§ 730. Slow Poisoning.—Slow poisoning has been caused accidentally by arsenical wall-paper, in the manufacture of arsenical pigments, by the admixture of small quantities of arsenic with salt or other condiments, and repeated small doses have been used for criminally producing a fatal illness intended to simulate disease from natural causes. The illness produced by small intermittent doses may closely resemble in miniature, as it were, those produced by large amounts; but, on the other hand, they may be different and scarcely to be described otherwise than as a general condition of ill-health and malaise. In such cases there is loss of appetite, feebleness, and not unfrequently a slight yellowness of the skin. A fairly constant effect seen, when a solution of arsenious acid is given continuously for a long time, is an inflammation of the conjunctivæ, as well as of the nasal mucous membrane—the patient complains of “always having a cold.” This inflammatory action also affects the pharynx, and may extend to the air-passages, and even to the lung-tissue. At the same time there is often seen an exanthem, which has received a specific name—“eczema arsenicale.” Salivation is present, the gums are sore, at times lacerated. In chronic poisoning by arsenic, nervous symptoms are almost constant, and exhibit great variety; there may be numbness, or the opposite condition, hyperæsthesia, in the extremities. In certain cases fainting, paresis, paralysis, and sometimes convulsions occur; towards the end a sort of hectic fever supervenes, and the patient dies of exhaustion.
§ 731. The Maybrick Case.[745]—The Maybrick case may be considered an example of poisoning extending over a considerable period of time:—Mr. James Maybrick, a Liverpool cotton-broker, aged 49, married Florence Elizabeth, an American lady, aged 21. They had two children. The marriage proved an unhappy one. Some two years before his death in May 1889 they had occupied two separate rooms. Seven weeks before the husband’s death, Mrs. Maybrick went to London on a false pretext, and lived for some days at an hotel, ostensibly the wife of another man. Two days after her return, Mr. and Mrs. Maybrick attended the Grand National race meeting, and there a serious quarrel arose between them respecting the man with whom she had cohabited in London; they returned from the race, each separately, and she slept apart. Next day an apparent reconciliation took place through the intervention of Dr. Fuller, the family medical attendant.
[745] “The Maybrick Trial and Arsenical Poisoning,” by Thos. Stevenson, M.D., Guy’s Hosp. Rep., 1889.
On or about April 12-19th, 1889, Mrs. Maybrick purchased arsenical fly-papers. On April 13-20th Mr. Maybrick visited London, and consulted Dr. Fuller for dyspepsia, who prescribed nux vomica, acids, and mild remedies (but no arsenic); in one bottle of medicine, ostensibly made according to Dr. Fuller’s prescription, arsenic was subsequently found.
Up to Saturday, April 27th, Mr. Maybrick was in his usual health; he was then sick, numbed, and in pain, and had cramps; he told his clerk he had been an hour in the water-closet, but whether for diarrhœa or constipation does not appear; he ascribed the symptoms to an overdose of Fuller’s medicine. About this date fly-papers were found by the servants soaking in Mrs. Maybrick’s bedroom in a sponge-basin, carefully covered up. On the 29th she again purchased two dozen fly-papers from another chemist. On April 28th Mr. Maybrick was sick and ill; at 11 A.M. Dr. R. Humphreys was called in; Mr. Maybrick complained of a peculiar sensation about his heart, and said he was in dread of paralysis. He attributed his illness to a strong cup of tea taken before breakfast. On the following day he was better, and on the 30th still improving. On May 1st and 2nd Mr. Maybrick went to his office and lunched, both days, off revalenta food, prepared at home and warmed at his office in a new saucepan purchased for the occasion; on one of these days the lunch was forgotten, and was sent to Mr. Maybrick by his wife; and on one of the two days, it is not clear which, Mr. Maybrick complained that his lunch did not agree with him, and he attributed it to inferior sherry put into his food.
In a jug found at the office, and in which food had been taken there, a trace of the food still remained after Mr. Maybrick’s death, and arsenic was found therein.
On May 3rd the last fatal illness set in. It is uncertain what food he had after breakfast; he went to the office, and returned home between 5 and 6 P.M. He had been seen by Dr. Humphreys in the morning, and appeared then not quite so well; he found him at midnight suffering from what he thought was severe sciatica; the patient said he had been sick from revalenta. On May 4th he was continually sick, nothing could be retained on the stomach, but the sciatic pain was gone; on May 5th the vomiting continued, the patient complained of the sensation of a hair sticking in the throat, and of a filthy taste in the mouth. The throat and fauces were only slightly reddened, the tongue was furred.