DETECTION OF POISON IN THE FOOD.

45

This is undoubtedly

healthy persons at the same time, and in the same manner. true, as a general principle, but the following case will show that mistakes may occasionally arise even under these circumstances. It occurred in London, during the prevalence of the malignant cholera in the year 1832. Four of the members of a family living in a state of great domestic unhappiness, sat down to dinner in apparently good health: some time after the meal, the father, mother, and daughter, were suddenly seized with violent vomiting and purging. The stools were tinged with blood, while the blueness of the skin, observed in cases of malignant cholera, was wanting. Two of the parties died. The son, who was known to have born ill-will against his father and mother, and who suffered no symptoms on this occasion, was accused of having poisoned them. A strict investigation took place Before the coroner; but it was clearly shown by the medical attendant that the deceased persons had really died of the malignant cholera, and there was no reason whatever to suspect that any poison had been administered to them. In this instance, it will be perceived that symptoms resembling those of irritant poison appeared suddenly in several individuals in perfect health, and shortly after a meal. We hereby learn that the utility of any rules for investigating cases of poisoning depends entirely on the judgment and discretion with which they are applied to particular cases.

It is well to bear in mind, in conducting these inquiries, that symptoms resembling those produced by irritant poison may be sometimes due to the description of food which may have been taken at the meal. Besides flesh rendered unwholesome from disease and decay, there are certain kinds of shell-fish, as well as pork, bacon, sausages, cheese, and bread, which, under certain circumstances, may give rise to formidable symptoms, and even death. In such a case, all the foregoing characters of poisoning are brought out; and, indeed, the case may be regarded as one of poisoning by an animal or vegetable irritant. The diagnosis is difficult; and great ambiguity frequently arises, from the fact that not more than one or two individuals may be affected, who have frequently before partaken of the same kind of food without any particular inconvenience.

4. The discovery of poison in the food taken, or in the matters vomited.—One of the best proofs of poisoning in the living subject is the detection of poison by chemical, or if of a vegetable nature, by microscopical analysis, either in the food taken by the person labouring under its effects, or in the matters vomited. The evidence is of course more satisfactory when the poison is detected in the matters vomited, than in the food; because this will show that the poison has really been taken, and will readily account for the symptoms. If the vomited matters have been thrown away, we must then examine the food of which the patient may have partaken. Should the results in both cases be negative, the probability is, that the symptoms may have been due to disease.

In investigating a case of poisoning in the living subject, a medical jurist must remember that poisoning is sometimes feigned, and at others imputed. It is very easy for an artful person to put poison into food, as well as to introduce it into the matters vomited or discharged from the bowels, and to accuse another of having administered it. There are few of these accusers who go so far as to swallow poison under such circumstances, there being a great dread of poisonous substances among the lower orders; and it will be at once apparent, that it would require a person well versed in toxicology to feign a series of symptoms which would impose upon a practitioner at all acquainted with the subject. In short, the difficulty reduces itself to this:-What inference can we draw from the chemical detection of poison in food? All that a medical man can do, is to say whether poison be present or not in a particular article of food:-he must leave it to the authorities of the law to develope the alleged attempt at administration:-but if the poison have been actually administered, then we should expect to find the usual symptoms. The absence of these symptoms would be a very strong fact against the alleged administration. With regard to the detection of poison in the

46

EVIDENCE OF POISONING IN THE DEAD BODY.

matters vomited from the stomach, this affords no decisive proof that it has been swallowed, except under two circumstances:-1. When the accuser really labours under the usual symptoms of poisoning, in which case there can be no feigning, and the question of imputation is a matter to be established by general evidence. 2. When the matters are actually vomited into a clean vessel in the presence of the medical attendant himself, or of some person on whose testimony perfect reliance can be placed.

CHAPTER III.

ON THE EVIDENCE OF POISONING IN THE DEAD BODY-PERIOD AT WHICH POISONS PROVE FATAL CHRONIC POISONING-POST-MORTEM APPEARANCES PRODUCED BY THE DIFFERENT CLASSES OF POISONS-REDNESS OF THE MUCOUS MEMBRANE MISTAKEN FOR INFLAMMATION -ULCERATION AND CORROSION-SOFTENING-PERFORATIONS OF THE STOMACH FROM POISON AND DISEASE.

SUPPOSING that the person is dead, and we are required to determine whether the case be one of poisoning or not, we must, in the first instance, endeavour to ascertain all the particulars which have been discussed in the last chapter, as indicative of poisoning in the living subject. Should the deceased have died from poison, the circumstances of the attack, and the symptoms preceding death, ought to correspond with the characters already described; and in these investigations it is well to bear in mind the following rule:-There is no one symptom or pathological condition which is peculiar to poisoning; but at the same time there is no disease which presents all those characters which are met with in a special case of poisoning. [Dr. G. reminds us that the evidence of medical men is frequently required to determine whether the deceased came to his death by poison, or from some other cause. (See 1 McNally, 329-335.) When this evidence is given, the facts on which the opinion is grounded must be stated. (Dickerson v. Barker, 9 Mass. Rep. 245.)-H.] The additional evidence to be derived from the death of the person may be considered under the following heads:

1. The time at which death takes place after the first occurrence of symptoms. -This question it is necessary to examine, because the more common poisons, when taken in fatal doses, generally produce their fatal effects within certain periods of time. By an attention to this point, we may, in some instances, be enabled to negative a charge of poisoning, and in others to form an opinion of the kind of poison which has been taken. In a court of law, a medical practitioner is often required to state the usual period of time within which poisons prove fatal. It is to be observed that not only do poisons differ from each other in this respect, but the same substance, according to the form or quantity in which it has been taken, will differ in the rapidity of its action. A large dose of prussic acid, i. e. from half an ounce to an ounce, may destroy life in less than two minutes. In ordinary cases of poisoning by this substance a person dies, i. e. all signs of life have commonly ceased, in from ten to twenty minutes:-if he survive half an hour, there is some hope of recovery. In the cases of the seven Parisian epileptics, accidentally poisoned by this acid, the first died in about twenty minutes, the seventh survived three quarters of an hour.-(See post, PRUSSIC ACID.) Oxalic acid, one of the most energetic of the common poisons, when taken in a dose of from half an ounce to an ounce, may destroy life in from ten minutes to an hour: if the poison be not perfectly dissolved when swallowed, it is a longer time in proving fatal. The strong mineral acids, in poisonous doses, destroy life in about eighteen or twenty-four hours. Arsenic, under the form of arsenious acid (white arsenic,) operates fatally in from eighteen hours to three

ACUTE AND CHRONIC POISONING.

47

or four days. It has, however, in more than one instance, killed a person in two hours, although this is by no means common. Opium, either as a solid or under the form of laudanum, commonly proves fatal in from six to twelve hours; but it has been known, in several instances, to destroy life in less than three hours: they who survive the effects of this poison for twelve hours are considered to have a fair chance of recovery. This must be understood to be merely a statement of the average results, as nearly, perhaps, as we are warranted in giving an opinion; but the medical jurist will of course be aware that the fatal period may be protracted or shortened, according to all those circumstances which have been elsewhere stated to affect the action of poisons.

There are various forms which this question may assume in a court of law:the death of a party, alleged to have taken poison, may have occurred too rapidly or too slowly to justify a suspicion of poisoning. The following case may serve as an illustration:-A woman of the name of Russell was tried and convicted at the Lewes Summer Assizes, in 1826, for the murder of her husband, by poisoning him with arsenic. The poison was detected in the stomach; but the fact of poisoning was disputed by some medical witnesses, for this among other reasons -that the deceased had died three hours after the only meal at which the poison could have been administered to him. The authority of Sir A. Cooper and others, was cited to show, that, according to their experience, they had never known a case to prove fatal in less than seven hours. This may have been; but, at the same time, there was sufficient authority on the other side, to establish that some cases of arsenical poisoning had actually proved fatal in three or four hours. So far as this objection was concerned, the prisoner was very properly convicted.

On the medical question raised at this trial, I may observe, that within the last few years, two distinct cases have occurred where the individuals died certainly within two hours after taking arsenic; and several instances have been reported since the trial, in which death took place in from three to four hours after the administration of this poison. It seems extraordinary in the present day, that any attempt should have been made by a professional man to negative a charge of criminal poisoning upon so weak a ground as this; but we must remember that this opinion was expressed many years ago, when the subject of toxicology was but little understood. It is quite obvious that there is nothing, so far as we know, to prevent arsenic from destroying life in an hour. A case will be hereafter related, in which death took place from arsenic most probably in half an hour. These matters can only be settled by a careful observation of numerous cases, and not by any à priori reasoning, or reference to individual experience.

In all instances of sudden death, there is generally a strong tendency on the part of the vulgar to suspect poisoning. They never can be brought to consider, that persons may die a natural death suddenly, as well as slowly; or, as we shall presently see, that death may really take place slowly, as in cases of disease, and yet be due to poison. This prejudice continually gives rise to the most unfounded suspicions of poisoning. One of the means recommended for distinguishing narcotic poisoning from apoplexy or disease of the heart, is the difference in the rapidity with which death takes place. Thus, apoplexy or disease of the heart may prove fatal either instantly or within an hour. The only common poison likely to operate with such fatal rapidity is prussic acid. Poisoning by opium is commonly protracted for five or six hours. This poison has never been known to destroy life instantaneously, or in a few minutes. Thus, then, it may happen, that death will occur with such rapidity as to render it impossible under the circumstances to attribute it to narcotic poison.

Chronic poisoning.-When a poison destroys life rapidly, it is called a case of acute poisoning, to distinguish it from the chronic form, i. e. where death takes place slowly. Chronic poisoning is not a subject which often requires medicolegal investigation. Most poisons, when their effects are not rapidly manifested,

48

POST-MORTEM EXAMINATIONS.

owing either to the smallness of the dose or to timely treatment, are capable of slowly undermining the powers of life, and killing the patient by producing emaciation and exhaustion. This is sometimes observed in the action of arsenic and corrosive sublimate, but it has been remarked also in cases of poisoning by the mineral acids and caustic alkalies. Death is here an indirect consequence:in poisoning by the acids or alkalies, either stricture of the oesophagus is induced, or the lining membrane of the stomach is destroyed and the process of digestion impaired, a condition which leads to emaciation and death. The time at which these indirect effects may prove fatal, is of course liable to vary. A person has been known to die from a stricture of the oesophagus, brought on by sulphuric acid, eleven months after the poison was swallowed; and there is no reason to doubt that instances may occur of a still more protracted nature. In these cases of chronic poisoning there is considerable difficulty in assigning death exclusively to the original action of the poison, since the habits of life of the party, a tendency to disease, and other circumstances, may have concurred to accelerate or produce a fatal result. To connect a stricture of the œsophagus with the act of poisoning by a mineral acid, it is necessary to show that there was no tendency to this disease before the acid was administered:-that the symptoms appeared soon after the first effects of the poison went off:-that these symptoms continued to become aggravated until the time of death:-and that there was no other cause, to which death could with any probability be referred. These remarks apply equally to the indirectly fatal effects of any poison,-such, for instance, as the salivation occasionally induced by corrosive sublimate, when the acute symptoms of poisoning by this substance have passed away. It has been stated, that chronic poisoning is not a subject commonly requiring a criminal investigation. Two cases have, however, come before our tribunals, in which the facts connected with this form of poisoning, were of some importance. I allude to those of Miss Blandy, tried at Oxford, in 1752, for the murder of her father by arsenic; and of a woman named Butterfield, tried at Croyden, in 1775, for the murder of a Mr. Scawen, by administering corrosive sublimate. In most cases, murderers destroy life by administering poison in very large doses; but in the instances referred to, small doses were given at intervals,- —a fact which led to great medical doubt of the real cause of the symptoms before death. It is, however, very rare to hear of this form of criminal poisoning.

2. Evidence from post-mortem appearances.-One of the chief means of determining whether a person has died from poison, is an examination of the body after death. In relation to external appearances, there are none indicative of poisoning upon which we can safely rely. It was formerly supposed that the bodies of persons who were poisoned putrefied more readily than those of others who had died from natural disease; and evidence for or against poisoning, was at one time derived from the external appearance of the body. This is now known to be an error: the bodies of persons poisoned are not more rapidly decomposed, cæteris paribus, than those of others who have died a sudden and violent death from any other cause whatever.

Irritant poisons act chiefly upon the stomach and intestines, which they irritate, inflame, and corrode. We may likewise meet with all the consequences of inflammation, such as ulceration, perforation, and gangrene. Sometimes the coats of the viscera are thickened, at other times thinned and softened, by the action of an irritant.

Narcotic poisons do not commonly leave any well marked post-mortem appearances. The stomach and intestines present no unnatural changes. There is greater or less fulness of the cerebral vessels; but even this is often so slight as to escape notice, unless attention be particularly directed to the brain. Extravasation of blood is rarely found.

The Narcotico-irritants affect either the brain or the alimentary canal, and commonly both, according to their peculiar mode of action.

REDNESS AS AN EFFECT OF IRRITANT POISONS.

49

It is important to bear in mind, that both Irritants and Narcotics may destroy life without leaving any appreciable changes in the body. To such cases as these, the remarks about to be made do not apply. The proofs of poisoning must, then, be procured entirely from other sources. Any evidence derivable from the appearances in the body of a person poisoned, will be imperfect unless we are able to distinguish them from those analogous changes often met with as the results of ordinary disease. These are confined to the mucous membrane of the stomach and bowels. They are redness, ulceration, softening, and perforation. Each of these conditions may depend upon disease, as well as upon the action of irritant poisons.

Redness.—It is a main character of the irritants to produce redness of the mucous membrane of the stomach and small intestines. This redness, when first seen, is usually of a deep crimson colour, becoming brighter by exposure to air. It may be diffused over the whole mucous membrane:-at other times it is seen in patches, dots, or lines (striæ,) spread irregularly over the surface of the stomach. It is sometimes met with at the smaller, but more commonly at the larger extremity of this organ; and again, we occasionally find that the rugæ or prominences only of the mucous membrane present this red or inflamed appearance. Redness of the mucous membrane may, however, be due to gastritis or gastro-enteritis; and in order to assign the true cause of the inflammation, it will be necessary to have an account of the symptoms preceding death, or some chemical proof of the existence of irritant poison in the contents of the stomach or the tissues of the body.

In the healthy state, the mucous membrane of the stomach is pale and white, or nearly so, except during digestion, when it becomes slightly reddened; and some observers have remarked that a slight redness has often remained in the stomachs of those who have died during the performance of the digestive process. When in contact with the spleen or liver, after death, the stomach is apt to acquire a deep livid colour from the transudation of blood; and it is well known that the bowels acquire a somewhat similar colour from the gravitation of blood, which always takes place after death. None of these appearances are likely to be mistaken for the action of an irritant poison.

There is an important class of cases in which redness of the mucous membrane of the stomach is found after death, not dependent on the action of poison or on any assignable cause. These cases, owing to their being so little known, and involved in much obscurity, deserve great attention from the medical jurist, since the appearances closely resemble those produced by irritant poison. A person may die without suffering from any symptoms of disordered stomach; but, on an inspection of the body, a general redness of the mucous membrane of this organ will be found, not distinguishable from the redness which is so commonly seen in arsenical poisoning. Several cases of this kind have occurred at Guy's Hospital; and drawings have been made of the appearance presented by the stomach, and are now preserved in the museum collection.

The redness of the stomach, in cases of poisoning, is so speedily altered by putrefaction, when circumstances are favourable to this process, as to render it impossible for a witness to speak with any certainty upon its cause. Putrefactive infiltration from the blood contained in the adjacent viscera and muscles, will give a reddish-coloured appearance to a stomach otherwise in a healthy condition. Great dispute has arisen respecting the length of time during which redness of the stomach produced by an irritant, will be recognisable and easily distinguishable from putrefactive changes. It is, perhaps, sufficient to say, that no certain rule can be laid down on the subject: it must be left to the knowledge and direction of the witness. I have distinctly seen the well marked appearances of inflammation produced by arsenic in the stomach and duodenum, in an exhumed body twenty-eight days after interment (Reg. v. Jennings, Berks Lent Ass. 1845;) and in another instance, referred to me by Mr. Lewis, the coroner for

LIBRARY