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We can no more define insanity than sional opinion with the possible result of we can by definition give an expression lowering the value of the whole expert of a rainbow or landscape. Except in a testimony." few cases, insanity does not develop A medical expert should not be persuddenly. “It does not begin and end mitted to express an opinion upon a with a criminal act as its sole manifes- hypothetical question which does not in tation.” The act when committed is his opinion cover all the points bearing but one of several symptoms of his dis on the subject. If the questions are ease. In the case of Ducovic, in coming skilfully framed the experts usually agree to a conclusion in our report to the

in their replies. Governor, we considered the whole. We, as a profession, have the right of group of symptoms to amount to insan- respectful protest; and to ask that a ity. In his own solitude, the physician mode of procedure calculated to bring will have less difficulty to demonstrate discredit upon the profession be changed. the fact that the accused is insane, than These questions are scientific and prowhen he is subjected to the irregulari. fessional and should not be relegated to ties of cross-examination by lawyers. juries and courts. The existence of

“ So carefully guarded do the courts these vague cases of insanity is a quesseek to preserve the sacred province of tion that should be decided by a comthe jury, that the medical expert, in mission of professional experts only. cases where the issue is the mental con On the other hand, however, it must be dition of the party involved, is only per

borne in mind that the courts are charged mitted to express an opinion upon a with the administration of criminal jushypothetical question."

tice for the protection of society, and "By a process of ingenious aggrega are not so much concerned about settling tion, or elinination of symptoms, an

scientific questions. swers favorable to either view of the What I say is expressed with respect. case are elicited, or such a congrega ful deference to the wiser judgment of tion of circumstances presented, so defi the learned judges of our courts and cient in essentials, that the witness is members of the bar, who, however, must unable to express an opinion."

agree with the medical profession in the While, however, the courts are dis- feeling of uncertainty and general disposed to insist that the basis of the trust that attaches to expert testimony hypothetical question shall embrace con as it is now admitted in the courts. ditions that have been developed in the And this is not confined alone to the incourse of the investigation, there is a fallibility of the medical profession in radical defect permitted in their forma- giving opinions. It has been suggested tion in this respect, that the hypothesis by some lawyer that physicians bury does not embody all the medical history, their mistakes six feet under ground; neither is the medical witness allowed but I am unwilling to admit that such to frame a question which will embrace is the case oftener than the legal profesa complete history of it. He is there to sion swing their mistakes six feet above answer questions - nothing more. ground, the case of Ducovic not ex

“The hypothesis contains just as cepted. much of the case as will elicit an answer The modus operandi gone through with or opinion favorable to the party in experts place them in a wrong light. whose interest it is framed; conse They are looked upon as partisans. quently many times answers must come “ Too often,” says Gray (New York with the automatism of a machine. Medical Journal), his personal address, Hence, at one stage of the trial a ques his coolness and his adroitness, rather tion will admit of one answer, and at than any exposition of the facts of science a subsequent stage another question offered by him, are all that impress the framed from additional evidence warrants jury, untrained in the consideration of another exactly opposite. Then is pre- weighty problems and unacquainted sented an apparent conflict in profes. with medical knowledge only through

the garbled gleanings of a sensational In our own America is there such a press.”

precedent ? In the case of Howard J. Questions of law are discussed only Schneider of Washington, D. C., for by those qualified to discuss them. double homicide, sentenced to death, a They are brought not to the jury, but to commission, consisting of Drs. Allan the judge. If not answered to the law McLane Hamilton, John B. Chapin and yer's satisfaction, he may appeal to still C. L. Dana, was appointed by Chief higher judicial power. No so with the Justice Bingham.

No so with the Justice Bingham. The hearing was question the medical expert is obliged held before a full bench composed of to discuss in court. The history of our Chief Justice Bingham and Justices Hagcourt records many failures of justice in ner and Cox, without a jury. This is determining medical questions under the the only way to get a full, free, expert present system. Men have been hanged and seemingly untainted decision. If a as sane, when experts have testified to cross-examination is permitted the opintheir insanity, and post-mortem exami ion will not be such, but carefully nations have proven the correctness of guarded and defensive. their testimony.

There is a popular feeling that mediErickson (Bramwell) suggests that cine is an uncertain science. In point after an examination by both sides that of fact, there should be no essential disthe experts hold a consultation in order agreement among educated physicians. that the exact views of all may be Differences of opinion may exist, but a known on any and all points. By such conference of qualified physicians will procedure all discordant views may be usually reach the reasonable certainty reconciled and a combined opinion ar aimed at by the law. Medicine has, to rived at ; and, if possible, a conjoint re a very great degree, emerged from the port drawn up and handed to the judge period of empiricism to one of reasonand council, thereby very much simpli. able certainty. This fact seems not to fying the strictly medical part of the have been grasped either by the laity or case. If a conference of all the medical legal profession, who are slow to commen result in such a discrepancy of prehend the great scope of modern medopinion that no conclusion can be ar icine, and the lengthy and special trainrived at, the judge should appoint a ing required for the mastery of this commission to draw up a report of the great science. The law should be defendant's past and present condition changed to meet the advances of modern and future prospects. This would aid

This would aid civilization. the judge in coming to an opinion on Finally, what is to be done with the the purely medical or surgical part of homicide after he is found to be insane? the case.

Such a commission would be What right has a lunatic, an idiot, an a purely independent one, free from bias. epileptic, a paranoiac, even a crank In my opinion all such cases are beyond mentally, to cripple his posterity, or to the province of a jury. It is not for burden society and the commonwealth them to comprehend. The proper meth with his kind? What right have they od would be the selection of medical to marry and intermarry? Heredity, men by the judge who are known to be O! morbid and vicious heredity ! men of ability and expert upon the sub- Through the advances of science, and ject in court, to sit with him in an ad- particularly medical science, the world visory capacity. Such a procedure is is coming to see the ravages of heredity not without precedent. In English Ad and consanguinity. But what is to be miralty Courts, and sometimes in jury done with him ? While we should be trials, we see it. So common is the cus- loyal to all rights sacred to every Ameritom in Leeds that the medical expert is can citizen, do we not owe something seldom cross-examined ; and, in fact, it to society? Do we not owe much to is not uncommon to call only one side, society? Then with this great avaso high is the standard of their profes- lanche bearing down upon us let us flee sional honor and so great their skill. from its path by emasculating them

criminals included - and caring for them about an hour. Since then he has not in our benevolent institutions. Senti been under restraint. Possibly two ment should have no place in this. weeks after his admission he seemed

NOTE.—This report having been pre very anxious to return to Etna. After sented to the Governor, he granted a a month of confinement he became so stay of ninety days in order to allow the persistent in wanting to go to Etna that Pardon Board to make further investi he was placed in the criminal ward for gation. This Board asked the Secretary safe keeping. Dr. Murdoch informed of the State Board of Lunacy, Dr. Henry me that there seems to be some one in M. Wetherill, to investigate our report. Etna, possibly one of the remaining Having done so he substantiated us in eleven conspirators, with whom he every particular after several days spent seems to desire some kind of settlement, with the prisoner. Upon this the Par apparently, with violence. In talking don Board recommended life sentence at with the prisoner I find that he still has Riverside Penitentiary. On January his delusions and insists that Dobrozdra17, 1895, he had become so crazy (morn vic would have killed him but for an ing paper of January 18), that the prison opportunity. His delusions are more authorities had to send him to the insane intensified than when seen at the jail. ward in the penitentiary. On May 15 Could he be at liberty with no untoward I visited Dixmont and obtained the fol- surroundings he might lead a moderlowing history from J. M. Murdoch, one ately quiet life, but were anything to of the medical officers : George Duco occur to which he might attach deluvic admitted to that institution from the sional importance he would become a penitentiary March 12, 1895, handcuffed. very dangerous man. He was placed in a strait jacket for

BURN THE GARBAGE.- The Newport, their garbage because they have no sea R. I., Herald says: The city's garbage into which to dump it. They have been should not be taken out to sea and compelled to solve the garbage problem, dumped. It should be burned. The and they have solved it. They burn communications recently received by their garbage ; Newport should also. the Board of Aldermen, from the Board Some cities receive an income from the of Health and Professor Agassiz, make garbage furnaces instead of paying large plain the necessity that exists for reliev sums to contractors to carry the stuff ing the inhabitants of Newport of the away. The garbage of the World's unmitigated nuisance that is apparent Fair was burned in a furnace that conand the unquestionable danger of disease sumed 100 tons a day. Cincinnati, St. that lurks in our present method of dis- Louis and Detroit have garbage furnaces. posing of the swill accumulations in this Bridgeport, Conn., has just made a concity.

tract for ten years for the disposal of its However well the contractors may refuse. It will, it is stated, deliver not do their work, their way is not the right only all the garbage, but also all the or the best way to dispose of the offen tainted fruit and meat seized by the sive stuff. It should be burned. Many health officers as well as all the dead people have protested in hopeless silence animals found in the streets. The Board against the practice of dumping the re of Health is doing a disagreeable duty, fuse of the city in the sea. Heavy tides but none the less a bounden duty, in and south winds cannot but wash the urging a reform in the mode of disposing unwholesome rubbish into the channel of the dregs of this city - the present and back upon the shores. The prac- inethod being a nuisance if only because tice is objectionable on more grounds our water front is made objectionable by than one.

It pollutes the water used by reason of the foul air and vile smells bathers, it is an offense to the sight, that cartloads and scowloads of garbage it offends the nostrils. Other cities burn exhale.

In a

THE RELATION OF MENSTRUATION TO THE OTHER

REPRODUCTIVE FUNCTIONS.
READ BY INVITATION BEFORE THE CHICAGO GYNECOLOGICAL SOCIETY.

By A. W. Johnstone, M. D.,

Cincinnati, Ohio. MENSTRUATION, which occurs in all fifty pairs of healty ovaries that had been erect animals, is simply a shedding of removed to stop the growth of a fibroma, the superficial layers of the endome not more than two or three of which trium, and is a kindred process to

contained a ruptured follicle. The perthe moult in birds, to the dropping centage is therefore about the same in of the horns and hair in the deer healthy and diseased ovaries. tribe, and to the loss of the dermal

recent paper by Mr. Walter structures which occurs periodically in Heape, of Cambridge, England, he has so many animals. Because of the super demonstrated that a similar condition stitions connecting menstruation with exists in the monkey. We are therefore the other reproductive functions, I will forced to the conclusion that the rhythm attempt to throw light upon the chaotic of ovulation is not coincident with that state which still influences our ideas. of menstruation, and that their associaMenstruation is most often confused tion, whenever it occurs, is accidental with ovulation and “the rut.” Ten and in no way interdependent. They years ago the general belief was that are totally independent functions, both ovulation was the cause of menstruation. of which are essential to reproduction, Most of our older authors used the terms and the cessation of either produces stersynonymously. Many of you are doubt- ility.

ility. The only connection between less more familiar than I with the litera them is that if the four or five ova which ture of this subject, and you all know form during the year happen to ripen how fierce the battle has been. The near the end of the menstrual cycle, the old idea has been gradually abandoned, congestion of the pelvis incident to and now very few, if any, operative menstruation so softens the 'ovary that gynecologists believe that they have any the follicle is more liable to rupture. relation. The scepticism started by Dr. So far as I know, no report of a systeSinety has grown, and has induced oper matic study of the “rut" has appeared ators to examine specimens of excised in print. Some centuries ago rut and ovaries more carefully, and now menstruation were declared identical, doubt exists that the ovary is active be and the error has been transmitted with. fore birth, and continues to form Graafian out question from one generation to follicles as long as the woman lives, and another until the last decade, when some that during menstrual life it is probable of the more thoughtful minds began to that no more than four or five ova ripen be sceptical and advanced reasons for during the year. These facts are borne their disassociation. No one has here. out by my experience. My favorate tofore systematically studied these functime for operating is on the fifth day tions, and I will therefore have to deafter menstruation. During the last nine pend very largely, if not entirely, on years I have carefully examined hun my own studies. My belief is that rut dreds of pairs of ovaries and have never and ovulation, in the natural state of seen more than a dozen freshly ruptured the animal, depend more on the nervous Graafian follicles. Some may claim system and general health than on any. that the vast majority of those ovaries thing else, and that menstruation is inwere diseased, but I have seen at least dependent of the other two functions.

no

Let us consider the animal in its the approach of cold weather the clima. natural state. Our common American tic deprivations and winter dangers redeer is a good subject to study. In the commence and the “rut” closes. winter time he is half-starved from lack In all wild animals the rut occurs of vegetation in the woods; the low only when the climatic and other conditemperature, snow and ice make his con tions favor the highest physical developditions of life harder from lack of the ment. This law holds good in all wild proper amount of food, whereby he be birds, for it is then only that they can comes an easier prey to wolves and other stand the strain incident to love-making. carnivorous animals. The consequence The common crow, blackbird, is a very is that he has difficulty even in preserv- good type to study. In the winter he ing life. In the spring he sheds his travels around the rice fields of the winter coat and is provided with a suit South, leading a tramp's existence in a of lighter hair, and while this is going country foreign to him, and to which he on the male grows antlers for defence. goes only to escape the rigors of the The female about this time is far along Northern climate. For several weeks in pregnancy, and when the antlers are

in the spring he goes about the fields, fully grown she drops the fawn. When gathering up the worms and grubs. the fawns are dropped vegetation is After his long flight from the South he plentiful and lactation sets in. During experiences several weeks of an almost this time the male is kept fully em ideal existence; his food is plentiful, he ployed in getting food and guarding his becomes strong and hearty, and then he more or less helpless family. As the turns to thoughts of love. season advances the vegetation increases In the pairing season he does more and the fawn begins to eat grass. When work than at any other time in the year, the heat of summer commences the little which consists in fantastic dances, racing streams begin to dry up, and the animal and chasing after the females, aud sayonce more has difficulty in supporting age fights with rivals. He endures life, because of the enervating, the heat, more than would be possible in his ordithe effect of drought on the vegetation, nary physical state. Then come the and the distances which have to be care of the young and the long flights travelled to get water. Fully ten months for water and food during the drought in each year, therefore, the deer has all of the summer. After the moult, autumn he can do to live, without the extra ex finds him once more in flock, and with ertion incident to rutting. Soon after the first frosts he is off again for the the fall rains commence, vegetation be South. In the wild state the “rut” is comes more luxuriant, the antlers of the the cap-stone of perfect physical condimale and new suits of hair for both are tion. fully grown, the heat of the summer The same law obtains in the tropical is gone, food and drink are plentiful carnivora ; the “rut” comes with them everywhere, the fawns are weaned, and when food is most plentiful. both sexes are in the very finest condi The law is different in domesticated tion. Then, and then only in the whole animals, for their food is plentiful at all year, comes the rut, which to them, times, and as a result of continual high like most other animals, means an un nutrition changes occur in the reproducwonted amount of physical exercise be tive functions. sides the everyday runs for life from All animals, whether viviparous or their natural enemies, and an unusual oviparous, have a desquamation time, amount of energy is used up. If a doe which follows the procreative season. dislikes the attentions of a special buck, In the deer it occurs in the early spring, miles and miles of chasing and racing after the “rut” is over and the necesresult. If jealous males meet furious sity for protection has passed. battles take place, and the strain on The deer sheds his antlers and his both sexes could not possibly be endured hair at the same time. In both wild at any other season in the year. With and domestic animals all the dermal

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