“This toleration of poison is common in certain cases of inflammation, but it is my opinion that, in this case, the opposite to toleration has been established. Aphthous ulcerations are not often observed in cases of poisoning by antimony. The absence of these symptoms, combined with the state of the liver and brain, in no way affect my opinion as to the poisoning in this case. There were peculiar symptoms in the vomiting of Mrs. James which induce me to believe that it was not caused by the ulcer. Antimony would aggravate the ulcerous disease and enfeeble the bodily powers, as well as affect the appetite. One of the effects of slow poisoning by repeated doses is that the stomach is prevented from receiving fresh nourishment.”
To the Judge.—“I have never attended a human patient poisoned by antimony. Persons suffering from sickness after food are relieved by vomiting; but in the case of Mrs. James there was considerable retching after the food was thrown off the stomach.”
John Baker Edwards, Analytical Chemist, said:—
“He analysed a bottle of urine which he received from Dr. Cameron on the 6th of June, and informed him that he found in it slight traces of antimony. On Saturday, June 9, he received two bottles from Dr. Cameron, one of which contained fæces, analysed it and found slight traces of antimony. The other bottle was marked ‘vomit.’ Analysed that, and found in it two considerable deposits of antimony. Subsequently confirmed this analysis by other chemical tests. He sublimed it by the application of heat, and obtained a white sublimate, which, when examined under the microscope, had the appearance of oxide of antimony. Afterwards dissolved this in tartaric acid, passed sulphuretted hydrogen gas through it, and obtained an orange precipitate—sulphuret of antimony. He could not scientifically distinguish whether it was ‘free’ or ‘eliminated’ antimony.[187] On Wednesday, the 13th of June, he received three bottles labelled ‘Mrs. James, Tuesday,’ one of which was labelled ‘vomit.’ It had scarcely a trace of antimony. The other two bottles contained fæces and urine, in each of which was a trace of antimony. On the same day he also received two cups, one of them containing about a tablespoonful of sago. This he analysed and found in it two considerable deposits of antimony on copper, which he sublimed and recognised under the microscope as oxide of antimony. On Thursday the 14th he received three bottles, one of them of vomit, containing no antimony; the other two containing fæces and urine, in which was no antimony. On the 15th he again received a bottle of vomit and also one of fæces, and in the former he found two antimonial deposits, which under the microscope he recognised as oxide of antimony, and in the latter a trace of antimony. On the following day he found traces of antimony in two bottles of urine. The day after he received two bottles, one of urine, and found a trace of antimony in each. He also examined some uncooked sago which contained no antimony. Subsequently (after Mrs. James had been removed to the hospital) he received bottles labelled ‘Mrs. James.’ The vomit contained no antimony, but there were still distinct traces of it in the fæces and urine. He subsequently received four jars containing brain, lungs, heart, spleen, kidneys, intestines, stomach, and blood, labelled ‘Mrs. James,’ and four bottles containing fluids. He analysed portions of these separately. From one half of the stomach he obtained five deposits of antimony. He also obtained five deposits of antimony from the intestines, four deposits of it from one of the kidneys, and three deposits of it from one half of the liver. He found no trace in the brain. In four ounces of blood he found a distinct deposit of antimony, and also from the fluid of the stomach. He also analysed six bottles of medicine and two of urine, and found no antimony. On the 26th of July he took a portion of the spleen and lungs of Mrs. James to London, and examined them there in conjunction with Dr. Miller and Dr. Taylor, and also the deposits of the viscera. He examined and tested them and found by the most approved tests applied that they contained antimony.”
On cross-examination, the witness admitted:—
“That the first satisfactory result which he obtained was on the 9th of June—that he had no doubt that the trace he found on the 7th was antimony, but it was not a satisfactory result—that he had examined the body of a dog which died from antimony, and which had been exhumed, and had not found a trace, and, that if the animal had vomited after taking it he should not have expected to find any.”
Dr. A. S. Taylor said:—
“That he received some jars at Guy’s Hospital from Inspector Horne, containing portions of the stomach, cæcum, liver, one kidney, and the heart, and afterwards from Dr. Edwards a portion of the spleen and lungs. He divided them and gave a part to Mr. Miller. Dr. Edwards showed him some sublimate on glass, and deposits on copper. He examined them. The deposits on copper were metallic antimony, and those on the glass were oxide of antimony. He was of opinion that antimony had entered the body during life. Assuming the deceased to have been labouring under the disease of the cæcum, and to have had two ulcers in her stomach, the administration to her of antimony, by depressing the bodily powers, would tend to accelerate death. Antimony had a powerful depressing influence and lowered the pulse in strength, produced great exhaustion of the system, and in a serious disease affecting the body was likely to aggravate its effects. A person might be able to bear a dose of antimony in health, who in a serious disease would be destroyed by it. His opinion, in this case, was that antimony had been administered at intervals in small doses. Antimony could be found in the tissues three weeks after it was taken. It might during that time be found, day by day and at intervals, in the secretions. The tests which he had applied were the most approved known in science.”
On cross-examination, the witness said:—
“The disease which has been described as affecting the deceased must have terminated fatally. The death had been caused by inflammation arising from the passage of the contents of the diseased bowel into the cavity of the abdomen. It was very difficult to draw the line where a patient had rallied from the effects of poison, and where she sank under disease. The medical man in attendance on the deceased person would be the best judge of the influence of poison in accelerating death. Small doses frequently repeated would have the effect of irritating the mucous membrane of the bowels. In two most marked cases of poisoning with which he bad been connected there had been no change in the condition of the liver. All the indications in Mrs. James’s case were referable to natural causes. If antimony were found in the fæces, he should conclude that the purging was occasioned by antimony. In vomiting caused by ulcers in the stomach, it was confined to the relief of the stomach from its contents, and then ceased. Antimony produced prostration of the nervous power.”