Ninety-five cases concerned deceased newborns. Seventy-five of the newborns were assessed as full-term. One child had evidently suffered intrauterine death (macerated at birth) and was therefore excluded from the analysis. Altogether 74 newborns, of which there were 33 males, 33 females, and eight whose gender was not indicated, were therefore included. Average weight and length was 3200 g and 52 cm for boys, 3005 g and 51 cm for girls.
Figure 4 shows the conclusions with regard to whether the child had breathed, compared with time elapsed post partum, and autopsy. There was generally a correlation between the conclusion from the forensic examination on the extent to which the child had lived, and a positive lung test, but also other criteria, such as intestinal gas, were included in the assessment. Only few of the children were assessed as not having breathed, even when significant decomposition was described, and the decomposition of other organs was seldom taken into consideration when the lung test was assessed.
Case 162/1910 is a typical example: «Forensic dissection of the body of a newborn child, found in the lake at Grönlien – The body of a child who, although the genital organs are very decomposed, can still be recognised as a male child – The lungs are set far back in the air sacs, which also contain large quantities of a red-coloured, clear fluid. On the surface of the lungs, particularly on the upper sections and along the front edge, there are numerous large, tightly packed bubbles of gas, partially in the lung tissue, and partially and significantly on the surface beneath the pleura. The majority, and the largest, of these bubbles of gas are in the right lung. – The lungs float with the greatest ease, together with the heart and the thymus. –With regard to the adrenal glands and pancreas, which like the other organs show themselves to be severely decomposed, there is nothing to remark. – All the intestines are extremely bloated with gas. – Conclusion: – Although the decomposition in this case is very pronounced and presents obstacles for the assessment of the finding in the external organs, we nevertheless believe we may conclude, taking into account the condition of the lungs and the gastrointestinal tract, that the child has lived and breathed after birth.»
Francis Harbitz, who incidentally was one of the two expert witnesses, and the other members of the Norwegian Board of Forensic Medicine, signed the declaration without comments.
In only two cases does decomposition result in a positive lung test being overridden. Municipal medical officer Einar Stoud Platou (1861 – 1946) and district medical officer Hakon Knudtzon (1857 – 1926) determined a positive lung test when performing the autopsy on a female child who was found in Stjørn Fjord in the middle of summer and concluded that the result «could be caused by gas produced during decomposition, taking into account the high level of decomposition of the other organs» (14). The Board made no comments about this conclusion. A similar conclusion, made two years later by district medical officer Konrad Adolf Haug (1868 – 1935) and Anders Falck (1873 – 1961) from the autopsy on the bodies of two infants found in a sack in a lake in Namdalen, was discussed by the Board. They assessed whether the conclusion would have been the same if the bodies had not been sunk in the lake, but agreed that it was not possible to draw any definite conclusion as to whether the children were born alive or not (15).
The expert witnesses were more reserved in their statements on cause of death, especially after some time had passed. Asphyxiation was given as the possible cause of death for less than half of the full-term infant corpses (33 of 74). Nevertheless, reports giving asphyxiation as the probable cause of death in highly decomposed corpses were signed without comments by the Board, even in cases where few criteria were fulfilled:
«The body appears to be in an advanced state of putrefaction and gives off an intense odour. –The face and left side of the head are contaminated with more or less dried blood mixed with sawdust, so that the contours of the face are indistinguishable, and eyes, nose and mouth may only be distinguished by way of suggestion. – There is no exudation of blood on the conjunctiva palpebrarum. – no exudation detected – The membranes of the mouth, larynx and trachea are blue-red. – Conclusion: – The cyanotic condition of the respiratory organs and their membranes indeed point to the possibility of death by asphyxiation immediately after the birth – (16).
Moreover, it is «congestion of the internal organs and exudation of blood on the surface of these, and the dark, liquid blood» that essentially make for the description of cases of death from asphyxiation, irrespective of the condition of the body (17).
«Asphyxiation» was given as the cause of death for 33 full-term newborns. Of these, autopsies were performed on 15 within seven days after the birth, three were the subject of autopsy between one week and one month post partum, and for 15 the time of autopsy was not given. Five of these 15 are described as being in a state of decomposition.
Only in one case did the Board make a comment on a conclusion of assumed death from asphyxiation. The body, for which the time of birth was unknown and which had to be thawed for two days before it could be examined, showed some «ecchymoses» on the pericardium and liquid, non-coagulated blood in the heart. The blunt statement of cause of death (Cause of death: asphyxiation) was criticised by the Board, which had no objections to the conclusion itself, but recommended a less direct phraseology (18).