Treatise on Poisons by Sir Robert Christison

CHAPTER III.

2354 words  |  Chapter 36

OF IMAGINARY PRETENDED, AND IMPUTED POISONING. The present seems the most convenient place for noticing the general mode of procedure by which the medical jurist may detect cases of imaginary, feigned, and imputed poisoning. It is by no means easy to lay down rules for the investigation of cases suspected to be of such a kind. But an attempt will be made to state the leading points to be attended to, and to illustrate them by the circumstances of a few examples of each variety. _Imaginary poisoning_ should rarely be the occasion of deception or embarrassment. The same wandering of the imagination which has led to a belief of injury from poison, will commonly also lead to such extravagant notions relative to the mode of administration and the symptoms, as will infallibly point out the true nature of the case to one who is well acquainted with the real effects of poisons. It is easy, nevertheless, to conceive cases which may be embarrassing; and certainly, in every instance, the physician should proceed in his inquiries with caution. It appears to me that in the first place, without seeming to take up at once the conviction of his patient, he should scrupulously abstain from treating it lightly, and should on the whole act rather as if he suspected poison had been given. Allowing his patient therefore apparently credit for the truth of his suspicions, the medical attendant should request him to give a full history of existing symptoms, of their origin and progress, of their relation in point of time to various meals, and of the mode and vehicle in which the supposed poison was administered. No unprofessional person can possibly go through such a narrative, without stating many circumstances which are wholly irreconcilable with the idea of poisoning generally, and still more of the administration of a particular poison. I have met with two instances of imaginary poisoning, the nature of which was thus at once made obvious by a host of impossibilities in the narrative of the patient. One of these may be here given as an example. An elderly lady, who had certain expectancies of the death of a relation, conceived that the family of her relative had resolved to defraud her of her supposed rights. She afterwards imagined that an attempt was made to poison her, and camphor was the poison she fixed on as the article which had been administered. In its general or moral particulars the narrative was all plausible and suspicious enough; but unluckily for its consistency, she stated that the poison could only have been given in wine,—that she did not remark any particular taste in the wine,—that her illness did not begin till the day after she took it; and although she alleged, without any leading question on my part, that camphorous perspiration was exhaled on the subsequent day, the whole train of symptoms differed entirely in every other respect from a case of poisoning, and resembled closely in their origin and progress a case of slight general fever. The incompatibility of her story with the idea of poisoning with camphor will be readily understood by referring to what is afterwards said of the effects of that substance. _Feigned_ or _pretended poisoning_ is more apt to escape suspicion, and when suspected is commonly more difficult to develope satisfactorily; for the actor has it in his power to lay his plans with care, and even to become acquainted with the properties of the poisons whose effects he intends to feign. Still he can rarely enact his part so well as to deceive a skilful physician both by existing symptoms and by his history of their origin and progress; much less can he contrive his scheme so adroitly that it shall not be unfolded by the refinements of chemical analysis. The investigation of such a case will be directed of course in the first instance to the state and progress of the symptoms. Here, as in imaginary poisoning, it is of moment to conceal from the individual the suspicion entertained of his falsehood. For even if a person who has actually taken poison knows he is unjustly suspected of feigning, it is not improbable that he might try to mend his story with impossibilities, and so lead the physician into error. In a case of feigned poisoning an excellent mode of investigation is, after hearing out the individual’s own story, to put a number of questions involving an alternative answer, one alternative being compatible and the other incompatible with the alleged nature of his illness. No unprofessional person can stand such a system of interrogation, if skilfully pursued. Not only will his answers be often wrong; but likewise his manifest perplexity how to answer will of itself supply evidence of falsehood. In the next place, great attention must be paid to the chemical analysis. A person who feigns poisoning will commonly produce the poisoned remains of a dish, or some other article, which he represents himself to have swallowed. Sometimes the substance contained in it will prove on analysis not to be poison at all, as in an instance I remember reading some years ago in a London newspaper of pretended poisoning with arsenic, where the dregs of a bowl of gruel contained, not arsenic, but finely pounded glass. Sometimes the quantity of a real poison contained in the remains of a dish may indicate, in what is said to have been swallowed, a portion wholly incompatible with the mildness or severity of the symptoms. Sometimes the vomited matter, even the matter first vomited, may not contain any of the alleged poison. Sometimes poison found in matter alleged to have been vomited may yield compounds during analysis which are not animalized, showing that it never was in the stomach. Sometimes the quantity of poison contained in such matter may be greater than that alleged to have been taken. Sometimes the quantity contained in the first matter vomited may be less than that contained in what is vomited or said to be vomited subsequently. By these and many other such inconsistencies the falsehood of the story may be unequivocally unfolded. The following example will illustrate some of the rules now laid down. A young married female, in the seventh month of pregnancy, having been discovered by her friends to be secretly addicted to dram-drinking, appeared to be much annoyed in consequence of the discovery; and one evening was found apparently very ill by her husband on his return from work. She represented that she had taken arsenic with a view to self-destruction, that she was in great torture, and that she was sure she must soon die. It was accordingly found, on reference to a neighbouring apothecary, that she had the same forenoon purchased about a drachm and a half of arsenic for the pretended purpose of poisoning rats; and in the bottom of a teacup, in which she said she mixed it, there was left a small quantity of white powder, that proved on analysis to be pure oxide of arsenic. Notwithstanding these strong facts, the mildness of the symptoms and the composure with which she complained of her tortures led her friends to suspect she was feigning. On investigating her case I first ascertained, in farther corroboration of her story, that the powder was nowhere to be found. But she then stated in reply to questions involving an alternative answer, that the arsenic had a sour taste, and that the pain began in the lower part of the belly, and spread upwards. She likewise said that she vomited a mouthful or two into a chamber-pot twenty minutes after taking the poison; that she vomited no more till the apothecary was sent for, who gave her emetics of sulphate of zinc, carefully preserving the discharges; and that she only vomited when emetics were given. When I first saw her, five hours after the alleged date of the taking of the arsenic, the skin was warm and moist, the face full and flushed, the pulse frequent and firm, the muscular strength natural. The chamber-pot contained only a small quantity of the fæces of a child and apparently a little water, but no vomited matters, and no white powder. The fluid discharged in presence of the apothecary was found on careful analysis to contain a large quantity of zinc, but not an atom of arsenic. She gradually recovered from the illness under which she laboured at the time I saw her, and in two days she admitted she was quite well, but continued to insist that she had taken the poison.—M. Tartra has related a singular case of the same kind, where a young woman feigned poisoning with nitric acid, and was not detected for several days.[136] _Imputed poisoning_ differs in general from feigned poisoning only in so far as the symptoms which are feigned are imputed to the agency of another. The imputation of the crime of poisoning by feigning or actually producing the symptoms, and contriving that poison shall be detected in the quarters where in actual cases it is usually sought for, has been not unfrequently attempted. Two important continental cases have already been referred to for other purposes [pp. 66, 76]; and I may here relate the heads of two English cases, which are of great interest, and will serve to illustrate the mode of procedure in such circumstances. The first of these, which I have related elsewhere in detail,[137] is a striking example of the power of science in eliciting the truth, and redounds highly to the credit of Mr. Thackrah, the medical gentleman who conducted the investigation. Samuel Whalley was indicted at York Spring Assizes in 1821, for maliciously administering arsenic to Martha King, who was pregnant by him. The woman King swore, that the prisoner, after twice trying, but in vain, to prevail on her to take drugs for the purpose of procuring abortion, sent her a present of tarts, of which she ate one and a half,—that in half an hour she was seized with symptoms of poisoning with some irritant poison,—and that she continued ill for a long time after. Mr. Thackrah found arsenic in the tarts that remained untouched, and likewise in some matter that was vomited in his presence after the administration of an emetic, as well as in other vomited matters which were preserved for him between his first and second visits. Her appearance, however, did not correspond with the complaint she made of her sufferings, her pulse and tongue were natural, and on careful investigation the following inconsistencies were farther detected. 1. She said she felt a coppery taste in the act of eating the tarts, a taste which arsenic certainly does not possess. 2. From the quantity of arsenic in the tarts which remained she could not have taken above ten grains, while even after repeated attacks of vomiting, the alleged matter subsequently preserved contained nearly fifteen grains. 3. The matter first vomited contained only one grain, while the matter alleged to have been vomited subsequently contained fifteen grains. 4. The time at which these fifteen grains were alleged to have been vomited was not till between two and three hours after the symptoms began; in which case the symptoms would before that time have been in all probability violent. The prisoner was acquitted, and the prosecutor and another woman who corroborated her deposition afterwards confessed that they had entered into a conspiracy to impute the crime to him, because he had deserted her on finding she was too intimate with other men. Another case not less interesting in its details was communicated to me by my colleague Dr. Traill, who was consulted by the medical attendant, Mr. Parr of Liverpool. A man accused his sister-in-law of administering poison in his tea. He stated that he was seized with pain in the stomach and uneasiness in the head half an hour after taking the tea; and when visited soon after, the countenance was anxious, the skin pallid, the pulse frequent, the throat red; and while Mr. Parr was examining the throat, a quantity of matter was vomited, containing a white, gritty, crystalline substance, which was afterwards ascertained to be oxalic acid. The following circumstances, however, proved that the poison could not have been given in the tea. The man alleged that he remarked in the very first mouthful an acrid taste, followed by sweetness, which is not the taste of oxalic acid. Notwithstanding this warning, he drank the greater part of the tea. He stated that the poison was dissolved in the tea, yet he vomited some oxalic acid in the solid form. Granting he was mistaken in supposing the whole poison dissolved, the quantity swallowed must in that case have been large; and nevertheless the symptoms were mild, though no vomiting took place for about an hour, and next day he was almost well. Four other individuals had tea at the same time from the same tea-pot, without sustaining any harm; and what remained of the infusion did not contain any oxalic acid. Finally, his niece took what he left of his tea in the cup, without remarking any unusual taste; and in the unwashed cup not a trace of oxalic acid could be detected. It was quite plain, therefore, that the man’s accusation was false; and certain points of general evidence, coupled with the medical facts, afterwards proved that he must have taken the oxalic acid himself. It has been alleged, that attempts have been made to impute the crime of poisoning by introducing poisonous substances into the body after death; and although I have not been able to find any actual instance of such ingenious atrocity mentioned by authors, it must be acknowledged to be quite possible; and the medical jurist should therefore be prepared for the requisite investigations. Every case may be clearly made out by attending to the relative effects of poisons on the dead and on the living tissues;—a subject which will receive some notice under the head of the principal poisons in common use. PART SECOND. OF INDIVIDUAL POISONS.

Chapters

1. Chapter 1 2. PART II.—OF INDIVIDUAL POISONS. 3. CHAPTER I. 4. 1. _On the Action of Poisons through Sympathy._ In the infancy of 5. 2. _Of the Action of Poisons through Absorption._—If doubts may be 6. 1. _Quantity_ affects their action materially. Not only do they produce 7. 2. _As to state of aggregation_,—poisons act the more energetically the 8. 3. The next modifying cause is _chemical combination_. This is sometimes 9. 4. The effect of _mixture_ depends partly on the poisons being diluted. 10. 5. _Difference of tissue_ is an interesting modifying power in a 11. 6. With respect to differences arising from _difference of organ_, these 12. 7. _Habit and Idiosyncrasy._—The remarks to be made under the present 13. 8. The last modifying cause to be mentioned comprehends certain 14. CHAPTER II. 15. 1. The first characteristic is the _suddenness of their appearance and 16. 2. The next general characteristic of the symptoms of poisoning is 17. 3. Another characteristic is _uniformity in the nature of the symptoms_ 18. 4. The fourth characteristic is, that _the symptoms begin soon after a 19. 5. Lastly, _the symptoms appear during a state of perfect health_. This 20. 1. As to the _suddenness of their invasion and rapidity of their 21. 2. As to the uniformity or _uninterrupted increase of the symptoms_, it 22. 3. It was stated above, that the third character, _uniformity in kind_ 23. 4. In the next place, it was observed that some reliance may be placed 24. 5. Little need be said with regard to _the symptoms beginning, while the 25. 1. It may have been discharged by vomiting and purging. Thus on the 26. 2. The poison may have disappeared, because it has been all absorbed. It 27. 3. Poisons may not be found, because the excess has been decomposed. 28. 4. Lastly, the poison which has been absorbed into the system, and may 29. 1. The evidence derived from _the effects of suspected food, drink, or 30. 2. In the case of _the vomited matter_ or _contents of the stomach_ 31. 3. The effects of _the flesh of poisoned animals_, eaten by other 32. 3. The next article, which relates to the proof of the administration of 33. 4. The next article in the moral evidence relates to the intent of the 34. 5. The next article among the moral circumstances,—the simultaneous 35. 6. The next article of the moral evidence relates to suspicious conduct 36. CHAPTER III. 37. CHAPTER I. 38. 1. _Arsenical_ White arsenic 185 39. 2. _Acids_ Sulphuric acid 32 40. 3. _Mercurials_ Corrosive sublimate 12 41. 4. _Other mineral irritants_ Tartar-emetic 2 42. 5. _Veget. irritants_ Colchicum 3 43. 7. _Opium_ Opium or Laudan. 180 44. 8. _Hydrocyanic acid_ Med. Hydroc. acid 27 45. 9. _Other veget. Narcotics_ Nux-vomica 3 46. 11. Unascertained 22 47. CHAPTER II. 48. 1. _Distension of the Stomach._—Mere distension of the stomach from 49. 2. _Rupture of the Stomach_ is not a common occurrence; but it sometimes 50. 3. _Rupture of the Duodenum_ is a very rare accident from internal 51. 4. Under the next head may be classed rupture of the other organs of the 52. 5. The next accident which may be noticed on account of its being liable 53. 6. _Of Bilious Vomiting and Simple Cholera._—Of all the diseases which 54. 7. _Of Malignant Cholera._—The history of this disease affords a fair 55. 8. _Of Inflammation of the Stomach._—Chronic inflammation of the stomach 56. 9. _Inflammation of the Intestines_ in its acute form is more common 57. 10. _Inflammation of the Peritonæum_, or lining membrane of the belly, 58. 11. The subject of _Spontaneous Perforation of the Stomach_ is an 59. 12. The _gullet_ may be perforated in a similar manner either with or 60. 13. _Perforation of the alimentary canal by worms_ may here also be 61. 14. The next diseases to be mentioned are melæna and hæmatemesis, or 62. 15. The last are _colic_, _iliac passion_, and _obstructed intestine_. 63. CHAPTER III. 64. 1. _When concentrated_ it is oily-looking, colourless, or brownish from 65. 2. _When diluted_, it may be distinguished from all ordinary acids by 66. 3. It is seldom that the medical jurist is called on to search for 67. 1. The most ordinary symptoms are those of the first variety,—namely, 68. 2. The second variety of symptoms belong to a peculiar modification of 69. 3. The third variety includes cases of imperfect recovery. These are 70. 4. The last variety comprehends cases of perfect recovery, which are 71. 1. _When concentrated_, nitric acid is easily known by the odour of its 72. 2. _In a diluted state_ this acid is not so easily recognised as the 73. 3. _When in a state of compound mixture_, nitric acid, like sulphuric 74. 1. Hydrochloric acid, _in its concentrated state_, is colourless, if 75. 2. _When diluted_, it is recognised with facility, first by 76. 3. In the last edition of this work I proposed for the detection of 77. CHAPTER IV. 78. CHAPTER V. 79. CHAPTER VI. 80. 1. In the form of a pure solution, its nature may be satisfactorily 81. 2. The only important modifications in the analysis rendered necessary 82. CHAPTER VII. 83. CHAPTER VIII. 84. CHAPTER IX. 85. CHAPTER X. 86. CHAPTER XI. 87. CHAPTER XII. 88. CHAPTER XIII. 89. 3. The arsenite of copper, or _mineral green_. 4. The arsenite of potass 90. 2. _Of the Tests for Arsenious Acid._ 91. 7. After the precipitate has thoroughly subsided, the supernatant liquid 92. introduction as a poison into the body. This topic, one of paramount 93. 1. _Arsenic may exist as an adulteration in some reagents._—It must be 94. 2. _Arsenic may be present in some articles of chemical 95. 3. _Arsenic may have existed in antidotes administered during life._—It 96. 4. _Arsenic sometimes exists naturally in the human body._—This 97. 5. _Arsenic may exist in the soil of churchyards._—This proposition too 98. 3. _Arsenite of Copper_. 99. 4. _Arsenite of Potass_. 100. 5. _Arseniate of Potass._ 101. 6. _The Sulphurets of Arsenic._ 102. 7. _Arseniuretted-Hydrogen._ 103. 1. In one order of cases, then, arsenic produces symptoms of irritation 104. 2. The second variety of poisoning with arsenic includes a few cases in 105. 3. The third variety of poisoning with arsenic places in a clear point 106. CHAPTER XIV. 107. 1. _Of Red Precipitate._ 108. 2. _Of Cinnabar._ 109. 3. _Of Turbith Mineral._ 110. 4. _Of Calomel._ 111. 5. _Of Corrosive Sublimate._ 112. 1. _Hydrosulphuric acid gas_ transmitted in a stream through a solution 113. 1. _Lime-Water_ throws down the binoxide of mercury in the form of a 114. 6. _Of Bicyanide of Mercury._ 115. 7. _Of the Nitrates of Mercury._ 116. 1. The symptoms in the first variety are very like what occur in the 117. 2. The second variety of poisoning with mercury comprehends the cases, 118. 3. The third variety of poisoning with mercury comprehends all the forms 119. introduction of corrosive sublimate into the stomach. The poison then 120. CHAPTER XV. 121. 1. _Mineral Green._ 122. 2. _Natural Verdigris._ 123. 3. _Blue Vitriol._ 124. 1. _Ammonia_ causes a pale azure precipitate, which is redissolved by an 125. 2. _Sulphuretted hydrogen gas_ causes a dark brownish-black precipitate, 126. 3. _Ferro-cyanate of potass_ causes a fine hair-brown precipitate, the 127. 4. A polished rod or plate of _metallic iron_, held in a solution of 128. 4. _Artificial Verdigris._ 129. 1. Should the subject of analysis not be a liquid, render it such by 130. 2. If the copper be extremely minute in quantity, sulphuretted hydrogen 131. CHAPTER XVI. 132. 1. _Caustic potass_ precipitates a white sesquioxide, but only if the 133. 2. _Nitric acid_ throws down a white precipitate, and takes it up again 134. 3. The _Infusion of Galls_ causes a dirty, yellowish-white precipitate; 135. 4. The best liquid reagent is _Hydrosulphuric acid_. In a solution 136. 5. When the solution is put into Marsh’s apparatus for detecting arsenic 137. 1. Subject a small portion of the liquid to a stream of hydrosulphuric 138. 2. If hydrosulphuric acid do not distinctly affect the liquid, or if no 139. 3. If antimony be not indicated in either of these ways in the fluid 140. CHAPTER XVII. 141. CHAPTER XVIII. 142. 1. _Of Litharge and Red Lead._ 143. 2. _Of White Lead._ 144. 3. _Of Sugar of Lead._ 145. 1. _Hydrosulphuric acid_ causes a black precipitate, the sulphuret of 146. 2. _Chromate of potass_, both in the state of proto-chromate and 147. 3. _Hydriodate of potass_ causes also a lively gamboge-yellow 148. 4. _A rod of zinc_ held for some time in the solution displaces the 149. 4. _Goulard’s Extract._ 150. introduction of lead into the body; and in the last the whole course of 151. introduction of lead into the body may be presumed to be the real cause. 152. introduction of lead into the system. Dr. Burton thinks it will when the 153. CHAPTER XIX. 154. CHAPTER XX. 155. CHAPTER XXI. 156. CHAPTER XXII. 157. CHAPTER XXIII. 158. CHAPTER XXIV. 159. CHAPTER XXV. 160. CHAPTER XXIV. 161. 1. Apoplexy is sometimes preceded at considerable intervals by warning 162. 2. Apoplexy attacks chiefly the old. It is not, however, confined to the 163. 3. The next criterion is, that apoplexy occurs chiefly among fat people. 164. 4. A fourth criterion is drawn from the relation which the appearance of 165. 5. Another criterion relates to the progress of the symptoms. The 166. 6. Although there is a great resemblance between the symptoms of 167. 7. In the last place, a useful criterion may be derived from the 168. 1. The epileptic fit _is sometimes preceded by certain warnings_, such 169. 2. The symptoms of the epileptic fit _almost always begin violently and 170. 3. As in apoplexy, so in epilepsy the patient _in general cannot be 171. 4. When a person dies in a fit of epilepsy, _the paroxysm generally 172. 5. M. Esquirol, a writer of high authority, says that epilepsy _very 173. CHAPTER XXVII. 174. 1. If there be any solid matter, it is to be cut into small fragments, 175. 2. Add now the solution of acetate of lead as long as it causes 176. 3. The fluid part is to be treated with hydrosulphuric acid gas, to 177. 4. It is useful, however, to separate the meconic acid also; because, as 178. 5. If there be a sufficiency of the original material, Merck’s process 179. 546. There is little doubt that poisoning with opium may cause 180. CHAPTER XXVIII. 181. CHAPTER XXIX. 182. CHAPTER XXX. 183. CHAPTER XXXI. 184. 1. M. Chomel of Paris has related a case of poisoning with the gas 185. 2. The fumes of burning charcoal have been long known to be deleterious. 186. 3. It is probable that in some circumstances a very small quantity of 187. 4. The vapours from burning coal are the most noxious of all kinds of 188. 5. Somewhat analogous to the symptoms now described are the effects of 189. CHAPTER XXXII. 190. CHAPTER XXXIII. 191. CHAPTER XXXIV. 192. CHAPTER XXXV. 193. CHAPTER XXXVI. 194. CHAPTER XXXVII. 195. CHAPTER XXXVIII. 196. CHAPTER XXXIX. 197. CHAPTER XL. 198. CHAPTER XLI. 199. 1. When the dose is small, much excitement and little subsequent 200. 2. When the effect is sufficiently great to receive the designation of 201. 160. In twenty-four hours more the breathing became laborious and 202. 3. The third degree of poisoning is not so often witnessed, because, in 203. CHAPTER XLII. 204. 1. _Poisoning with Arsenic and Alcohol._—A man, after taking twelve 205. 3. _Poisoning with Tartar-Emetic and Charcoal Fumes._—Under the head of 206. 4. _Poisoning with Alcohol and with Laudanum._—Under the head of 207. 5. _Poisoning with Laudanum and Corrosive Sublimate._—Of all the cases 208. 6. _Poisoning with Opium and Belladonna._—A lady, who used a compound 209. 7. In the following cases, the active poisons to which the individuals 210. 2. Apparatus for the distillation of fluids suspected to contain 211. 3. Tube for reducing very small portions of arsenic or mercury. The 212. 4. A small glass funnel for introducing the material into the tube 213. 5. The ordinary apparatus for disengaging sulphuretted-hydrogen. The 214. 6. Instrument for washing down scanty precipitates on filters. It is a 215. 7. Tubes of natural size for collecting small portions of mercury by 216. 8. Pipette, one-fourth the natural size, for removing by suction 217. 9. Apparatus for reducing the sulphurets of some metals by a stream of 218. 36. Quoted by Marx, die Lehre von den Giften, I. ii. 163. 219. 92. Vicarius, Ibidem, Obs. 100. Riselius, Ibidem, Dec. i. An. v. Obs. 220. 1762. See Marx, i. ii. 29. 221. 1. P. 476, changed “exasperated by the use of oil” to “exacerbated by 222. 2. P. 513, changed “I may here add a very opposite instance of 223. 6. Enclosed italics font in _underscores_.

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