Chapter LI: Section III: Of the Morbid Appearances caused by Arsenic

The morbid appearances caused by arsenic will next require some details. In treating of them the same plan will be pursued as in the preceding section: the various morbid appearances left by it will first be mentioned in their order; and the subject will then be wound up with some remarks on the force of the evidence from these appearances, as they are usually combined in actual cases.

In the first instance, there are some cases in which little or no morbid appearance is to be seen at all. These all belong to the second variety of poisoning, which is characterized by the absence of local inflammation, and the presence of symptoms indicating an action on the heart, or some other remote organ. In such circumstances death takes place before a sufficient interval has elapsed for inflammation to be developed.

Several examples of the absence of diseased appearances in the dead body are to be found in authors. Thus in Chaussier’s case formerly quoted (p. 243), in that related by Metzger (p. 242), in another related by Etmuller, which was fatal in twelve hours,[713] and in a fourth related by Professor Wagner of Berlin, where life was also prolonged for twelve hours under incessant vomiting,[714] there was positively no morbid alteration at all. Such was also the state of the whole alimentary canal in the extraordinary case related by Orfila (p. 243). In the case quoted from the Medical and Physical Journal (p. 242), there was merely a slight redness at the pyloric end of the stomach. In the case of the American grocer too, there was only a little redness. In Mr. Wright’s case (p. 243), there was scarcely any morbid appearance,—nothing more than two small vascular spots and a minute ecchymosis. In that which fell under my own notice (p. 242), the villous coat of the stomach was of natural firmness, and had an exceedingly faint mottled-cherry-red tint, barely perceptible in a strong light; and the rest of the alimentary canal, as well as the body generally, was quite healthy.

Although in these examples the morbid appearances were trifling or undistinguishable, it must not be supposed that the same happens in all cases of rapid death from arsenic. In Gérard’s case, where the usual irritant symptoms were wanting, and which proved fatal in five hours, there was dark redness of the whole villous coat of the stomach. In Mr. Holland’s case, fatal in eight or nine hours (p. 243), the stomach was of an intense purple colour at its pyloric end, and contained bloody mucus; and the mucous coat of the cœcum presented extensive softening and congestion. Mr. Alfred Taylor refers to three cases observed by Mr. Forster of Huntingdon, in which the mucous coat of the stomach was highly inflamed, though death took place in 6½, 3½, and 2 hours only:[715] in Mr. Hewson’s case, fatal in five hours, the whole stomach was exceedingly vascular, and presented both spots of extravasation, and several small erosions (p. 201). In a case alluded to at p. 239 as having fallen under my own observation, and which was also fatal in five hours, the whole villous coat of the stomach was intensely red, except where the folds of the rugæ protected it from contact with the poison; and the prominences of the rugæ presented corroded spots of ecchymosis. In Dr. Dymock’s case, fatal in two hours and a half, the stomach, which I had an opportunity of examining, presented on its mucous coat many scarlet patches, and here and there a purplish appearance (p. 240). Lastly, an instance is related by Pyl of this poison proving fatal in three hours, and leaving nevertheless in the dead body distinct signs of inflammation in the stomach.[716]

In the ordinary cases in which death is delayed till the second day or later, a considerable variety of diseased appearances has been observed. They are the different changes of structure arising from inflammation in the alimentary canal, in the organs of the chest, and in the organs of generation—together with certain alterations in the state of the blood and condition of the body generally.

The first set of appearances to be mentioned are those indicating inflammation of the alimentary canal, viz., redness of the throat and gullet,—redness of the villous and peritonæal coats of the stomach, blackness of its villous coat from extravasation of blood into it, softening of the villous coat, ulceration of that as well as of the other coats, effusion of coagulable lymph on the inner surface of the stomach, extravasation of blood among its contents,—finally, redness and ulceration of the duodenum and other parts of the intestinal canal, and more particularly of the rectum; to which may also be added, though not properly a morbid phenomenon, certain appearances put on by the arsenic which remains undischarged.

Redness of the throat and gullet is not common, at least it does not often occur in the descriptions of cases. Jaeger, however, says that in his experiments he usually found redness at the upper and purplish stripes at the lower end of the gullet:[717] and Dr. Campbell likewise found the gullet red in animals,[718] Similar appearances have also been remarked in man. In the case of a man who lived eight days, Dr. Murray found the gullet very red;[719] in that of a woman who lived scarce seven hours, Dr. Booth observed the gullet inflamed downwards very nearly to the cardia;[720] and Wildberg has reported two cases of the same nature, in one of which it is worthy of remark that the poisoning lasted only six hours.[721] On the whole, it appears probable that inflammation of the throat and gullet would be found more frequently in the reports of cases, if it was more carefully looked for.

Redness of the inner coat of the stomach is a pretty constant effect of arsenic, when the case is not very rapid. All the varieties of redness, formerly mentioned among the effects of the irritant poisons generally, may be produced by arsenic. There is nothing, however, in the redness caused by this poison, any more than in the redness of inflammation generally, by which it is to be distinguished from the pseudo-morbid varieties. (See p. 110.)

It is singular, that, however severe the inflammation of the inner membrane of the stomach may be, inflammatory redness of the peritonæal coat is seldom found. Yet inflammatory vascularity does occur sometimes on the peritonæal coat. Sproegel found it in animals;[722] and it was present in the case of the girl Warden, whose death gave rise to the trial of Mrs. Smith.[723] Dr. Nissen, a Danish physician, has related another case in which the external coat of the stomach appeared as if minutely injected with wax. But the patient had been attacked with incarcerated hernia during the progress of his illness, and the whole peritonæal membrane was in consequence inflamed.[724] A common appearance when the internal inflammation is well marked, and one often unwarily put down as inflammation of the peritonæum, is turgescence of the external veins, sometimes so great as to make the stomach look livid.

Blackness of the villous coat from effusion of altered blood into its texture is sometimes met with. When the colour is brownish-black, or grayish-black, not merely reddish-black, when the inner membrane is elevated into firm knots or ridges by the effusion, and the black spots are surrounded by vascularity or other signs of reaction, the appearances strongly indicate violent irritation. I have already said that such appearances are never imitated by any pseudo-morbid phenomenon.

One of the most remarkable appearances occasionally observed in the stomach in those instances where the body has been buried for at least some weeks before examination, is the presence of bright yellow patches, of various sizes, which appear as if painted with gamboge, and obviously arise from the oxide of arsenic diffused throughout the tissues having been decomposed and converted into sulphuret of arsenic by the sulphuretted-hydrogen disengaged during putrefaction. I have witnessed this appearance in several cases. In the case mentioned at p. 247, where the body had been buried twenty days, numerous brilliant yellow patches were visible on the villous coat of the stomach. In the case of a female who was poisoned about the same time with that man, and, as was suspected, by the same individual, the body was not examined till three months after interment; and here broad, bright, yellow patches, disappearing under the action of ammonia, were found under the peritonæal coat of the left end of the stomach, the adjoining great intestine, and also the muscular parietes of the abdomen. In the case of Mr. Gilmour, for whose murder his wife was tried a few months ago in this city, but acquitted,—and who undoubtedly died of poisoning with arsenic, howsoever administered,—there were found fourteen weeks after death numerous yellow streaks and patches both on the inner surface of the stomach, on its outer surface under the peritonæum, on the adjoining transverse colon, and on the small intestines in contact with the stomach. From these and other parallel facts which have been occasionally noticed by the periodical press, it seems probable that the appearance in question is common in bodies which have been some time buried. It is an extremely important part of the pathological evidence. I doubt whether natural causes can occasion any appearance similar to it. And indeed, what is it but the effect of a chemical test applied to the poison by nature?

The next appearance which may be mentioned is unnatural softness of the villous coat of the stomach. This coat has certainly been often found, after death from arsenic, unusually soft, brittle, and easily separable with the nail.[725] But the same state occurs in dead bodies so often and so unconnected with previous symptoms of irritation in the stomach, that it cannot with any certainty be assumed as the effect of irritation when it is found subsequently to such symptoms. So far from softening and brittleness being a necessary effect of the irritation produced by arsenic, it is a fact that a condition precisely the reverse has been also noticed. In a case which I examined, the villous coat, except where it had been disintegrated by effused blood and ulceration, was strong and firm; and the rugæ were thickened, raised and corrugated, as if seared with a hot iron.[726] Metzger once found the mucous membrane dense, thickened, and the rugæ like thick cords.[727] Pyl too once met with the same appearance, and ascribes the thickening to gorging of vessels;[728] and in a case related by Dr. Wood of Dumfries, where I had an opportunity of examining the stomach, this appearance was present in a remarkable degree, and it clearly arose from elevation of the villous coat by effusion of blood under it.[729] Remer, in his edition of Metzger’s Medical Jurisprudence, says he once met with an instance where the stomach was shrivelled like a bladder subjected to boiling water.[730]

Sometimes the villous and also more rarely the other coats of the stomach are found actually destroyed and removed in scattered spots and patches. This loss of substance is occasionally owing to the same action which causes softening and brittleness of the villous coat,—the action, however, having been so intense as to cause gelatinization. That such is the nature of the process appears from the breach in the membrane being surrounded by gelatinized tissue, and not by an areola of inflammatory redness. Of this species of destruction of the coats I have seen a characteristic example.[731] But in other cases the loss of substance is owing to a process of ordinary ulceration, as is proved by the little cavities having a notched irregular shape, and being surrounded both by a red areola and a margin of firm tissue. This was the character of the ulcers in the case of Warden, which I have described elsewhere.[732] Destruction of the coats of the stomach by ulceration is not a very common consequence of poisoning with arsenic, as death frequently takes place before that process can be established. It does not often occur, unless the patient survive nearly two days. Mr. Alfred Taylor, however, mentions a case fatal in seventeen hours where he found ulceration of the stomach, and another fatal in ten hours where several small ulcers were seen on the lesser curvature, and two nearly circular ones as big as a sixpence.[733] Mr. Hewson too informs me he found many eroded spots even in his case which proved fatal in five hours (p. 56). I suspect, however, that spots of healthy membrane surrounded by vascular redness are sometimes mistaken for ulcers in such cases; for indeed nothing can more exactly resemble them. In many general works on Medical Jurisprudence, and in some express treatises on arsenic, it is stated that this poison may cause complete perforation of the stomach.[734] But this effect is exceedingly rare. I have related one distinct example of it;[735] Professor Foderé has briefly alluded to a case he witnessed which proved fatal in two days and a half;[736] I have likewise found in an account of a trial in North America, an instance in which the stomach was perforated by numerous small holes, so that when held before the light it appeared as if riddled like a sieve;[737] but I have not been able to find in medical authors any farther authority for the general statement. Destruction of the coats of the stomach as produced by arsenic has been variously described by authors under the terms erosion, corrosion, dissolution, ulceration. But the correct mode of describing it appears to be by the terms gelatinization, or ulceration, according to the nature of the diseased action by which it is induced. At all events it is necessary to beware of being misled by the terms erosion, corrosion, and the like, which all convey the idea of a chemical action; while it is well ascertained that a chemical action either does not exist at all between arsenic and the animal tissues, or, if it has existence, tends to harden and condense rather than to dissolve or corrode them. Arsenic is not a corrosive.

Another species of destruction of the coats of the stomach, which will require a little notice, is sloughing or gangrene. This appearance occurs frequently in the narratives of the older writers; but it has not been enumerated in the list of morbid appearances at the commencement of this section, because its existence as one of the effects of arsenic is problematical. It has not been witnessed so far as I know by any recent good authority. Those who have mentioned it have probably been misled by the appearance put on by the black extravasated patches, when they are accompanied by disintegration of the villous coat and effusion of clots of black blood on its surface—an appearance which resembles gangrene closely in everything but the fetor. Sir B. Brodie has stated that Mr. John Hunter has preserved in his museum, as an example of a slough of the villous coat caused by arsenic, which turned out on examination to be nothing else than an adhering clot.[738] It is clear too, that, when Mr. James speaks of having found “several gangrenous patches” on the villous coat of the stomach, and “patches of sphacelus” in the intestines, on examining the body of a notorious French criminal, Soufflard, who poisoned himself with arsenic in prison in 1839, he mistook for gangrene what was merely extravasation; for the man lived only twelve hours.[739]

Various secretions have been found on the inner surface of the stomach. The mucous secretion of the inner membrane is generally increased in quantity. Frequently it is thin, but viscid, as in its natural state; but sometimes it is both abundant and solid, as if coagulated; and then it forms either a uniform attached pellicle, or loose shreds floating among the contents.[740] In both forms it has been mistaken for the mucous membrane itself. I believe this increased secretion and preternatural firmness of the gastric mucus cannot take place without some irritating agent being applied to the stomach. Both may occur without any other sign of inflammation in the mucous membrane. In a case of suicide after seduction which came under my notice in this city in 1843, and which proved fatal in five hours [p. 239], the mucus in the stomach, which was very abundant, put on the appearance of curdled milk, owing to its being rendered opaque and white by the large quantity of finely powdered arsenic diffused through it; and it was actually mistaken for curdled milk by several medical men.—Sometimes the matter effused is true coagulable lymph. This is rarely seen as the effect of arsenic. I have remarked it, however, very distinctly in dogs, and Dr. Baillie saw it once in the human subject.[741] It is of course quite decisive of the presence of inflammation. It is known from tough mucus, to which it bears some resemblance, by its reticulated disposition, and by the threads of the reticulation corresponding with inflamed lines on the stomach beneath.

Another very common appearance is the presence of a sanguinolent fluid, or even actual blood in the cavity of the stomach. In several of the cases which have come under my own notice, the subject of analysis was a thick, dirty brownish-red fluid, evidently containing a large proportion of blood; and many other examples of the same nature are on record.[742] In Laborde’s case formerly mentioned actual clots were found among the contents; in the instance of a woman who died in five days, as related by Zittmann, half a pound of coagulated blood was found in the stomach;[743] and in another case mentioned by Professor Bernt, the stomach contained no less than three pounds of black ichor mixed with clots of blood.[744] A good deal of reliance has been placed on bloody effusion in proof of the administration of arsenic or some other active irritant. It is of some importance, as it appears not to be an effect of that irritation which causes cholera.

Among the appearances observed in the stomach the presence of arsenic may be included, though not properly speaking a morbid appearance. Under the head of the medical evidence of poisoning generally it was stated, that many causes conspire to remove from the stomach during life poisons which have actually caused death. In addition to the illustrative cases there alluded to, I may here also refer to an interesting case communicated to me by Mr. J. H. Stallard, and already noticed for a different purpose [p. 235]. Arsenic in no large quantity had been swallowed in tea, and death took place in four hours only. Here none of the poison could be detected by Marsh’s process, either in the contents of the stomach, or in its tissues, or in the liver.—In the instance of arsenic, however, the operation of the causes which tend to remove the poison is prevented by various circumstances, in particular by its insolubility and firm adhesion to the stomach. Hence it happens, that even after long-continued vomiting a portion still generally remains behind, either in the contents of the stomach or in its tissues. Sometimes the arsenic exists dissolved in the contents; more commonly it is present there in the solid form; and is then either in loose particles, or enveloped in coagulated mucus,[745] or in little clots of blood,[746] or is wrapped up in the more solid parts of the contents.[747] Frequently it adheres to the coats of the stomach, and is then either scattered in the form of fine dust or collected in little knots. The adhering particles are always covered by mucus; they are often surrounded by redness of the membrane or by effused blood; and sometimes they are imbedded in little ulcers.—A remarkable appearance which the arsenic sometimes puts on is a brilliant yellowness of its surface, owing to its conversion into the sulphuret. This appearance existed in six cases which have come under my own notice, first in one related in the Edinburgh Medico-Chirurgical Transactions,[748] next in the instance of Margaret Warden,[749] again in the case of a young woman whose death gave rise to the trial of John Lovie held at Aberdeen in the Autumn Circuit of 1827, again in a case described by Dr. Wood, which I had an opportunity of examining;[750] and lastly, in two others which I had occasion to examine in 1842 and 1843. In one of these, the case of Mr. Gilmour, adverted to at p. 265, Drs. Wylie and M’Kinlay, who examined the body in the country, found the inner surface of the stomach thickly sprinkled with small yellow particles, some of which were very bright. In all of these cases oxide was found, as well as the sulphuret of arsenic. In the case related by Dr. Nissen [p. 264], a similar yellow appearance, observed on the surface of the arsenic, was ascribed with justice to the action of sulphuretted hydrogen-water, which had been given as an antidote during life.[751] In a very important case examined here a few years ago by my colleague Dr. Traill, and which will be noticed more particularly for a different purpose afterwards, this conversion of the oxide into sulphuret had taken place to a great extent [p. 277]. In every instance of the kind yet examined, however, the conversion has been only partial, so that a large proportion of oxide could easily be detected by the usual process.

Care must be taken not hastily to consider as arsenic every white powder which may be found lining the inside of the stomach. Many other white powders may obtain entrance from without; and besides, small, white, shining, pulverulent scales, not unlike finely powdered arsenic, but rarely composed of animal matter, sometimes form naturally on the mucous coat of the stomach and intestines. In a medico-legal report published a few years ago, Professor Orfila has noticed two instances in which these scales were mistaken for arsenic;[752] in another published not long after he mentions that he found white particles which crackled when bruised, and appeared brilliant before the microscope, and which nevertheless were not arsenic.[753] Buchner too says he is acquainted with an instance where, in a medical inspection on account of a suspicion of poisoning, the villous coat of the stomach was found lined with a white granular substance which presented the properties of a fat and contained no mineral admixture;[754] and in the case of Warden I remarked a similar appearance, which, as arsenic was found in the stomach, I was disposed to consider a sprinkling of that poison, until the contrary was ascertained by analysis. The present caution, therefore, is not superfluous.

In a few cases the stomach is the only situation where morbid appearances are visible, even though life has been prolonged for so much as two days. This state of matters is well exemplified by a French case of death in forty-three hours, where the stomach presented much redness and extravasated patches, but where the intestines, the larynx and the contents of the head and chest were in a natural condition.[755] Such limitation, however, of the diseased appearances are rare.

Redness of the mucous membrane of the intestines is often present when the stomach is much inflamed. Dissolution of the mucous coat is much less frequent in the intestines than in the stomach. Ulceration occasionally occurs in lingering cases. In the case of Mitchell, which has been several times alluded to, the inner coat of the duodenum was dark-red, pulpy, thickened, easily separable; and on a spot as big as a crown piece, both the inner and the muscular coats were wanting.[756] Perforation of the small intestine was found in a case communicated to me by Mr. Sandell, and detailed at page 277. But as the person survived only eight hours, and had laboured under symptoms of disease in the bowels for some days before taking the arsenic, it is unlikely that this appearance, which has not been observed, to my knowledge, in any other instance, arose from the action of the poison.

The signs of inflammation are seldom distinct in the small intestines much lower down than the extremity of the duodenum; and they do not often affect the colon. But the rectum is sometimes much inflamed, though the colon, and more particularly the small intestines, are not. Dr. Male mentions, that in man he has found the rectum abraded, ulcerated, and even redder than the stomach itself;[757] and Dr. Baillie also notices two cases in which the lower end of the rectum was ulcerated.[758] A common appearance in lingering cases is excoriation of the anus,[759] and it is said that even gangrene has been produced.[760]

A late writer draws attention to the fact that in the only two fatal cases he had seen the whole colon was contracted to an extraordinary degree;[761] and this state is mentioned in other cases. The appearance deserves notice; but of course whatever empties the colon thoroughly will have the same effect.

The chief appearances in the alimentary canal have now been mentioned. The next quarter in which deceased appearances are to be met with is the cavity of the chest. Here are sometimes seen redness of the pleura, redness and congestion of the lungs, redness of the inner surface of the heart, and redness of the lining membrane of the windpipe.

Redness of the diaphragmatic part of the pleura, or even of the whole of that membrane, has been at times observed; as one would expect, indeed, from the pectoral symptoms which occasionally prevail during life. Inflammation of the lungs themselves has also been noticed. Dr. Campbell twice found great congestion of blood in the lungs of animals poisoned by the application of arsenic outwardly.[762] Sproegel likewise found the pleura, pericardium, and whole lungs deeply inflamed in animals.[763] Dr. Venables found the pleura of a bright crimson colour in some poultry maliciously poisoned with arsenic,—more redness there indeed than in the stomach.[764] Mr. James says that in his experiments on animals he constantly found the lungs much gorged with blood, unless when death occurred quickly; but that he could see no evidence of the congestion being inflammatory.[765] A distinct example of advanced pneumonia in man is related in Pyl’s Magazine: the patient died after vomiting and purging incessantly for eight days; and on dissection the lungs were found “in the highest state of inflammation; and so congested as to resemble a lump of clotted blood.”[766] A distinct case of the same nature is related in Henke’s Journal; this patient had obvious pneumonic symptoms during life; and in the dead body the lungs were found so gorged, that, on being cut into, nothing could be seen but clotted blood in their cellular structure.[767] In a case formerly adverted to [p. 252] of death from arsenic applied externally for scirrhus, excessive congestion was found in the lungs, “both lungs being completely gorged with blood, and presenting all the characters of pulmonary apoplexy.”[768] In another described by Dr. Booth of Birmingham, where death occurred in seven hours only, the lungs presented sufficient congestion to have completely impeded respiration.[769]

It has been alleged that the inner surface of the heart has been found red from inflammation. In a case examined judicially at Paris by Orfila, the left cavities of the heart were of a mottled red hue, and in the ventricle were seen many small crimson specks which penetrated into the muscular part of the parietes. The right cavities had a deep reddish-black tint, and the ventricle of that side contained specks like those in the other, but more faint. Orfila adds, that he had previously seen the same appearance in animals.[770] These observations are not satisfactory. There is no evidence that the observer drew the distinction between the redness of inflammation, and that produced by the dyeing of the membrane with blood after death. The subject was afterwards brought before the Royal Academy of Medicine at Paris by M. Godard, who had also observed the appearance in question in a person killed by arsenic, and who dwelt strongly on it as characteristic of this species of poisoning. It was distinctly proved, however, by many members present that the appearance arises from various other causes.[771]

The inner membrane of the windpipe is said to be sometimes affected with inflammatory redness. Jaeger found it so in animals;[772] and the symptoms referrible to the windpipe during life would lead us to expect the same thing in man.

The organs of generation are occasionally affected. The penis in the male and the labia in the female have been found distended and black; in an interesting case related by Bachmann the external parts of generation (in a female) were surrounded by gangrene;[773] and in a case related in Pyl’s collection the inside of the uterus and Fallopian tubes was inflamed.[774] It is probable that signs of inflammation in the internal organs of generation will be found if there have been corresponding symptoms during life. But in truth this part of the pathology of poisoning with arsenic has not been particularly attended to.

To complete this account of the morbid appearances of the mucous membranes, it may be added that the conjunctiva of the eyes frequently presents vascularity and spots of extravasation.[775]

It now only remains, under the head of the morbid appearances produced by arsenic, to mention certain alterations that are said to take place in the state of the blood and general condition of the body.

With regard to the state of the blood Sir B. Brodie observes in general terms, that in animals killed by arsenic it is commonly fluid.[776] Harles, on the authority of Wepfer, Sproegel, and Jaeger, says it is black, semi-gelatinous, and sometimes pultaceous.[777] Novati alleges that the blood after death is without exception black and liquid as after cholera, of a blackish-purple tint that colours linen reddish-brown, viscid, opaque, and without any trace of coagulation.[778] In a fatal case related by Wildberg the blood was everywhere fluid.[779] This condition, however, is not uniform; for Dr. Campbell found the blood coagulated in the heart of a rabbit;[780] and Wepfer found it also coagulated in the dog.[781]

It has been stated by some authors in medical jurisprudence that the dead body occasionally exhales an aliaceous odour, resembling that of sublimed arsenic. This is a very questionable statement. The only fact of the kind worth mentioning is one brought forward by Dr. Klanck, as occurring in the course of certain experiments, which will presently be noticed, on the antiseptic virtues of arsenic. Several animals which had been killed with arsenic are said to have exhaled an odour like that of sublimed arsenic from three to eight weeks after death.[782]

A great discordance of opinion at one time prevailed among authors, as to the influence of arsenic on the putrefactive process in the bodies of those poisoned with it. The vulgar idea, borrowed probably from the ancient classics, that the bodies of those who have been poisoned decay rapidly, was till lately the prevalent doctrine of medical men, and even of medical jurists; and it was applied to arsenic as well as other poisons. Even so lately as 1776 we find Gmelin stating in his History of Mineral Poisons, that the bodies of those who have died of arsenic pass rapidly into putrefaction, that the nails and hair often fall off the day after death, and that almost the whole body quickly liquefies into a pulp.[783] A similar statement has been made in 1795 by a respectable author, Dr. John Johnstone.[784] It appears that this rapid or premature decay does really occur in some instances. Thus in a case related by Plattner of death from arsenic administered as a seasoning for mushrooms, the body had a very putrid odour the day after death.[785] Loebel also asserts he found by experiments on animals, that after death from arsenic putrefaction took place rapidly, even in very cold weather.[786]

In other instances the body probably decays in the usual manner. For example, in Rust’s Magazin is related the case of a child who died in six hours of poisoning with arsenic, and in whose body, fourteen days after death, the integuments were found considerably advanced in putrefaction, and the liver and kidneys beginning to soften.[787] In the case of a man who died in two days, and in whose body arsenic was found by MM. Chapeau and Parisel throughout many of the tissues, “putrefaction was so far advanced eight days after death as to render the examination of parts obscure.”[788] And in the course of some experiments on dogs poisoned with the oxide Dr. Seeman found the usual changes after five months’ interment.[789]

But it has been proved in recent times that in general arsenic has rather the contrary tendency—that, besides the antiseptic virtues which it has been long known to exert when directly applied in moderate quantity to animal substances, it also possesses the singular property of enabling the bodies of men and animals poisoned with it both to resist decay unusually long, and to decay in an unusual manner. The observations and inquiries which have been made abroad on this subject were little known any where else than in Germany before the publication of the earlier editions of the present work; but parallel examples have been since met with both in Britain and France; and in this country the importance of the subject is generally appreciated.

The first occasion on which the antiseptic property of arsenic was brought under public notice was about the beginning of the present century, in the course of the trial of the widow of a certain state-councillor, Ursinus of Berlin. Some time before that Dr. Welper, then medical inspector in the Prussian capital, having remarked that the body of a person poisoned with arsenic remained quite fresh for a whole week in summer, he attended carefully to the subject at every opportunity, and invariably, he says, found that the body resisted putrefaction. Not long after making this remark, he was concerned in 1803, by virtue of his office, in the investigations in the case of the widow Ursinus. This lady having been discovered in an attempt to poison her servant, suspicions arose regarding the previous sudden death of three persons in her family, her husband, a young officer who had carried on an amour with her, and an aunt from whom she derived an inheritance. They had all died in mysterious circumstances, and the lady had been their only nurse. Dr. Welper disinterred the bodies of the husband and aunt, which had been buried, the former two years and a half before at Berlin, the latter half a year afterwards at Charlottenberg; and he found them not putrid, but dried up; and specks of an appearance, which is described as being gangrene, but which was probably warty extravasation, were visible in the stomach. Arsenic could not be detected.

He afterwards got Dr. Klanck, his acquaintance, to make some express experiments on animals; and the results were strikingly conformable. In dogs poisoned with arsenic and left for two months sometimes buried in a damp cellar, sometimes exposed to the air of the cellar, the flesh and alimentary canal were red and fresh, as if pickled; and though the place where the carcases were subsequently buried again was flooded for eight months after, the intestines were eventually found entire and red, the fat converted into adipocire, and most of the muscles unaltered,—those only being soft and greasy which were directly acted on by the water. From a set of comparative experiments which were made on dogs killed by blows, or poisoned by corrosive sublimate, or by opium, Klanck found, that, after being buried in the same place, and for the same space of time the whole soft parts of the carcases were converted into a greasy mass. In a subsequent year he repeated his experiments, the bodies, however, being this time left exposed to the air of the cellar. The experiments were commenced in the month of August. In ten days there appeared slight signs of incipient putrefaction; a faint putrid smell was exhaled, and all flies that settled on the carcase died. This state continued for eight or ten weeks without increasing. After that the soft parts began to grow firmer and drier, and at the same time the putrid odour was succeeded by a smell like that of garlic, which became insupportably strong when the carcases were removed into warm air. The bodies, three years afterwards, still continued dry and undecayed.[790]

A similar set of facts was again brought before the public between 1809 and 1811, during the criminal proceedings in a case like that of the widow Ursinus, tried first at Bayreuth and afterwards by appeal at Munich. A lady near Bayreuth died of five days’ illness, under symptoms of violent general irritation of the alimentary canal. Some months afterwards a variety of circumstances having raised a suspicion that she had been poisoned by her maid, Margaretha Zwanziger, a judicial investigation was set on foot; the consequence of which was, that the same woman came under suspicion of having also previously poisoned another lady and a gentleman with whom she had been successively in service. The bodies of the three people were accordingly disinterred, one of them five months, another six months, and the third fourteen months after death. In all of them the external parts were not properly speaking putrid, but hard, cheesy, or adipocirous; in the last two the stomach and intestines were so entire as to allow of their being tied, taken out, cut up, and handled; and in one a sloughy spot was found in the region of the pylorus. Arsenic was detected in two of the bodies by Rose’s process of analysis.[791]

The next example to the same effect which will be mentioned is perhaps the most satisfactory of all, because it was the result of an express experiment on the human subject. Dr. Kelch of Königsberg buried the internal organs of a man who had died of arsenic, and whose body had remained without burial till the external parts had begun to decay; and on examining the stomach and intestines five months after, he found that the hamper in which they were contained was very rotten; but that “they had a peculiar smell, quite different from that of putrid bowels, were not yet acted on by putrefaction, but as fresh as when first taken from the body, and might have served to make preparations. They had lost nothing of their colour, glimmer, or firmness. The inflamed spots on the stomach had not disappeared, and the small intestines also showed in some places the inflammatory redness unaltered.”[792]

In a recent French case, although the degree of preservation was less remarkable, the other circumstances are so striking as to render it well worthy of notice. In this instance the body was disinterred after having been seven years in the ground, in a high situation and sandy soil. The coffin, which was of oak, had become dry and brittle, and no moisture appeared on the inside. The body was entire: the head, trunk, and limbs retained their situation; but the organs of the chest and belly were converted into a brown soft mass of the consistence of plaster, which lay on each side of the spine. In this mass MM. Ozanam and Idt, the medical inspectors, succeeded in discovering by chemical analysis a considerable quantity of arsenic.[793]

M. Ollivier describes another French case, where the body had been buried for three years, and was found so completely dried up that the trunk weighed only two pounds. The integuments were entire, dark-brown, and of a faint odour like decayed wood. The organs of the chest and belly were confounded together in a foliaceous membranous mass, in which the liver only could be distinguished, but in an exceedingly shrivelled state. Arsenic was detected in the membranous matter by MM. Barruel and Henri. The preservative power of the arsenic was promoted in this case by the sandy nature of the soil.[794]

In the case of the girl Warden, which has been several times alluded to, the internal organs were also preserved somewhat in the same manner as in the German cases. The body had been buried three weeks; yet the mucous coat of the stomach and intestines, except on its mere surface, was very firm, and all the morbid appearances were consequently quite distinct. Nay, three weeks after disinterment, except that the vascularity had disappeared, the membranes and the appearances in them remained in the same state.[795] A similar case has been recorded by Metzger. It is that of an old man who died of six hours’ illness, and in whose stomach three drachms of arsenic were found. The body had been kept ten days in February before burial, and was disinterred eight days after that; yet there was not the slightest sign of putrefaction any where.[796] A parallel case was described by myself in the Edinburgh Medico-Chirurgical Transactions;[797] and I have met with three others of the same kind since.

In a very important case, that of Mrs. Smith, which was made the subject of investigation at Bristol in December, 1834, the body was also found in a state of great preservation, modified, however, by adipocirous decomposition, owing to the presence of water in the coffin. The body had been fourteen months interred. The internal parts, especially of the head and neck, were here and there decayed somewhat or converted into adipocire, the muscles and internal organs entire, though more or less shrivelled, the alimentary tube remarkably preserved, “every part being almost as distinct as if the inspection had been made at a very short period after death,” “the mucous membrane sufficiently tenacious to be lifted by the forceps in as large flakes as usual;” and the reporters, Drs. Riley and Symonds, Messrs. Herapath and Kelson, seem to have had no difficulty in ascertaining the absence of vascularity, extravasation, or even abrasion of the inner membrane. Artificial orpiment, the preparation proved to have been given [see p. 225], was found in the stomach by Mr. Herapath, and the quantity appeared to be about half a drachm.[798]

A similar instance, very remarkable in all its circumstances, was investigated here in 1834 by my colleague Dr. Traill to whom I am indebted for the particulars. The master of a foreign vessel died in about twenty-four hours, apparently of malignant cholera, at a small port in the neighbourhood of Edinburgh: and the body was forthwith buried. A suspicion, however, having arisen in his native country that he had been poisoned by his mate, an inquiry was instituted at the request of the foreign government; and the body was disinterred five months after death. The face and neck was swollen, black, and decayed; but the rest of the body was quite free of the usual signs of putrefaction. The skin was white and firm, the muscles fresh, the lungs crepitating, the liver and spleen much shrivelled, the stomach and intestines entire throughout their whole tissues, and capable of being handled freely without injury. On the mucous coat of the stomach several dark patches of extravasation were found, likewise several spots and large patches which presented on their surface a firmly adhering bright yellow crust; and the contents of the stomach consisted of a considerable quantity of yellow sandy matter of the consistence of paste. The contents and adhering crusts were found to consist chiefly of oxide of arsenic partially converted into sulphuret. In this instance, as in that last described, the coffin contained water, owing to its having laid in a sandy soil resting on clay.

An important case of the same nature was communicated to me in 1843 by Mr. Sandell of Potton, Bedfordshire, and afterwards published by Mr. Hedly of Bedford. A man Dazley at Wrestlingford, affected with symptoms of gastro-enteric irritation for five or six days, was seized with sickness, vomiting, heat and constriction in the throat, and great weakness, about an hour after getting a white powder from his wife; and in eight hours he expired, without any suspicion of unfair usage arising at the time. Suspicions, however, being entertained afterwards, the body which had not been examined at first, was disinterred in five months, during the month of March. The countenance was so entire as to be recognisable. Adipocire had been formed in many places. The stomach and intestines were “in a most perfect state of preservation,” as if death had taken place only a few days previously. The stomach presented yellow patches on its outer and inner surface,—was generally red over its villous coat, which had also been abraded near the cardiac end,—and, together with the small intestines, was lined with white powder and contained more of it enveloped in much red mucus. This powder proved to be arsenic. About the middle of the small intestines a small ulcerated opening was found, through which some arsenic had escaped.[799]

The following cases which have come under my own notice during the last five years are also worthy of observation. In a case submitted to me on the part of the crown in 1841, which has been adverted to above for another purpose [p. 265], the body after being three months interred was found with the head and face decayed and putrid; but the muscular substance was little changed; and the inspectors were particularly struck with the state of preservation of the body, and also with the very distinct state of inflammation seen over almost the whole external and internal surfaces of the alimentary canal,—a description, the accuracy of which I had afterwards an opportunity of verifying. In the case of Mr. Gilmour (p. 265), whose body had been buried 101 days, the external parts were more decayed; but the alimentary canal appeared equally entire both to the original inspectors, Drs. M’Kinlay and Wylie, and likewise to myself three weeks later. But the following instance, in which I was consulted in 1839, is the most remarkable one of the kind that has hitherto occurred to me; because the observations then made were the result of an express experiment in a medico-legal investigation. The history of this case, which arose from small doses of arsenic frequently administered, has been already given above in some detail [p. 250]. Arsenic not having been detected in the contents or tissues of the stomach, and the trial of the individual suspected of giving the poison being necessarily postponed for some months, I recommended that a third examination of the body,—for it had been twice disinterred for inspection within ten days after death,—should be made at as distant an interval as possible, in order to ascertain whether it underwent preservation from decay. It was accordingly disinterred again, five months after death. It had an ammoniacal, but not a putrid odour. The skin was here and there covered with a thin sebaceous matter, at one or two places stripped of the epidermis, but for the most part natural in appearance, firm, and elastic. The nails were loose. The muscles of the head and near the tops of the scapulæ were adipocirous, on the chest and abdomen obscurely fibrous in texture and hardened, but elsewhere unaltered, and “in the lower extremities so perfect that they might have been used for an anatomical demonstration.” The liver and lungs were also in a state of good preservation, and the latter crepitated when cut. The other viscera had been removed at the previous examinations.

It may be added that the experiments of Klanck on dogs adverted to above have been more recently repeated by Hünefeld on rabbits and mice, with precisely the same results. The animals were sometimes left in the air, at other times buried, and generally in a moist place. In every instance putrefaction made more or less progress at first; but in a few days a peculiar garlicky odour arose, from which time the progress of decay seemed to be arrested; and the bodies underwent a process of hardening and desiccation which completely preserved them.[800]

On considering attentively the illustrations now given, the toxicologist can hardly doubt that in some cases arsenic has appeared both to retard and to modify putrefaction in the bodies of persons poisoned with it.

Assuming arsenic to have been the cause of the preservation of the bodies, it becomes a point of consequence to account for its effect, and more particularly to reconcile that effect with what has certainly been noticed in other cases of poisoning with the same substance, namely, ordinary rapidity of decay, if not actually an increased tendency to putrefaction.

At the outset of this part of the inquiry some light may be thrown upon it by separating the local from the general operation of arsenic.

Arsenic is a good preservative of animal textures when it is directly applied to them in sufficient quantity. This is well known to stuffers of birds and beasts, was experimentally ascertained by Guyton Morveau,[801] and has come also under my observation.[802] It is now likewise known to be an excellent substance for preserving bodies, when injected in the form of solution into the blood-vessels.

Hence, if in a case of poisoning the arsenic be not discharged by vomiting, and the patient die soon, it will act as an antiseptic on the stomach at least, perhaps on the intestines also; while the rest of the body may decay in the usual manner. This is very well shown in a case examined by Dr. Borges, medical inspector at Minden, fourteen weeks after death. The stomach and intestines were firm, of a grayish-white colour, and contained crumbs of bread, while all the other organs in the belly were pulpy, and the external parts adipocirous.[803] It is also equally well exemplified in a case that happened at Chemnitz so early as 1726, and which was examined five weeks after burial. The skin was every where very putrid, but the stomach and intestines were perfectly fresh.[804] In the case of Warden the appearances were precisely the same. Three weeks after burial the Dundee inspectors found the external parts much decayed, yet three weeks later the stomach and intestines were found by myself in a state of almost perfect preservation. A striking experiment performed by Dr. Borges on a rabbit will likewise illustrate clearly the fact now under consideration. The rabbit was killed in less than a day with ten grains of arsenic, and its body was buried for thirteen months in a moist place under the eaves of a house. At the end of this period it was found, that “the skin, muscles, cellular tissue, ligaments and all the viscera, except the alimentary canal, had disappeared, without leaving a trace; but the alimentary canal from the throat to the anus, along with the hair and the bare bones, was quite entire.”[805]

In all of these cases arsenic was found in the body. In the rabbit experimented on by Dr. Borges, above five grains of arsenic were separated in the form of a metallic sublimate.

But, on the contrary, if the arsenic is all or nearly all discharged by vomiting, not only the body generally, but likewise even the stomach and intestines, may follow the usual course of decay. Accordingly, in the case of the child formerly quoted (273), where the body putrified in the usual manner, only four grains and a half of arsenic had been taken; and as it was swallowed in a state of solution and caused violent vomiting, it must have been almost all ejected. Nay, in such circumstances, the alimentary canal, in consequence of its unnatural supply of moisture and incipient disorganization, may decay somewhat faster than other parts. Thus Dr. Murray observed in the case of a man formerly mentioned (264), who lived under violent gastritic symptoms for seven days, and vomited much, that the stomach, which was removed for more minute examination, decayed so rapidly that in twenty-four hours an examination was impracticable, while the body in general rather resisted putrefaction.[806]

The preceding statements on the differences in the state of preservation of the body after poisoning with arsenic are not then incapable of some explanation. Nevertheless, it must be granted that the reasons assigned will not account for all the apparent cases of the preservative powers of arsenic. And especially they will not explain how the whole body has sometimes resisted decay altogether, and become as it were mummified. It is impossible to ascribe this preservation to the spelling power of the arsenic diffused throughout the body in the blood; the quantity there being extremely small. Consequently if the preservation of the bodies is not occasioned by some accidental collateral cause (a mode of accounting for the phenomena which seems inadmissible), this property of arsenic must depend on its causing, by some operation on the living body, a different disposition and affinity among the ultimate elements of organized matter, and so altering the operation of physical laws on it. There appears no sound reason for rejecting this supposition, especially as it is necessary to admit an analogous change of affinities as the only mode of accounting for a still more incomprehensible violation of the ordinary laws of nature,—the spontaneous combustion, or preternatural combustibility, of the human body.

The following judicious observations by Harles on this subject are worthy of attention:—“In regard,” says he, “to this singular property of arsenic, now no longer doubtful, it should be remembered that certain circumstances will limit or impair it, while others will favour or increase it;—circumstances, for example, connected with the soil of the burying-ground, or the air of the vaults where the bodies are deposited. Different soils and different conditions of the air will materially affect the decomposition of all bodies indiscriminately, and will therefore affect likewise the antiseptic properties of arsenic. For it would be absurd to ascribe to arsenic the power of preventing putrefaction in all circumstances whatsoever,—a power which those who make use of it for preserving skins know very well it does not possess, and a power possessed by no antiseptic whatever, not even by alcohol.”[807]

An important consequence of the preservative tendency of arsenic is, that in many instances the body in this kind of poisoning may be found long after death in so perfect a state as to admit of an accurate medico-legal inspection and a successful chemical analysis. In one of his cases Dr. Bachmann detected arsenic in the stomach fourteen months after interment; Dr. Borges had no difficulty in detecting it in an animal after thirteen months; Mr. Herapath discovered it after fourteen months in the human body; M. Henry detected it after three years and a half, and obtained no less than seven grains of metallic arsenic from the shrivelled viscera;[808] and MM. Ozanam and Idt found it after the long interval of seven years.—The late experiments of Orfila and Lesueur confirm the fact that arsenic may remain long in contact with decaying animal matter, and yet continue in such a state as to be easily detected.[809] It might be supposed that the poison would pass off partly in the gaseous state by being converted into arseniuretted-hydrogen, partly in the liquid state by becoming arsenite of ammonia, a very soluble compound. But the fact nevertheless is, that, notwithstanding these reasons for its disappearance, it may be detected after the lapse of several years.

Under the head of the diseased appearances left by arsenic in the dead body, every change of structure has now been described which has been mentioned by authors and supported by trustworthy statements. Another set of appearances may still be noticed; but they are here separated from the rest, because the author who first notices them has not been supported in the statement by any special observations of his own, or by an adequate number of facts observed by others. In an elaborate essay on a case of poisoning by Professor Seiler of Wittemberg, it is said in general terms that arsenic may cause gorging of the vessels of the brain, effusion of serum into the ventricles, inflammation of the brain, and even extravasation of blood.[810] Turgescence of vessels is mentioned in several published cases, and I have myself met with it. But it is seldom so considerable as to attract attention. In the following instance, however, which has been related by Dr. Hofer of Biberach the evidence of cerebral congestion was unequivocal. A man addicted to intoxication, but enjoying good health otherwise, was attacked after supper with sickness, vomiting, and pain in the belly. On going to bed he fell soon quiet; and six hours after he took ill, he was found dead. Arsenic was detected in the stomach, and in what he vomited; and considerable redness was seen on the villous coat of the stomach. But the most remarkable appearances were gorging of the cerebral vessels, adhesion of the dura mater to the membranes beneath, and the effusion of eight ounces of serosity into the lateral ventricles.[811] The only instance I am acquainted with to justify the opinion that extravasation of blood into the brain may occur from poisoning with arsenic, is the remarkable case of apparent death from eating poultry poisoned with arsenic, which was communicated to me by Mr. Jamieson of Aberdeen. The individual, after suffering under the usual primary symptoms, became apoplectic after a fit of sneezing, and died three days afterwards; and in the dead body, besides other signs of disease in the brain, a recent clot of blood was found in the right anterior lobe. (See p. 69.)

It is quite unnecessary to notice lividity of the skin among the signs of poisoning with arsenic, except for the mere purpose of reminding the medical jurist that, although it has been sometimes much relied on as a sign of death from arsenic, it is not of the slightest importance as a sign either of that or of any other kind of poisoning. (See p. 51.)

The action of arsenic on the alimentary canal after death will now require a few remarks; the purpose of which is to prepare the medical inspector for investigating attempts to impute the crime of poisoning to innocent persons, by introducing arsenic into the dead body. Such attempts, according to Orfila, have been made; but I am not acquainted with any actual instance.

The action of arsenic on dead intestine has been fully examined by the last mentioned author. If it is introduced into the anus immediately after death, and allowed to remain there twenty-four hours, the mucous membrane in contact with it becomes of a lively red colour, with darker interspersed patches as if from extravasation. The other coats are natural; and so is the mucous membrane itself wherever the poison does not actually touch it. Consequently the margin of the coloration is abrupt and well defined. When the arsenic is not introduced till twenty-four hours after death, the part to which it is actually applied presents dark patches, while the rest of the membrane is quite healthy.[812]

The appearance of redness in the former case is probably the result of lingering vitality. The cause of the dark appearance in the latter it is not easy to comprehend.

When arsenic has been applied, during life, the redness, if it has had time to begin at all, extends to some distance from the points with which the poison has been in contact, and passes by degrees into the healthy colour of the surrounding membrane.

On reviewing what has been said of the pathological appearances caused by arsenic, it must appear that the medical jurist can never be supplied from this source alone with satisfactory evidence of the cause of death. But in some circumstances the evidence may amount to a strong probability of one variety or another of irritant poisoning. Mere redness, conjoined or not with softening of the mucous membrane, may justify suspicion only. But if there should be found in the body of a person who has died of a few days’ illness, redness, black warty extravasation, and circumscribed ulcers of the villous coat of the stomach,—effusion of blood or bloody clots among the contents of that organ,—also redness of the intestines, more especially redness and ulceration of the colon and rectum,—and redness of the pharynx, or of this along with the gullet,—the proof of poisoning with some irritant will amount to a strong presumption. At least it is difficult to mention any natural disease which could produce in so short a time such a conjunction of appearances as this; which arsenic and other analogous poisons sometimes occasion.