It cannot be stated too strongly that the trouble is not in the science of toxicology, nor in the real students of it. So far as mineral poisons are concerned, any qualified expert will determine the question of poisoning with the unwavering step of a mathematical demonstration.
The legal recognition of the true character and position of the expert, and of certain principles of medical jurisprudence, would probably improve the present status, but it is doubtful whether some other method of reform may not be more available. Professor Henry Hartshorne, at the last meeting of the American Medical Association, suggested that the court should appoint in poisoning cases a commission to collect the scientific testimony and make report on the same. This seems at first sight practicable, but suppose the court had appointed, as is not at all improbable they would have done, Professors Aiken and Chew and Dr. Williams as the commission in Mrs. Wharton's case? The result would certainly have been an unjust conviction.
In Spain and some other countries of Europe the custom is to refer the case to the local medical society. If the opinion afterward given is unanimous, the court is bound by it; if any member object to the opinion, the case is referred to the medical society of the province; if the disagreement continue, the matter is brought before the chief society of the capital. Evidently, this plan would not work well here. In Prussia it was formerly, and may still be, the custom for an expert holding a fixed appointment under the government to investigate the case, and to send his report to the Royal Medical College of Prussia. A standing committee of this body, after investigating the matter, sent the original report, with their comments, to the ministry, by whom it was referred to a permanent commission of experts. The report of the latter body, with all the other papers, was finally sent to the criminal court. This method seems complicated, but it resulted in giving to Prussia the best corps of experts the world has ever seen, as well as the most eminent individual medical jurists.
It is not, however, the object of the present paper to urge any especial method of reform, but to call attention to the need of it, and to show that the present evils do not grow out of the imperfections of medical jurisprudence, but out of the methods of our criminal procedures. Certainly, the matter needs investigation, and it is hardly possible but that some practicable means of relief could be devised by the deliberations of a mixed commission of lawyers and medical jurists of eminence.
H.C. WOOD, JR., M.D.
Footnote 13: [(return)]
The utter absurdity of Dr. Williams's assertion is shown by the fact that on the first and second trials of Mrs. Wharton he affirmed that the violent convulsions, the extreme muscular rigidity, the retentive stomach, seen in the last day of General Ketchum's life were due to tartar emetic, and that to tartar emetic were due the excessive vomiting, the motionless prostration and muscular relaxation of Mr. Van Ness on the Sunday and Monday of his illness. Tartar emetic the sole possible cause of precisely opposite symptoms!
Footnote 14: [(return)]
The parsimony of many legal authorities is an indication of their want of appreciation of the differences in men. Not rarely medical experts are forced to sue a borough or county for compensation, even when the fee has been agreed on beforehand. In Huntingdon county, Pennsylvania, some time ago a woman was arrested on the charge of poisoning her mother-in-law, and the stomach of the deceased was sent to Professor Reese of this city for analysis. Warned by previous experience, he refused to make the analysis without a written agreement as to the fees. Nearly three months were spent by the authorities in vainly trying to get him to do it without such arrangement, and finally the stomach was returned unopened. During the whole of this time the poor woman, very probably innocent, was lying in prison with the dreadful charge hanging over her.
Footnote 15: [(return)]
A very forcible illustration occurs to me from my own experience. I was once summoned to see a woman in the Philadelphia Hospital to whom an assistant nurse of bad character had been seen to administer laudanum. At the time of my arrival she was apparently suffering from the advanced stages of opium poisoning. I spent about five hours in trying to restore her. The nurse protested that she had given only the medicinal dose ordered by the doctor, but was not believed. After death we found thrombosis of the brain—a rare affection, leaving such minute traces behind it that a careless examination will always fail to detect them. This was one of the affections which, as I had stated on the witness-stand some months before the occurrence just narrated, might have caused the death of Miss Stennecke with symptoms resembling those of opium poisoning.
Footnote 16: [(return)]
According to the testimony in both the cases of alleged poisoning by Mrs. Wharton, professional advice was called in at her request.
Footnote 17: [(return)]
I think the general opinion of the profession has endorsed the position of the defence. It is very probable that General Ketchum did die of the disease named, but there are other affections of which he I may have died; and certainly there were no sufficient grounds for asserting that the facts of his case were inconsistent with natural disease. The truth is, disease is often so hidden, its manifestations so obscure, its stamp upon the tissues so faint, that rarely is a physician justified in asserting from the symptoms and a partial negative post mortem, such as was performed on General Ketchum, that any given death could not have been due to a natural cause. Numerous cases of death from natural causes have occurred in which science has been apparently baffled. I have myself seen at least one sudden death in which a careful post mortem failed entirely to detect the cause.