Account of a remarkable case of suicide : with observations on the fatal issue of the rapid introduction of air in large quantity into the circulation during surgical operations / by P.D. Handyside.

  • Handyside, P. D. (Peter David), 1808-1881.
Date:
1838
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Licence: Public Domain Mark

Credit: Account of a remarkable case of suicide : with observations on the fatal issue of the rapid introduction of air in large quantity into the circulation during surgical operations / by P.D. Handyside. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    3. The preceding observation explains satisfactorily, what in the practical examination of similar cases to those adverted to calls usually from medical practitioners for especial regard ; viz. the extreme irregularity of form in the incisions, a condition which has been, by Sir Everard Home,* regarded as a presumption al- ways against suicide, -f- For we now sec how, if a body be disco- vered on a road or in a retired spot, under circumstances leading to the apprehension of some suspected individual, and the marks usually assumed as those of suicide be found wanting on it, while others of a quite opposite character present themselves, medical testimony may (in ignorance of the facts alluded to) give counte- nance and support,—and that too, far wide of the truth,—towards establishing the validity of the charge which may be presented against the individual, solely on collateral and indirect evidence. And thus farther proof is afforded of a fact which criminal law so often serves to display, how an inadequate amount of knowledge,— like an insufficient post mortem inspection,—may render, in the progress of a serious trial, the results of the examination of me- dical witnesses matter of such momentous importance. 4. The uncommon situation of the wounds in this case is ex- plicable on the circumstance of the partial acquaintance of the in- dividual with the anatomy of the neck. 5. The unusual amountof importantparts here divided,in wounds limited superficially, but made after repeated introductions of the cutting instrument,—is perhaps worthy of remark. 6. The circumstance, that notwithstanding the very deep and ex- tensive incisions made with the view of opening the carotid artery, the anatomical relations of that vessel are such, that it alone, of all the contents of the cervical sheath of vessels, escaped injury, is probably an unique occurrence. 7. The heart, as in M. Beauchene's case, was perfectly empty of blood, and contained air alone ; other cases of death from this ac- cident having usually presented in this organ, commixed with the air, some blood, either in a fluid, j or else in a frothy state. The lungs, as in Beauchene's, Dupuytren's § and a few other cases on record, were emphysematous,—a condition not ascribable apparently • Dr Gordon Smith's For. Med. 1824, p. 305. t I have given, (See Plate, Fig. 3.) from a subject brought this season into my Practical Anatomy Rooms, a comparative sketch of the regularity of form of a wound inflicted by another person, and which caused death in a few minutes. A woman plunged into the left side of the neck of her husband, in a direction down- wards and forwards, between the angle of the jaw, and the anterior margin of the slcrno-mastoid muscle, one of the pointed straight knives used for cutting leather. She thereby divided the posterior two-thirds of the internal carotid artery, the ante- rior part of the internal jugular vein, and the pneumogastric nerve. The incision in the skin was only three-fourths of an inch in length; its long axis lay in a trans- verse direction, and its edges were perfectly smooth and regular. In this case the state of the veins was not ascertained. $ Dupuytren, Archiv. Gen. v. 433. § Ibid.