A handy-book of forensic medicine and toxicology / by W. Bathurst Woodman and Charles Meymott Tidy.

Date:: 1877

Credit: A handy-book of forensic medicine and toxicology / by W. Bathurst Woodman and Charles Meymott Tidy. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$McQuirk was found guilty. Soon after this the case was referred to the Court of Examiners of the Surgeons’ Company, on the ground that neither Mr. Bromficld nor the apothecary had been examined, and that Mr. Foot only saw him after death. The Court (without assigning any reasons) gave, as their opinion, that Clarke did not die of the blow. McQuirk received a full pardon. Percival Pott was a member of this Court ; and Mr. Foot refutes this dictum from Potts’ own Memoir on the nature and consequences of th/jse injuries to which the head is liable from external violence. With Foot and Beck we fully agree, that the first verdict was the right one. The various injuries of the head referred to will be better understood by the following scheme of the different layers from without inwards. There are, in fact, three complex layers, viz,:— A. The outer layer, or hairy scalp, containing—(a) the hair and skin, with its epidermis, rete mucosum, and corium [see p. 1073] ; (b) the muscles of the scalp [occipito-frontalis, complexus temporal muscles, Ac.]; and (c) the peri-crcmium, or external layer of periosteum. B. The bony skull, or cranium, consisting of the frontal, two parietal, two temporal, and occipital bones, with the sphenoid bone, each bone being made up of—(a) an outer table of compact bone; (b) intervening diploe, or spongy cancellous bone, very vascular: absent in young children, and in very old people ; (c) the inner table, or vitreous plate of compact bone, very brittle and glass-like. C. The membranes, consisting of—(a) the dura-mater, or external thick, fibrous membrane, which is really the internal periosteum or peri- cranium ; (b) the arachnoid or serous membrane; (c) the pia-mater, or vascular membrane, dipping down deep between the convolutions of— D. The brain itself. The spinal cord has similar membranes, and is enclosed in a bony case, formed by the vertebrae. Outside this are muscles, and then comes the skin In the brain, however, the grey matter, or true nerve- cell layers, are on the outside chiefly. In the spinal cord most of the grey matter is in the interior of the cord. The brain and spinal cord, though centres for sensation, are themselves almost devoid of feeling. The differential diagnosis of compression of the brain from apoplexy, is almost entirely dependent on the history. In the latter there is no accident, and no marks of external injury; whilst in compression of the brain there is generally a history of accident, and marks of external injury. Yet cases are constantly occurring in which the compression depends upon fracture of the skull, which can only be detected post- mortem, there being no external signs of injury. Such fractures of the skull are usually of the base of the cranium. In some of these cases, besides the history of an accident, and the symptoms of compression just given, we have a discharge of cerebro-spinal fluid [often containing sugar] from the ear, extravasation of blood into the conjunctiva}, and into the tissues of the orbit. There may be free bleeding from the ear on one side, the blood coming from the diploe, through the lacerated or absent membrana tympaui. Deafness will point to the auditory nerve, facial paralysis to the portio dura; as does inability to close the eye, &c. ; loss of sensation in the face and tongue to the filth nerve; strabismus, ptosis, and dilated pupil to the third nerve; inability to$