gracious a proof of your confidence in us, that your Majesty entertains a favourable opinion of our institutions and discipline, as calculated to make our profession respected in this country, above what it is in any other part of Europe, and most capable of forming a Physician worthy to be placed near the sacred person of the King.
‘To our President,Sire, we entrust this expression of our dutiful thanks, our loyalty, our attachment, and devotion to your Majesty, and we pray that no weight of cares which your Majesty’s great office imposes upon you may prove injurious to your health; and that Providence in His infinite goodness, may continue to watch over a life so highly important to the welfare, and happiness of your kingdoms.’
It now only remains for us to offer some observations upon the plan and execution of the work before us.
The classification of the various topics of forensic medicine has ever been a fertile source of controversy; and we will venture to assert that, from the diversity, as well as versatility of the numerous subjects involved in the study of medical jurisprudence, no arrangement can ever be constructed which shall vie, in perspicuity and precision, with that of most branches of natural science, the objects of which, however numerous, maintain a mutual relationship, and admit of being displayed in a striking and natural order of connection. If an arrangement be attempted to meet the legal view of the subject, such, for instance as that proposed byProfessor Plenck, of Vienna, and adopted byTortosaand many others, viz. of distributing the subjects according as they relate to thecriminal,civil, orecclesiasticalcourt, we shall immediately perceive that the same subject will frequently belong with as much propriety to one division, as to another, and may require to be considered under all;thus, insanity must come before acivilcourt when the person is supposed incapable of managing his own affairs; and before acriminaltribunal, when the soundness of a murderer’s intellect is disputed.Professor Foderé, it must be admitted, escapes from this difficulty by creating, under the term “Medecine Lègale mixte,†a division that comprehends subjects appertaining at once to the civil and criminal law; but it will be immediately perceived that such a scheme is far too general and indefinite to ensure the advantages of systematic arrangement, or even to merit the appellation of a classification. If, on the other hand, an arrangement be projected upon purely physiological and pathological principles, such as that adopted byValentini, in his “Corpus juris Medico-legale,†and which was followed byRoose, and very lately preferred byDr. Elliotson,[58]we shall find that similar embarrassments will arise, with respect to their legal relations, as we have just stated must attend their physiological bearings, where the basis of the classification has an exclusive reference to the law. The same objections will apply to the divisions of our respected cotemporaryDr. Gordon Smith, who appears to have appreciated all the difficulties of the subject, and, like ourselves, to have despaired of the success of any attempt to surmount them. He arranges the subjects of forensic medicine into three parts, viz. 1.Those which regard the extinction of human life; particularly by unusual or violent means; such are many kinds of sudden death, and all cases of homicide. 2.Injuries done to the person, not leading to the extinction of life; such are disfiguring and maiming, causing diseases, the violation of females,&c. 3.Circumstances connected with the physical system, that disqualify for the discharge of civil offices, or the exercise of social functions; such are mental alienation, the existence of certain diseases, the want of certain organs, &c.
After mature consideration, the arrangement which has been followed on the present occasion, although greatly liable to the many objections which we have so strongly urged against that of other writers, appears to the authors to be the one best calculated to accomplish the mixed objects of the publication. The ample synopsis of this arrangement, as presented in the table of contents prefixed to the present volume, would render any detailed account, in this place, superfluous. We have only to observe that the work is divided into three parts, thefirstcomprehending the enumeration of the different medical corporations, with an account of their charters, powers, and privileges, together with the subjects of medical police. Thesecond, all those subjects connected with medical evidence, as applicable tocivilandecclesiasticalsuits, in which the order of the subject corresponds with that of the progress of human life from infancy to old age. Thethird, the inquiries which are necessary to medical evidence, as applicable tocriminalcases.
In limiting the boundaries of each division, it will be perceived that we have strictly adhered to the general principle of excluding every topic that had not some direct or constructive relation to the health, life, and physical welfare of the subject. Had we regarded chemistry as synonimous with medicine, and pursued the numerous subjects in which it might be rendered available in the construction, elucidation, and administration of the laws, we should have far exceeded the scope of our labours, and have wanderedinto a rich and imperfectly explored region, as boundless in its extent, as it is interesting in the novelty and utility of its productions. In this case the subject of patents would have formed a prominent feature in the second division of our work; for so rapid is the progress of chemical science, and so precarious the language by which its growing objects and phenomena are expressed, that, in the present state of the law, it becomes an extremely delicate task to draw the specification of a chemical patent in such terms as to escape the snares which ingenuity is ever ready to invent for its destruction. We cannot, perhaps, better exemplify the truth of this position than by the relation of a case that has lately excited a considerable share of public interest. A patent was granted toMessrs. HallandUrling, for a new mode of manufacturing lace. The merit of the improvement turned upon the mode of singeing or burning off the raw ends of the cotton by a flame of gas, which was made to play rapidly through the meshes of the lace, instead of the red hot cylinder, over which it is commonly passed. The infringement of this patent byBooteformed the grounds of the action. The defendant stated that he had employed the flame of burning alcohol for this purpose, which not being agas, but avapour, could not be said to fall within the meaning of the plaintiff’s specification. Fortunately for the justice of the case, an additional apparatus was required to draw the flame through the meshes of the lace, and, without such a contrivance, the operation whatever might be the nature of the combustiblegas, orvapour, employed, could not succeed; and since it is an acknowledged principle that an adoption of any part is an infringement of the whole, a verdict was returned for the plaintiff. Butsuppose the merits of the case had wholly rested, as had been expected, upon the distinction betweengasandvapour; the chemical evidence would no doubt have urged that the one being permanently elastic and incapable of condensation, must be considered as very distinct in its nature from the other which admitted of being condensed into a liquid. Under such a conviction the plaintiff might probably have lost his verdict. But had the same trial, under the same circumstances, been deferred only for a few weeks, the effect of the chemical evidence must have been widely different,Mr. Faradayhaving, within the last month, succeeded in condensing no less than nine[59]of these gaseous bodies that were universally acknowledged to be permanently elastic! and thus has this ingenious and indefatigable chemist, by a happy generalization, annulled the supposed characteristic distinction betweengasandvapour.
The subject of forgery, and of frauds upon banker’s checques, accomplished by the well-known agency of acids in discharging ordinary writing, would upon the same grounds have been considered as a legitimate object of medical jurisprudence; and we should have proceeded to inquire into the different chemical means by which such frauds might be prevented.[60]The subject of nuisances would also have received a more extended notice; and we should not have deemed it necessary to limit our observations upon the detection of fraudulent adulteration to those substances, the purity of which is essential to thehealth of the community. But it is unnecessary to multiply examples in proof of the latitude of the subject, or of the utter impracticability of any attempt to pursue its ramifications in the present work.
In our physiological illustrations we have, upon all occasions, sought to establish general principles for the solution of the various problems of forensic medicine. It has been said that “it is not so much the knowledge of the laws of physiology, as that of the exceptions to which they are liable, that is required in elucidation of abstruse medico-legal questions.†If this were admitted, the propriety of such scientific applications might be altogether doubted. “Leges fiunt de his quæ vulgo, non de his quæ raro eveniuntâ€; but, in truth, the exceptions of Nature are but apparent—the mere illusions arising from our imperfect view of her phenomena; and will diminish as our knowledge increases, just as the motions of the heavenly bodies cease to appear irregular as soon as their orbits are submitted to a more extended field of observation.
The second volume of our work commences with a physiological research into the “Causes and Phenomena of Sudden Death.†To the views developed in this chapter we are the more particularly anxious to direct the attention of the student, as they may be said to constitute the centre, and master-key of forensic physiology; while the obvious importance of their applications, in directing the treatment of asphyxia and cases of poisoning, will convey a striking rebuke to those who still deny thepracticalutility of such researches. We might even extend this remark to the more ordinary duties of the surgical practitioner, and in support of its truth, maintain, that he can neither fully comprehend, nor successfully treat the more importantsymptoms which attend injuries of the head, without an acquaintance with those mutual relations which subsist between the functions of the brain and heart, and those of the organs of respiration. To an ignorance of such views we may trace the origin of those discordant opinions which have existed with regard to the proper mode of treating concussion, or compression of the brain. Some practitioners, from having observed that the action of the heart frequently becomes enfeebled on these occasions, have unconditionally insisted upon the necessity of cordials; while others, reasoning upon the state of the brain, have with equal confidence advocated the propriety of immediate and copious depletion by the lancet. Let us see how far a knowledge of the physiological doctrines to which we have alluded will reconcile such conflicting opinions, and point out the proper plan which ought to be pursued in such cases of difficulty.
It has been stated,[61]that the first violent impression upon the brain, whether occasioned by an external force, or a “coup de sang,†from hemorrhage within the skull, will be very liable to produce syncope. This effect, when it occurs, ought of course to be distinguished from the more ordinary symptoms of concussion and compression, and which may be said to approach the nature of suffocation, rather than that of syncope, as they depend upon impeded respiration, from a failure in the action of the muscles which are essential to it. In the former case it would be highly injudicious to resort to the lancet, until the action of the heart shall have been restored by cordials; whereas in the latter, prompt and copiousblood-letting must be considered as the most effectual of all the resources of art.
For much of the novelty contained in this part of our work, the reader will find that we are greatly indebted to the liberality and friendship ofMr. Brodie, who afforded us the assistance of hisManuscript Notes, from which he delivered his lectures from the anatomical chair of the College of Surgeons.
With regard to the manner in which the subjects have been individually elucidated, we may venture to hope that, in a work of such extensive range, the reader will scarcely expect to find every department equally elaborate in execution; our discretion on this point has been, in great measure, directed by the degree of importance attached to each subject, and the extent and nature of the popular fallacies with which it is surrounded. In dealing with subjects thus embarrassed we have ever deemed it a great point to clear away every adventitious incumbrance, so as to make a naked circle around the object in dispute, and to afford an uninterrupted view of it on every side. We have, therefore, in pursuance of such a principle, endeavoured to bring the leading points of controversy within the scope of a few prominent questions, that we might discuss the merits of each with a share of attention commensurate with our idea of its importance. The advantages of such a plan will receive, we trust, a favourable exemplification in our history of poisons.
For our numerous quotations, if any apology be necessary, we may offer that of the learnedTortosa, deeming it more expedient to incur the charge of scholastic affectation, than to leave our readers in the dark, as to the sources from which we have derived our information, and particularly as we are thusenabled to furnish the student with various references to which he may advantageously apply for more extended information.
Some writers have objected altogether to the science of Medical Jurisprudence, alleging that it is an unnecessary addition to the already too numerous pursuits of the medical student; to their doctrine we cannot assent, even though so high an authority as a dictum ofSir Wm. Blackstoneis adduced in its support; the learned commentator says, “for the gentlemen of the faculty of physic, I must frankly own that I see no special reason why they in particular should apply themselves to the study of the law; unless in common with other gentlemen, and to complete the character of general and extensive knowledge—a character which their profession beyond others has remarkably deserved. They will give me leave, however, to suggest, and that not ludicrously, that it might frequently be of use to families upon sudden emergencies, if the physician were acquainted with the doctrine of last wills and testaments, at least so far as relates to the formal part of their execution.†It is not merely our object to show that, in common with other gentlemen, medical practitioners should have some general knowledge of the law, without which they cannot in any scene of life discharge properly their duty either to the public or themselves; but to demonstrate, that there are many and intricate branches of law, in which the physician or surgeon, by competent knowledge, may not only materially serve himself in reputation, and his patients by advice, but also render important benefit to the community.
It is true that medical practitioners, for reasons hereafter stated, are exempt from serving on juries,and are seldom charged with magisterial duties, at least till they have retired from the more active employment of their profession; it must be remembered, however, that they are charged with important and peculiar jurisdictions; and it is impossible to look at the various litigations which we have enumerated in the first part of our work, without feeling that every member of the medical colleges ought to possess some legal knowledge. Can the President and Censors of the College of Physicians execute their power of fine and imprisonment; can they restrain unlicensed intruders, or punish the bad practices of ignorant pretenders, without some study of the law? can they vindicate their rights without reference to the numerous acts of parliament on which they are founded? can they prove the guardians of the public health, without knowing the enactments by which it is protected? can they advise the legislative or executive power on numerous points submitted to their consideration, (as vaccine inoculation, quarantine, &c.) without understanding the bearings of the question referred to them? can they in fine do or advise any public act, without considering either the existing law as it may stand, or the policy and mode of future enactment? they may indeed state as much of the medical, chemical, or physiological facts of each case as their imperfect view may enable them to take; leaving it to the lawyer, who knows no physic, to correct the errors of the physician who knows no law. That acts of parliament have been framed on this principle of the mutual independence of law and science, it were vain to deny; but that they would have been better framed, if the parties employed in drawing them up had possessed some understanding in common on the subject before them, is equally indisputable.Let us therefore hope that, when our reader shall have considered the many points in which medicine and its branches may become auxiliary to legislation or government, he will feel convinced that legal studies are not useless to medical practitioners in their public capacity.
In considering the use of legal knowledge as applicable to private practice,Sir William Blackstonehas mentioned one of many instances; it would be useful if the medical attendant were acquainted with at least the formal part of executing wills; in the moment of danger and distress, when all around the bed of death are confused with fear, or overwhelmed in affliction, the physician, probably a confidential friend, whose duty and habit ensures self-possession, may be the only person competent to advise. How many estates have been lost to the intended heir, by the want of a third witness to a devise of real property? or by an attestation informally signed, because the curtains of the bed were drawn, and the testator could not see the witnesses? From considering the last, let us turn back and enquire whether medical observation may not be necessary in the first scene of life. A midwife, unacquainted with the law of tenant by the courtesey, will scarcely note whether a child, certainly dead within a minute of its birth, did in that period move a limb or open an eye; he will not consider whether a momentary quivering of the lip was a sign ofindependent vitality, or the expiring remains of uterine life. If after a lapse of ten or twenty years he should be examined in a court of justice on this point in order to determine the right of the father to his estate for life, he will be unable to satisfy his own conscience, or the ends of justice; but once acquainted with theimportance of these observations, he will never fail to note the occurrence, whenever he has reason to believe that the circumstances of the case may give rise to legal question.
In cases of impotence, sterility, idiotcy, and lunacy, the confidential medical attendant is the first person consulted on the subject; how often may he refute a groundless accusation, remove a causeless fear, and prevent a public exposure, by forming and demonstrating correct views of the subject? how often too may he aid the oppressed, defeat the guilty, and protect the innocent, by a knowledge of the legal remedies against fraud or coercion?
In many criminal cases too the surgeon is of necessity among the first witnesses of the deed; is it not important that he should know what evidence will be required to prove its perpetration? surrounded by ignorant or prejudiced persons, his calm and accurate view, not only of medical, but of general points, becomes of peculiar importance; yet if he be unacquainted with the forms of judicial enquiry, unversed in the history of criminal courts, he will be as little able to direct his attention to the proper objects, or to divest his mind of undue bias, as the most ignorant of the by-standers.
As we shall have frequent occasion in the course of this work to revert to these points, we do not now dwell on them more minutely, than to repeat our opinion, that a general knowledge of the law is not only becoming to the medical practitioner in his character of a gentleman, but highly useful and necessary to his professional career. We do not expect that medical students shall become special pleaders, or that the bar shall vie in chemistry and physiology with the professors of those sciences; but we shall endeavour topoint out to each the sources from which they may draw information if they are desirous of acquiring it; we are of necessity confined within narrow bounds; but if within those limits we enable the two professions of law and physic to understand and appreciate each other, our object is accomplished.
Medical Jurisprudence.
Medical Jurisprudence.
Medical Jurisprudence.