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HALF-YEARLY REPORT ON FORENSIC MEDICINE,
TOXICOLOGY, AND HYGIENE.

By BENJAMIN W. RICHARDSON, M.D., L.R.C.P.

Physician to the Royal Infirmary for Diseases of the Chest, and Lecturer on Physiology and Hygienic Medicine at the Grosvenor-place Medical School.

I. TOXICOLOGY.

Poisoning by Arsenic.-In a case ("The People v. James Stephens") recently tried in New York City, for the murder of a wife by her husband, the jury, after long consultation, brought in a verdict of "guilty." The facts of this case are of great moment. The wife of the prisoner, a robust woman weighing one hundred and sixty pounds, and forty-six years of age, was in good health until about three weeks before her death, when she complained of general indisposition and of a sensation of heat in the "chest." A physician called in at that time discovered no indication of disease sufficient to make treatment necessary; he told her she would be well in two or three days. The symptoms, however, advanced, the sense of burning being located at the epigastrium, and vomiting soon setting in. The vomiting always followed the ingestion of food or liquid after a short interval, five to fifteen minutes. A second physician was now summoned, who found the patient suffering from symptoms of severe gastritis. He prescribed as a mixture, nitrate of potassa in five-grain doses, in combination with two grains of Dover's powder. He also ordered quinine in pills in one grain dose, together with three grains of oxgall. A large blister was applied over the stomach, and the blistered surface was dressed with an opiate ointment. These remedies were of little avail. The vomiting continued; the matter vomited was at first yellow, but gradually became green, and toward the close of the case became dark, bordering on brown, and containing spots of blood and a thick, ropy mucus, which could be lifted out of the vessel on a stick. Whatever was swallowed by the patient was rejected; nevertheless, she craved for drinks, and took a variety of fluids. During the last week of her life nervous symptoms manifested themselves. The extremities were cold, though the face was flushed; there was a hesitation in answering questions; partial anesthesia of the hands, slight impairment of voluntary motive power and convulsive tossings of the arms. The expression of the face was languid and anxious, with a peculiar sharpness of the eye. The legs and feet were ædematous, the lips swollen; the urine was scanty, high coloured, and irritating to the urethra. Diarrhoea did not set in until thirty hours before death; the evacuations being then dark coloured and offensive. The respiration, which had before been hurried, became laboured; stupor, interrupted but once by a wild scream, set in; and the scene closed with complete collapse. In regard to the stupor, it is to be borne in mind that opium and brandy were given on the last day by the husband. One witness stated that probably three ounces of laudanum and a pint of brandy were given within a space of ten hours on the last day. Mrs. Stephens died, and was buried in the Greenwood Cemetery on the 23rd of September, 1857, no suspicion being expressed that the death was from poison. On September 24th, 1858, the body was exhumed and taken to Bellevue Hospital for official inspection. Dr. James Wood and Professor Doremus conducted the leading scientific inquiries. The body was in a remarkable state of preservation. All the viscera were well preserved except the brain, which was much decomposed; the muscles retained their redness. The mucous membrane of the stomach was hard, much harder than natural, and its veins were large, as if congested. The contents of the stomach were unusually small, and resembled coffee-grounds; the body gave out a very

peculiar odour, not of decomposition. The small intestines, also well preserved, were nearly empty, but lined with a thin layer of yellowish pasty material; the large intestines were slightly reddened in parts of the colon and rectum, and contained a small quantity of a brown pasty substance. The analysis of the body was conducted by Professor Doremus, whose careful labour and con

scientiousness is a lesson which deserves diffusion this side the Atlantic. He made no guesses as to quantity of poison found; he used no tests until he was assured that they were free of poison; while he even considered the prisoner as a man who, before trial, deserved to have the benefit of every scientific doubt, and against whom positive evidence should be freed from exaggeration, colouring, and invention. His anxiety for justice rather than victory led Professor Doremus to examine the whole body of the deceased, in order to present to the jury weighable amounts of any poison found. It resulted from the inquiry, that arsenic was pretty generally distributed through the organism. A quantitative analysis of the heart, a portion of the lungs, liver, and kidneys, with the small and large intestines, the spleen, pancreas, omentum, bladder, and uterus, weighing altogether 7 lbs. 3 oz., gave as a result, 0·185 grain, nearly the fifth of a grain of arsenious acid. The defence at the trial seemed to have urged the old hypothesis of arsenic as a normal constituent of the body; it also suggested that the symptoms might be caused by natural disease, but admitted that there were no cases known to sustain the theory. The verdict went against the prisoner.—The American Medical Monthly, May, 1859.

[Granting the above to have been a case of arsenical poisoning, as some of the symptoms, especially those affecting the nervous system, would seem to indicate, the absence of the ordinary appearances of lesion caused by arsenic is not a little remarkable. The doubt naturally suggested is, always assuming the case to have been one of poison, that the long interment of the deceased -twelve months and a day-must have modified the appearances which would have been recognisable in a recent autopsy.]

Poisoning by Arsenic. Another curious case, known as the King case, has been tried at Toronto, and has caused considerable excitement in the district. The poisoner was a medical man; the poisoned was his wife. The deceased was in good health up to the 18th of October, 1858. She was then seized with violent internal pains, burning sensation in the throat, and retching, which, with other symptoms of poisoning, continued until the 3rd of November, when death occurred. There was, however, throughout, no purging. After death the stomach was found engorged, in an early stage of inflammation. The intestines were coloured and the rectum was coloured, an effect also attributed to early inflammation. The peritoneum was dark over its entire surface. The lower part of the right lung was slightly congested; the liver was hard; the uterus contained a fœtus of from four to five months. It was proved in evidence that Dr. King had repeatedly administered to the deceased a white powder, which she said was "fiery tasted." This administration caused vomiting of dark-greenish matter. The severe pain was felt only during the vomiting. On analysis, Professor Croft found no less than eleven grains of arsenic in the stomach and its contents, and smaller quantities in the liver. On the side of the defence various questions were raised. The lady had fallen from a buggy nine weeks before her illness, and this accident was noticed as accounting for the symptoms. The occurrence of the vomiting as incident to the pregnant condition was contested. The absence of symptoms indicating disturbance of the bowels was dwelt on as opposed to the known effects of arsenic. It was argued that the poison found might have been introduced into the stomach after death. It was urged that the patient had taken arsenic in homoeopathic globules, and that this might account for the presence of the poison. The jury found the man guilty. - Toronto Weekly Globe, April 8th, 1859.

[As yet we are not aware that any scientific history of this case has been recorded. Dr. Croft, from his evidence, clearly formed an opinion that this was a case of acute arsenical poisoning, and that the poison could not have been taken into the stomach long before death. In this opinion we entirely concur. From the facts that there were no morbid appearances of natural origin to account for death; that the prisoner had poison; that he was seen to mix and administer white powder; and that poison was found in abundant quantity in the contents of the stomach and in the tissues; the chain of evidence against the accused was complete. He died confessing himself guilty.]

Acute Poisoning by Phosphorus.-Dr. Lewinsky records a case of poisoning by phosphorus, in which the symptoms and pathology were most peculiar. A girl, twenty-two years old, and healthy, was brought to Dr. Lewinsky on the 19th of November, 1858. She stated that on that and on the evening of the previous day she had taken a portion of phosphorus scraped off from a small packet of lucifer-matches, for the purpose of self-destruction. Soon after taking the phosphorus, she felt a sharp burning pain in the abdomen, followed by vomiting. Her sister observed a luminous appearance of the ejected matter during the act of vomiting. When admitted under Dr. Lewinsky, the patient was suffering from vomiting and diarrhoea, but no smell of phosphorus was perceptible in the excretions; the vomited matters were of a dirty-grey colour, and mixed with mucous flakes. The abdomen was somewhat swollen, and was sensitive on pressure. The tongue was white and moist; the pulse normal; the mind clear. Analysis of the evacuations by Dr. Folwarczny indicated bilious substance and phosphoric acid. Magnesia was given internally, and portions of ice; ice was also applied externally to the stomach. Vomiting, alternating with hiccup, continued unceasingly on this and the two following days, but the diarrhoea ceased on the second day, and the mind continued undisturbed. Sleep was interrupted. There was no fever. On the third day there were signs of jaundice; the urine was scanty and of dark colour, and the pupils were widely dilated and reacted feebly to light. On the next day (the fourth) the jaundiced appearance of the face was much increased, collapse and great restlessness, with extreme thirst and weak and quick pulse, were present, but the vomiting had abated, a small quantity of blood only being thrown up. In the evening, these symptoms were intensified, and great sleepiness presented itself. In the night there were convulsions, and the consciousness was impaired. At the same time, a little clear red blood was vomited. The death of the invalid occurred on the sixth day after the taking of the poison.

The post-mortem appearances presented evidence of extensive changes. The brain structure was free of blood, but the ventricles contained a drachm of serum. The throat cavity contained a bloody frothy mucus, and the same extended into the bronchial tubes. The right lung was fixed by infiltrated plastic matter; the left lung, together with the costal pleura, was covered with flaky exudation; the visceral pleura was suffused in large spread patches. In the pericardium there was half an ounce of serum; the heart was ecchymosed at its base and was contracted, its muscular structure being of fawn colour. In the cavities there was fluid blood with a little loose coagulum of fibrin. The liver was large and very fatty. The gall-bladder contained a little bile mucus. The spleen was hard and friable. The stomach was filled with gas and with a blackish-brown fluid; its mucous coat, raised from beneath, was covered with a thick mucus streaked with dark brown lines. The intestine and even the small intestine contained a blackish-brown thin frothy fluid. The kidneys were large, pale, fawny, and fatty. The bladder was contracted and empty. The ovaries were small, charged with follicles, and contained extravasated ova. The uterus was large, and its cavity was lined with a bloody mucus.

A chemical examination of the stomach and its contents, by Dr. Schauenstein, showed no indication of phosphorus.

In commenting on this case, Dr. Lewinsky remarks that in this, as in a similar case recorded by Dr. Nitsche, the symptoms and pathology show much more evidence of an influence exerted on the stomach and intestines than is commonly found in instances of phosphorous poisoning. He infers that this difference may have arisen from the transformation of the phosphorus into phos phoric acid, or from its combination with organic substances, and from its rapid absorption, in one or other of these combinations, into the blood. He further suggests that the peculiar appearances in the liver and kidney could scarcely be set down to the effects of the phosphorus. These must have been of a chronic nature, although the deceased was reported healthy. Lastly, he opines that magnesia as an antidote for phosphorus is of no effect, inasmuch as the local effect of the poison on the stomach is too rapid for the remedy to be effectively applied.—Zeitschrift der k.k. Gesellsschaft, der Aerzte zu Wien, Dec. 27th, 1853.

On Poisoning with Sulphocyanide of Potassium. - Dr. Setschenow, in a paper on this subject, supplies the following inferences as to the action of the sulphocyanide on animal bodies; in his experiments he used frogs as the animals to be operated on, except in one instance, when a rabbit was selected.

(a) The sulphocyanide introduced into the stomach acts as a poison; causes decrease of the muscular irritability, and destroys life.

(b) The sensibility of the skin in poisoning by sulphocyanide, either by introduction of the poison into the stomach by the mouth, or by injection of it under the skin, decreases more quickly than the motive power of the animal.

(c) Brought into contact, in solution, with muscular structure, it does not produce direct paralysis of muscle.

(d) The symptoms induced by this salt when introduced into the body, prove that the action of the poison is primarily exerted on the brain, then upon the spinal cord, and through these nerve centres on the organs of locomotion and sensation.

(e) When the heart has ceased to beat, its action may be excited for a time by external irritation; but this action or irritation ceases much sooner in the heart than in the voluntary muscles in cases where the poison has been inserted under the skin. On the contrary, in cases where the poison was introduced by the mouth, the heart, even to the period of three hours after the administra tion, and when the animal was reactionless (reactionslos), may be excited to contraction. The author therefore infers that there is a difference between the two modes of poisoning. In most instances the heart ceases to act during the diastole, and is left full of blood.

In one instance noted by Dr. Setschenow, he injected a portion of concentrated solution of the sulphocyanide into the external jugular vein of a rabbit. Death was almost momentary, with convulsions. A quarter of an hour after the operation the heart was found rigid, and the muscles of the neck and of the hinder extremities were also found rigid. In this example it was admitted by the experimentalist that by the direct action of the poison on the muscles, their paralysis and death result. In this respect, therefore, Bernard's view is admitted as correct; but Setschenow qualifies the admission by trying to prove that there is a difference between absence of irritability of muscular fibre and actual death.-Archiv fur path. Anat. und Phys., von R. Virchow, Sept.

1858.

Poisoning by Cyanide of Potassium.-Dr. A. Schauenstein, in a communication on poisoning by cyanide of potassium, gives an account of five cases of death by

the cyanide. The author, who is a judicial chemist, comments upon the great increase of deaths by suicide through the agency of this poison. Thus, in Vienna, from 1851 to 1856, only two poisonings were noted, one of which was doubtful; while from August, 1857, to December, 1858, no less than five cases came under the personal observation of the author. In proportion to this increase of deaths from the cyanide there was a corresponding decrease of deaths from arsenic.

Dr. Schauenstein relates at length three of the cases observed, and in brief the pathology of the two others. In all cases the death seems to have been sudden. In one case, in a young girl, strong tetanic spasms came on directly after the poison had been taken, and death took place in less than an hour. In the second case, occurring in a young man, death took place almost instantly, and with no striking symptoms. The third case was similar; no note of the symptoms in the remaining two cases is given, but Dr. Schauenstein observes, that in several of the cases death took place suddenly, as in apoplexy.

In all the cases a post-mortem examination was conducted, but the appearances observed are considered by the author as offering nothing very characteristic. They were:

(a.) The brain containing more or less blood.

(6.) The blood in the cavities of the heart dark, and of thick consistency. (c.) The condition of the stomach various. In one case the mucous surface presented no particular colouring. In the case where life was prolonged nearly an hour the mucous membrane was slightly red, but offered no other extraordinary appearance. In another case, the death being very sudden, the mucous membrane was of a dark red colour, swollen, and in places covered with numerous bloody points; the contents of the stomach were also of bloodred colour; the two remaining cases of the five presented similar appearances in a less degree.

(d.) The smell of prussic acid in the stomach was very evident in four of the cases. But in one case, on account of the quantity of undigested food in the stomach, the smell remained hidden entirely.

(e.) The reaction of the contents of the stomach was strongly alkaline, and in every case chemical research proved without doubt the presence of prussic acid; but constantly formic acid was also found, showing that prussic acid in the stomach is transformed into formic in many cases.

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[This latter fact, one of great interest, was originally pointed out by Dr. Schauenstein in the Wochenbl. der Zeitschrift der k. k. Ges. der Aerzte, No. 3, 1857.]

Dr. Schauenstein, in commenting on the cases, opines that there are no true and distinguishing pathological indications by which the effects of the poison can be safely pronounced. He further observes that the chemical detection may become equally difficult in instances where, from the body having been dead several days, or having undergone a rapid decomposition, the poison has been decomposed.-Zeitschrift der k. k. Gesellsschaft. der Aerzte zu Wien, No. 1, Jan. 3, 1859.

Researches on some New Varieties of Woorara.-Messrs. Hammond and Mitchell have recently made some very valuable inquiries on two varieties of arrow poison, named "corroval," and "vao," or "bao." These poisons, while apparently allied to the variety of woorara which has been experimented on by European physiologists, differ materially in respect of physiological action from the better known substance. Corroval," when in lumps, is of brownish black colour. Reduced to fine powder it becomes a tawny yellow. Its taste is intensely bitter and persistent. Both water and alcohol extract the active principle. The aqueous solution mixed with blood does not retard coagulation, nor alter the shape of the blood discs more than any other blood fluid of

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