Chapter V: Part 5

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.