with the placenta was expelled from the uterus many hours after death, is reported (Casper's 'Vierteljahrsschr.' 1861, 1, 186). 3. The child must be born capable of inheriting. Monstrosity. If the woman is delivered of a monster, which cannot inherit, the husband does not acquire a right of tenancy by the courtesy of the Courts. 6 MONSTERS. The connection of monstrosity with medical jurisprudence has been most ably investigated by St. Hilaire. Although legal questions connected with monstrous births do not often occur, yet a medical witness should be acquainted with certain facts respecting them. The law of England has given no precise definition of what is intended by a monster. According to Lord Coke, it is a being which hath not the shape of mankind; such a being cannot be heir to or inherit land, although brought forth within marriage.' A mere deformity in any part of the body, such as supernumerary fingers or toes, twisted or deformed limbs, will not constitute a monster in law, so far as the succession to property is concerned, provided the being still have 'human shape.' Even a supernumerary leg would not probably be allowed to avert an inheritance. A monster, in which the third leg was a fusion of two legs, was exhibited in London in 1846. (Med. Gaz.' vol. 37, p. 619.) From Lord Coke's description it is obvious that the law will be guided in its decision by the description of the monstrous birth given by a medical witness. It would not rest with a witness to say whether the being was or was not a monster-the Court would draw its own inference from the description given by him. Various classifications of monsters have been made, but these are of no assistance whatever to a medical jurist, because each case must be decided by the peculiarities attending it; and his duty will not be to state the class and order of the monster, but simply in what respect it differs from a normal human being. In consequence of the want of a sufficient number of precedents on this subject, it is difficult to say what degree of monstrosity would be required in law in order to cut off the civil rights of a being. Monsters may be acephalous (headless), dicephalous (two heads with one body), or disomatous (two bodies with one head). Others again, like the Siamese twins, may have two distinct bodies united by a broad band of skin. Would an acephalous monster be considered as devoid of human shape? Would a disomatous monster be allowed to inherit as one?-to marry as one?-or how would legal punishment be inflicted in the event of one of the bodies infringing the laws? Such are the singular questions which have been propounded by medical casuists in relation to these beings; and there is obviously ample room for the exercise of much legal ingenuity in respect to these questions. According to St. Hilaire, the rule which has been followed in all countries respecting these monstrosities is to consider every monster, with two equally developed heads, whether it be disomatous or not, as two beings; and every monster with a single head, under the same circumstances, as a single being. He ascribes the origin of this rule to the performance of the rite of baptism in all Christian countries upon each head, when the monster is dicephalous. This view appears rational when we consider that with two heads there are two moral individualities; while with a single head, there is one will and one moral individuality. But it is doubtful how far this doctrine would be accepted by jurists and legislators. The question whether, in a dicephalo-disomatous monster, the two beings would be bound by the act of one, either in civil or criminal jurisprudence, is a matter which, if these monstrosities were more frequent, would give rise to serious difficulties. Such a question is not purely speculative, because it might easily have been raised in respect to the Siamese twins during their stay in this country. According to St. Hilaire a case of this kind was actually decided in Paris in the seventeenth century, in relation to a double-headed monster. This author states that a double monster killed a man by stabbing him with a knife. The being was condemned to death, but was not executed on account of the innocence of one of its competent halves. ('Ann. d'Hyg.' 1837, 1, 331.) According to the same authority, compound monstrosity is not transmissible by generation. The reader will find an account of the most remarkable monsters born during the present century in a paper by Rüttel. (Henke Zeitschr. der S. A.' 1844, p. 229.) Among them is mentioned a three-headed monster, born living in Paris in 1830. Each head was baptized under a separate name. Monsters, especially the two-headed variety, are usually either born dead or die soon after birth. The varieties of monsters are very numerous. In the Museum of Guy's Hospital there is a large collection-some with two heads and one body, others with two bodies and one head. Phillips described one of these productions, in which the head and neck only were double. It had all the appearance of a mature fœtus. Both heads were covered with thick hair, and each was as large as that of a foetus at full time. The faces were similar, and directed forward. There was nothing specially noticeable about the external form of the chest or abdomen. The navel-string was single and central in position. The genital organs were single and of the male sex. The testicles had descended into the scrotum. The upper limbs were natural and of full size. There were three lower limbs, two joined to the body in the usual way and one ill-formed and rudimentary. (Guy's Hosp. Rep.' 1870, p. 457.) Dalton found on dissection that each head had a distinct spinal column. In the chest there was one heart and four lungs. In the abdomen there were two stomachs and one intestinal canal, partly single and partly double. There were other anatomical peculiarities showing that the abnormal conditions existed internally as well as externally. It had 'human shape,' but of a duplex character, resembling two children blended into one. For other cases of duplex monsters, the reader is referred to the Lancet' (1872, 1, pp. 465, 538, and 563). The 'Obstet. Trans.' contain also many accounts of recent monsters, with illustrations. In general they were born dead, or died during delivery, or, as in the above case, from the result of operations required for their extraction. When a woman is pregnant with twins one may be a monster and the other a well-developed child. Gervis met with a case of this kind. (Obstet. Trans.' 1869, vol. 10, p. 113; Edin. Med. Jour.' vol. 55, pp. 76, 435.) There is a traditional superstition that this malformation or monstrosity of offspring arises from mental emotions of the mother during pregnancy. Fisher, who collected a number of facts on the subject, affirms that there is no reasonable ground for this popular opinion. The instances related in support of it are in his view simply accidental coincidences, and these are neither sufficiently numerous nor authentic to justify the theory that monstrosity of the offspring is in any way caused by the mental emotions of a pregnant woman. On the contrary all vices of conformation and monstrosity are due to retarded, arrested, or excessive development. (Amer. Jour.' Ap. 1870, pp. 575.) Among the monsters which have attracted attention in this country during the present century there are three which require a short notice. The first was Christina Ritta, born in Sardinia in 1829. The parents were well formed, and the mother had already borne eight normal children. This monster was double from the head to the pelvis, the two vertebral columns being distinct as far as the os coccygis. The left bust was christened by CHRISTINA RITTA. THE SIAMESE TWINS. Fig. 150. 221 the name of Christina, the right by that of Ritta. The monster was brought to Paris, where it died about nine months after its birth. A cast of it may be seen in the Museum of Guy's Hospital. The engraving of this monster, fig. 150, is from a photograph of the plaster cast. In the further description of it, it may be observed that below the pelvis the monster is single. There are two heads, resting on two necks; and the union or fusion of the two busts is effected laterally towards the middle portion of the chest, so that the two corresponding breasts are almost blended. The abdomen, as well as the pelvis, evidently formed by the junction of two primitive pelves, is single. In the chest there were found two distinct sets of lungs and two hearts; but these were enclosed in a single bag or membrane (pericardium). During life the pulsations of these organs were so uniform that there was considered to be a single heart. There was only one diaphragm a fact which accounted for the simultaneous death of both bodies, one only having been previously indisposed. be The two-headed female monster, The Siamese twins, Chang and Eng, may regarded as forming the most remarkable duplex monster of modern times. They were two men accidentally bound together by a living tie, but not monsters in the anatomical sense of the term. They were born in Siam in 1811, and died in 1874, at the age of sixty-three years. In 1829-30 they visited England, and were seen by the author. They subsequently settled in the United States, and married two sisters. Chang had nine children, and Eng ten. In 1869 they again visited this country, and were examined by many medical men. These "twins" were small children, born without difficulty by a head and foot presentation, and up to twelve years of age the band connecting them was sufficiently flexible to allow of their lying with their heads in opposite directions. They were short men, Eng being five feet two, and Chang five feet one inch in height. The band uniting them was a fleshy mass of considerable depth and thickness-about four and a half inches in extreme length, and about three and a half inches deep at its juncture with each body. It proceeded from the lower end of the breastbone to the cartilages of the ribs. On the lower aspect of the band was the single navel, and in early life there was a distinct hernial protrusion into the band from each side. On each side of the median line of the band, each brother felt a touch over a space of about an inch; but beyond that range their sensations were purely personal and individual. The two brothers were, in fact, entirely distinct individuals both corporeally and mentally. Chang indeed died and became cold, and his brother only became aware of the fact on being told of it. Potassium iodide given to one individual appeared in his urine, and not in that of the other brother. Their tastes and dispositions were unfortunately entirely different, and all their physical functions were performed separately and unconnectedly. What Chang liked to eat, Eng detested; Eng was good-natured, Chang was cross and irritable. Indeed, the result was a quarrel ending in blows, and one day they came before the law for an encounter. The sickness of one had no effect on the other. Chang drank freely, and got drunk; Eng was temperate. Chang was physically inferior to Eng, but superior in mind. In 1870, Chang had an attack of paralysis, and in 1874 he died after exposure to cold, and a short illness. He is supposed to have died from a clot in the brain. On waking one morning, and being informed of his brother's death, Eng became greatly excited, fell into a state of syncopal coma, and died in about an hour, before he was seen by a medical man. (For full accounts of these celebrated and interesting twins see ‘Lancet,' 1869, 1, p. 228; 1874, 1, p. 385.) Under the circumstances mentioned, it would have been impossible in relation to civil and criminal jurisprudence to make both responsible for the acts of one. Living for forty years in America, they exercised the rights of citizenship as independent persons, and marrying two sisters, they entered into the contract as separate beings. No charge of bigamy was raised against them for this double union. It is clear, from this independence of will and action, that one might kill a person under circumstances which would constitute murder or manslaughter, the other not being an assenting party, and endeavouring to prevent the perpetration of the crime. The application of the criminal law would, as in the Parisian case related by St. Hilaire, become a subject of great difficulty. No punishment could be inflicted on the guilty without necessarily involving the innocent (undivided) moiety. Such cases of monstrosity must be regarded as setting at defiance all the ordinary rules of law, whether civil, criminal, or canonical. Another duplex monster, Millie and Christine, was exhibited in London in 1871. (Lancet,' 1871, 1, p. 725.) Like the Siamese twins they were two independent beings, females, united by a band extending from one os coccygis to the other. They were in all respects independent in thought and action. Malpositions, transpositions, or defects of the internal organs of any of the cavities, do not form monstrous births within the meaning of the English law. The legal question relates only to external shape, not to internal conformation. It is well known that many internally malformed persons live to a great age; and it is not until after death that malpositions and defects of this kind are discovered. One test of monstrosity has been based on the viability of offspring. According to some authorities a monster implies such a malformed being that the child would be pronounced nonviable, i.e. incapable of continuing to live after it was born. (Horn's "Vierteljahrsschr.' 1865, 2, 264.) Some medical jurists have discussed the question of viability' in new-born children, i.e. their healthy organization, with a capacity to continue to live, as if it were part of the jurisprudence of this country; but the author was not aware of any facts which bear out this view. The English law does not regard internal monstrosity as forming a bar to civil rights; and the cases of Fish v. Palmer, of Brock v. Kelly (1861), and of Llewellyn v. Gardiner (ante, pp. 207, 209, and 213), show clearly that the simple question in English jurisprudence is, not whether a child is or is not viable,' but whether it has manifested any distinct sign of life after it was entirely born. The French law is much more complex, and throws a much greater degree of responsibility on French medical jurists. (See Viability, post.) No person is justified in destroying a monster at birth. There are some other legal conditions which are required to be fulfilled in order to establish a tenancy by courtesy, but our remarks are confined chiefly to that which may become matter for medical evidence. PLURAL BIRTHS-SUPERFŒTATION-SUPERCONCEPTION-SUPPOSITITIOUS CHILDREN FOR Plural births. This has been regarded as a subject appertaining to medical jurisprudence; but we are not aware that there is any case on record in which the evidence of a medical man has been required respecting it. It is a simple question of primogeniture, which has been generally settled by the aid of depositions or declarations of relations or servants present at the birth. Of course in the absence of eye-witnesses the question of priority of birth must be a matter of conjecture. It cannot be determined by the size of the child. Women may have two, three, four, or five children at a birth. Twins are comparatively frequent, but triplets and quadruplets are very rare. Crooks met with a case in which a woman, labouring under dropsy, was delivered at the eighth month of three children, at intervals of fifteen minutes. They were contained in separate sacs, and connected with one placenta. There were two males and one female. The first two weighed about seven pounds, the second six pounds. One died within forty-eight hours, and the other survived a fortnight. (Amer. Jour. Med. Sc.' Jan. 1868, p. 279.) In the same journal (Oct. 1861, p. 576) a case of triplets is described by Pittinags. The expulsion of the children and placentæ did not occupy more than twenty minutes. There were two boys and a girl, and two placenta. Routh met with a case of triplets in 1867, of which he has given a report. (Trans. Obst. Soc.' vol. 9, p. 156.) Martyr has contributed another, in which the three children were of the size of a small seven-months' child. The first and last were males They all died within twenty-four hours, but lived long enough to give rise to a question of primogeniture. (Obst. Trans.' vol. 11, p. 208, 1870; see also another instance Lancet,' 1872, 2, p. 67.) pro According to Rüttel, out of 574,293 births in the kingdom of Prussia in 1840, there were 6381 cases of twins, 72 of triplets, and 1 of quadruplets. This writer knew an instance in which a woman had six children at a birth. (Henke, Zeitschr.' 1844, p. 226; and Med. Gaz.' vol. 36, p. 607.) Guthrie stated that in the Museum of the Royal College of Surgeons of England there is a large bottle containing five young ladies and gentlemen, all brought forth at one birth, and destroyed by an accident;' and he also says that he was for many years acquainted with a man whose mother duced twenty-eight living children in the first twelve years of her married life. ('Lancet,' Feb. 15, 1851, p. 176.) Russell met with a case, in 1849, in which there were five children at a birth. They were all males, and all born dead. The largest was six inches, and the smallest five inches long. They were prematurely born. There was one placenta of the ordinary size, with five umbilical cords attached to it round its centre. ('Lancet,' Feb. 3, 1849.) Young states that he attended a woman who was delivered of four males at one birth, three being from seven to eight months' children: they survived to the following day. One of the four was a fœtus of from fifty to sixty days, apparently showing conception at different periods. There was one placenta with four navel-strings quite distinct. ('Lancet,' March 1, 1856, p. 234.) Black reported the case of a woman who was delivered of four children, two males and two females. Three of the children weighed nearly four and a half pounds each. They were alive and thriving eight months later. (North. Jour. of Med.' |