OF MURDER GENERALLY.
There are so many various modes by which this infamous and horrid crime may be perpetrated, that it would be an almost endless task to enumerate them. In a legal point of view it is scarcely necessary; for wherever death ensues from illegal violence[[92]], with malice prepense, it is felony; yet for the better aid of medical investigation it is expedient to class them under several heads.
Sir Matthew Hale, in his pleas of the Crown, vol. 2, p. 431, enumerates several ways of killing.
1. By exposing a sick or weak person or infant unto the cold, to the intent to destroy him, 2 Ed. 3, 189, whereof he dieth.
2. By laying an impotent person abroad, so that he may be exposed to and receive mortal harm, as laying an infant in an orchard, and covering it with leaves, whereby a kite strikes it and kills it. 6 Eliz. Compt. de Pace; 24 Dalton, cap. 93, (new edit. 145.)[[93]]
3. By imprisoning a man so strictly that he dies, and therefore where any dies in gaol, the coroner ought to be sent for to enquire of the manner of his death.
4. By starving or famine.
5. By wounding or blows.
6. By poisoning.
7. By laying noisome and poisonous filth at a man’s door, to the intent by a poisonous air to poison him. Mr. Dalton, cap. 93, out of Mr. Cook’s reading.[[94]]
8. By strangulation or suffocation.
“Moriendi mille figuræ.”
The two first of these modes frequently occur in cases of infanticide, and to that head, which requires separate consideration on account of its intricacy, we shall therefore refer it. Adults can seldom, if ever, be exposed to destruction in this manner; though, as in —— Brownrigg’s case, and others of the same class, it may constitute a part of the crime of murdering children, even of an advanced age, by duress and starvation; where it is by a combination of cruel injuries, and not by one specific blow or wound, that death is produced. These cases we shall include under a general head, having first disposed of those which require more specific notice.
“By imprisoning a man so strictly that he dies, and therefore where any dies in gaol[[95]] the coroner ought to be sent for to enquire of the manner of his death.”[[96]]
Death by duress of imprisonment was in all probability a very frequent occurrence in the earlier periods of our history, we know that it has often been inflicted by the individual tyranny of the nobles on their vassals; and we have every reason to suppose, that even the keepers of our public prisons were not free from the imputation of cruelty to their unfortunate inmates; many have died by violence, more by neglect; it was therefore a wise and humane precaution that the circumstances of every death of a prisoner should be made the subject of minute enquiry; it is also desirable that such enquiry should be carried on by persons of competent skill, and with every possible and proper publicity. Our own times we will hope are entirely free from the crime of premeditated murder on the body of a prisoner; but we must not allow our confidence in the modern improvements of prison discipline to lull us into a false security as to the conduct of gaolers and their underlings many of these may be men of mild and humane disposition, but as their daily occupation must tend to blunt the finer feelings of humanity, it is well that every charge of misconduct should be met by immediate and rigorous enquiry. On this subject see Rex v. Huggins, warden of the Fleet, 2 Lord Raym. 1578; 2 Str. 882; 9 Harg. St. Tri. 107; Bambridge’s case, 9 Harg. St. Tri. 146, 151; Acton’s case, 9 Harg. St. Tri. 182, 210, 218; see also the several Parliamentary Reports on Coldbath-fields, Ilchester, &c.
“A gaoler, knowing a prisoner to be infected with an epidemic[[97]] distemper, confines another prisoner against his will, in the same room with him, by which he catches the infection, of which the gaoler had notice, and the prisoner dies; this is a felonious killing. Stra. 856; 9 St. Tri. 146. So, to confine a prisoner in a low damp unwholesome room, not allowing him the common conveniences which the decencies of nature require, by which the habits of his constitution are so affected as to produce a distemper of which he dies; this also is felonious homicide. Stra. 884; Lord Raym. 1578. For although the law invests gaolers with all necessary powers for the interest of the commonwealth, they are not to behave with the least degree of wanton cruelty to their prisoners. O. B. 1784, p. 1177; and these were deliberate acts of cruelty, and enormous violations of the trust the law reposeth in its ministers of justice. Forster, 322.” See I Hawk. P. C. by Leach, p. 119.
Previous to the researches of the celebrated John Howard, (see his treatise on Prisons and Lazarettos) our prisons appear to have been in a most disgraceful state; they are now greatly improved, but something may yet be done for their amelioration, more particularly as affecting the health of the prisoners; and this principally, by allowing the most unrestrained medical inspection by disinterested practitioners, who should be as much as possible unconnected with local prejudices, or partialities; some of the parliamentary regulations of madhouses might in this respect be usefully extended to all places of confinement; those who are not sui juris are ever entitled to additional protection.[[98]]
The best practical proof of improvement, in the construction of our prisons, and in our prison discipline, is to be found in the disappearance of that fatal pest, which was commonly called the gaol fever, a disorder which, with something of retributive justice, frequently extended its ravages to those, whose proper vigilance might have prevented its generation. At the assizes held at Oxford in 1577,[[99]] called the black assize, we learn from Baker’s Chronicle (p. 353) that all who were present died within forty hours: the Lord Chief Baron, the Sheriff, and about three hundred more. Lord Bacon ascribed the fatality to a disease brought into court by the prisoners, and Dr. Mead entertained the same opinion; nor was similar infection, though to a less extent, an uncommon occurrence[[100]], see vol. 1, p. 125. The ancient practice of strewing the court with aromatic herbs and flowers, and presenting bouquets to the Judges, is said to have derived its origin from the idea of preventing infection: fresh air, still wanting in our courts, would have proved a more powerful, and not less agreeable prophylaitic.
BY WOUNDING, OR BLOWS.
In investigating the subject of Wounds, it will be convenient to adopt, on the present occasion, the usual classification of local injuries, viz. 1. Incised wounds, or cuts; 2. Punctures, or such as are inflicted by pointed instruments; 3. Bruises, injuries occasioned by blunt instruments; 4. Lacerations, where the integuments are torn, and 5. Gun-shot wounds; upon each of which we shall offer a few observations, and, in the first place, it may be remarked generally, that no graduated scale of wounds, expressive of the degree in which they are curable or dangerous, can ever be constructed; in appreciating the probable degree of danger that attends a wound other data will be required for the solution of the problem than those deduced from situation and extent, such as the constitution and temperament, age, habits of life, especially as they regard temperance and sobriety, previous state of health, unnatural structure and disposition of parts, and existing diseases of the wounded individual; together with the temperature of the season, and other extrinsic circumstances. As a general rule for our guidance a division of wounds into four classes has been suggested, viz. 1. Absolutely mortal. 2. Dangerous. 3. Accidentally mortal. 4. Not mortal. Every practitioner, however, must be aware that death will occasionally supervene on the slightest injury, and at other times that the patient recovers in spite of the most serious and extensive mischief; in proof of the former assertion, the author may state that he has seen a case in which the extraction of a tooth was followed by death in less than forty-eight hours; and every experienced surgeon must in the course of his practice have observed the slightest wound[[101]] productive of alarming and even fatal consequences; in illustration of the occasional occurrence of a contrary result we may recal to the recollection of the reader the extraordinary case[[102]] of Mr. Thomas Tipple, who recovered after an accident, by which the shaft of a chaise had been forced through the thorax! There have also been instances of the recovery of persons whose brain has been wounded to a considerable depth, of others shot through the head; Dr. Male states that a pauper in Paris, some years ago, used to receive charity in a piece of his skull. In the second volume of the Medico-chirurgical Transactions, we have a well attested case of a bayonet wound in the heart not causing immediate death. Littre has given us a report of a man who inflicted upon himself no less than eighteen stabs in the abdomen with a knife; and although some of them did not penetrate beyond the parieties, yet others wounded the contents; the symptoms which followed are stated to have been very severe, but by judicious treatment the patient recovered; seventeen months afterwards, however, he threw himself into the street from a three pair of stairs window, and was instantly killed. On examining the body all the wounds were found healed, and, with the exception of one, all the cicatrices were firm and level; they were traced into the intestines, where corresponding adhesions were observed.[[103]]
The surgical practitioner will, after such cases, be cautious in his prognosis, and profit by the experience of Hoffman, who says, “In judicio de vulnerum lethalitate ferendo multorum Medicorum fama et fortuna periclitantur.”[[104]] Fortunately for the administration of justice, that act of the Legislature, called “the Ellenborough act,” relieves us from many of those embarrassments under which the professional witness[[105]] must otherwise have laboured, and the surgeon will appreciate the high importance and utility of the law, by which wounding with an intent to kill is deemed equally criminal, whether death be the result or not. Still, however, the testimony of the medical practitioner will always be important; indeed the evil intent is often to be inferred, or disproved, by the nature of the injury inflicted; as is so well illustrated in the case of a man, who fractured the skull of a boy with a stick, upon finding him in the act of plundering his orchard; when it was clearly made out in evidence, that a mere chastisement was only intended, for the size of the stick was not such as to have occasioned any fatal effect, had not the skull of the unfortunate boy been unusually thin.
If the surgeon is called upon to inspect a wound, with a view to ascertain whether it produced death, he should in the first instance, endeavour to examine its nature and direction, so as to disturb as little as possible the position in which the body was found; the knife of the anatomist must afterwards explore its more particular condition and relations, by a dissection, for the performance of which we shall give ample directions in a future chapter.
The importance of examining the wound, so as not to alter the position of the parts must be obvious when we consider how necessary it may afterwards become to compare as strictly as possible the internal appearances with the external lesions. The direction of a wound is frequently a circumstance of much greater importance than may at first appear, we ought not therefore to probe it without extreme caution, lest we should give to it a direction which it did not originally possess. This precaution becomes the more necessary as the putrefactive process advances.
Of incised wounds, or cuts. The prognosis of wounds made with a cutting instrument varies, cæteris paribus, according to the extent and depth of the division, the nature of the injured parts, and the circumstances which attend the operation; where the instrument has been so sharp as not to occasion any contusion or laceration, the fibres and texture of the wounded part will have suffered no other injury but their mere division; and there is consequently less tendency to inflammation, suppuration, gangrene, and other bad consequences; if the wound be large and deep it will be more dangerous, as well as more difficult to heal, than one which only affects the skin. Wounds, accompanied with injury of considerable vessels or nerves, are more or less hazardous, according to the magnitude or number of those vessels or nerves; generally speaking, the most dangerous examples of incised wounds are those which are made about the throat; here there are so many large blood-vessels, nerves and other parts of great importance, that deep incised wounds often prove fatal, either immediately, or in a few days; in some cases of suicide the carotid artery is opened, and the person perishes from hemorrhage on the spot, before any assistance can be afforded; in other instances he divides some of the principal branches of the external carotid, and after losing a great deal of blood, he faints, and the hemorrhage being thus checked, the life of the patient is preserved, until surgical assistance can be procured. Cut wounds of the extremities, when such arteries as the femoral and brachial are injured, may also suddenly destroy the patient, by hemorrhage.
Punctures, or such as are made by the thrust of pointed weapons, as by swords, daggers, lances, and bayonets, or by the accidental and forcible introduction of considerable thorns, large nails, skewers, &c. into the flesh,[[106]] comprise a class of wounds of great importance and danger, as they generally penetrate to a great depth, so as to injure large blood-vessels, nerves, viscera, and other organs of importance; and being inflicted with considerable violence the parts always suffer more injury than what would be produced by their simple division. It must also be considered, that a great number of the weapons by which such wounds are occasioned, increase materially in diameter from the point towards their other extremity; and hence, when they penetrate far, they must force the fibres asunder like a wedge, and cause a serious degree of stretching and contusion. It is this circumstance which gives so dangerous a character to bayonet wounds in the soft parts. The opening which the point of such a weapon produces is quite insufficient for the passage of the thicker part of it, which can therefore only enter by forcibly dilating, stretching, and otherwise injuring the fibres of the wounded flesh. But mortal injury may be inflicted by an extremely slender instrument, so as to occasion an apparently trivial puncture; and in some cases, the external injury is healed before the death, which it occasions, takes place. Such cases can only receive satisfactory elucidation from the lights of an anatomical dissection, under which head we have furnished several instructive examples.
Bruises, or Contusions, strictly comprehend those injuries which are occasioned by the violent application of blunt or obtuse instruments to the soft parts. They are not unfrequently complicated with severe internal injury resulting from the violence which the parts have sustained, such as inflammation, suppuration, or even the rupture of some of the viscera, of which we shall hereafter present several illustrative cases.
A blow on the region of the stomach sometimes occasions instant death; an effect which would appear to arise from an injury inflicted upon the eighth pair, and great sympathetic nerves, by which the heart is instantly paralysed. In these cases the heart has been found empty, and the stomach has appeared red and inflamed; this latter appearance is the obvious effect of the sudden cessation of the heart, producing the settling of the blood in the extreme arterial branches.
Wounds of this description are, of course, more or less important, according to their locality; unless complicated with laceration, they are never attended with any considerable hemorrhage, although the minute vessels are necessarily ruptured, and the effusion of their contents produces the discoloration so characteristic of this kind of injury.
As in the case of wounds, so also in respect of blows, injuries apparently inadequate have produced death; it then becomes difficult to fix the degree of guilt which should be attached to the aggressor; for though according to the strict letter of the law, every man is responsible for the ultimate effect of an illegal act committed by him; yet in moral justice there is much difference between the atrocity of him who strikes a grievous wound with a deadly weapon, from which by chance his victim may recover; and the fault of him who transported by sudden passion gives an ordinary blow, which by accident, by reason of some inward and unknown disease of his adversary, or by injudicious treatment, becomes fatal. Numerous cases might be cited in support of this position: that of Brain for the murder of Watts, Cro. Eliz. 778: H. P. C. 455. is one of the most remarkable, not only from the circumstances attending the trial, where the jury were fined and imprisoned for a corrupt verdict, but also for the physiological circumstance, that the deceased died instantly from a blow on the calf of his leg. The parties had previously quarrelled and fought; and Brain, the prisoner, was hurt; the next day Watts passing his shop made mouths at him, on which new provocation Brain hit him the blow which instantly proved fatal. The Court held that the new provocation was insufficient, and that the death must be referred to precedent malice—might they not also have considered that a blow on the calf of the leg was more insufficient to produce death under ordinary circumstances, than a wry face to induce or inflame a quarrel? The prisoner was found guilty, but not without considerable and as it appears to us proper resistance on the part of the jury; the case being on Appeal, the Crown could not pardon, though the appellant might compromise his suit:—we are not informed whether the prisoner was executed.
A case, nearly parallel to the above, is that of Lydia Alder, who was tried in 1744 for the murder of her husband, whom she kicked on the groin; in consequence of which, having at the time an inguinal rupture, mortification came on, and he died. Verdict, Manslaughter. The circumstances attending the case of Bartholomew Quain were, in some respects, different; he was tried and convicted for the murder of his wife, at the Assizes for the Isle of Ely, in 1790. It appeared in evidence, that a rupture of the spleen was produced by the violent kicks, of which the indictment stated that she had died. The jury, under the direction of the Chief Judge of Ely, found a special verdict, in order to take the opinion of the Court of King’s Bench upon the following question, whether the facts found by the jury amounted to murder, or only to manslaughter, when the Court was clearly of opinion that it was murder, because there did not appear to have been any provocation on the part of the deceased; and no man had a right, even to inflict chastisement, without a just provocation.
Lacerations, where the integuments are torn.—These differ from incised wounds not only in the circumstance of their being less disposed to heal by the first intention, but in the singular fact of their not bleeding to any extent; there are perhaps no facts, in the history of surgery, more extraordinary than those which have been recorded on the subject of whole limbs being torn away, without hemorrhage. The most remarkable of these is related by Cheselden, in his work on Anatomy, being the case of a miller, “whose arm, with the scapula, was torn off from his body, by a rope winding round it, the other end being fastened to the coggs of a mill; there was no hemorrhage, nor did any severe symptoms supervene, so that the wound was cured by superficial dressings only, the natural skin being left almost sufficient to cover it.” Analogous cases are recorded by La Motte, in his Traité des Accouchemens; by Mr. Carmichael, in the fifth volume of the Edinburgh Medical Commentaries; and by others, in the second volume of the Mem. de l’Acad. de Chirurgie. In appreciating the degree of danger attendant upon wounds of this description, the practitioner must not overlook the possible occurence of Tetanus.
Gun-shot wounds. Long after the invention of gunpowder, Surgeons continued to entertain very vague opinions respecting the nature of wounds produced by it; some considered that the injured parts were either dreadfully burnt by the heat of the projected body, or were irritated by the presence of poison, communicated to them by the powder. Thomas Gale, who served as a Surgeon in the army of Henry 8th, at Montreuil in 1554, was the first to refute the absurd opinions of “the poisoning, burning, and conquassation of gun-shot wounds.” A gun-shot wound is now defined “a violent contusion, with, or without a solution of continuity, suddenly and rapidly effected by a solid body projected from fire-arms.” If a musket or pistol ball has struck a fleshy part, without injuring any material blood-vessel, we see a hole about the size of, or smaller than the bullet itself; with a more or less discoloured lip forced inwards, and if it has passed through the parts, we find an everted edge, and a more ragged, and larger orifice at the point of its exit; the pain in this case is so inconsiderable that the wounded person is frequently not aware of his having received any injury. The course of balls is frequently most extraordinary, and it behoves the judicial surgeon to keep in mind a fact which may often throw considerable light upon the subject of his investigation. A ball will often strike the thorax or abdomen, and, to an inexperienced eye, appear to have passed directly across, or to be lodged in one of the cavities. If great difficulty of breathing or hemorrhage from the mouth, with sudden paleness and laborious pulse, in the one case, or deadly faintness, coldness of the extremities, and the discharge of stercoraceous matter from the wound, in the second, are not present, we shall perhaps find that the ball has coursed along under the integuments, and is marked in its progress either by a redness, which Mr. Hunter compared to a blush, or by a wheal, or dusky line, terminated by a tumour, on the opening which it will be easily extracted. In some of these long and circuitous routes of balls, where we have not this mark, a certain emphysematous crackling discovers their course, and leads to their detection. The ball is in many instances found very close to its point of entrance, having nearly completed the circuit of the body. In a case related by Dr. Hennen, as one that occurred to a friend of his in the Mediterranean, the ball, which struck about the Pomum Adami, was found lying in the very orifice at which it had entered, having gone completely round the neck, and being prevented from passing out by the elasticity and toughness of the skin which had confined it to this circular course. This circuitous route is a very frequent occurrence, particularly when balls strike the ribs, or abdominal muscles, for they are turned from the direct line by a very slight resistance indeed, although they will at times run along a continued surface, as the length of a bone, along a muscle, or a fascia, to a very extraordinary distance. If there is nothing to check its course, and if its momentum be very great, it is surprising what a variety of parts may be injured by a musket ball. Dr. Hennen states that in one instance, which occurred in a soldier, who having his arm extended in the act of endeavouring to climb up a scaling ladder, had the centre of his humerus pierced by a ball, which immediately passed along the limb, and over the posterior part of the thorax, coursed among the abdominal muscles, dipped deep through the glutæi, and presented on the fore part of the opposite thigh, about midway down. In another case, a ball which struck the breast of a man standing erect in the ranks lodged in the scrotum. The propensity of balls to take a curved direction is often seen in their course on a concave surface; in short, they take very unusual and deep-seated routes, not at all to be accounted for by any preconceived theories drawn from the doctrine of projectiles, nor to be explained by diagrams founded upon mathematical rules. These considerations ought to render the Surgeon very cautious how he delivers his opinion, as to the direction in which the shot was fired, and yet instances frequently occur where no difficulty can arise upon this point, such was the case of Richard Annesley, tried for the murder of Thomas Eglestone (9 Harg. Sta. Tri. 327). The deceased was a poacher. Annesley who was in company with the game-keeper, stated in his defence, that his gun had accidentally gone off in his attempt to secure the deceased. The instructions given by the Court on this occasion was that if the jury were of opinion that the gun had so gone off accidentally, they should bring in a verdict of Chance-medley, which was returned accordingly, in consequence of the evidence of the Surgeon who had examined the wound, and stated that its direction being upwards, very satisfactorily proved that the fowling-piece had not been levelled from the shoulder, which would have implied design; but must have been discharged at the trail, which must have been accidental.[[107]] An idea long existed that a ball might produce injury without striking any part of the body; this was supposed by some to arise from the violent commotion produced in the air by the rapid motion of the ball; and by others, to depend upon an electrical shock on the parts, in consequence of the ball being rendered electrical by friction in the calibre of the gun, and giving off the electrical matter as it passes by. This, however, is contrary to all our received notions respecting electricity; metals can never acquire such a property by friction.
In avowing our total disbelief in the existence of such wind-contusions, as they have been called, we are well aware that we shall oppose many very respectable authorities. “Amicus Plato, sed magis amica Veritas.”
An important question, connected with the present subject, still remains for elucidation; where a body has been found dead with wounds and contusions, by what signs we are to determine whether they were inflicted during life, or after death. As the solution of this interesting problem requires various data, its consideration will be reserved for that part of our work, where all the Objects of Inquiry, in cases of sudden and mysterious death, are considered in their various relations to each other, with a view to appreciate their individual and joint importance.
BY POISONING.
No species of murder is so base and cowardly, or so cool and deliberate in its perpetration as murder by poison, which because of its secresy prevents all precaution, whereas most open murder gives the party killed some opportunity of defence;[[108]] it is generally committed in violation of domestic duty and confidence, and too frequently evinces that unrelenting and barbarous depravity, which can witness the sufferings of its victim for days nay months unmoved; therefore our ancient laws adjudged those convicted of poisoning to a severer punishment than other offenders. 3 Nels. Abr. 363. Jac. Law Dict. tit. Poison. By the 22 Hen. 8. it was ex post facto enacted that Richard Roose, (or Cooke), for putting poison into a pot of pottage in the Bishop of Rochester’s kitchen, by which two persons were killed, should be boiled to death; and that the offence in future should be adjudged High Treason; but this among other new treasons (with which the reign of Henry the 8th had abounded) was abolished by the statute of Edward 6, and now to poison any one wilfully is murder if the party die in a year. 1 Edw. 6. c. 12.
By the 43 Geo. 3. c. 58. (commonly called Lord Ellenborough’s Act) any person administering poison with intent to murder another, (though no death ensue) or to procure the miscarriage of a woman quick with child, is declared guilty of felony without benefit of clergy: and persons administering medicines to procure miscarriage, though the woman is not quick with child, are declared guilty of felony, punishable by imprisonment or transportation (vide post). If a man persuade another to drink a poisonous liquor, under the notion of a medicine, who afterwards drinks it in his absence, or if A, intending to poison B, put poison into a thing, and deliver it to D who knows nothing of the matter, to be by him delivered to B, and D innocently delivers it accordingly in the absence of A;[[109]] in this case the procurer of the felony is as much a principal as if he had been present when it was done (2 Hawk. P. C. 443: Vin. Ab. tit. Accessory) or if one mix poison with any eatable with intent to kill another, and a stranger casually eat it and die,[[110]] it is murder; Dalton, 93. Agnes Gore’s case for poisoning by ratsbane (9 Co. Rep. 81: Palm. R. 547.), not so if it be to kill vermin; but query if it be manslaughter where there is not proper precaution, as where the poison is laid in ordinary places for keeping meat, and mixed with ordinary food, so that a child may take it. 1 East. P. C. He that counsels another to give poison, if that other doth it, the counsellor, if absent, is accessory before. Coke, P. C. 49. Case of the murder of Sir Thomas Overbury, Harg. St. Trials. But he that absolutely gives or lays the poison, to the intent to poison, though he be absent when it is taken by the party, yet he is principal, and this was Weston’s case. Harg. St. Trials: Co. P. C. p. 49. Vaux’s case, ubi supra, and Donellan’s case for the murder of Sir Theodosius Boughton, Warwick Assizes, 1784. See Appendix, 243.
It is not our intention to detail every mode by which murder by poison may be committed; too many are already known to the world in general; on those which are known, we may safely comment; nor would there be as much mischief as is commonly supposed in hinting at some others; for if any should study this subject with evil intention, he may be assured that the progress of modern science, though it may have discovered some new modes of destruction, has been yet more fertile in antidotes for the injured, and in means of detecting the guilty.
OF POISONS,
CHEMICALLY, PHYSIOLOGICALLY, AND PATHOLOGICALLY CONSIDERED.
Toxicology, or the history of Poisons, forms one of the most important and elaborate branches of Forensic Medicine, and in tracing the subject through all its numerous and interesting relations to Jurisprudence, we shall experience no small degree of gratification by observing, how greatly and progressively this obscure department of science has, within the last few years, been enlightened by the discoveries of Chemistry and Physiology.
The labours of the modern Chemist, indeed, have enabled us to recognise and identify each particular substance by its properties and habitudes, with an infallible delicacy, which the Physicians of a former age could scarcely have anticipated, and much less practised.
The Physiologist, by an invaluable series of observations and experiments, has demonstrated the particular organ, or texture, upon which each individual poison exerts its energies; and the Pathologist has been thus enabled to establish the mode in which it depraves the health, or extinguishes the life of an animal. Nor has the Anatomist withheld his contributions upon this interesting occasion, for he has demonstrated the situation, extent, and intensity of the organic lesions which result from the operation of these terrible agents upon the living body; and has pointed out several appearances which occur from natural causes, but which might be mistaken by the unskilful or superficial observer, for the ravages of poison. It remains for the Forensic Physician to converge into one focus the scattered rays which have thus emanated from so many points, and thereby to elucidate and determine the line of conduct which the medical attendant is called upon to pursue, for the relief of the patient suffering under the torments of poison, and for the establishment of the guilt or innocence of the party charged with the perpetration of a crime, which may be said to rob courage of its just security, while it transfers to cowardice the triumphs of valour. That engines so powerful and secret in their work of destruction, should have universally excited the terror of mankind is a fact which cannot surprise us, and, when we consider how intimate are the relations between fear and credulity, we need not seek farther for the solution of the many problems to which the exaggerated statements of ancient Toxicologists[[111]] have given origin; the most extraordinary of those relate to the alleged subtlety of certain poisons, which was believed to be so extreme as to defeat the most skilful caution, and at the same time so manageable, as to be capable of the most accurate graduation; so that, in short, the accomplished assassin was not only thus enabled to ensure the death of his victim through the most secret, and least suspicious agents, but to measure his allotted moments with the nicest precision, and to occasion his death at any period that might best answer the objects of the assassination. The writings of Plutarch, Tacitus, Theophrastus, Quintillian, and Livy, abound with such instances of occult and slow poisoning; most of which, however, notwithstanding the weight they may acquire from their testimony, bear internal evidence of their fallacious character. Plutarch informs us that a slow poison which occasioned heat, cough, spitting of blood, a lingering consumption of the body, and a weakness of intellect, was administered to Aratus of Sicyon. This same poison is also alluded to by Quintillian in his declamations. Tacitus[[112]] informs us that Sejanus caused a secret poison to be administered by an eunuch to Drusus, who in consequence gradually declined, as if by a consumptive disorder, and at length died. Theophrastus[[113]] speaks of a poison, prepared from Aconite, that could be so modified as to occasion death within a certain period, such as two, three, or six months, a year, and even sometimes two years.
To such an extent does the crime of poisoning appear to have been carried, about two hundred years before the Christian æra, that according to Livy,[[114]] above one hundred and fifty ladies, of the first families in Rome, were convicted and punished for preparing and distributing poison. The most notorious and expert character of this kind is handed down to us by the historians and poets under the name of Locusta, who was condemned to die on account of her infamous actions, but was saved in order that she might become a state engine, and be numbered, as Tacitus expresses it, “Inter instrumenta regni.” She was accordingly employed to poison Claudius by Agrippina, who was desirous of destroying the Emperor, and yet feared to despatch him suddenly, whence a slow poison was prepared by Locusta, and served to him in a dish of mushrooms, of which he was particularly fond, “Boletorum appetentissimus;” but it failed in its effects, as we learn from Tacitus, until it was assisted by one of a more powerful nature. “Post quem nihil amplius edit.” This same Locusta prepared also the poison with which Nero despatched Britannicus, the son of Agrippina, whom his father Claudius wished to succeed him on the throne. This poison appears to have proved too slow in its operation, and to have occasioned only a dysentery. The Emperor accordingly compelled her by blows and threats, to prepare in his presence one of a more powerful nature, and as the tale is related by Suetonius, it appears that it was then tried on a kid, but as the animal did not die until the lapse of five hours, she boiled it for a longer period, when it became so strong as instantaneously to kill a pig to which it was given. In this state of concentration it is said to have despatched Britannicus as soon as he tasted it.[[115]] Vide Tac. An. 13. s. 15. 16. Now it would clearly appear from these statements that Locusta, avowedly the most accomplished poisoner of ancient Rome, was wholly incapable of graduating the strength of her poisons to the different purposes for which they were applied.
The records of modern times will furnish examples no less atrocious than those we have just related. Tophana, a woman who resided first at Palermo, and afterwards at Naples, may be considered as the Locusta of modern history; she invented and sold those drops so well known by the names of Aqua Toffania; Aqua della Toffana; Acquetta di Napoli, or simply Acquetta. This stygian liquor she distributed by way of charity to such wives as wished for other husbands; from four to six drops were sufficient to destroy a man, and it was asserted that the dose could be so proportioned as to operate within any given period.[[116]] It appears that in order to secure her poison from examination, she vended it in small glass phials, inscribed, “Manna of Saint Nicolas Bari,” and ornamented the vessel with the image of the Saint. Having been put to the rack she confessed that she had destroyed upwards of six hundred persons, for which she suffered death by strangulation in the year 1709[[117]]. In 1670 the art of secret poisoning excited very considerable alarm in France; the Marchioness de Brinvillier, a young woman of rank and great personal beauty, having intrigued with, and subsequently married an adventurer named Saint Croix, acquired from him the secret of this diabolical act, and practised it to an extent that had never before been equalled. She poisoned her two brothers through the medium of a dish at table. She also prepared poisoned biscuits, and to try their strength she distributed them herself to the poor at the Hotel Dieu. Her own maid was likewise the subject of her experiments. To her father she gave poisoned broth, which brought on symptoms characteristic of those induced by corrosive sublimate. Her brothers lingered during several months under much suffering. The detection of this wretch is said to have been brought about in the following manner. Saint Croix, whenever engaged in the preparation of his poisons, was accustomed to protect himself from their dangerous fumes by wearing a glass mask, which happening to fall off by accident, he was found dead in his laboratory.[[118]] A casket directed to the Marchioness, with a desire that in case of her death it might be destroyed unopened, was found in his chamber, a circumstance which in itself was sufficient to excite the curiosity and suspicion of those into whose hands it fell. The casket was accordingly examined, and the disclosure of its contents at once developed the whole plot, and finally led to the conviction of this French Medea, who after a number of adventures and escapes, was at length arrested and sent to Paris, where she was beheaded, and then burnt, on the 11th of July, 1676. The practice of poisoning, however, did not cease with her execution, and it became necessary in 1679 to establish a particular Court, for the detection and trial of such offenders; which continued for some time to exert its jurisdiction under the title of Chambre de Poison, or Chambre Ardente.
With respect to the secret modes in which poisons have been supposed capable of acting, mankind have ever betrayed the most extravagant credulity, of which the numerous tales upon record afford ample proof; such as that reported of Parasapis by Plutarch, from Ctesias, in his life of Artaxerxes, who, it is said, by anointing a knife on one side by poison, and therewith dividing a bird, poisoned Statira with one half, and with the other regaled herself in perfect security. We are also told of Livia who poisoned the figs on a tree which her husband was in the habit of gathering with his own hands. Tissot informs us that John, king of Castille, was poisoned by a pair of boots prepared by a Turk; Henry VI, by gloves[[119]]; Pope Clement VII, by the fumes of a taper[[120]]; and our king John, in a wassail bowl, contaminated by matter extracted from a living toad. To these few instances of credulity may be added the offer of the priest to destroy queen Elizabeth by poisoning her saddle[[121]], and the Earl of Essex, by anointing his chair.
Incredible and absurd as these opinions now appear, they continued until a late period to alarm mankind, and to perplex and baffle judicial investigations; even Lord Bacon in his charge against the Earl of Somerset for the murder of Sir Thomas Overbury, in the Tower, seemed to give credit to the story of Livia, and he seriously stated, that “Weston chased the poor prisoner with poison after poison; poisoning salts, poisoning meats, poisoning sweetmeats, poisoning medicines and vomits, until at last his body was almost come, by the use of poisons, to the state that Mithridates’s body was by the use of treacle and preservatives, that the force of poisons was blunted upon him;” Weston confessing, when he was reproached for not despatching him, that he had given enough to poison twenty men.[[122]] The power of so graduating the force of a poison as to enable it to operate at any given period seems to have been considered possible by the earlier members of the Royal Society, for we learn from Spratt’s history of that learned body, that very shortly after its institution, a series of questions were drawn up by the direction of the Fellows, for the purpose of being submitted to the Chinese and Indians, viz. “Whether the Indians can so prepare that stupifying herb, Datura, that they make it lie several days, months, years, according as they will have it, in a man’s body, without doing him any hurt, and at the end kill him without missing half an hour’s time?”
That mankind were, in a very early stage of their existence, not only acquainted with the deadly effects of certain natural substances when applied in minute quantities, but that they availed themselves of such knowledge for the accomplishment of the worst purposes, is very satisfactorily shewn by the records of sacred as well as profane authors. But such is the ambiguity of ancient writers upon this subject, and so intimately blended are all their receipts with the practices of superstition, that every research, however learned, into the exact nature of the poisons which they employed, is necessarily vague and unsatisfactory. Of this one fact, however, we may be perfectly satisfied, that they were solely derived from the animal and vegetable kingdoms, for the discovery of mineral poisons was an event of later date; owing however to the defect of botanical nomenclature, it is even doubtful whether the plants which are designated by the terms Cicuta, Aconitum, &c. in ancient authors, were identical with those we designate by the same names. (See Pharmacologia, edit. v. vol. 1, p. 66.) With respect to the poisons of Locusta, all cotemporary writers speak of the venom of the toad as the fatal ingredient of her potions, and in the Alexipharmaca of Dioscorides we find the symptoms described, which are said to be produced by it;[[123]] but what is very extraordinary, the belief of the ancients on this matter was all but universal. Pliny is express on the subject; Ætius describes two kinds of this reptile,[[124]] the latter of which, as Dr. Badham has suggested, was probably the frog, as well from the epithet, as that he ascribes deleterious powers only to the former. It is scarcely necessary to observe that this ancient belief has descended into later times; we find Sir Thomas Browne treating such an opinion as one of the vulgar errors; and we have before alluded to the legend of king John having been poisoned by a wassail bowl in which matter extracted from a living toad was said to have been infused. In still later times, we have heard of a barrel of beer poisoned by the same reptile having found its way into it. Borelli and Valisnieri maintain that it is perfectly harmless, and state that they had seen it eaten with impunity. Spielman[[125]] expresses the same opinion, “Minus recte itaque effectus venenati a bufonibus metuuntur.” Franck,[[126]] on the contrary, accuses Gmelin of too much precipitancy in rejecting the belief respecting toad-poison,[[127]] Modern naturalists recognise no poisonous species of toad; even the most formidable of the species, to appearance, that of Surinam, is said to be perfectly harmless.
If we may venture to offer a conjecture upon this subject, we are inclined to consider the origin of this opinion to have been derived from the frequency with which the toad entered into the composition of spells or charms, into philtres or love potions, and which, like the bat and the owl, most probably derived its magical character from the gloom and solitude of its habitation. Shakspeare has accordingly introduced this reptile into the witches’ enchanted cauldron, in Macbeth.
“Round about the cauldron go;
In the poison’d entrails throw.
Toad that under coldest stone
Days and nights hast thirty-one
Swelter’d venom sleeping got,
Boil thou first i’ the charmed pot!”
This opinion receives further strength when it is considered how frequently poisons were administered under the insidious form of charms or incantations.[[128]]
It has, however, been shewn by late experiments that the toad has, under particular circumstances, the power of ejecting from the surface of the body an acrid secretion which excoriates the hands of those that come in contact with it; and this fact may perhaps have assisted in supporting the general belief respecting the poisonous nature of this reptile. Pelletier has ascertained, that this corrosive matter, contained in the vesicles which cover the skin of the common toad, (Rana Bufo) has a yellow colour, and an oily consistence, and to consist of,—1st, an acid partly united to a base, and constituting 1/20th part of the whole. 2d, very bitter fatty matter. 3d, an animal matter bearing some analogy to gelatine.
It would also appear from the writings of Dioscorides, Galen, Nicander, Ætius, Ælian, and Pliny, that the ancients derived a very energetic poison from the Sea Hare, Lepus Marinus,—the Aplysia Depilans of Linnæus; and, if we may credit Philostratus, it was with such a poison that Titus was killed by Domitian.
There is, however, ample ground for supposing that the poisons of the ancients were, for the most part, obtained from the vegetable kingdom, and from the class of Narcotic plants;[[129]] that they were compounded of a great variety of such ingredients, together with others that were quite inert and useless, and which merely served to disguise their composition.
Ancient writers also allude to the blood of the bullock as a poison; Themistocles is said by Plutarch to have destroyed himself by this fluid; and Strabo states that Midas died of drinking the hot blood of this animal, which he did, as Plutarch mentions, to free himself from the numerous ill dreams which continually tormented him. Some historians assign the death of Hannibal to the same draught.
With respect to the poisons employed by Tophana, the Locusta of modern days, and her infamous successors, there is less doubt; Arsenic, Corrosive Sublimate, Sugar of Lead, and Antimony,[[130]] were amongst the most powerful of their instruments of torture and death. According to the declaration of the Emperor Charles VII to his physician Garelli, the Aqua Toffania was a solution of arsenic in Aqua Cymbalariæ.[[131]] Dr. Hahneman considered its basis to have been an arsenical salt. Others have, with little probability, regarded Opium and Cantharides as the active ingredients. Franck,[[132]] speaking of the Aqua Toffania, agrees with Gmelin,[[133]] that it is no other than a solution of arsenic. The Pulvis Successionis, another instrument of death, whose title announces the diabolical intention with which it was administered, has been supposed to have been a preparation of lead; while others have considered it to have consisted of diamond dust, and to have acted mechanically.
Having thus noticed a few of the more remarkable and interesting features in the literary history of Toxicology, we shall proceed to consider the subject of Poisons, in relation to their operation.
A Poison, (Toxicum, Venenum, Virus), has been very correctly defined by Gmelin to be a substance which when administered internally, or applied externally, in a small dose, impairs the health, or destroys life. This definition is adopted by Mead, Sproegel, Plenck, and Tortosa, and is to be preferred to every other,[[134]] not only for its simplicity, but for its independence of any theory relative to the modus operandi of such agents. But it will be seen that, by accepting this definition, we are necessarily led to admit the fact, that poisoning may be acute, or chronic, that is to say, that it may at once destroy life, or produce a disease which can be protracted to any indefinite period. After the erroneous and vague notions which have been entertained upon the subject of “Slow poisons,” it is highly essential that the latitude of our belief should be accurately ascertained, and the precise meaning of our terms defined.
OF SLOW, CONSECUTIVE,[[135]] AND ACCUMULATIVE POISONING.
1. Slow Poisons. According to the popular acceptation of the term, they may be defined, Substances which can be administered imperceptibly; and a single dose of which will operate so gradually, as to shorten life like a lingering disease; their force, at the same time, admitting of so nice an adjustment as to enable the artist to occasion death at any required period. We have now to inquire how far such alleged powers are consistent with the known laws of physiology. It cannot be denied that certain substances have been introduced into the alimentary canal, where they have remained for an indefinite period, without occasioning the slightest inconvenience, and at length excited a disease that has terminated fatally; in the London Medical and Physical Journal for February 1816, a case is related in which death was occasioned by a chocolate-nut having lodged in the entrance of the Appendix Vermiformis; and in the Edinburgh Medical and Surgical Journal for July 1816, we have an analogous case, communicated by Dr. Briggs of Liverpool, where the Appendix cæci sphacelated, owing to the irritation of a human tooth which was found sticking in its cavity. Mr. Children has lately communicated to the Royal Society a case where a concretion in the colon produced death; upon examination it was found to contain a plum-stone, as a nucleus, and to consist of a fine fibrous vegetable substance, from the inner coat enveloping the farina of the oat, and which was derived from the oatmeal upon which the deceased had fed. (Phil. Trans. 1822.) However disposed we may feel, by a forced construction of the term, to consider such agents as slow poisons, it is very evident that they can rarely have been made subservient to the purposes of secret poisoning; although a case occurred in the practice of the author,[[136]] in which a girl swallowed six copper pence for the avowed purpose of destroying herself; the coin produced a disease which remained chronic for a very considerable period, when, after a lapse of five years, they were voided, and the young woman recovered. A similar attempt was also made by Theodore Gardelle, after his conviction for the murder of Mrs. King (vide ante), he swallowed a number of halfpence, for the purpose of destroying himself, but without any ill effect. Dr. Baillie, in his ‘Morbid Anatomy,’ relates an instance where five halfpence had been lodged in a pouch in the stomach for a considerable time, without occasioning any irritation; and Mr. A. Thomson has also furnished us with two analogous cases in children, in one of which the copper coin remained six months in the intestines, and in the other, two months. These facts furnish sufficient data to enable the practitioner to appreciate the degree of danger attendant upon such agents, and to determine how far they can ever become successful instruments in the hands of the assassin.[[137]]
But it has been supposed that certain bodies, as glass, enamel, diamonds,[[138]] agates, smalt, &c. when administered in the form of powder, so lacerate the membranes of the stomach, by the sharpness of their particles, as slowly to destroy life; and upon the same principle, it has been asserted, that human hair, chopped fine,[[139]] constitutes the active ingredient of a slow poison frequently employed in Turkey, and that it induces, by irritation, a chronic disease resembling cancer. With respect to the danger arising from the ingestion of diamond dust, enamel powder, powdered glass, and the like, there still may be said to exist some difference of opinion. Caldani, Mandruzzato,[[140]] and M. Le Sauvage, have reported experiments made upon men and inferior animals, in which no bad consequences followed the administration of such bodies; whereas Schurigius[[141]] and Cardanus[[142]] cite instances where persons have died of ulcerations of the stomach from such causes; and this opinion receives the support of Plouquet,[[143]] Stoll,[[144]] Gmelin,[[145]] Foderé,[[146]] Mahon,[[147]] Franck,[[148]] and many others. The modern pathologist will not find much difficulty in reconciling such conflicting testimony. The experimentalist may administer mechanical substances a thousand times without producing any ill effects, while, under certain circumstances, the most trivial body may lodge in the intestines and produce death; but surely the occasional occurrence of such accidents ought not to confer the general title of poison upon the substances which may happen to produce them.
Having thus disposed of a considerable number of bodies, which have been classed as slow poisons, we may proceed to observe that most of the other substances which have found a place in the same division, appear to us to deserve consideration under a very different head, and that we shall get rid of much obscurity by adopting the following arrangement.
2. Consecutive Poisoning. Where the patient, having recovered from the acute effects occasioned by the ingestion of a single dose of poison, subsequently suffers a series of symptoms from the injured structure to which it had given origin. By referring to our definition of slow poisoning, we shall at once perceive the striking and important distinction between that and Consecutive poisoning. The following case, related by M. Orfila, may serve as an illustration. Maria Ladan drank by mistake a spoonful of Aqua fortis, the most violent symptoms supervened, but which by judicious treatment gradually subsided, when at length she passed by stool a long membranous substance, rolled up, and which represented the form of the æsophagus and stomach, and which, in fact, was found to be the interior membrane of these organs; from that moment the sensibility of the digestive organs became excessive, and two months after the accident she experienced a sudden shock and died. M. Tartra, in observing upon cases of this kind, asserts that the symptoms produced at first by the nitric acid decrease insensibly; and that at the end of a certain period, the internal membrane of the digestive canal is struck with death, and thrown off, and the person dies of a Marasmus. Fordyce[[149]] relates the case of a woman who was subject to cholics for the space of thirty years, in consequence of having once taken an infusion of the pulp of Colocynth prepared with beer. This was undoubtedly an extraordinary instance of idiosyncrasy, but it is probable that some organic lesion was occasioned by its operation, to which the subsequent suffering is to be referred. We have hitherto only considered the effects that may arise from the ingestion of a single dose of poison, but there are numerous and very interesting cases in which fatal results have been produced by the repetition of small doses at various intervals. We therefore propose a third, and new subdivision of our subject, viz.
3. Accumulative Poisoning.—By the repeated administration of a substance, in doses, of which no single one could occasion harm; but which, by gradually accumulating in the system, ultimately occasions disease, and death.
The familiar operation of mercury will at once suggest itself to the Physician, as a striking illustration of that species of poisoning which we have ventured to name Accumulative, and to the forensic student the effects of this metal, in reference to such a quality, will form a more than ordinary object of interest, as involving questions which have frequently embarrassed judicial inquiry; as, for instance, Whether it can lie dormant any considerable time without betraying its effects upon the constitution, and, having displayed its powers, and the symptoms having subsided, viz. salivation, &c. Whether they can be renewed without a fresh application of the substance? See Corrosive sublimate.
To how many substances this power of accumulation extends is at present not well understood. It may occur in those that act by absorption, and in those whose action is wholly local. Arsenic, digitalis, and several of the narcotic plants, as hemlock, may undoubtedly occasion serious mischief in this manner, as the author has more fully explained in another work,[[150]] and we have lately heard of several fatal cases arising from accumulated masses of magnesia in the primæ viæ, from the habitual use of small doses of that earth.
The history of many of the arts, especially those of metallurgy, would furnish also abundant examples of this kind of poisoning.
These few facts are we trust sufficient to authorise the foregoing arrangement, and we apprehend that the adoption of the distinctions, upon which it is founded, will be of great service in establishing fixed and definite notions with regard to the chronic operation of poisons. It may perhaps be useful to present the reader with a synoptical recapitulation of the subject.
A Slow Poison. A single dose is sufficient; which produces upon its administration no sensible effect, but gradually undermines the health.
A Consecutive Poison. A single dose is sufficient; producing the most violent symptoms, very shortly after its ingestion, but which gradually subside, and the patient is supposed cured; when, at some future period, death takes place from the organic lesions that had been occasioned.
An Accumulative Poison. Many doses are required; the effects being produced by the repetition of doses which would, individually, be harmless.
There still remains another point of view in which it is essential to regard the operation of a poison, in order to establish a distinction between those substances which, in a given dose, will destroy life under every circumstance of constitution, and those which occasion death in consequence of some constitutional peculiarity in the individual to whom they may have been administered, and which are innocuous to the general mass of mankind; the gradations by which food, medicine, and poison, are thus enabled to branch into each other cannot be defined, because the circumstances with which they are related, defy generalization. The distinction, however, must be acknowledged and preserved, and we know no terms better adapted for expressing it than those of Absolute and Relative poisons; and our readers are accordingly requested to receive them in conformity with this explanation, whenever they occur in the following pages. Every work professing to treat the subject of Poisons, abounds with instances, in which articles that, by universal consent, are considered innocuous, have occasioned the most direful effects. Morgagni relates a case of a person who died from eating bread made with the farina of the chesnut. Dr. Winterbottom[[151]] says that he is subject to severe nettle-rash after eating sweet almonds. Schenkius relates a case in which the general law of astringents and cathartics was always reversed. Donatus tells us of a boy whose jaws swelled, whose face broke out in spots, and whose lips frothed, whenever he eat an egg: we might add many more examples, but it is needless to encumber a subject with illustrations which is already so obvious and indisputable. Nor do the anomalies of constitutional idiosyncrasies end here, for they not only convert food into poison, but they change poison into food, or at least, into a harmless repast. The most extraordinary exemplification of this on record is contained in the history of the old man at Constantinople, as related by M. Pouqueville, physician to the French army in Egypt, and who was a prisoner at Constantinople in the year 1798[[152]]. “This man,” says he, “was well known all over Constantinople, by the name of Suleyman Yeyen, or Suleyman, the taker of corrosive sublimate. At the epoch when I was there he was supposed to be nearly a hundred years old, having lived under the Sultans Achmet III, Abdul Hamet, and Selim III. He had in early life habituated himself to taking opium; but, notwithstanding that he constantly increased the dose, he ceased to feel from it the desired effect, and then tried sublimate, the effects of which he had heard highly spoken of; for thirty years this old man never ceased to take it daily, and the quantity he could now bear exceeded a drachm. It is said, at this epoch he came into the shop of a Jewish apothecary, and asked for a drachm of sublimate, which he swallowed immediately, having first mixed it in a glass of water. The apothecary, terrified, and fearing that he should be accused of poisoning a Turk, immediately shut up his shop, reproaching himself bitterly with what he had done; but his surprise was very great, when, the next day, the Turk came again, and asked for a like dose of sublimate.”
Morbid states of the body may also exist which are capable of resisting, to a certain extent, or of modifying, the violent operation of particular poisons. In the history of the Royal Academy of Sciences for 1703, a case is related of a woman, who being tired out by a protracted dropsy, under which her husband had suffered, charitably administered to him fifteen or twenty grains of opium with the intention of despatching him; but the dose immediately produced such copious evacuations by sweat and urine, that it restored him to health. This relation will immediately recal to the recollection of the classical reader the story, recorded by Plutarch, in his life of Crassus, of Hyrodes king of the Parthians, who having fallen into a dropsical complaint had poison (Aconite) administered to him by his second son, Phraates, but which, instead of destroying the king, as intended, cured his disease. The son, however, having thus failed in his attempt, shortly afterwards smothered his father with his pillow.
GENERAL REMARKS
ON THE MEDICAL EVIDENCE REQUIRED TO SUBSTANTIATE AN ACCUSATION OF POISONING.
Although the phenomena by which we are enabled to discover the administration of poison, will be fully enumerated, and carefully examined, under the history of each particular substance, and will necessarily vary according to the chemical properties, and physiological action of each individual poison; yet there are some general points of evidence, and several questions of importance, upon which it is very essential to arrive at some definite conclusion, some fixed understanding, before we proceed to the consideration of the particular details, and subordinate ramifications, of this complicated subject.
The great constituents which form the medical proof of poisoning, are derived from Chemical, Anatomical, and Pathological researches; viz.—the existence of poison in the stomach or intestines; the morbid appearances, corresponding to such poison, upon dissection; and the characteristic symptoms which accompanied the action of it, previous to death. Where these circumstances occur in combination, the demonstration may be said to be complete, for we have arrived at absolute certainty.
But scientific evidence, short of such perfection, may be amply sufficient to lead to conviction. The fact of a poison having been found in the body may supersede the necessity of pathological testimony: thus Hoffman,[[153]] “Si venenum adhuc intra ventriculum reperitur, res est clarissima, ubi vero, illud haud deprehenditur, res adhuc dubii plena est.” We shall hereafter find that the discovery of organic lesions, without the chemical proof (“experimentum crucis[[154]]”) is often vague, and seldom satisfactory, and that even when sanctioned by the testimony of the pathologist, will frequently be deemed insufficient to sustain an indictment, unless indeed it be collaterally supported by a very strong chain of circumstantial evidence of a moral nature, especially such as relates to the character, conduct, and presumed object of the prisoner.
As the duty of the medical witness, upon such occasions, must always be anxious, and generally perplexing, it becomes our duty at least to clear away those adventitious difficulties with which ignorance on the one hand, and sophistry on the other, have obstructed a path of inquiry, which, from its very nature and direction, must necessarily be obscure and intricate.
We shall endeavour upon this, as we have upon similar occasions, to bring the more leading and popular points of controversy within the scope of a few prominent questions, assigning to each a share of attention, commensurate with our idea of its importance.
Q. 1. Whether all, or most of the symptoms, characteristic of the action of corrosive and narcotic poisons, may not arise from morbid causes of spontaneous origin?
Q. 2. Whether organic lesions, similar to those produced by poisoning, may not occasionally result from natural causes?
Q. 3. Whether the rapid progress of putrefaction, in the body generally, or in any particular part, is to be considered as affording any presumptive evidence, in favour of a suspicion of poisoning?
Q. 4. How far the absence of poison, or the inability of the chemist to detect it, in the body, or in the fluids ejected from it, is to be considered as a negative to an accusation of poisoning?
Q. 5. What degree of information can be derived from administering the contents of the stomach of a person supposed to have been poisoned, to dogs, or other inferior animals?
We shall now consider these questions in succession.
Q. 1. Whether all, or most of the symptoms, characteristic of the action of corrosive and narcotic poisons, may not arise from morbid causes of spontaneous origin?
It must be admitted that the symptoms produced by violent irritation in the primæ viæ, are not characterised by a diversity, corresponding with that of the causes which may excite it; thus it is, that we have a disease to which the term “cholera” has been assigned, and which is indicated by the following symptoms, “Humoris biliosi vomitus, ejusdem simul dejectio frequens; anxietas; tormina; surarum spasmata,” (Cullen Syn: LX. 1.) symptoms which supervene, and with nearly the same force, the spontaneous effusion of acrid bile into the intestines, and the ingestion of some acrid poison; and hence the nosologist has very properly divided cholera into two species, viz.
C. Spontanea, “Tempestate calida, sine causa manifesta oboriens.”
C. Accidentalis, “A rebus acribus ingestis.”
The problem therefore for solution, is the mode of distinguishing the two species from each other. Although the leading characters are, as we have said, the same in both, such as bilious vomiting, and purging, violent tormina of the bowels, cold sweats, cramps, faintings, and death, yet by a careful and circumstantial examination of the case, the intelligent practitioner will generally be enabled to arrive at a probable conjecture; the season of the year[[155]], the prevailing epidemics, the age[[156]] and constitutional predisposition of the patient, his habit with respect to diet, are circumstances which will greatly assist the diagnosis. The progress of cholera morbus is also rarely, or never, fatal in this climate, especially in so short a period as that in which death occurs from the operation of a violent, corrosive poison.[[157]] There are besides in this latter case, very frequently other symptoms which do not attend cholera spontanea,[[158]] such as sanguineous vomiting, extreme burnings in the æsophagus and region of the stomach, swollen countenance, great dryness and tumefaction of the fauces, peculiar fætor of the breath, ischuria, with discharges of bloody urine, and ulcerations about the fundament[[159]]; this latter symptom was particularly remarkable in the case of Mr. Blandy, whose history, as related by his physician, Dr. Addington, will be found in our Appendix, p. 236, and well deserves the attentive consideration of the medical jurist. The matter voided will also sometimes lead to a just diagnosis; in the true cholera spontanea there is a discharge of almost pure bile by vomiting and stool, simultaneously or alternately; now, although the same vomiting and purging may arise from the action of a poison, yet it does not follow that the matter discharged is bilious. The evidence delivered on the extraordinary trial of Donnall, for the wilful murder of his mother-in-law, Mrs. Elizabeth Downing, has been also printed in the Appendix, as well illustrating those doubts with which the present question is naturally encompassed. An opinion has existed that the appearance of jaundice during, or after the severe symptoms of cholera, offers a satisfactory proof of its spontaneous origin. Upon this point we would observe, that by violent and protracted retching a person may sometimes become jaundiced, a circumstance not unlikely to occur in cases of poisoning. The stomach, diaphragm, and abdominal muscles are, under such repeated efforts, very apt to be rendered eminently irritable, so that at each effort of the former to discharge its contents, the latter will frequently be simultaneously thrown into strong spasmodic contractions, and the liver, together with the gall-bladder, will be suddenly caught, and, as it were, tightly squeezed in a powerful press, in consequence of which the bile will regurgitate, and be carried into the venæ cavæ; for Haller has shewn with what facility a subtle injection, when thrown into the hepatic duct, will escape by the hepatic veins; upon which Dr. Saunders has made the following remark, “I know this to be a fact, for I have ascertained by experiment, that water, injected in the same direction, will return by the veins in a full stream, although very little force is used.”
The fact of the bile becoming, under certain circumstances, highly acrid and deleterious, has been seized by the humoral pathologist as a powerful argument in support of his doctrines. Amongst the more distinguished authors who have fully treated this subject, and maintained that our secretions may thus become acrid poisons, we have Galen[[160]], Aretæus[[161]], Fernelius[[162]], Morgagni[[163]], Hebenstreit[[164]], Hilchen[[165]], Hoffman[[166]], Baumer[[167]], Belloc[[168]], Alibert[[169]], Foderé[[170]], Mahon[[171]], De la Mettrie[[172]], and Tronchin[[173]]. Some of the authors above enumerated have expressed their opinions in the strongest terms; thus Morgagni (loco citato) “Facile agnosco a prava ipsa corporis dispositione internum aliquando posse venenum gigni;” and Hebenstreit observes, “Possunt omnino in corpore venena nasci, atque ipsi humores vitales vim vasa sua destruendi sæpe acquirunt.[[174]]” Hilchen, after attempting to establish a diagnosis between the effects of poison, and those arising from a morbid degeneracy of the fluids, exclaims, apparently in despair, “Inquilinos corruptosque humani corporis humores, eum acrimoniæ gradum, eamque corrodendi vim acquirere posse, quæ eosdem edat effectus, quos venena corrosiva sistunt, eamdem sordium vomitu rejectarum putrilaginem, fætorem, haud dissimilem, et acerrimam, et pelves arrodentem acrimoniam certum est.” And Plouquet, after describing all the phenomena of poisoning, concludes by acknowledging “Probe autem notandum hæc omnia etiam ex aliis statibus morbosis nasci posse.” De la Mettrie also has observed upon this question, “Il est prouvé que la bile se peut changer dans nos corps en espece d’Arsenic!” Our own countryman, Dr. Currie[[175]], has furnished the public with an opinion upon the subject under discussion, and he states his belief that, under a peculiar state of irritation, the biliary organs may secrete a bile of so very acrid a nature as to excite an almost immediately fatal impression upon the alimentary canal, especially when suddenly effused, and in a highly concentrated form.
We have deemed it right to adduce these various authorities, in relation to the important question before us, still, however, reserving our opinion, that the physician will on such occasions, by means of the subsidiary sources of discrimination above enumerated, generally be enabled to form a diagnosis[[176]] which, although it may not amount to certainty, must be considered as capable of increasing the weight of the general mass of circumstantial evidence.
As the medical treatment to be adopted in cases of acute disease, or poisoning, can hardly be considered a subject of Medical Jurisprudence, we should have passed it over in silence, did not the evidence delivered upon the trial of Donnall imperiously call upon us for some animadversion; and we feel it our painful duty upon this occasion to observe, that the whole tenor of the medical defence displayed a very unbecoming contest; the witnesses conducted themselves like advocates, raising doubts, and defending their positions with a pertinacity that belongs to those who seek triumph rather than truth.
In the cure of cholera the experience of the physicians of all ages wholly concurs. In the commencement of the disease the evacuation of the redundant bile is to be favoured by the plentiful exhibition of mild diluents, and after the redundant bile has been thus eliminated, or when the spasmodic affections of the alimentary canal become dangerously violent, opiates, in sufficiently large doses, but in small bulk, may be administered. To employ evacuants, as Sydenham quaintly observes, “is to increase the disturbance, and as it were, to endeavour to quench fire by oil; and on the other hand, to commence with opiates is shutting up the enemy in the bowels.” Under such authority, we presume, one of the witnesses in the defence of Donnall, felt justified in condemning the practice of the respectable physician who attended the deceased (Appendix, p. 304); but we here see a witness assuming as a fact, what was never proved in evidence, and then deducing conclusions from it. Dr. Edwards informed the court that “there were no symptoms of cholera morbus when he saw Mrs. Downing; but from what he heard of her complaint, he imagined that there was something offensive either in the stomach or bowels, which ought to be evacuated.” (Ibid. p. 286.)
Nor are the symptoms produced by the operation of narcotic poisons so distinct as to escape the possibility of being confounded with those of spontaneous disease. They may, for instance, simulate those of apoplexy, or epilepsy; but the history of the case, the odour of the breath, and the subsequent examination of the body after death, will generally clear up the difficulties which may at first present themselves. But we shall have occasion to consider this subject hereafter; the difficulties of the case are well illustrated by the evidence on the trial of Donellan, for the murder of Sir Theodosius Boughton, with laurel water, for which see Appendix, p. 243.
Before we quit the subject which involves the consideration of our fluids degenerating, under particular circumstances, into poisons, we may just notice the opinion of some foreign chemists, that in certain diseases the Prussic acid[[177]] is generated in some of the fluids of the animal body. We are not inclined to accede to this proposition, because during life we do not think the chemical decompositions, known to be necessary for the production of this substance, can ever take place. At all events, it must be preceded by a state of the system which would necessarily prevent the chance of any medico-judicial fallacy.
Q. II. Whether organic lesions, similar to those produced by poisoning, may not occasionally result from natural causes?
In entertaining this question, we are prepared to meet with numerous alleged difficulties; but as many of them appear to have arisen, rather from the ignorance or carelessness of the operator, than from the natural obscurity of the subject itself, we are inclined to hope that by getting rid of the former source of fallacy, we shall be enabled to examine with some satisfaction and advantage, those which, in a greater or less degree, will be liable to baffle the researches of the more experienced anatomist.
Such are the changes which an animal body undergoes after death, that unless the anatomist be intimately acquainted with their nature and extent, it is impossible that he should be able to derive any safe conclusions from his dissection; thus, said Mr. John Hunter, we may see appearances which are natural, and may suppose them to have arisen from disease; we may see diseased parts, and suppose them to be in a natural state, and we may suppose a circumstance to have existed before death, which was, in reality, a consequence of it; or we may imagine it to be a natural change after death, when it was truly a disease of the living body. It is not difficult, therefore, to perceive, how a person in such a state of ignorance must blunder, when he attempts to connect the appearances in the dead body, with the symptoms that were observed during life; and indeed it may be safely asserted, that the great utility of anatomical inspections depends upon the accuracy, judgment, and sagacity with which such comparisons are made. In our chapter, on the art of conducting dissections, we have endeavoured to point out each fallacy which is likely to present itself to the inexperienced anatomist, we shall therefore confine ourselves, on the present occasion, to the consideration of those points whose obscurity must be admitted to belong intrinsically to the subject, and to be wholly independent of the ignorance or skill of the dissector.
Amongst the signs of the action of poison on the human body, disclosed by the light of dissection, the separation of the villous coat of the stomach has been generally considered the most certain criterion. Hebenstreit, whose opinion has been adopted by Mahon, and many other forensic physicians, has delivered his unreserved judgment upon the question, in the following emphatic sentence. “Præterea sola atque infallibilis deglutiti veneni nota est, separata et veluti decorticata simulque cruenta interna ventriculi tunica: nam separatio ista supponit applicatam superficiei internæ ventriculi materiam fervidam, igni similem, quæ tunicam istam a substrata solvit vasculari nervea.”[[178]] In opposition to such an opinion, it is our duty to state that several cases stand recorded[[179]] in which the detachment of the villous coat of the stomach and intestines has taken place, without the slightest ground to suspect the administration of poison, while many vegetable poisons destroy life without occasioning any inflammation in the primæ viæ, and consequently leave no traces of disorganization. But there still remains another source of fallacy connected with the present question which demands a full and impartial inquiry, viz. that the gastric juice, by its action upon the dead stomach, can occasion such changes in structure, as may be mistaken for the effects of a corrosive poison; these changes are according to circumstances liable to vary in every possible degree of intensity, from the slight erosion of the interior villous coat of the stomach, as displayed by the smooth, thin, and more transparent condition of that viscus, to the destruction of all its membranes, and the production of large perforations in its great extremity. This phenomenon, the nature of which was first explained by Mr. John Hunter[[180]], depends upon the gastric juice, which the stomach secreted during life, becoming its solvent after death. Amongst the endless proofs which the history of the animal economy affords of that universal law by which chemical and vital forces are wisely preserved in a state of perpetual hostility, there is no illustration more striking and satisfactory, than that which is furnished by the phenomenon in question. If animals, or parts of animals, while possessed of the living principle, be taken into the stomach, they are not in the least affected by the solvent powers of its juices; thence it is that we so constantly find animals of various kinds living in the stomach, or even being hatched and bred there; but no sooner do these animals lose the living principle, than they become subject to the digestive powers of the stomach, and are accordingly dissolved, and assimilated. If it were possible, says Mr. Hunter, for a man’s hand to be introduced into the stomach of a living animal, and kept there for some considerable time, it would be found that the dissolvent powers of the stomach could produce no impression upon it; but if the same hand were separated from the body, and introduced into the same stomach, we should then find that this organ would immediately act upon it. Spallanzani, with a patience that almost wearies his readers, made many attempts at dissolving the stomach by its own juice, but succeeded satisfactorily in none; he proved, however, two important facts, first, that the process of digestion, or more correctly speaking, of solution, continues after death; and secondly, that the stomach itself is digestible. The truth of the first he demonstrated by introducing food into the stomach, after he had killed his animal; and that of the second, by giving the stomach of one dog to be devoured by another. The fact then is clearly established, that the stomach, after death, may be dissolved by its own juice[[181]]; and this may exist in its cavity, or be retained in the vessels which had secreted it. It remains for us then to examine the circumstances under which it is likely to occur, and the appearance by which it may be distinguished; and we may here be allowed to observe with an ingenious writer,[[182]] that were these points merely of a speculative nature, or were their decision a matter of mere curiosity, it would be idle to consume so much valuable time in their discussion; but when we remember that they are questions upon which the medical practitioner may be called upon to deliver a solemn opinion, in order to determine the fate of a criminal, they undoubtedly demand the highest attention of those who profess to aid the administration of Justice, by the lights of science. We have, therefore, first to inquire into the circumstances under which this natural erosion of the stomach is known to take place. Mr. John Hunter[[183]] details the history of three examples, in which the stomach was considerably perforated. Two of the men had died shortly after having their skulls fractured, and the third was a man who had been hanged, so that in each of these cases the person had been deprived of life by violence; whence Dr. Adams[[184]] inferred, that Mr. Hunter limited the action of the gastric juice on the stomach to such as died from violent and sudden causes; and many physiologists have, accordingly, supposed that solution of the coats of the stomach never takes place, except where the person has died suddenly; this, however, is an inference, as Mr. Burns[[185]] has very justly observed, “by no means warranted by the general tenour of Mr. Hunter’s essay,” indeed he expressly states, that “there are few dead bodies in which the stomach is not, at its great end, in some degree digested;” “and any one,” continues Mr. Hunter, “who is acquainted with the art of dissection, can easily trace the gradations from the smallest to the greatest.” The consideration of the vast importance of this fact, and frequent opportunities of investigating the subject, induced Mr. Burns to collect the observations which he had made during the dissection of those bodies in which he found the stomach digested; and these observations, he informs us, have led him to conclude, that the phenomenon in question is neither so rare in its occurrence as some have imagined, nor confined to such subjects as had been, previous to death, in a healthy condition; they have also convinced him, that other parts of the stomach, besides the large end, may be occasionally acted on by the gastric juice. “That the digestion of the coats of the stomach after death is not a very rare occurrence, I think myself authorised to infer, from my having examined nine bodies in which the solution had proceeded to such an extent as to have made holes of considerable size through that viscus; and, besides these nine instances in which the digestion of part of the stomach was complete, I have had occasion to see, in opening this viscus, various degrees of dissolution of its villous coat.”[[186]]
In three of the instances alluded to by Mr. Burns, the patients had been worn out by debilitating diseases; and they were emaciated and anasarcous. That the solution of the coats of the stomach in these cases was properly attributed to the gastric juice is very satisfactorily shewn by the relation of the following instructive dissection. “I had occasion,” says Mr. Burns, “two days after death, to open the body of a very emaciated and anasarcous young girl, who had died from scrofulous enlargement of the mesenteric glands. On raising the coverings of the abdomen, the stomach, which was empty, presented itself to view, with its front dissolved.[[187]] The aperture was of an oblong shape, about two inches in its long diameter, and an inch in its short, with tender, flocculent, and pulpy edges. This I demonstrated to the pupils attending my class; and I especially called their attention to the fact, that the liver, which was in contact with the hole, had no impression made on it. Having proceeded thus far, I placed all the parts as they had been, stitched up the abdomen, and laid the body aside in a cold situation for two days. Then I opened it again, in presence of the same gentlemen, and we found that, now, the liver, where it lay over the dissolved part of the stomach, was pulpy; its peritoneal coat was completely dissolved, and its substance was tender to a considerable depth. At this time the other parts of the liver were equally solid as before, and as yet every part of the subject was free from putrefaction; the posterior face of the stomach, opposite to the hole, was dissolved, all except the peritoneal coat, at least the internal coats were rendered pulpy and glutinous; the peritoneal covering had become spongy and more transparent than it ought to have been.” These facts, in addition to the many other important conclusions to which they will give rise, admonish us, that in judicial investigations into the cause of dissolution of the coats of the stomach, the appearances will vary, according to the period after death at which the body is examined. But the most satisfactory case which has been reported, in proof that the post mortem solution of the stomach may occur after a lingering disease, is that just published by Dr. Haviland,[[188]] where the patient died of fever after an illness of 22 days; when upon opening the body about 12 hours after death, the following appearances were noticed: “On raising the stomach and examining the little omentum, we were surprised by the appearance of a dark-coloured fluid, which seemed to escape from the former viscus. A most careful search was now made, and a large opening was perceived in the stomach on the upper and back part, near the cardia. The stomach was then detached, with a portion of the œsophagus and duodenum, when a large perforation of the diaphragm came into view, in the muscular part, corresponding precisely to, and communicating with, the hole in the stomach; so that a portion of the contents of the latter organ had escaped into the cavity of the chest. This part of the diaphragm was next removed. A careful examination of the other abdominal and thoracic viscera did not lead to the detection of the slightest diseased appearance. There was no where the smallest evidence of previous inflammation, no adhesions or ulcerations of any part of the viscera. The fluid which had escaped appeared to be nothing more than the contents of the stomach, of which the wine and water[[189]] formed a part, and probably gave it its dark colour. The stomach, on being examined after its removal from the body, afforded the following observations. The mucous membrane appeared to be more red and vascular than usual throughout its whole extent, and, here and there, were small spots of what seemed to be extravasated blood, lying below the mucous coat—for these spots were not to be washed off, nor to be removed by the edge of the scalpel. There were two holes in the stomach, the larger very near to the cardiac end of the small curvature, and on the posterior surface: this was more than an inch in length, and about half that breadth; the other not far from the former, also on the posterior surface, about the size of a sixpence. The edges of these holes were smooth, well defined, and slightly elevated. The coats of the stomach were thin in many other spots, and in one in particular nothing was left but the peritoneum, the mucous and muscular coats being entirely destroyed. The hole in the diaphragm was through the muscular portion, where it is of considerable thickness, and was large enough to admit the end of the finger. There was no appearance of ulceration or of pus adhering to the edges of this perforation of the diaphragm.” We have extracted a full account of this dissection, as the case is in itself truly interesting. The symptoms of the patient had been carefully watched, and no pain, or uneasiness was ever heard of, throughout the whole course of the disease, except in the head.
The powers of the stomach, as it would appear from the report, had suddenly revived at about twelve hours before his death, for “he asked for food, and swallowed a few spoonsfull of calves’-foot jelly with apparent relish.” May we not then conclude by observing, that the facts above related very satisfactorily corroborate the truth of the corollary deduced by Mr. Burns, “that the digestion of the coats of the stomach may take place under two very different conditions of the body; that although such solution is most frequent in those who have been suddenly deprived of life, when in full health, that it is not confined to those alone, but does, under certain circumstances, occur in those who have died from lingering diseases.”
Having then shewn under what circumstances the phenomenon in question may take place, we shall now proceed to describe more minutely the appearances which it may assume, and first, with respect to the part of the stomach, more usually acted upon by the gastric solvent. Mr. Hunter thought, that digestion of the stomach after death was occasioned by that portion of the gastric juice contained in the cavity of the stomach; consequently it followed, as a fair inference from this doctrine, that the coats of this viscus will only be acted on at that part on which the contents of the stomach rested. In Mr. Hunter’s cases, the great end of the stomach, which in the supine position of the body is the most depending part of this viscus, was found to be chiefly affected; a fact which tended to corroborate and support his opinion, and to render his conjecture extremely probable. Other anatomists, however, have discovered instances of solution of other parts of the stomach than the great end, indeed we have already described such an instance in the case of the emaciated and anasarcous girl examined by Mr. Burns, where the situation of the aperture was different from what it had been in any of Mr. Hunter’s cases. It was seated on the fore-part of the stomach, about an inch distant from the pylorus, and mid-way between the smaller and greater curvatures of this viscus; at a part of the stomach with which the gastric juice could not have come into contact, as the body had constantly been in the supine posture. “If then,” asks Mr. Burns, “the stomach was not acted on by the fluid contained in its cavity, how came it to be dissolved?” To us we confess his solution of the problem appears sensible and satisfactory. “We cannot, with propriety, ascribe the digestion of the stomach, in every case, to the gastric juice which has been poured into the cavity of that viscus; we are more properly in some instances to refer it to the action of the fluid retained in the vessels which had secreted it.” If this be admitted as a correct explanation of the fact, we shall cease to have any difficulty in accounting for the dissolution of other parts of this viscus besides the large end. We shall learn that the part acted on must vary, according to the place of the stomach where the gastric juice is retained in the apparatus which secreted it, and thus we shall be enabled to explain some cases, which, at present, seem to be in opposition to the observation of Mr. Hunter.
With respect to the appearances, which such erosions assume, some difference of opinion has also unfortunately existed. Mr. Hunter has asserted that “there are very few dead bodies, in which the stomach is not, at its great end, in some degree digested; and the anatomist,” says he, “who is acquainted with dissections can easily trace the gradations from the smallest to the greatest. To be sensible of this effect, nothing more is necessary than to compare the inner surface of the great end of the stomach, with any other part of the inner surface; what is sound will appear soft, spongy, and granulated, and without distinct blood-vessels, opaque, and thick, while the other will appear smooth, thin, and more transparent, and the vessels will be seen ramifying in its surface; and upon squeezing the blood which they contain, from the larger to the smaller branches, it will be found to pass out at the digested ends of the vessels, and appear like drops on the inner surface.” This condition, however, of the vessels does not invariably accompany such solution. In three of the subjects dissected by Mr. Burns, there was no appearance of vessels ramifying on the coats of the stomach. To account for the absence of this vascular appearance several explanations have been attempted; “but we are not,” says Mr. Burns, “to regard the cause of this deviation from Mr. Hunter’s description, as depending upon the particular part of the stomach acted on in the different cases; neither are we to imagine that the stage of the process at which we examine the body will assist us in this investigation; we are rather to obtain an explanation of this fact, from contemplating the difference of condition of the different individuals at the time of death; the subjects, whose cases are detailed by Mr. Hunter, were persons cut off by violence, in the plenitude of health, their stomachs at the time excited by the stimulus of food to vigorous action, and the process of digestion at the instant of death going on briskly, circumstances under which it is reasonable to infer that all the blood-vessels would be filled with blood, which it is evident, from the nature of the causes depriving them of life, would be detained in the veins. This being the state of his subjects at the moment of death, we shall not wonder that, when he afterwards opened the bodies, he could squeeze the blood from the digested ends of the vessels.” This is certainly an ingenious explanation, and receives considerable support from the important fact of the stomach presenting a very high degree of vascularity, in cases of sudden death, as exemplified by Dr. Yelloly[[190]] in his account of the appearances found in the stomachs of several executed criminals soon after they had undergone the sentence of the law. So also has dissection disclosed the same phenomena, in those cases where life has been suddenly extinguished by a blow on the region of the stomach; inflammation, in such instances, is necessarily out of the question, for death is immediate; the red and inflamed appearance therefore of the stomach can alone be accounted for by regarding it as the effect of the sudden cessation of the heart, producing an accumulation of the blood in the extreme arterial branches. But what shall we say of Dr. Haviland’s case? so far from the patient dying suddenly, and in the plenitude of health, he expired after a lingering illness of three weeks, and yet, upon dissection, the stomach was found highly vascular. This is in direct opposition to the theory of Mr. Burns, and, we must confess, is not a little embarrassing. Where the gastric solution has proceeded so far as to produce perforations in its coats, Mr. Hunter states that, “the contents of the stomach are generally found loose in the cavity of the abdomen, about the spleen and diaphragm; and that in many subjects this digestive power extends much farther than through the stomach. I have often found,” says he, “that after it had dissolved the stomach at the usual place, the contents had come into contact with the spleen and diaphragm, and had partly dissolved the spleen, &c.” With respect to the appearance of the gastric perforations, Mr. Hunter characterises them as having “their edges apparently half dissolved, very much resembling that kind of dissolution which fleshy parts undergo when half digested in a living stomach, viz. pulpy, tender, and ragged.”
As certain corrosive poisons will occasionally produce such organic lesions in the stomach, as lead to perforations in its membranes, a question naturally arises, how are we to distinguish such disorganizations, produced by causes acting during life, from those which result from solution after death? To this we may at once return a general answer, that in a judicial investigation, we ought not to attribute erosion of the stomach to poison, except it be accompanied by evident marks of previous inflammation and reaction, or with gangrenous appearances; unless indeed the poisonous substance be found in the stomach, or the symptoms, previous to death, be characteristic and satisfactory. It has been stated that the edges of the natural perforation are “pulpy, tender, and ragged,” whereas those produced by the caustic action of a poison will generally be found well defined, and of the same thickness as any other part of the stomach. But let it be remembered, that, after all, it is upon the detection of poisonous matter in the stomach, that the prudent physician will place his great reliance. We have thus offered a review of the different opinions which have been entertained upon this important question, and in conclusion we may observe, that there will necessarily exist in each particular case, circumstances which no general views can comprehend, and upon which the practitioner must exercise his judgment and discretion. It is not our intention at present to enter fully into the several questions which were raised on the memorable trial of Charles Angus for the murder of Margaret Burns, but as we have already very frequently alluded to the medical evidence delivered on this occasion, and as we shall hereafter be called upon to notice some of its more striking features, we have subjoined a report of the trial, and of the unhappy and ill-conducted controversy to which it has given origin.[[191]] Whether the holes in the stomach were the effects of corrosive poison or of that solvent action after death, which we have just endeavoured to explain, must remain a matter of doubt, for the erosion in this case was so considerable, and the inflammation so slight, that it is impossible to assert that they both depended on the same cause.
With respect to the possibility of confounding the appearances of gangrene, in the stomach, with those of putrefaction, some notice is necessary in this place; and we cannot better illustrate the subject, than by introducing the marks of discrimination which are considered by Mahon[[192]] as decisive upon such occasions. The spots in the stomach, resulting from putrefaction, says he, may be distinguished from those which have resulted from violent causes, during life, in the following manner. If the stomach retain its natural colour, and the spots are mixed with a red hue, or the ulcers have pale, or bright red edges, such have been the effect of some violent impression upon the living membrane; whereas, on the contrary, if the stomach be pale, livid, or green, and exhibit spots of the same colour, but of rather a deeper hue, we may safely conclude that they are the genuine phenomena of putrefaction. See the interesting account of the dissection of William Mitchell, p. 191.
Q. 3. Whether the rapid progress of putrefaction, in the body, generally, or in any particular part, is to be considered as affording presumptive evidence, in support of an accusation of poisoning?
There are few opinions more popular than that which considers the speedy putrefaction of the body as the universal and never failing consequence of poisoning. To appreciate, however, the true value of such an indication, and to avoid the fallacies with which it is surrounded, it is essential to remember that the body of a person dying suddenly, and in what may be called full health, is very liable to run rapidly into a state of decomposition. As far, however, as our observations enable us to deduce any conclusion, certain vegetable poisons appear to accelerate such a change; for, very shortly after death, the body, under such circumstances, will frequently swell, become highly offensive, assume a black[[193]] appearance, and exhibit gangrenous spots on its surface. No such appearances, however, it is said, usually follow as the specific consequence of the fatal operation of mineral poisons; Dr. Jaeger in an Inaugural dissertation,[[194]] which deserves to be better known, states, as the result of numerous experiments, that the putrefaction of animal bodies, poisoned by arsenic, whether buried or not, does not appear to be either unusually accelerated or retarded; and he moreover found that the generation of infusory animals, the production of larvæ and subterraneous vegetation, in and about the bodies of poisoned animals, took place as usual; and he remarked that “the immediate contact of an arsenical solution seemed, in several instances, to retard, in some degree, the putrefaction of the part to which it was applied in sufficient quantity.” In the extraordinary case examined by Metzger, in which the largest quantity of arsenic ever, perhaps, taken into the stomach, was found after death, the body was not opened until eighteen days after dissolution, and yet, says the anatomist, “cadaver, quod mireris, sine ullo fœtore aut putredinis signo erat, ut et absque maculis lividis, si digitorum apices excipias.” A case is also related by Dr. Yelloly,[[195]] in which death was occasioned by arsenic, but where not the slightest appearance of putrefaction was visible at the time of examination, which did not take place until forty-nine hours after death.
On the other hand, Morgagni[[196]] states that, on dissecting a female who died from Arsenic, “facies corporis posterior, ne suris quidem et calcibus exceptis, tota erat nigra.” And in the interesting case of William Mitchell, as hereafter related, the appearance of the body appears to have indicated that decomposition had proceeded with more than ordinary celerity.
The fact of accelerated, or retarded putrefaction, therefore, cannot be received with any confidence as a collateral indication of poisoning. Dr. Carson, however, in the trial of Charles Angus, adduced the circumstance of its absence, as a negative proof that the deceased had not been poisoned; and in the celebrated Scotch trial of Patrick Ogilvy, and Catharine Nairne,[[197]] the same fact was forcibly urged in their defence.
Gaspard à Reies,[[198]] and other writers, have maintained that the discovery of living worms in the intestines of a person, suspected to have died from poison, ought to be received as a direct refutation of the charge. We are, however, not disposed to concur in such an opinion. With respect to the value of the indication supposed to be afforded by the circumstance of froth issuing from the mouth of the corpse, soon after death, Mr. Hunter has given a very satisfactory opinion, and to which we must refer the reader, see Appendix, p. 273.
Q. IV. How far the absence of poison, or the inability of the chemist to detect it, in the body, or in the fluids ejected from it, is to be received as a negative to an accusation of poisoning?
We have already stated, that of all the proofs which can be adduced by the physician, in support of a charge of murder by poison, no one can be put in competition with that which arises from the discovery of the poisonous substance itself, in the stomach, or in the contents of the matter ejected by vomiting or purging. The law expects, therefore, that the professional witness should be prepared to state, that every experiment, calculated to detect the presence of poison, has been scrupulously and faithfully performed; and we may take this occasion to observe, that the circumstance of advanced putrefaction can rarely, in the present state of our chemical knowledge, be admitted as a satisfactory plea for not having proceeded to an anatomical inspection, as preliminary to chemical inquiry; and, as to the danger of such dissections, Dr. Gordon Smith has very truly observed, “that much is placed to this account which belongs merely to disgust.” Had an examination of the body taken place in the case of Ogilvy and Nairne, how many doubts would have been cleared away; indeed, this omission afforded the prisoners a strong ground of defence; they complained that the informer had intentionally prevented the dissection of the body, being conscious that the suspicions he had raised, and the project he had formed for their ruin, would, by such a measure, have been totally removed and defeated. To this it was answered, that when the informer (a younger brother of the deceased) arrived, he did insist on the body being opened and examined, as soon as a physician of eminence could be present, which the prisoners did not then oppose; but that when the physician arrived on the ensuing day, he declared the body to be in such a putrid state, that no certain conclusions could be drawn from outward appearances, nor even from a dissection of the body, which, besides, could not be performed with safety to the surgeon and attendants, and that he therefore thought proper to decline the investigation. Fortunately for the ends of justice, the circumstantial evidence of guilt was too strong to be affected by this culpable defect in the medical testimony, although it has been often asserted that the prisoners should have received the benefit of the omission by an acquittal. See Donellan’s case in the Appendix, p. 243.
With respect to the mode of conducting a chemical analysis upon these occasions, we have reserved our directions, until we shall enter on the discussion of poisons individually. We have, however, in this place some remarks of a general nature to offer, to which we are desirous of drawing the attention of those, who, without much experience, may be called upon to conduct such investigations. In the first place, we are desirous of convincing him, that the processes which he must institute, for the detection of a mineral body, are by no means so elaborate and embarrassing, as a superficial view of the subject may lead him to conclude. During the progress of the present work the author has repeatedly felt the truth of the opinion which he is now expressing; for, like Becher, he has laid down his pen, and taken up his tests, and, by the most simple modes of manipulation, has satisfied his own mind of the extreme delicacy of the different processes which are recommended for the detection of a poisonous mineral; in short, it is very difficult to convince those whose chemical knowledge is wholly theoretical, with how little trouble, and with how much pleasure and profit, such experiments may be conducted. If such then be the perfect state at which our analytical knowledge has arrived, the reader may perhaps conclude, that in every case of mineral poisoning the deleterious substance should be found, and that the inability of the chemist to detect its presence, should go far to negative the charge. Such an inference, however, is neither correct, nor philosophical, for the poison may have been absorbed, or eliminated, during life, it may have undergone chemical changes, or it may have entered into combinations, by which its characters are masked, or wholly changed. To Dr. Bostock the judicial physician is under many obligations, but there is no discovery for which he is more deeply indebted to him, than for that which has resulted from his satisfactory experiments, in elucidation of the present question. He has shewn, in the instance of Corrosive Sublimate,[[199]] that an animal may be suddenly killed by receiving a metallic poison into the stomach, and yet that the most delicate chemical re-agents may not be able to detect any portion of such poison, after death, in the contents of that viscus. Dr. Henry, in a letter to Dr. Duncan,[[200]] communicates the case of Hannah Tomlinson, aged twenty, who died, under the care of Dr. Holme, on the sixth day after a dose of Corrosive Sublimate. In this case, although an ounce of the mercurial salt had been swallowed, and the fluid ejected from the stomach was examined, only twelve hours afterwards, by Drs. Henry and Roget, yet not the slightest trace of the poison could be detected! More recently we have received from the pen of Mr. Alexander Murray,[[201]] surgeon of Alford, some highly interesting cases of poisoning by Arsenic, and which are so illustrative of the present question, as well as several others that have fallen under consideration, that no apology can be necessary for introducing some account of them in this place. A family of the name of Mitchell, and which consisted of William, a robust man, aged 45, James, æt: 52, Mary, æt: 50, and Helen, æt: 48, breakfasted together on Sunday morning, (August 19, 1821) on porridge, consisting of milk, salt, and meal. William partook largely, but James, who perceived “a sickening taste,” took less than common, while the sisters had their usual quantity. William was seized with sickness shortly afterwards, about 10 a. m., on his way to church, and then with thirst and headache; and, on his return home, between three and four in the afternoon, he was seized with vomiting, which recurred often during the next four or five days, especially on his attempting to quench his thirst. In the early part of the week, he was heard to complain of pain in his stomach, eyes, throat, breast, and arms; he was observed to void his urine frequently; and about this time, he pointed out to one of his sisters a hollow[[202]] between his breast and belly, into which according to her expression, “she could have laid her arm.”
His illness had scarcely at any time confined him to bed. On the evening of Friday, the 24th of August, he rode six miles, for the purpose of consulting Mr. Murray, the surgeon, and reporter of the cases; on Wednesday the 22d he had taken a dose of Epsom salts which operated, and at the time Mr. Murray first saw him he complained of the following symptoms:—pain and heat in the region of the stomach and lower part of the chest; occasional uneasiness in the abdomen, and sometimes ineffectual efforts to go to stool; thirst; difficulty of breathing; heat and uneasiness of throat, with hoarseness; soreness of eyes, which had the common appearance of inflammation; shifting pains in his extremities, particularly the arms, which had not their usual strength; great restlessness; anxious expression of countenance; pulse frequent, 100-110, not strong.
A blister was applied over the stomach and lower part of the chest, and he took an opiate at bed time. On the following day, (Saturday 25th) Mr. Murray visited him at his own house, and found him nearly as before, except that his countenance more strongly exhibited a disturbed and anxious expression, and the redness of the eyes, and the hoarseness were increased. Mr. Murray also observed small roundish white accuminated prominences, on the palate and uvula, apparently as if the membrane covering the palate bones and velum pendulum, was detached at the parts by a whitish liquid. This day he took an ounce of castor oil, which operated in the afternoon, his illness was not observed to change during the evening, and he retired at about eight o’clock to rest. At a little past two in the morning, he rose in search of water to drink, and on returning to bed he was heard to utter a deep groan; after which he lay motionless and quiet, and very soon was found to have expired. The surgeon who saw the body, about 10 a. m., states that “many bluish spots were observed on the inferior extremities.” James, Mary, and Helen Mitchell were attacked the same forenoon with their brother William, and with nearly similar symptoms; they were all, however, fortunate enough to recover, although a considerable period elapsed before their usual strength returned, and in all of them a numbness of the arms, or legs, occurred, together with a loss of muscular power.
The body of William Mitchell was, owing to particular circumstances, not opened until the 29th of August, (3 days 8 hours after death) when the following appearances presented themselves. “The face had a natural, composed appearance; and the rigidity of the body did not appear to be different from what is common. The right ear, and corresponding side of the face, as well as the scalp, exhibited a deep clay-blue colour. On the chest and belly, several spots and streaks, some green, others blue, were observed; and the back, upon which the body lay, was from head to foot of a livid colour; while several roundish spots, of a still deeper hue, gave to the shoulders and neck a mottled appearance. The penis was much swollen and red. The scrotum also was enlarged, and of a dark blue colour.
Upon opening the abdomen, the smell was not unusually offensive, and its contents did not appear to have undergone alteration after death, but several ounces of a highly-coloured liquid were found in the cavity. The surface of the jejunum and ilium presented many purple spots, some of which were several inches in circumference. The peritoneal surface of the stomach, in a tract which extended from the cardia, and occupied, for some distance downwards, the whole circumference of that viscus, except the small curvature, was of a clear, dark red colour; and through this space dark lines, apparently veins, were observed to ramify. This appearance, perhaps, from 20 to 30 square inches in extent, was strongly marked in contrast with the natural state of the inferior extremity and small curvature. The substance connecting the stomach to the spleen, was, as well as a small part of the transverse colon, of a red colour. The spleen was gorged with blood; the liver healthy. The duodenum, from a small distance below the pylorus, almost to its inferior extremity, and round nearly the whole intestine, was of a very dark purple colour. Upon opening the stomach, the internal surface of that part where the outward appearance, already described, existed, was found of a bright red colour, and over this lighter dots were thickly scattered[[203]], making such an appearance as might be produced by a red colour being dashed from a painter’s pencil, upon a somewhat darker ground.
The internal coats of the duodenum were very dark coloured, with a slightly reddish hue, pulpy, thickened, and easily separated from the peritoneal covering, while in one roundish spot, of the size of a crown piece, the villous and muscular coats were entirely wanting. Red patches were observed on the inner surface of the jejunum and ilium, the shape, size, and situation of which were the same as those of the appearances already noted as occurring on the outside of these intestines. The stomach and duodenum contained about a quart of a brown, semi-opaque, thickish liquid; the jejunum and ilium were empty, and coated with a yellow viscid matter. The lungs and heart were quite healthy; but in the cavity of the thorax were ten ounces of a reddish turbid liquid, and about half that quantity in the pericardium. The pharynx was of an unusually red colour. The whole of the brain was healthy, and of firm consistence.”
Mr. Murray concludes by stating that no part of the salt and milk used on the sunday morning, was to be found after he visited the family, and that although the remainder of the meal, and also the contents of William Mitchell’s stomach and duodenum were examined by Drs. Henderson and Fraser, of Aberdeen, as well as by Mr. Craigie, surgeon, who assisted in the dissection, and Mr. Alexander Murray, yet, “no poisonous ingredient was detected in these substances.”
The pathological and anatomical facts were, however, in themselves, so striking and satisfactory, that not the slightest doubt can exist as to the cause of the sufferings and death of the deceased; while, as Mr. Murray very justly states, the high probability, arising from the separate symptoms of each individual, is strengthened almost to certainty, by the simultaneous occurrence of these in a whole family of four persons; while no similar disease, indeed no epidemic of any kind, prevailed at that time.
We have only to add that the brother-in-law of this family was, in October, 1821, tried before the Judiciary Court at Aberdeen, for administering poison to his four relations; when the testimony given by the medical witnesses induced the judge and jury to consider the abstract act of poisoning proved. The accused afterwards confessed his guilt, and that he perpetrated the crime by means of Arsenic, put among the salt on the sunday morning on which the family were taken ill.
The public, and the profession, are greatly indebted to Mr. Alexander Murray for the details of this instructive case; and the patient attention and judgment with which he conducted the investigation, deserve the highest commendation, and afford an example which we sincerely hope future practitioners will endeavour to follow.
Q. V. What degree of information can be derived from administering the contents of the stomach of a person supposed to have been poisoned, to dogs, or other animals?
It has from time immemorial been generally believed, that no proof of poisoning is more satisfactory than that which is furnished by the effects produced upon dogs, by their swallowing the contents of the stomach of persons who are supposed to have died from poison. Writers on Forensic medicine have, however, adduced several objections to the validity of such a test; some of which are undoubtedly worthy of consideration, while others are the deductions of a theory which receives no support from experience. In the first place it has been stated, that substances poisonous to man, will not always occasion deleterious effects upon animals[[204]]; this, to a certain extent, is undoubtedly true; some of the Ruminantia appear to be less sensible to the operation of narcotic plants, than carnivorous animals. Aloes are injurious to dogs and foxes. Oxen are said to eat the Philandria Palustris, which is pernicious to horses; but we are very much inclined to believe that a poison sufficiently powerful to destroy the life of a man, would if administered in the same state of concentration, destroy that also of an inferior animal. It is in smaller doses only that the difference in the action of such bodies upon various animals becomes evident and appreciable. This opinion is confirmed by numerous experiments. Mr. John Hunter, in his evidence[[205]] on the trial of Donellan, in answer to the question, whether any certain conclusion can be drawn respecting the poisonous operation of a substance upon man, from its effects upon an animal of the brute creation, replied, “As far as my experience goes, which is not a very confined one, because I have poisoned some thousands of animals, they are very nearly the same; opium, for instance, will poison a dog similar to a man; arsenic will have very near the same effect upon a dog, as it would have, I take it for granted, upon a man; I know something of the effects of them, and I believe their operations will be nearly similar.” If any farther confirmation of this opinion were required, how extensively and satisfactorily has it been afforded by the late experiments of M. Orfila.[[206]] Mr. Hunter also, on the memorable trial above mentioned, explained a source of fallacy which attends such experiments upon animals; he is asked “whether there are not many things which kill animals almost instantaneously, that will have no detrimental or noxious effect upon a human subject, such, for instance, as spirits?” He replies that a great deal depends upon the manner of conducting the experiment, and that by forcing an animal to drink, the liquor often passes into the lungs. See Appendix, p. 272. Orfila, in his valuable work on poisons, instituted a series of experiments upon this subject, with the intention of determining the value of an experiment so generally accredited; from which he is led to conclude, 1st. That the practitioner should never attempt by force to make an animal swallow the suspected substance, nor should he put it into his food; for by such a proceeding he would not only run the hazard of losing the greatest part of it, because the animal would reject it, but the food with which it is combined might exert upon it some chemical action, or so envelope it as to protect the coats of the stomach from its contact; besides which it would, says he, happen, at least six times in ten, that a part of it would flow through the larynx into the lungs, and the animal will die of Asphyxia. 2d. The best method that can be employed, consists in detaching the œsophagus, perforating it with a small hole, introducing into it a glass funnel, and pouring the liquid into the stomach; that being done, the œsophagus is to be tied below the opening. It would, observes M. Orfila, be imprudent to prefer to this method, the use of an elastic gum tube adapted to a syringe, for many bite the tube, pierce it with holes, and the fluid then flows out of the mouth; besides which, syringes of tin might decompose certain poisonous fluids. The obvious objection to such a mode of administration is anticipated by this laborious experimenter with much ingenuity. It may be asserted, says he, that the animal perished from the operation of tying the œsophagus, and not from the action of the poison thus introduced into the stomach, but such an objection has no foundation in truth, for either the suspected substance is in quantity sufficient to destroy the animal, or it is not; in the first case death will take place during the first forty-eight hours, and will be preceded by symptoms more or less severe, a phenomenon never observed in the simple ligature of the œsophagus; in the second case, the experiment will not be more conclusive, than if the œsophagus had not been tied: and the author asserts, that the operation of tying the œsophagus would not, of itself, produce during the first forty-eight hours any other symptom than a slight dejection, and that consequently all other morbid phenomena that may be observed, upon such trials, ought to be attributed to the poisonous substance. To all this we reply, that we believe, in the hands of Orfila who has made a thousand experiments, that such results may be satisfactory, but we feel no hesitation in declaring, that we should not place the smallest reliance upon such an experiment when conducted by a person unaccustomed to the operations of experimental physiology. If there be no other mode of employing an animal as a test for poison, but by tying his œsophagus, we must, in a judicial point of view, reject it altogether.
But there still remains another source of fallacy connected with these experiments, to which considerable importance has been attached. It has been said that the acrid humours ejected from the stomach of a person labouring under a spontaneous disease, may kill an animal. Morgagni[[207]] relates a very remarkable instance, in illustration of this fact. A child having died of a fever was opened, when a quantity of green bile was found in the stomach, which changed the colour of the scalpel to violet; having dipped the point of the knife into this bile, two pigeons were wounded with it, and they soon died in convulsions. The bile was then mixed with some bread, and given to a cock, which also died in the same manner. From this general view of the subject before us, the forensic physician will be enabled to appreciate its just value, and to apply the indications it may furnish, in each particular case, without the risk of error. In some instances such experiments may prove nothing, in others they may afford only equivocal results, but which may add something to the general weight of circumstantial evidence; while others, again, may furnish proofs so unquestionable, as to leave no doubt upon the subject; such was the case in the instance of Michael Whiting[[208]], who was convicted of administering corrosive sublimate to his brothers-in-law, when it appeared in evidence that a portion of the poisoned dumpling was given to a sow, who in consequence became sick, and remained ill for several days.
We have now disposed of the several questions connected with the subject of poisoning, which must be regarded, in their forensic relations, as being of the highest importance. In considering the subjects, generally, there must necessarily remain doubts, many of which will be considerably diminished, or entirely removed, upon their application to particular cases; still, however, the nature of medical evidence upon such occasions must be frequently regarded as only sustaining high probabilities, and the professional witness may exclaim with Hoffman[[209]] “Ardua sane provincia ei imponitur cui determinandæ ejusmodi quæstiones exhibentur.”