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«THE MEDICAL JURISPRUDENCE OF THE
See Proceedings of the Medico-Legal Society, March 26, 1874.
The President stated that he supposed that nearly all remembered that Dr. Peugnet read a paper on the medical jurisprudence of the Stokes case, a few months since, which excited a good deal of interest. Dr. Peugnet divided his monograph as you observe as follows: First, he gives a succinct and careful history of the case of James Fisk, Jr.; second, he proceeds to an elaborate description of shock; third, he applies his definition to penetrating gunshot wounds of the abdomen; fourth, he describes the physiological and toxical actions of morphine ; and, finally, he considers the medical jurisprudence of the Stokes case, and claims that the facts as shown demonstrate scientifically : 1st, that the shooting of Fisk was not done in self-defense, but with premeditation ; and 2d, that the wound in the abdomen was not necessarily fatal, and that the morphine was the immediate cause of death. To this paper I now invite yonr attention, and call on Dr. E.
I C. Harwood.
Dr. HARWOOD.-I must confess that I am quite surprised at being distinguished in the manner that I have been this evening, by being called upon to open the discussion of so important a paper as we have before us for consideration, when we have so many learned gentlemen, representing both the legal and medical profession, present with us. I have had a copy of the monograph bestowed upon me, but am sorry to say that I have not had an opportunity to peruse it; consequently I can say but little more than indorse the views of the author in regard to the cause of the death of Colonel James Fisk, Jr. I have felt much interested in Dr. Peugnet's paper. He has made bold assertions; and as I recollect the paper as presented to this body last December, he sustained them in the most scientific manner. By so doing, the medical profession of the world incurred a debt of gratitude to this learned gentleman, which I feel they will not fail to promptly acknowledge. I knew Col. Fisk in my early boyhood; he was the only son of worthy parents, who lived in close proximity to the home of my youth, in the old historic town of Bennington, Vt. On the night of January 6th, 1872, I was with Mr. Fisk's father, who was depressed and overwhelmed with grief in anticipation of fatal results from the wound his son had received.
I consoled the old gentleman by telling him his son was surrounded by the best medical and surgical talent that our city could boast of, and that I hoped that the means that they would devise for the restoration of their patient would be blessed with success. I could say much in regard to personal observations that I made at the Grand Central Hotel, on the fatal evening, but I know I would not be in order. Therefore I drop the subject relating to personal interest, and return to the one relating to science. We know that Col. Fisk received a severe penetrating wound of the abdomen. From the objective signs and symptoms we might naturally expect death to promptly issue from shock or internal hemorrhage, but as death did not follow from either of these causes, we would naturally expect recovery, and treat the patient with such anticipation in the case; and if recovery did not follow from proper treatment, the only mode of death we could expect would be the same as occurred in the Richardson and Vallandingham cases—Peritonitis and Septicæmia—and that could not occur short of forty-eight hours or longer.
The sworn testimony rendered on the trial of Edward S. Stokes, shows that 32 gr. of morphia, equivalent to 21 gr.
of opium, or 28 doses of morphia were given to Col. Fisk, hypodermically and otherwise, within the space of three and a half hours; and when we come to consider that from to i of a grain of this drug is the ordinary dose, and that prudence requires that we should not, under ordinary circumstances, duplicate the minimum or maximum dose until after the lapse of four or six hours; and that the autopsy revealed the fact that Fisk died from neither of the causes I have stated—we must, therefore, in the present light of science, and in all honesty, come to the conclusion that Col. JAMES Fisk, Jr., came to his death from the injudicious administration of morphine (31 grs., 28 doses having been given within the space of 31 hours), independent of the wound he received from the bullet that was hurled from the pistol of Stokes. In this case we admit local shock, which paralyzed the absorbent powers of the stomach, and allowed 2 grs. of morphia to remain within it inert until 13 grs. more were given hypodermically, which lighted up a flame that burnt out the life of one of the most noted characters of our continent. The death of Fisk, under these circumstances, is one of the most unfortunate reflections that could fall upon the medical profession of the United States; but, as much as we regret it, it is not without its lessons in science.
No physician of to-day will instruct his student to administer morphia by the stomach in similar cases to this or any case; but the more judicious method of hypodermic administration will be taught and used.
THE EFFECTS OF ALCOHOL UPON THE NERVOUS
Remarks upon a Paper by Prof. Wm. A. Hammond, before the New York Neurological Society, May 4, 1874, at the College of
Physicians and Surgeons.
Mr. President :-I came into this distinguished body of learned men this evening through the courtesy of an invitation from one of your officers, expecting merely to be a listener. The subject of “The effect of Alcohol upon the Nervous System,” as first presented by the distinguished author, has afforded me an amount of instruction that I hope we shall all profit by.
As a therapeutical agent, alcohol, I am free as a practitioner of medicine to admit, has proved incalculably beneficial under many circumstances; but on the other hand we must all admit that it has been one of the most frequent causes of a long train of nervous and physical diseases, among which may be enumerated insanity, oinomania, mental debility in the offspring, inflammatory diseases of the brain, apoplexy, paralysis, epilepsy, etc. The experience of many a practitioner must bring the terrible result of intemperance frequently before his eyes; but while he is thus rendered familiar with its consequences as regards individuals, few save those who have expressly inquired into this subject have any idea of the extent of the social evils resulting from it, or the degree in which they press upon every member of the community. I believe that you will justify me in the assertion that of all the causes which are at present conspiring to degrade the physical, moral and intellectual condition of the mass of the people, there is not one to be compared in potency with the abuse of alcoholic liquors ; and that if this could be done away with, the removal of all other causes would be immeasurably promoted.
It is admitted by physiologists as an indomitable fact in Organic Chemistry that there is not the slighest relation of composition between alcohol and muscular tissue. Dr. Hammond very beautifully demonstrates that alcohol is found in the brain and spinal cord and nerves of the rabbit that has been fed upon alcohol; and he also proves that his own weight increased under its use ; but this does not prove that the weight added to his body can be regarded as a healthy condition, for we have many pathological conditions where our weight is increased, and at the same time we are in greater danger of being cremated or put into the undertaker's hands.
We do not usually find that those most distinguished for a combination of intellectual power which is known as talent, are disposed to make use of alcoholic stimulants to augment their mental power. Of this we have a remarkable illustration in the habits of practical gamblers, who, when about to engage in contests requiring the keenest observation and the most sagacious calculations and involving an important stake, always “keep themselves cool," either by entire abstinence from fermented liquor, or by the use of those of the weakest kind in very small quantities.
The greater part of the intellectual labor which has most extended the domain of human knowledge, has been performed by men of remarkable sobriety of habit: many of them have been constant water-drinkers. Under this category, it is said, may be ranked Demosthenese and Haller. Dr. Johnson, in the latter part of his life, took nothing stronger than tea, while Voltaire and Fontenelle used coffee, and Newton and Hobbes were accustomed to solace, not to excite, themselves with the fumes of tobacco. Of Locke, whose long life was devoted to constant intellectual labor, and who appears independently of his eminence in his special objects of pursuit, to have been one of the best informed men of his time-explicit and remarkable testimony is borne by one who knew him well. His diet was the same as other people's, except that he usually drank nothing but water, and he thought that his abstinence in this respect had preserved him so long, although his constitution was so weak.” The subject is one worthy of our scientific consideration-we should press our investigations, arrive at conclusions and yield nothing to religious fanatics or temperance praying-bands that science will not approve.