The Medico-Legal Case Reported by Hodgkin in 1832

Wilson I. B. Onuigbo^*

Medical Foundation & Clinic, 8 Nsukka Lane, Enugu 400001, Nigeria.

Corresponding Author:

Wilson I. B. Onuigbo
Medical Foundation & Clinic
8 Nsukka Lane, Enugu 400001, Nigeria
Tel: 08037208680
E-mail: wilson.onuigbo@gmail.com

Received Date: May 02, 2015; Accepted Date: June 15, 2016; Published Date: June 22, 2016

Citation: Onuigbo WIB (2016) The Medico-Legal Case Reported by Hodgkin in 1832. Glob J Nurs Forensic Stud 1: 103. doi: 10.4172/2572-0899.1000103

Copyright: © 2016 Onuigbo WIB. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

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Abstract

Case reports of historical vintage are of considerable interest in the medico-legal field. Thus, a previous such case was demonstrated personally concerning a seaman; although he was sentenced, postmortem examination instituted by a lawyer versed in Anatomy was salutary. Therefore, the present case is deemed worthy of extraction from the famous 1832 work of Hodgkin. Indeed, with reference to the postmortem examination, the suspicious appearances of the liver and spleen, which were observed, were led to rest as not being due to violence

Keywords

Liver; Spleen; Trauma; Nursing; Autopsy

Introduction

The medico-legal arena merits documentation as regards autopsied cases. One such case has been reported by me earlier [1]. The Abstract ran thus:

A seaman died after suffering a month due to a heavy blow he received in his liver region. This was an incident of approximately 150 years ago. Due to the results obtained in the fresh autopsy the person was imprisoned. Later on, the defense counsel was instructed to investigate the case further and go for an exhumation. The detail investigation revealed presence of lethal disease and the case was concluded by discharging the allegation by the grand jury. The case is inspected from all possible angles and proved to depend on the expert evidences derived through modern principles.

Evidence is crucial. Accordingly, another historical case is presented here especially because it manifested as a special case that was culled from the 1832 series with which Thomas Hodgkin [2] established the eponymous “Hodgkin Disease.” Incidentally his biography was documented by me and presented elsewhere [3]. Here, I would like to summarize the relevant data in the following section.

Historical Case Report

Mary Hamblin was admitted in Charity Ward under Dr. Bright on April 27th, 1831 with a complication of mania, which she was suffering more than a week. This case was recorded on May 3, 1831. She gave birth to twins and suckled them for sixteen months. Being of sensitive mentality, her perception towards life altered. Before these situations she complained problem in her head and further claimed that she may become a person with unstable mentality to her known people.

The information on the symptoms were not quite perfect, even though it appeared that there might be some restriction had been engaged, while being in the hospital she provided her agreement positively towards not likely to be used in an ill-mannered way. Her stay at hospital was reported with an almost comatose state. Alongside it has been reported that while she was nearing a state of hallucination, she use to utter hymns and attempted to go out of bed while following her condition she was easily restrained by others. No evidence of erotic tendency was observed in her delirium state. Following her admission to the hospital, she died after six days.

The post-mortem examination revealed mostly normal appearances as follows:

The post-mortem report suggested activity of violence on the liver while apparently the liver was found healthy in terms texture and form. The convex surface of the liver was having yellowish irregular spots along with marks.

Similarly, the spleen was presented with normal shape and size and seemed to be healthy. Surprisingly, it was having unexpected spots containing darker venous hue. Lighter colour was observed for some of the region in the central part.

Just a little over the middle, the spotted regions displayed affected impact on transverse direction. Further observation of these spots through dissection it was found that certain spotted regions actually were containing coagulated blood from venous origin. Such coagulated regions were quite similar to the lung having pulmonic apoplexy. Particular masses of this type were having internally light colour. Any kind of softening was not observed in this case. From these evidences of injuries found in the liver and the spleen indicated that it might have happened during restraining her while she went out of control during her hospital stay.

Discussion

This report is of considerable interest, especially for a Journal combining both Nursing and Forensics in its title! Indeed, as reported above, she was delirious. No wonder that she tried “to get out of bed, but was easily restrained.” Of course, the question of trauma came into the picture.

Incidentally, trauma has been recognized as a neglected disease of modern society [4]. In this context, there are established historical principles [5]. Nowadays, the peculiar position of the nurse was adverted to by a group [6]. As they put it, “The information the nurse gathers and documents can be crucial to what happens after the emergency.” They went further thus: “Minor injuries often occur during treatment. If not explained, their cause may be misinterpreted.”

References

1. Onuigbo WIB (1985)Expert evidence. Historical perspectives. Am J Forensic Med Pathol 6: 141-143.
2. Hodgkin T (1832)On the morbid appearances of the absorbent glands and spleen. Med-Chir Trans 17: 68-114.
3. Onuigbo WIB (1964)Thomas Hodgkin (1798-1866) on cancer cell carriage. MedHist11: 406-411.
4. Tederchi LG (1981)Trauma. The neglected disease in modern society. Am J Forensic Med Pathol 2: 105-106.
5. Onuigbo WIB (2014)Historical origins of informed consent in cancer surgery. J Forensic Res 5: 246-247.
6. Mittleman R, Goldberg HS, Waksman D (1983)Preserving evidence in the emergence department. Am J Nursing 83: 1652-1656.