FOOTNOTES:
[23] Reprinted by the Association for the Advancement of Medicine by Research, 1882.
[CHAPTER XXVII.]
SIR R. CHRISTISON, SWAINE TAYLOR, AND POISON DETECTION.
Although the detection of crimes of poisoning is but one of the departments of service which the medical profession is able to render to the law, yet it is one which has very largely attracted public attention, owing to the many awful aspects of death by poisoning, and the helplessness which mankind has always felt in regard to these crimes. Latterly the skill displayed in the detection of the existence of poisons after the death of the victims has set at rest many of the doubts as to the certainty of judgment in regard to poisoning, and the discovery of antidotes to many poisons has supplied a means of remedy in numerous cases before it is too late. It is obvious that these results could only begin to be realised when chemistry had made considerable progress; and consequently it was not till 1813 that a young doctor, the celebrated Orfila, published in Paris the first part of a treatise on Poisons, which was subsequently merged in his “Legal Medicine,” 1821-3. The names most conspicuous in founding this new department of investigation in Great Britain are those which stand at the head of this chapter.
Robert Christison, one of the twin sons of Alexander Christison, many years Professor of Humanity in Edinburgh University, was born at Edinburgh in July 18, 1797. After a complete education, in arts at the University, he finally chose the medical profession, and was for two years and a half resident assistant in the Royal Infirmary. Taking his M.D. degree in 1819, he spent the next eighteen months at St. Bartholomew’s Hospital, London, and in Paris, where he worked in the laboratory of Robiquet at practical chemistry, and studied toxicology with Orfila himself.
When Dr. Christison was about to leave Paris, Dr. Gregory’s death led to a vacancy in the Chair of Medical Jurisprudence at Edinburgh, and Christison was proposed to fill it while still absent. It is significant of the state of knowledge that not one of the candidates besides Christison had any practical knowledge of chemistry. The influence of Lord Melville, however, who had been his father’s resident pupil when young Christison was born, was the determining cause of his success in the election.
At first students were very few, not half-a-dozen attending the earliest course. Christison devoted himself with characteristic energy to make his chair a real influence in the university. And here we may remark briefly on the extraordinary vigour of constitution which the new professor possessed, and retained almost till death. He could walk, run, or row better and with more endurance than any man of his time in Edinburgh, and that is saying a great deal. He made his new chair his primary object. Being an extremely neat and clean worker in the laboratory, his investigations soon became noted, and it was found, when he was called in to give evidence on matters of medical jurisprudence, especially in poisoning cases, that his mind was equally clear and accurate, and that he could give reasons for his beliefs which rendered his statements unimpeachable. From the famous trial of Burke and Hare in 1829 down to 1866 Dr. Christison appeared as a scientific witness in almost every case of medico-legal importance in Scotland, and in many in England.
“As a witness,” says the Scotsman (Jan. 28, 1882), “he was remarkable for a lucid precision of statement, which left no shadow of doubt in the mind of court, counsel, or jury as to his views. Another noteworthy characteristic was the candour and impartiality he invariably displayed, and which, backed as it was by the confidence that came of mature deliberation, rendered him almost impregnable to cross-examination. This was notably illustrated in the celebrated Palmer trial. Some of the medical witnesses for the Crown had got so severely handled by the prisoner’s counsel that the case seemed in danger of breaking down, but Christison had not been long in the box when the lawyers found they had at last met one who was a match for the subtlest of them: and so complete was the failure of all their efforts to discredit his evidence, that the case, by the time he finished, had assumed the gravest possible complexion.”
As a persevering experimentalist, Christison was daring even to rashness in making trials on himself. He thus tested the taste of arsenious acid, which was held by Orfila and most others to be rough and acrid, and which he proved to be rather sweet. He ate an ounce of the root of Œnanthe crocata , which had stood most poisonous in England and on the Continent; but the Scotch specimen at any rate did not poison Dr. Christison. A most striking risk was run in the case of the Calabar bean. He took a dose before going to bed, and found its effects resembled those of opium. Not satisfied, he took a larger dose next morning on rising, with the result of almost paralysing him. But he fortunately had a good emetic close at hand, a bowl of shaving water, and administering a large quantity, he was partially relieved. But much prostration remained, and medical assistance had to be summoned.
Christison’s principal services to the literature of his subject consisted in his work on Poisons, which was first published in 1829, and went through several successive editions, and in numerous memoirs and papers contributed to medical and scientific journals, some of which detailed improved chemical processes and tests for poisons, as those on “The Detection of Minute Quantities of Arsenic in Mixed Fluids,” “On the Taste of Arsenic, and on its Property of Preserving the Bodies of Persons who have been Poisoned with it,” and on the poisonous properties of numerous vegetable alkaloids.
In 1832 Christison, having raised his class to no fewer than ninety students, resigned his chair on appointment to that of Materia Medica, intending to become, in addition to a clinical teacher of medicine, an original investigator on the therapeutical action of remedies. But before he had got fully afloat in this, practice, for which he had not specially laid himself out, flowed in upon him, and prevented the realisation of his desire. He accumulated a fine museum of materia medica, and his lectures were very popular. But it cannot be said that he left his mark on medicine or therapeutics to the same extent that he did on toxicology.
Christison was eminently a lover of his university, and exceedingly conscious of its great merits. In numerous matters he was very conservative, and strongly resisted some modern views of pneumonia and fevers. He wielded great influence for many years in the administration of university matters. In 1838 and in 1846 he was President of the Edinburgh College of Physicians. From 1868 to 1873 he was President of the Royal Society of Edinburgh. From 1857 to 1873 he occupied a seat at the General Medical Council. After having been for many years Physician-in-Ordinary to the Queen in Scotland, Dr. Christison received a baronetcy in 1871, on the recommendation of Mr. Gladstone. In the same year his bust by Brodie was presented to the university, by general subscription among the medical profession.
In 1872 Sir Robert Christison completed his fiftieth year of active service as professor in the university, the only case of the kind that had ever occurred; and a large and enthusiastic assembly entertained him at dinner. Further honours still awaited him; he was in 1875 elected President of the British Medical Association at its Edinburgh meeting; and in 1876 he was selected for the Presidency of the British Association, a distinction which however he declined on the ground of his advanced age. He soon afterwards retired from active duty; but lived in considerable vigour till about Christmas 1881. He died on January 23, 1882, in his eighty-fifth year.
“As regards his personal characteristics,” says the Scotsman, “Sir Robert was perhaps liable to be somewhat misunderstood by those who did not know him. Dogmatic and positive in his opinions, he was inclined to lay down the law in a way that might not always be quite agreeable.... On the other hand, friends who had the good fortune to know him intimately found in his nature a fund of geniality such as the casual observer could never have dreamt of. Warmth of heart and simple unaffected kindness would seem to have been distinguishing qualities of his private and social demeanour.” He was a strong Churchman and Tory. He married in 1827 a Miss Brown, who died in 1849, leaving three sons.
Some years younger than Christison, Alfred Swaine Taylor was contemporary through life with him, and occupied for many years a quite exceptional position in the English mind in connection with the detection of cases of poisoning. He was born at Northfleet in 1806, and educated at Hounslow. At the early age of sixteen he became the pupil of a surgeon near Maidstone, and in October 1823 entered as a student at Guy’s and St. Thomas’s Hospitals, then forming a united medical school. Later on he was exclusively connected with Guy’s as pupil and lecturer until his retirement in 1878.
From the year 1826 Taylor gave much attention to medical jurisprudence, although his diligence was such as to win for him a prize for anatomy at Guy’s. Chemistry proved a congenial subject to him under the instruction of Allen and Aikin, and he was further stimulated in the same direction by frequent visits to Paris and all the principal Continental medical schools. At Paris he heard among others Orfila and Gay-Lussac. Geology, mineralogy, and physiology likewise engaged his attention, and so was formed a mind singularly broad in its views of natural phenomena, and well calculated to expound their laws. Taylor passed his examinations at the Apothecaries’ Hall in 1828 and at the College of Surgeons in 1830, and entered upon practice, continuing, however, to study in the chemical laboratory of Guy’s Hospital.
In 1831, when the Apothecaries’ Society first required candidates for their diploma to attend lectures on Medical Jurisprudence, Mr. Taylor was appointed to lecture on the subject at Guy’s Hospital, a post which he continued to hold for forty-seven years. In the next year he succeeded Mr. Barry as co-lecturer on chemistry with Mr. Aikin, whose colleague he continued till 1851, after which he was sole lecturer on chemistry till 1870, when he resigned this lectureship. In these important functions Dr. Taylor acquitted himself admirably. He was exceedingly clear in his statements, exact and successful in his experiments, while yet very undemonstrative in manner.
In 1832 the new lecturer commenced his long series of memoirs bearing on poisoning, by publishing an account of the Grotto del Cane, near Naples, with remarks on suffocation by carbonic acid. This appeared in the London Medical and Physical Journal. In subsequent years he contributed important papers to Guy’s Hospital Reports, on the action of water on lead, on poisoning by strychnia, on the tests for arsenic and antimony, &c., and was soon a recognised authority on medico-legal questions. He contributed to the London Medical and Physical Journal valuable memoirs on poisoning, child-murder, &c. In 1836 he published the first volume of a work on medical jurisprudence which was not completed at that time. In 1842 he brought out his well-known “Manual of Medical Jurisprudence,” which reached its tenth large English edition in 1879, in the author’s lifetime, in addition to numerous American editions. The Swiney Prize of 100 guineas, together with a valuable silver vase for a work on Jurisprudence, were also awarded to him.
In 1848, when he became a member of the College of Physicians, Dr. Taylor published a work on Poisons which was at once accepted as standard, and has gone through several editions. In 1865 his large work entitled “The Principles and Practice of Medical Jurisprudence” appeared, including much matter for which there was not space in his manuals. This work attained its third edition in 1883, having been edited by Dr. Thomas Stevenson, his distinguished successor at Guy’s Hospital.
But this represents only a portion of the literary labours of Dr. Taylor. From 1844 to 1851 he was the editor of the London Medical Gazette, afterwards incorporated with the Medical Times. He largely co-operated in editing various editions of Pereira’s Materia Medica. He brought out in conjunction with Professor Brande a Manual of Chemistry in 1863, and in 1876 edited Dr. Neil Arnott’s celebrated work on Physics. He was elected in 1853 Fellow of the College of Physicians, having had previously conferred upon him the honorary M.D. of St. Andrews University. He was elected a Fellow of the Royal Society in 1845. He married in 1834 a Miss Cancellor.
It was as a medical witness in important legal cases that Dr. Swaine Taylor was most widely known. If a case of unusual character was before the courts, it came to be expected that he should be called as a witness, and for many years he was retained by the Treasury as their medical adviser on such cases. It is impossible here to refer to the numerous important cases of this character in which Dr. Taylor figured. A writer in the Medical Times for June 12 and 19, 1880 (pp. 642, 671), enters into this question from full knowledge, and describes him thus: “Personally Taylor was of a tall and imposing figure, gracious to friends and bitter to foes, and, as the lawyers found, a superb witness, not to be shaken by any light word of doctrine.... There was a thoroughness about Taylor’s work which was always satisfactory.”
In regard to the celebrated Palmer trial, Dr. Taylor was severely cross-examined, and was contradicted in important points by experts called for the defence. In fact, it is possible that the case would have gone in favour of the prisoner but for the strong confirmation of the view of the prosecution given by Dr. Christison, to which we have already referred. Dr. Taylor expressed his strong views on this question in an extended pamphlet “On Poisoning by Strychnia,” most of which appeared in Guy’s Hospital Reports for 1856. He died on May 27, 1880.
[CHAPTER XXVIII.]
PARKES, GUY, SIMON, AND PUBLIC HEALTH.
“Prevention is better than cure” is the homely proverb which marks out a large proportion of the work of sanitary science. The prevention of disease and of its spread, and the promotion of the general healthiness of the people—these are objects which modern progress has brought into view. When they are completely attained we shall all die of old age unless cut off by accidents or violence; and this is a goal which many sanitarians of the present day have vividly before their mind.
The public health and the public welfare have been sought by no man more earnestly than by Edmund Alexander Parkes. Of him Dr. Russell Reynolds said:[24] “In the combination of moral, mental, and physical beauty, Dr. Parkes was to my knowledge never equalled, to my belief cannot be surpassed. Pure as a sunbeam, strong as a man, tender as a woman, keen as any scientist to unravel the hidden mysteries of life in its minutest detail of chemical and physiological research, yet practical in the application of his knowledge to the cleansing of a drain or the lightening of a knapsack; he made the world much richer by his life, much poorer by his death.”
Parkes was born on March 29, 1819, in the village of Bloxam, Oxfordshire, his father being Mr. William Parkes, of the Marble-yard, Warwick, “a man of superior mind, remarkable alike for industry, firmness, and nobility of character.”[25] His mother, Frances Byerly, daughter of Mr. Thomas Byerly of Etruria, Staffordshire, was much occupied in literature, and her sister, wife of Professor A. T. Thomson of University College, London, was a well-known biographer and novelist.
Under such favouring influences young Parkes grew up a gentle but unusually merry and happy boy. After being educated at the Charterhouse, he entered as a medical student at University College, and spent much time in his uncle’s laboratory, becoming an excellent manipulator, and already showing a fondness for research. At the first M.B. examination at London University in 1840 he was exhibitioner and medallist in anatomy, physiology, and chemistry, and medallist in materia medica. In 1841 at the final M.B. he was medallist in physiology and comparative anatomy, and gained honours in medicine. He had taken the College of Surgeons’ diploma in 1840.
Of this period of Parkes’s life Sir William Jenner, an intimate fellow-student at University College, says:
“As a student he was distinguished by brightness and cheerfulness, amiability, unselfish willingness to help others at any cost of trouble to himself, energy in work, diligence in the using of each hour for the studies of that hour, the high moral tone that pervaded his converse, and above all, and crowning all, by the real living purity of his being.”
Early in 1842 Parkes entered the army medical service, and went as assistant-surgeon to the 84th regiment to Madras and Moulmein. Here he prosecuted inquiries which bore fruit in two small publications on the Dysentery and Hepatitis of India (1846), and on Asiatic and Algide Cholera (1847). But before this period he had retired from the army and entered upon practice in Upper Seymour Street, Portman Square, becoming further known as a physician by editing and completing Dr. Thomson’s work on Diseases of the Skin (1850). This was only a portion of his literary and original work at this time, during which he contributed largely to the Medical Times, and from 1852 to 1855 edited the British and Foreign Medico-Chirurgical Review, for which difficult task he was exceedingly well fitted.
Having been appointed one of the physicians to University College Hospital, his influence was very marked, both on his students and his colleagues. One of his pupils, afterwards a distinguished physician, said that he never went round the wards with him without feeling an intense wish to become better, and at the same time feeling that he could become so. In 1855 Parkes delivered the Gulstonian Lectures at the College of Physicians, taking the subject of Pyrexia, or the State of Fever.
During the Crimean War, when great pressure existed upon the hospitals at Scutari, Dr. Parkes was selected by Government to proceed to the seat of war to establish an additional large hospital. He fixed upon Rankioi on the Dardanelles, and his choice proved excellent. He worked most zealously to make everything as perfect as possible, and he accomplished much in spite of the red-tape which was so disastrously prominent in the war administration of that time. He did not in any way spare himself, though his constitution had shown serious signs of weakness in London, when he had had severe attacks of pneumonia and phlebitis. His report on the work of his hospital at the conclusion of the war was a most valuable one, and he gained the high esteem of Mr. Sidney Herbert, afterwards Lord Herbert of Lea.
One result of the Royal Commission of Investigation into the administration of the war was the foundation of the Army Medical School, and Mr. Herbert never showed better judgment than in selecting Dr. Parkes to be Professor of Military Hygiene in connection with it. Consequently he gave up in 1860 his post at University College; he was appointed Emeritus Professor, and a marble bust of him was placed in the College museum.
Parkes found that in order adequately to teach the subjects involved in preserving and promoting the health of the army, he must not only study the special features of army life and the peculiar liabilities attaching thereto, but also the general science of hygiene, then almost new. He organised at the cost of immense labour a detailed system of instruction, based on the principle of making the student apply practically what he taught. All the special questions which came up relating to air, water, food, temperature, clothing, house construction, drainage, &c., were as far as possible illustrated in the laboratory, and individual instruction was most carefully given.
In 1864 was published the first edition of Parkes’s “Manual of Practical Hygiene,” a masterly book, accurate, learned, clear, full, and of the highest interest to the thoughtful mind. The introduction to this work opens with a clear definition of the subject. “Hygiene is the art of preserving health; that is, of obtaining the most perfect action of body and mind during as long a period as is consistent with the laws of life. In other words, it aims at rendering growth more perfect, decay less rapid, life more vigorous, death more remote.”
Later he says: “It is undoubtedly true that we can, even now, literally choose between health and disease; not, perhaps, always individually, for the sins of our fathers may be visited upon us, or the customs of our life and the chains of our civilisation and social customs may gall us, or even our fellow-men may deny us health, or the knowledge which leads to health. But, as a race, man holds his own destiny, and can choose between good and evil; and as time unrolls the scheme of the world, it is not too much to hope that the choice will be for good.” He further powerfully indicates the basis of state medicine, to secure for all individuals the conditions of health which they often cannot secure for themselves. He shows too that self-interest, state-benefit, and pecuniary profit are at one in these matters when rightly understood. “It is but too commonly forgotten,” he says, “that the whole nation is interested in the proper treatment of every one of its members, and in its own interest has a right to see that the relations between individuals are not such as in any way to injure the well-being of the community at large.” It is almost needless to add that numerous editions of Parkes’s Practical Hygiene have been called for; it has also been translated into several foreign languages.
We have enumerated, however, but a small portion of the subjects upon which Parkes’s unceasing philanthropic activity was exercised. For many years he wrote an annual review of the Progress of Hygiene, contributed to the Army Medical Reports. He served on many public inquiries relating to matters of health, and did more for the diminution of mortality in the army than any other man. He carried on many protracted and difficult physiological investigations, such as those on the effects of diet and exercise, on the elimination of nitrogen, on the effects of alcohol on the human body, on the effects of coffee, extract of meat, and alcohol on men marching, chiefly contributed to the Royal Society. As a member of the Senate of London University, and of the General Medical Council, and as Secretary to the Senate of the Army Medical School, he performed detailed work of the highest value, and all in spite of delicate health.
“With increase of years,” says Sir William Jenner,[26] “his mind ripened, his sphere of action widened, his influence over others operated in new and perhaps more important ways; but in all moral and intellectual essentials Dr. Parkes was as a man what he was as a youth—he was animated by the same principles and stimulated by the same faith. As years went on his mind proved itself to be singularly well balanced; he possessed an extraordinary power of acquiring information; his memory was very retentive; he was the best-informed man in the medical literature of the century I ever met; he was unprejudiced as he was learned; he could use with ease the information he acquired, and could express his ideas clearly and simply; his language was always elegant, and on occasions eloquent. His powers of observation, of perception, of reasoning, and of judgment were all good, and equally good. But as in his youth, so in his manhood, the beauty of his moral nature, his unselfish loving-kindness, his power of inoculating others with his own love of truth, with his own sense of the necessity of searching for the truth, of questioning nature till she yield up the truth, of earnest work, were his most striking characteristics.”
At last the seeds of weakness which were constitutional in Parkes developed into acute tuberculosis, and he died on March 15, 1875, after an illness of four months. His domestic life had been a very happy one, but his wife, a Miss Chattock, whom he married in 1851, had died in 1873, and he was much broken by her loss. He left no children. His monument is in the Parkes Museum of Hygiene, which enforces eloquently the lessons of his life.
Dr. William Augustus Guy, F.R.S., is one of the most eminent of modern promoters of the public health. He was born at Chichester in the year 1810, his ancestors for three generations having been medical practitioners there. His grandfather, William Guy, was a pupil of John Hunter, and in Hayley’s life of Romney it is stated that “Cowper said of him that he won his heart at first sight, and Romney (who painted his portrait) declared that he had never examined any manly features which he would sooner choose for a model if he had occasion to represent the compassionate benignity of the Saviour.”[27]
After a childhood spent with this estimable grandfather, young Guy was educated at Christ’s Hospital, and later studied for five years at Guy’s Hospital. Winning the Fothergillian medal of the Medical Society of London for the best essay on Asthma, in 1831, at the early age of twenty-one, he was encouraged to enter at Cambridge, where, after a further period of two years spent at Heidelberg and Paris, he took his M.B. degree in 1837.
In 1838 Dr. Guy became Professor of Forensic Medicine in King’s College, London, and later Assistant-Physician to King’s College Hospital. He early directed his attention to statistics, and joined the Statistical Society in 1839, and became one of its honorary secretaries in 1843. 1844 he contributed important evidence before the Health of Towns Commission, on the state of the London printing-offices, and the consequent development of pulmonary consumption among printers. He co-operated in founding the Health of Towns Association, and has been incessantly occupied in public lectures, investigations, and writings, in calling attention to questions of sanitary reform. He has been notably concerned in the improvement of ventilation, the utilisation of sewage, the health of bakers and soldiers, hospital mortality, and many other like subjects. In 1873 he was President of the Statistical Society, and he has successively been Croonian, Lumleian, and Harveian Lecturer at the College of Physicians. His various publications and papers are too numerous to recount. We may, however, mention the “Principles of Forensic Medicine,” and successive editions of Hooper’s “Physicians’ Vade Mecum.”
Mr. John Simon, C.B., F.R.S., is one of the veterans of the present day in matters of public health, besides having the highest reputation as a surgeon and pathologist. Born in 1816, Mr. Simon was a student of King’s College, London, and was elected a fellow of the College of Surgeons in 1844. He was appointed in 1847 lecturer on Pathology at St. Thomas’s Hospital. His subsequent researches and writings, especially those on Inflammation, have proved his great fitness for the post. In 1850 he published a very original course of lectures on General Pathology, as conducive to the establishment of Rational Principles for the Diagnosis and Treatment of Disease.
Mr. Simon’s career in connection with public health began with his being appointed the first Medical Officer of Health to the City of London. He was before long selected as medical adviser to the General Board of Health, and was thence transferred to the important post of medical officer to the Privy Council. In this capacity his labours, ably seconded by a crowd of zealous workers, have been of priceless value to the nation at large. The successive annual reports published by the Privy Council sufficiently attest this.
In his first report to the Privy Council, Mr. Simon stated “that more than half of our annual mortality results from diseases which prevail with a very great range of difference in proportion as sanitary circumstances are bad or good; that, according to the latest available evidence, some of these diseases prevail twice or thrice, some of them ten or twenty times, some of them even forty or fifty times, as fatally in some districts as in other districts of England; that the result of their excessive partial development is to render the mortality of certain districts from 50 to 100 per cent. higher than the mortality of other districts, and to raise the death-rate of the whole country 33 per cent. above the death-rate of its healthiest parts.”
In his eleventh report Mr. Simon was able to write as follows: “It would, I think, be difficult to over-estimate, in one most important point of view, the progress which, during the last few years, has been made in sanitary legislation. The principles now affirmed in our statute-book are such as, if carried into full effect, would soon reduce to quite an insignificant amount our present very large proportions of preventable disease.... Large powers have been given to local authorities, and obligation expressly imposed on them, as regards their respective districts, to suppress all kinds of nuisance, and to provide all such works and establishments as the public health primarily requires; while auxiliary powers have been given for more or less optional exercise in matters deemed of less than primary importance to health.... The State ... has interfered between parent and child ... between employer and employed ... between vendor and purchaser; has put restrictions on the sale and purchase of poisons; has prohibited in certain cases certain commercial supplies of water; and has made it a public offence to sell adulterated food, or drink, or medicine, or to offer for sale any meat unfit for human food.... Its care for the treatment of disease has not been unconditionally limited to treating at the public expense such sickness as may accompany destitution; it has provided that in any sort of epidemic emergency, organised medical assistance, not peculiarly for paupers, may be required of local authorities; and in the same spirit requires that vaccination at the public cost shall be given gratuitously to every claimant.”
Mr. Simon has been a distinguished surgeon to St. Thomas’s Hospital, and attained some years ago the Presidency of the College of Surgeons. He is also a member of the General Medical Council. In 1878 his bust in marble was presented to the College of Surgeons by public subscription, in recognition of his eminent services in sanitary science.