sides were to meet together in an amicable spirit, and consider the evidence, much difference of opinion might be removed. No agreement among ourselves will, however, entirely remedy the existing state of things, without a change of law, and I hope to see such a change brought about by the means which are now being attempted. The new department of state medicine has grown rapidly, and it is proposed that a Royal Commission shall be issued to inquire into a great many subjects of much interest to our profession, and in which its members have been most earnest and persevering. The initiative has been taken by a joint committee of the Social Science and British Medical Associations, and their efforts have been already successful in bringing the subject before the government. I shall be satisfied if I have shown you how much need there is of considerable reform in the present state of legal medicine. -Journal of Mental Science.

Diagnosis of Hanging. By ANDREW ALLISON, M. D., one of the Honorary Surgeons to the Lloyd Dispensary, Bridlington.

Questions of medical jurisprudence have not hitherto occupied a very prominent place in our periodical literature. The practical interest taken in medico-legal subjects is limited to a few experts, and the general practitioner is seldom employed in the higher branches of forensic medicine. Gentlemen who have been educated in Scotland often neglect to cultivate a competent knowledge of chemistry and physiology, in their application to the detection of crime. Caledonian students affect to believe that their altitude in scientific attainments will warrant a degree of indifference to the less attractive branches of an encumbered education. Such persons, in after-life, generally exhibit a notable ignorance of the able teachings of the northern schools.

In Scotland, coroners' inquests are unknown; but in England they are of daily occurrence, and medical practitioners are liable to be summoned to give evidence as often as scientific difficulties are involved in such investigations. When the professional referee manifests any degree of ignorance or oscillation in his testimony, the jury invariably draw conclusions adverse to the professional reputation of the witness, and the facts which the inquiry ought to establish are sometimes obscured by his unsound deductions.

Before proceeding to comment upon the fallacy of marks upon the throat as a diagnostic sign of hanging, I shall take the liberty of reasoning somewhat analogically on to the ques tion which I am desirous of ventilating. In morbid states of

the nervous system, expressed by neuralgic pains, the tolerance of anodynes is proportioned to the pathological lesion. For example, in tic-doloureux, a large dose of opium may be administered without even giving rise to a sense of drowsiness; whereas, in the physiological state, this dose would in all probability produce decided symptoms of narcotism. Thus, by graduating the dose to the urgency of the disease, the excess, if any, is alone liable to detection. This fact serves to show the characteristic impressions produced in opposite states of the organism. By gauging the quantity of calomel capable of being converted into the bichloride of mercury in the stomach, the therapeutic properties of the alterative are obtained, and that only which is in excess, and disproportioned to the action of the gastric chlorides, can be detected as a subchloride in the intestines. In like manner, by regulating the amount of strychnine taken into the stomach for killing purposes only, all traces of the alkaloid disappear from the body at death; and that portion, if any, which remains unabsorbed can alone be detected by the analyst. In hanging or strangulation, provided the constricting force applied be moderate, and not continued beyond the extinction of life, no furrow of the cord is usually apparent upon the neck; for it must be remembered that the mark is a post-mortem production, and not invariably present as a diagnostic sign of hanging, unless the drop be considerable, or the suspension continued beyond the actual death of the individual. I was recently summoned to a woman who had suspended herself by means of a piece of sheepnet-band, but who was cut down by her husband before life was extinct. No mark of the ligature was ever visible; and had she died, and the cord been secreted, the cause of death might have remained a mystery for want of the alleged diagnostic mark upon the neck, and the attention of the coroner's jury probably directed to some unintelligible spasm of the heart as the supposed cause of the visitation. Had this woman been suspended for a longer time, the post-mortem mark would then, no doubt, have been visible. On another occasion, I was called to a man who hanged himself by means of a plough-string. He was absent from his family only six minutes, and when he was cut down no print of the cord was afterward found upon the neck. Indeed, in the case of this drunkard, had an homicidal act taken place by hanging, and the real cause of death been concealed, the alleged diagnostic cordmark could have thrown no light on the manner of his death. Some years ago, I saw a weighty farmer, who had been suspended for a few minutes. At the inquest no perceptible ecchymosis, or mark of the halter, was then observable. A

person may be murdered by hanging or strangulation, and the absence of a mark only indicate that the ligature had been removed as soon as life became extinct, or before the postmortem indentation had been developed. As in the cases of opium, calomel, and strychnine, already alluded to, the excess of those drugs only manifests their detectible presence in the system; so the excess of hanging, beyond that which causes death, alone gives rise to the characteristic secondary impression of the cord. The presence of a groove encircling the neck only proves that it was originated after death, and not that hanging was the primary cause of the calamity. A few years ago, mechanical force was applied to a gentleman's throat at Scarborough, which he survived for several days; and, as the signs of the outrage were but slightly displayed externally, several medical gentlemen of the borough imagined the original cause of death to be apoplexy, forgetting that the living tissue will resist impressions which the post-mortem condition will readily yield to. The judge who tried the culprits in this case was of opinion that death was primarily caused by strangulation.

The conclusions which I draw from a full consideration of such transactions are-that death, in the case either of strangling or hanging, is so sudden, that the production of a mark of the cord, in any of its peculiar forms, takes place after death. Indeed, the track of the cord is a purely cadaveric phenomenon, and its value exceedingly questionable as a diagnostic proof either of suicidal or homicidal hanging. A body cut down as soon as life has become extinct will hardly exhibit any external signs of violence; while a dead subject, suspended for five minutes, will afterward manifest mummification of the mark of the cord, the result of evaporation from the body, and must, therefore, be a post-mortem production. In diagnosing death from hanging or strangulation, where no marks are visible, the medical jurist must take into consideration the surrounding circumstances of the whole case, and then proceed to satisfy himself, pathologically, whether apoplexy, asphyxia, or neuro-paralysis, were conditions immediately concerned in arresting life. Under such an ordeal the medical inquisitor will be able to deduce conclusions satisfactory to a jury, and creditable to his own forensic sagacity.--The Lancet.

In the course of a very admirable article on the "Continement of the Insane," published in the January number of the American Law Review, the writer makes the following sensible remarks, which every one having an acquaintance with the phenomena of insanity will recognize as correct and just:

People who have little knowledge of insanity, and a great deal of faith in time-honored phrases, have proposed, as a preventive of the abuses incident to isolation, a trial by jury, impanelled especially for the purpose. This method has been actually adopted in Illinois by legislative enactment, under a pressure of popular excitement arising from accidental causes. Except that it leaves the property undisturbed, it is open to all the objections that lie against the measures already considered. It is equally shocking to every notion of domestic propriety, and equally repugnant to that instinctive delicacy which shrinks from exposing the infirmities of those we love. A jury trial is a public affair: the proceedings may be printed in the newspapers, and the griefs of a stricken family become food for heartless gossip. A grosser perversion of this noble institution from its proper ends can scarcely be imagined. Although an admirable contrivance for eliciting truth in disputed transactions between man and man, it is totally unsuitable as a means of obtaining correct results in regard to questions purely scientific. When we are told that in the place where it was adopted, all the patients in a large public hospital -the epileptic and the paralytic, the idiotic and the imbecile, the raving maniac and the poor demented creature not knowing his right hand from his left-were subjected to its operation, it seems more like a phantasmagoric jumble of social and legal proprieties—

"The brood of folly without father bred ".

than the work of the assembled wisdom of a large and intelligent State.

Let us look at it for a moment. The question for the jury to decide, is, whether the person before them is sane or insane. The friends and attendants tell their story, the family physician, and perhaps other experts, give their opinions, and then the jury must agree or disagree upon a verdict. In will or contract cases, where the mental condition of the party is in question, there are always side issues on which a verdict may be made to rest, irrespective entirely of the principal issue. But here the naked question, sanity or insanity, is the only possible avowed issue, and it must be squarely met. If they are sensible men, they will be governed by the views of the experts. If, as is more probable, they think that they, as well as doctors, know something about insanity, they will have an opinion of their own, and decide accordingly. Now, in the former instance, it is the experts who really decide the case, and the jury becomes a superfluous appendage to the procedure. In the latter, a question of medical science, involving

the happiness of families, and the highest welfare of an individual, is determined by men completely ignorant of the whole subject. In all jury trials, the jury are not allowed to be judges of the law. Are they any more competent to be judges of medicine? If it were a question between medical men whether a certain patient had this or that affection of the heart, or whether another is suffering from rheumatism or neuralgia, who would think of submitting it to a jury of twelve men drawn from the common walks of life? And yet this is just like what we propose to do when we undertake to settle the question of insanity by means of such a tribunal. Only those who are much acquainted with the popular notions of insanity can conceive how futile the result would be. For twenty-five years the writer of this was in charge of a hospital for the insane; and of the many hundred patients under his care-setting aside the raving and the demented-there was scarcely one who was not regarded by some friend, neighbor, or acquaintance, as unequivocally sane. The most common forms of insanity—those which include the great majority of cases-are regarded, by many people, no small portion of whom may be found among the refined and educated classes, as any thing but insanity. So surely as this question is given to a jury who undertake to think for themselves, just as surely will they fail to agree upon a verdict.

People, who expect to find in legislation a panacea for all social evils, have imagined that the requirements of the case would be met by the appointment of a commission, whose business it should be to take cognizance of every case proposed for admission into a hospital, and give or withhold its sanction. It might be a permanent board consisting of a few members, or the duty might be performed in each town or county by some resident therein appointed especially for this purpose. While this is regarded as a mere matter of form, very little can be said against it, or for it. But, in order to prevent the abuses which are supposed to be so imminent, a regular inquisition is necessary, conducted strictly according to the forms of law. Any good which this procedure may possibly accomplish, would be obtained at the sacrifice of many important objects. For, observe how it would work practically in a case of acute mania, as it often appears. The patient is noisy, boisterous, and selfsufficient, bent on going out about his business, and threatening violence to all who endeavor to prevent it. He refuses proper food and medicine, perhaps insists on having stimulants, and requires the unremitted attention of two or three men. The house is in confusion, the family are frightened, attendants are obtained with difficulty, and every day reveals