Death investigation was a central aspect of forensic medicine. However, doctors struggled with uncertainty in defining and evaluating signs of death, at the same time as popular fears of premature burial abounded. Moreover, they faced considerable difficulties in distinguishing between homicides, suicides, and natural or accidental deaths and in determining the cause of death. Anxiety about insufficiently trained and incompetent practitioners who performed medicolegal duties that exceeded the limits of their knowledge and skills fueled demands for medicolegal reform. As medicolegal expertise played a more and more decisive role in criminal investigations and prosecutions, flawed forensic expertise became an increasingly salient problem that sparked ongoing debates about possible structural solutions.

Medicolegal experts often struggled to discern whether a suspicious death was caused by poisoning or natural causes, particularly during cholera epidemics, and faced difficulties in detecting traces of poison in cadavers. Changing understandings of the absorption of poisons in the body and the advent of new techniques, including the Marsh apparatus test, presented possibilities for demonstrative evidence of poisoning and revealed the dangers of flawed forensic expertise. Some doctors, scientists, jurists, writers, and other commentators issued warnings about the high sensitivity of the Marsh test, the possibility of numerous sources of contamination, and the problem of incompetent practitioners operating beyond the bounds of their knowledge and training. Nonetheless, the prevalence and nature of poisonings shifted over the course of the nineteenth century, largely in response to the evolution of scientific knowledge. However, public battles over the state of scientific and medical knowledge in poisoning trials raised concerns that the very means by which forensic doctors sought to establish their authority might undermine it.

Malingering, the practice of feigning medical conditions for specific purposes, became a pressing concern for many practitioners of legal medicine following the introduction of conscription during the Revolutionary and Napoleonic Wars. A burgeoning medicolegal literature on malingering revealed that some doctors went to great lengths to detect and expose malingerers by using deceit, coercion, painful procedures, and altered states of consciousness as diagnostic tools. Doctors justified the far-reaching tactics used in adversarial contests with suspected malingerers in the name of the public good. Acting on behalf of the state to expose them, doctors engaged in adversarial relationships with suspected malingerers. These encounters also provided an impetus for debates about medical ethics; however, ethical concerns about doctors’ methods of detecting malingering were rarely raised and debated until the end of the nineteenth century.

Sexual crimes against children appeared before the courts with a dramatically increasing frequency over the course of the nineteenth century. But these prosecutions did not always translate into successful convictions of sexual offenders, in part due to contradictory and ambivalent understandings of childhood innocence and doctors’ frequent negative findings concerning the physical traces of these crimes. Medicolegal experts routinely cast moral judgements on the children, particularly working-class girls, identified as victims of sexual crimes. Influenced by bourgeois attitudes toward male honor and notions about the perceived immorality of the working class, these doctors warned that children’s accounts of sexual assault could not be trusted and could destroy men’s reputations. By discounting children’s accounts, doctors laid claim to their exclusive ability to evaluate proof of sexual offenses against children. Furthermore, by discrediting children identified as victims of sexual crimes, medical practitioners shaped attitudes toward sexual assault that presented long-lasting challenges to the pursuit of justice.

The emergence of forensic medicine as a distinct specialty in the nineteenth century sparked debates about the extent which it could reveal truth, furnish legal proof, and serve justice. This question was particularly salient in the context of the institutional and juridical changes that the French Revolution had created, which transformed the field of legal medicine. This introduction provides an overview of the legal landscape in which medicolegal experts operated, the professionalization of medicine, and the rising influence of medical experts in French criminal courts and beyond.

Male medical experts faced challenges and uncertainty in examining presumably pregnant or postpartum women, particularly condemned women facing execution who declared pregnancy, as well as women accused of infanticide. Forensic doctors’ efforts and methods to establish the facts of infanticide cases commonly elicited criticism from other medical men or judicial authorities, and their conclusions were frequently at odds with the accused’s version of events. In many cases, forensic reports and testimony appeared to be the most decisive factor in shaping jury verdicts. However, all-male juries often weighed forensic evidence against evaluations of the character and life circumstances of the accused, and the sympathies of jurors shaped the interpretation of forensic evidence as well as judicial verdicts. Medical men’s role in the search for material proof of the crime was often both crucial and problematic, and changing, ambivalent social attitudes towards infanticide shaped the interpretations and consideration of forensic evidence.

The stature of the medicolegal expert grew in France over the course of the late eighteenth and nineteenth century. Although the trajectories of medicolegal experts in France and in the American adversarial system diverged, both American and French citizens today have relatively high levels of confidence in forensic expertise. This conclusion and epilogue explores the legacy of the rise of forensic medicine in nineteenth-century France, the enduring public interest in forensics, the dangers of the TV-induced “CSI effect,” and changing attitudes towards expertise in the twentieth and twenty-first centuries.