MEDICO-LEGAL WORK OF CIVIL SURGEONS. late
Of
there
has
been
good
deal of
the Indian
Medical
a
correspondence regarding Service, special reference being
made to the
duties which the medical officers this
country
draw.
perform in they
and the handsome salaries
In this connection it might be useful to some of the duties which
draw attention to
called upon to perform. We propose first of all to deal with certain of the medico-
they
legal time in
are
duties of
system
a
Civil
Surgeon.
These at
one
particularly onerous, but changes and the demands of a more complex
were not
434
INDIAN MEDICAL GAZETTE.
form of government have, as in other departments, made itself felt in this branch of State
distances
medicine.
tended.
Within recent years the amount of medico-legal work has greatly increased, and the orders on the subject are much more stringent than
formerly. The result of this is that in many districts bodies are sent into head-quarter stations to be examined by the Civil Surgeon
l^ersonally
instead of
mined at the medical
subordinates.
100
previously,
exa-
of sub-divisions
Hence bodies
by not
are
sent in from distances of 40 to
unfrequently even
being,
head-quarters
as
miles,
and
days often elapse after
death
[Nov.
with the examination of bodies sent in from Such
beyond securing the viscera for analyses for poison, it is absolutely impossible to tell the cause of death
unless
it
be due to broken bones.
Justice under these circumstances must often fail. Nor is this work without its
dangers.
this work unnecessarily exposes the patients of the Civil Surgeon in the station and in the The Civil
composition has
to render
families in the station; and it is
No
canons
the
autopsy
become
so
advanced
most loathsome
as
duty.
com-
We will
let pass those personal risks which the Civil Surgeon incurs in making these autopsies, but we would draw attention to the dangers to which
Civil
a
long
the purpose for which it is inbodies are so decomposed that
serves
occurred before an examination can be made. When that examination is made dehas
1895.
Hospital.
Surgeon's duty
is
to attend to the civilians and their wives and
against
all the
of medical science that delicate ladies and
parison can be made with similar work in children should be attended, or patients operated England, Germany or other European countries. upon by a medical man who on the same day has There, in the majority of cases, the bodies are been examining a decomposed body. That these fresh, while here it is exceptional for them to be risks are reduced to a minimum by the extreme not decomposed. The conditions are totally care and precautions taken by the Civil Surgeon different, and the rapid decomposition and its goes without saying. But we are of opinion that effects which take place on a dead body in an the Government has a duty to the living as Indian climate are not seen in Europe, and it is well as to the dead, and that a system which is certain and other auto endanger the life of a lady in childthat calculated German, English quite thorities have no conception of the appearances birth, or of other patients who require their presented by a body which has been subjected wounds to be examined or attended to, requires If the Government are to an Indian climate, and which, for the purpose to be speedily changed. of medico-legal examination, has been sent into of opinion that it is necessary to insist on an head-quarters, carried on a light stretcher on the elaborate system of medical jurisprudence, the shoulders of bearers.
Bapid decomposition
not
only swells up the cellular tissue of the body, distorting, and misshaping every part, and rendering the opening and examination of the body a process, but produces such changes on the tissues as to obliterate the signs which are depended on for information in a fresh body. The
sickening body with
is in such
a
with
state
as
to be sometimes alive
of it
remedies lie in their other elaborate
own
system
hands, but like every costly. It is neces-
it is
sary for them to appoint medical officers qualified to perform medico-legal work in various selected
portions
of
districts, such as the headquarters of sub-divisions and outlying dispensaries, to whom bodies can be sent within a reasonable distance and in
condition.
a
compaiatively fresh
only portions remaining ; There is another point in this connection to unfrequently the bowels protruding, these having burst through their natural bounds which it is desirable to draw attention. Most by the pressure to which they are subjected by people would suppose that when Government gases of decomposition, and often the brain is insist on their medical officers performing such found to be a stinking fluid. The work undoubt- loathsome duties that they would provide thein edly is without parallel, the most loathsome with accommodation which would ensure the duty that falls to a European in this country. least amount of danger and discomfort, and at the same time provide all the necessary appliances. Can For this disgusting work there is no special pay. it be believed that the so-called mortuary usually It is a duty assigned to the Civil Surgeon in consists of an ordinary hut with mud-walls and order that there shall be available to Government an in independent expert witness judicial cases. mud floor containing generally a dilapidated 1 It is questionable, however, whether the system wooden table and no other appliances. Kecently now in practice of the Civil an burdening Surgeon attempt has been made to remedy this, and in maggots
it has not
O
'
Nov.
1895.]
few
places
a
MEDICAL NEWS. better mortuaries have been
ed. We have
specting to
one
provid-
had the
opportunity of inof these mortuaries, built according lately
what is termed
standard
a
plan
and
we
find it to be a brick-building surrounded by a low mud-wall and having an ordinary tiled roof, with
no
verandahs
wind
or
rain.
its interior
or
other
protection from
sun,
The
building, which measures in 10'x 14/x 12', has only sufficient
space to enable the examiner to walk round the table on which the body is laid, but does not permit of a writing table being placed in such a
position
to allow of the medical officer to report. The plan in fact appears
as
write
his
to
to be
us
entirely
unsuited for its purpose,
and
being too small, giving no protection against the sun or weather, and rendering the performance of the 'post-mortem a task of danger and difficulty.
435