THE LIBRARY
OF
THE UNIVERSITY
OF CALIFORNIA
LOS ANGELES
OV he last date stamped '
UNlVBRfTT of CALIFORNIA
t I
LOS ANGELES
LIBRARY
TEXT-BOOK
OF
MEDICAL JURISPRUDENCE
AND
TOXICOLOGY.
By JOHN J. REESE, M.D.,
PROFESSOR OF MEDICAL JURISPRUDENCE AND TOXICOLOGY IN THE UNIVERSITY OF
PENNSYLVANIA; VICE-PRESIDENT OF THE MEDICAL JURISPRUDENCE SOCIETY OF
PHILADELPHIA; PHYSICIAN TO ST. JOSEPH'S HOSPITAL; MEMBER
OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA;
CORRESPONDING MEMEER OF THE NEW
YORK MEDICO-LEGAL SOCIETY.
PHILADELPHIA :
P. BLAKISTON, SON & CO. :
IOI2 WALNUT STREET,
1884.
317
Entered, according to Act of Congress, in the year 1SS4. by
P. BLAKISTOX, SOX & CO..
in the Office of the Librarian of Congress, at Washington, D. C.
• l J7
w
loo
PREFACE
This Text-book has been written more particularly to
meet the wants of students of Legal Medicine. The author
is aware that the field has already been occupied by able
and popular treatises on medical jurisprudence, well known
to the professions of medicine and law ; but an experience
of over twenty years, as a public teacher of this branch of
science, has convinced him that students in both these
professions, who desire to acquire a knowledge of medical
jurisprudence, are too often deterred from their purpose by
being confronted by the ponderous works of recognized
masters, extending to three, and even six large octavo
volumes.
To avoid the above objection, the author of the present
work has endeavored to condense in a handy volume all
the essentials of the science, and to present the various
topics in a simple and familiar style, giving greater promi-
nence, of course, to those of the greatest practical im-
portance.
The subject of Toxicology occupies, as was proper, a
considerable space, and has been carefully prepared; special
attention being bestowed upon the most important poisons —
such as Arsenic, Strychnine, Opium, Prussic Acid, etc.
The chapter on Insanity is as full as the size of the
volume would justify, and will be found, it is hoped, to
iii
iv PREFACE.
contain all the essential medico-legal points pertaining to
this subject.
The author has not hesitated to avail himself freely of
the materials so abundantly presented in the elaborate and
classic works of Casper, Taylor, Beck, Wharton and Stille,
Tidy, Guy, Tardieu, and others ; always desiring to give
due credit to the authority quoted, and usually doing so at
the time ; and he would embrace this opportunity to
express his obligations to these authorities. He is sincerely
desirous to encourage an increasing interest in the students
of both medicine and law for that most important, but too-
much neglected, subject — Forensic Medicine; and he would
indulge the hope that the present treatise, in its unpre-
tentious size and style, may aid in so doing.
Philadelphia, September, iSSj..
TABLE OF CONTENTS.
CHAPTER I.
Introduction. PAGE
Definition. — Importance to Students of Medicine and Law. — Order of
Proceeding in a Medico-legal Case. — The Coroner's Inquest. — The
Criminal Court. — Medical Evidence. — Medical Experts. — Dying
Declarations. ............ 9
CHAPTER II.
Phenomena and Signs of Death.
Section I. — Molecular and Somatic Death. — The Immediate Cause of
Death to be found in either the Heart, Lungs or Brain. — Post-mortem
Evidences of these. — The "Signs of Death." — Cessation of Respiration
and Circulation. — Changes in the Eyes. — Pallor of the Body. . . -25
Section II. — Signs of Death continued. — Loss of Animal Heat. — Post-
mortem Caloricity. — Rigor Mortis. — Post-mortem Lividity, or Suggillation 32
Section III. — Signs of Death continued. — Putrefaction. — External and
Internal Signs. — Adipocere. — Mummification. — How long since the
Death? 41
CHAPTER III.
Medico-legal Investigations. — The Post-mortem.
Responsibility involved. — Accuracy and Method necessary. — Examination
of the surroundings. — External examination of the Body. — Internal ex-
amination. — Details of the Examination. — Measurements and Weights.—
Notes 56
CHAPTER IV.
Presumption of Death and of Survivorship.
Cases involving Presumption of Death and of Survivorship. — French Law
of Survivorship. — Probabilities afforded by Age, Sex, and Mode of Death. 65
CHAPTER V.
Personal Identity.
Section I. — Important Medico-legal bearings. — I. Identification of the
Living. — Personal Appearance. — Peculiar bodily marks. — Remarkable
Cases 69
VI TABLE OF CONTEXTS.
PAGE
Section II. — II. Identification of the Dead. — Mutilated Remains. — Identi-
fication by means of the Skeleton, as to Age, Sex, and Stature. — Rules of
Proportion. — Fractures, Deformities, and Callus. — Age of Bones. — Ex
amination of Hairs and Fibres 76
CHAPTER VI.
The Causes Producing Violent Death.
Section I. — Death from Wounds. — Definition of a Wound. — Danger of. —
Examination of the Body. — Absence of external marks of violence. —
Wounds made before and after death. — Hemorrhage. — Ecchymoses. —
Classification. — Homicidal, Suicidal and Accidental Wounds. . . .92
Section II. — Gunshot Wounds. — Differ from other wounds. — Deflection
of the Ball. — Wounds made by Shot, Wadding and Powder. — Wounds of
the Head, Xeck, Spine, Chest and Abdomen 107
CHAPTER VII.
Examination of Blood Stains.
Importance of their identification. — Three methods of identifying. — 1. The
Chemical Tests. — 2. The Microscopic Test. — 3. The Spectroscopic Test.
—Blood Crystals 121
CHAPTER VIII.
Burns and Scalds.
Definition. — Classification. — Symptoms. — Cause of Death. — Post-mortem
appearances. — Burns made before and after death. — Accidental, Suicidal
and Homicidal Burns. — Spontaneous Combustion. . . . . . 134
CHAPTER IX.
Death from Different Forms of Asphyxia.
Section I. — Death from Suffocation. — Accidental, Suicidal and Homicidal
Suffocation. — Post-mortem signs, 143
Section II. — Death by Strangulation. — Modes of Strangulation. — External
signs. — Internal lesions. — Accidental, Suicidal and Homicidal Strangu-
lation. — Mark of the Cord, ......... 146
Section III. — Death by Hanging. — Cause of Death. — Post-mortem appear-
ances. — Cord marks. — Generally suicidal, . . . . . . 151
Section IV. — Death by Drowning. — Mode of Death. — Time required. —
Signs of Death, external and internal. — Accidental, Suicidal and Homi-
cidal Drowning, . . . . . . . . . . .156
CHAPTER X.
Death by Lightning.
Medico-legal relations. — Mode of Death. — Post-mortem signs, . . . 166
TABLE OF CONTENTS. Vll
PAGE
CHAPTER XI.
Death from Heat and Cold.
Diverse effects of Heat upon the body. — Postmortem appearances. —
Effects of Cold. — Post mortem signs, 170
CHAPTER XII.
Death by Starvation.
Accidental, Homicidal and Suicidal Starvation. — Pretended cases of volun-
tary starvation. — Symptoms, and Post-mortem signs. — Medico-legal rela-
tions, 175
CHAPTER XIII.
Death from Poisoning. — Toxicology.
Section I. — Definition of a Poison. — Effects. — Proofs of Absorption. —
Subsequent disposition of the Poison. — Elimination. — Cause of Death. —
Circumstances modifying their action. — Antagonism of Poisons, . .178
Section II. — Evidences of Poisoning. — 1. Evidences from Symptoms. — 2.
From post-mortem lesions. — 3. Chemical Analysis. — Post-mortem Imbi-
bition of Poisons. — Rules in performing a toxicological analysis. — 4.
Physiological experiments. — 5. Circumstantial Evidence. — Medico-legal
conclusions. — Classification, . . . . . . . . .186
CHAPTER XIV.
Poisoning by the Mineral Acids.
Certain common symptoms. — Post-mortem appearances. — Treatment. —
Chemical analysis. — Toxicological examination for the different Acids, 202
CHAPTER XV.
Poisoning by the Alkalies and their Salts.
Section I. — Potassa, Soda, and Ammonia. — Similarity of effects. — Symp-
toms. — Fatal Dose. — Treatment. — Post-mortem appearances. — Chemical
analysis. ............ 215
Section II. — Poisoning by the Alkaline and Earthy Salts. — Nitrate of
Potassium. — Bitartrate of Potassium. — Sulphate of Potassium. — Alum. —
Chlorinated Potassium and Sodium. — Salts of Barium. .... 220
CHAPTER XVI.
Irritants Possessing Remote Specific Properties.
Section I. — Poisoning by Phosphorus. — Symptoms. — Fatal Dose. — Treat-
ment. — Morbid appearances. — Diagnosis. — Chemical analysis. — Amor-
phous Phosphorus. ........... 224
Section II. — Poisoning by Iodine, Bromine, and Chlorine. . . . 234
Vlll TABLE OF CONTENTS.
PAGE
CHAPTER XVII.
Poisoning by Arsenic.
Metallic Arsenic. — Arsenious Acid. — Properties. — Symptoms. — Chronic
Poisoning. — Fatal Dose. — Treatment. — Post-mortem signs. — Chemical
analysis. — Toxicological examination. — Other Preparations of Arsenic. . 238
CHAPTER XVIII.
Poisoning by Antimony (Tartar Emetic).
Properties of Tartar Emetic. — Symptoms. — Fatal Dose. — Post-mortem ap-
pearances. — Slow Poisoning. — Chemical analysis. — Toxicological exami-
nation - 262
CHAPTER XIX.
Poisoning by Mercury (Corrosive Sublimate).
Corrosive Sublimate. — Properties. — Symptoms. — Post-mortem appearances.
— Fatal Dose. — Antidotes. — Chemical analysis. — Toxicological examina-
tion. — Salivation 273
CHAPTER XX.
Poisoning by Lead.
Frequency of Chronic Poisoning. — Acetate of Lead. — Symptoms. — Treat-
ment. — Post-mortem appearances. — Painters' Colic. — Lead Palsy. — Toxi-
cological examination. .......... 285
CHAPTER XXI.
Poisoning by Copper.
Accidental Poisoning. — Salts of Copper. — Fatal Dose. — Treatment. — Morbid
appearances. — Chemical analysis. — Toxicological examination. . . 294
CHAPTER XXII.
Poisoning by Zinc, Bismuth, Tin, Iron and Chromium.
Section I. — Poisoning by Zinc. 301
Section II. — Poisoning by Bismuth 305
on III. — Poisoning by Tin, Iron and Chromium 306
CHAPTER XXIII.
Vegetable and Animal Irritants.
Section I. — Poisoning by Oxalic Acid.— Sources of the Acid in Nature. —
Symptoms. — Fatal Dose. — Treatment. — Morbid appearances. — Chemical
analysis. — Toxicological examination. — Binoxalate of Potassium. . . 308
Section II. — Poisoning by Carbolic Acid. 315
TABLE OF CONTENTS. X
PAGE
Section III. — Poisoning by Croton Oil, Elaterium, Castor Oil Beans,
Colchicum and Savin 317
Section IV. — Poisoning by the Hellebores. — Veratria. — Yellow Jessamine.
— Poisonous Mushrooms. 320
CHAPTER XXIV.
Animal Irritants.
Poisoning by Cantharides. — Poisonous Animal Food. — Sausage Poison. —
Trichinosis. — Cheese Poison. — Poisonous Fish. — Putrescent Food. — Pois-
oned Flesh 325
CHAPTER XXV.
Class II. Neurotic Poisons.
Section I. — Narcotics. — Poisoning by Opium. — Nature of Opium. — Pois-
onous Symptoms. — Fatal Period and Dose. — Treatment. — Morphia. —
Properties. — Tests. — Meconic Acid. — Tests. — Toxicological examination. 330
Section II. — Poisoning by Alcohol. — Acute Alcoholism. — Symptoms. —
Post-mortem lesions. — Chemical analysis. — Detection in the Tissues. . 341
CHAPTER XXVI.
2. Anaesthetics.
Poisoning by Ether, Chloroform, and Chloral Hydrate. .... 345
CHAPTER XXVII.
Spinal Neurotics. — Poisoning by Nux Vomica. — Strychnia.
Nux Vomica. — Strychnia. — Effects. — Fatal Dose. — Treatment. — Post-mor-
tem lesions. — Diagnosis. — Chemical analysis. — Interferences. — Physio-
logical Test. — Toxicological examination. 351
CHAPTER XXVIII.
Cerebro-spinal Neurotics. — (1) Deliriants.
Section I. — Poisoning by Belladonna.— Symptoms. — Atropia. — Fatal Dose.
— Treatment. — Post-mortem appearances. — Chemical analysis. — Toxico-
logical examination. .......... 373
Section II. — Poisoning by Stramonium, Hyoscyamus and Solanum. . . 376
CHAPTER XXIX.
2. Depressants.
Section I. — Poisoning by Tobacco and Lobelia. — Effects of Tobacco. —
Post-mortem lesions. — Nicotina. — Properties. — Chemical reactions. —
Toxicological examination. — Lobelia 380
X TABLE OF CONTENTS.
PAGE
Section II. — Poisoning by Hemlock — Conia. — Symptoms. — Post-mortem
appearances. — Conia. — Chemical reactions. — Toxicological examination.
— Other poisonous Hemlocks. 3S6
Section III. — Poisoning by Aconite and Calabar Bean. — Properties of the
Plant. — Effects. — Post-mortem appearances. — Aconitine. — Fatal Dose.
— Treatment. — Chemical analysis. — Toxicological examination. — Calabar
Bean. — Eserine. ........... 390
CHAPTER XXX.
(3) Asthenics.
Section I. — Poisoning by Hydrocyanic Acid. — Natural Occurrence in
Vegetables. — Pure and Officinal Acids. — Symptoms. — Fatal Period ai 1
Dose. — Treatment. — Post-mortem appearances. — Tests. — Toxicological
examination. — Cyanide of Potassium. — Oil of Bitter Almonds. — Cherry-
laurel Water. — Xitro-Benzole. 397
Section II. — Poisoning by Digitalis. — Symptoms. — Post-mortem lesions.
— Fatal Dose. — Digitaline. — Chemical analysis. — Toxicological exami-
nation. — Case of De la Pomerais. — Poisoning by Cocculus Indicus. . . 409
CHAPTER XXXI.
The Alkaloids of Putrefaction. — Ptomaines.
ur"
^es v.-he:
. "- ■ .icert
nr . jjead,
aninal Abort.^n, or !•;.
Definition. — Frc rUency of Abortion from Natural
Fcetus has been desf^yed. — Signs afforded by
F<:etus. — Means < ;d,
-permit -
i.u.ant. — Was it born alive ?■
a Live Birth ' ' Lungs. — The
TEXT-BOOK
MEDICAL JURISPRUDENCE
AND
TOXICOLOGY.
CHAPTER I.
DEFINITION. — IMPORTANCE TO STUDENTS OF MEDICINE AND LAW.—
ORDER OF PROCEEDING IN A MEDICO-LEGAL C\SE. — THE CORO-
NER'S INQUEST. — THE CRIMINAL COURT. — MEDICAL EVIDENCE.—
MEDICAL EXPERTS. — DYING DECLARATIONS.
Medical Jurisprudence, or Legal or Forensic Medicine,
as it is sometimes named, may be defined to be the science
which applies the knowledge of Medicine to the require-
ments of Law. To aid in the discovery of truth, which is
the great purpose of the Law, every department of human
knowledge should be made to contribute, and Medicine
among the rest. When certain cases are presented for legal
decision, affecting the life or property of an individual,
and these cases require for their proper elucidation an
appeal to medical knowledge, they are termed medico-legal
cases, and the science on which they are based is named
Medical Jurisprudence.
It should require no argument to show the importance
of the knowledge of this science to the student and prac-
titioner of both the professions of medicine and law. The
former cannot entirely evade its claims, although he may
9
10 MEDICAL JURISPRUDENCE.
seek to do so, since the very nature of his profession,
together with his assumed public position as an accredited
physician, renders him liable at any moment to be con-
fronted with a case involving the intricate questions of
homicidal, suicidal, or accidental death ; of infanticide ;
of criminal abortion; of rape ; of drowning, and of numer-
ous other similar cases, all of which, when they become
the subjects of legal investigation, must necessarily depend
for their proper elucidation, chiefly, if not solely, upon the
physician who had previously given his professional at-
tendance in the case, and who must subsequently give his
evidence before the court and jury. How important, then,
that the practitioner of medicine, even though he may have
no special leaning towards legal medicine, should become
acquainted at least with the general principles and leading
facts of this science. A proper regard, both for his own
professional reputation and the general interests of the
community, should constrain him not to neglect so import-
ant and practical a branch of knowledge. And as regards
the profession of the law, it is difficult to understand how
a criminal cause of any kind can be satisfactorily conducted
without some knowledge o( medical jurisprudence, inas-
much as criminal law is indissolubly connected with legal
medicine. It is much to be regretted that many of the
present generation of lawyers in this country, graduate in
their profession without the slightest knowledge of medical
jurisprudence. Indeed, strange as it may appear, it is
entirely ignored in some of our law schools, whilst in
others, although professedly taught, it is not made obliga-
tory upon the student, and therefore is virtually disregarded.
The consequence of such neglect must be either, that
criminal law is entirely abandoned by many distinguished
practitioners, causing such cases to fall into the hands of
RELATION OF MEDICINE TO LAW. 11
inferior persons, who are not always the best qualified to
conduct them ; or else, when a really important criminal
case is undertaken, the lawyer finds himself compelled to
cram for the occasion, and is subjected to no little annoy-
ance, and loss of time, in preparing for the impending trial.
In truth, in such cases he is necessarily obliged to depend
almost exclusively upon his medical witnesses, both as to the
general mode of developing his case, and especially as to the
manner of questioning the expert witnesses on either side.
The superficial observer is often surprised at the intimate
relationship subsisting between the two great sciences of
medicine and law. As has just been shown, numerous
cases brought before a court and jury can only be settled
by an appeal to medical knowledge ; sometimes it is to one
department of medicine, and sometimes to another ; and it
not infrequently happens that several branches of medical
science may be simultaneously called into requisition, in
order to aid the law in arriving at a proper decision. For ex-
ample, — is the case one of suspected homicide, where a dead
body has been discovered under suspicious circumstances ?
Who but the skillful anatomist and pathologist, by a carefully
conducted autopsy, can shed the requisite light upon it ? Is
it a case of alleged rape, or criminal abortion, or infanticide?
Who so well qualified to conduct the investigation as the
well trained obstetrician ? Or is it a case involving the dark
suspicion of criminal poisoning ? Who shall impart the
necessary information upon which may hang suspended
the life or death of the accused, save he who is thoroughly
acquainted with the mysteries of toxicology ? Thus it may
happen that, in a multitude of cases, the well instructed prac-
titioner of medicine, when called upon to act the part of the
legal physician, may be obliged to bring into requisition all
the various departments of his science.
12 MEDICAL JURISPRUDENCE.
It is, perhaps, as a medical witness, that medico-legal
knowledge is of the most important service to the physician.
After he has accomplished the investigation of the case be-
fore him by a carefully conducted autopsy, or by a critical
toxicological examination, with perhaps the aid of micros-
copy, and by other methods of scientific research, there yet
remains the all-essential duty of giving the results of his
investigations to the court and jury, in the form of evidence;
and to be prepared to do this in the proper manner, consti-
tutes the chief acquirement of the medical jurist.
The Coroner s Inquest. — The first public duty imposed
upon the legal physician is to testify before the Coroner's
Inquest. In all civilized countries a special officer, named
the coroner, is appointed to investigate the unknown, or
unexplained causes of sudden death, whenever this occurs
under suspicious circumstances. For example, a dead body
is discovered on the highway or in some sequestered spot,
with, or without marks of external violence, or it may have
been dragged out of the river; the body of a new-born
child has been found in a well or cesspool, or discovered
floating in the water; a stranger is discovered, in the morn-
ing, dead in bed, at some hotel, far distant from his home;
or a person in apparent sound health suddenly drops dead
in the street, or in his room. In all these, and analo-
gous cases, the law very wisely provides that a careful in-
vestigation shall be instituted, so as to ascertain whether the
death was due to natural causes, or whether it was the re-
sult of violence. If the latter, then the nature of this vio-
lence, e.g. whether from a wound (gunshot or otherwise),
a bludgeon, an axe, hammer, or other blunt weapon; or
whether occasioned by a fall. In the absence of all external
marks of violence, — then, might the death not have been pro-
THE CORONER'S INQUEST. 13
duced by poison ? In each one of these cases, the farther
question must be solved — was the death homicidal, suicidal,
or accidental ?
The coroner's jury usually consists of six men (the
number is not definitely fixed in this country), who are
mostly selected from the neighborhood where the inquest
is held. Their duty consists in (i) viewing the body and
establishing its identity, and (2) in holding the inquest,
which is a sort of petty court, wherein inquiry is made as
to the cause of death, and (in a case of homicide) to ascertain,
if possible, the guilty culprit. For this purpose, witnesses
duly subpoenaed and sworn are examined, and the medical
man who has performed the post-mortem examination
(whether he be the coroner's recognized physician, or some
other who has been specially appointed for this purpose)
now makes his detailed report, and gives his opinion as to
the real cause of death. The jury having heard the evi-
dence, and consulted together, bring in their verdict, which
is usually in accordance with the report of the medical
officer. In some cases, particularly in cities, where the
coroner has one or more specially appointed physicians, it
is not considered necessary that the jury should personally
view the body before holding the inquest ; it being regarded
as sufficient that the body has been properly identified by
the examining physician, and the autopsy carefully made,
and the result duly reported.
It will be observed that the special duty of the coroner's
inquest is to discover the real cause of death; usually it
does not fall within his province to discover the person who
caused it. Nevertheless, it does sometimes happen that in
the course of the investigation, suspicion may so strongly
point to some particular individual, as to warrant the
coroner to commit him to prison, to await further investiga-
14 MEDICAL JURISPRUDENCE.
tion. The usual verdict in cases of violent death (shown
to have been neither suicidal nor accidental) is, that of
murder, or manslaughter, against some person, known or
unknown.
As the post-mortem examination is an inseparable part
of the coroner's inquiry, and, in fact, constitutes its most
important factor, it is indispensable that it should be per-
formed in the most careful and thorough manner; and no
one is fit to undertake it but a skilled anatomist and
pathologist. The medical man should never permit himself
to be hurried in this work ; he should allow himself ample
time, and always perform the autopsy by daylight, if pos-
sible, inasmuch as he might fail to distinguish certain alter-
ations of color by artificial light. When it is remembered
that the most serious issues may be at stake — even those of
life and death — it will be acknowledged that the utmost
caution should be exercised in conducting the autopsy.
There may be cases, involving strong suspicion of murder,
where it might be deemed advisable that the post-mortem
examination should be performed by two independent ex-
perts, in order to avoid the imputation of ex parte influence.
One of these medical examiners should represent the State,
and the other the accused.
In giving his evidence before the coroner's jury the medi-
cal man should not undervalue the situation. Although
the inquest be held in some remote hovel or barn, and the
jury be composed of rude, illiterate persons, he should not
fail to remember that his testimony is all taken down by
the proper officer, and that it will surely confront him at
the approaching trial. This fact should alone be sufficient
to impress upon him the seriousness of the occasion, and
remind him of the importance of drawing up his report with
due care and accuracy.
MEDICAL EVIDENXE. 15
The Criminal Court. — After the coroner's inquest the
case (if a criminal one) is sent to the Grand Jury, who
institute a preliminary examination, and either ignore it al-
together, or else find a true bill. In the latter event, the case
next comes before the judge and petty jury, for trial. To
this trial the medical witness is summoned by a subpoena,
which he cannot evade, but which it is his duty to obey.
Before this court and jury, he will undergo a most strict and
impartial examination as to his opinion of the cause of death,
and the reasons on which this opinion is founded. He will
be questioned most closely, in the cross-examination, as to
his professional knowledge and acquirements, the extent of
his opportunities for making such investigations as the one
now pending, the accuracy of his post-mortem, or toxico-
logical examination, the modes of distinguishing between
wounds made before and after death, the method of dis-
criminating between the effects of poisons and of disease, the
danger of confounding these latter together, the liability to
mistake in chemical results, and a hundred other matters,
which will annoy and confuse the medical witness to no
small degree, unless he be prepared beforehand, by his
thorough medico-legal knowledge and training. A medical
witness so properly fortified, need have no fear for himself; for,
as he goes upon the stand honestly, to testify to the truth,
" he need only," in the language of the late Professor Tay-
lor, "bear in mind two considerations: first, that he should
be thoroughly prepared on all points of the subject on
which he is to give evidence; and secondly, that his de-
meanor should be that of an educated gentleman, and suited
to the serious occasion on which he appears."
In the matter of Medical Evidence there are several points
that require a brief notice here. After opening the case
before the court, the prosecuting attorney, or some one
]•; MEDICAL JURISPRUDE
associated with him in the prosecution, calls the witnesses
and examines them "according to the rules of evidence;"
this is technically called the examination in chief. The
" rules of evidence " prohibit counsel, in the examination in
chief, from putting leading questions to the witness, i. c.,
questions that suggest their own answers; and for the reason
that the witness may be supposed to be willing to say any-
thing favorable suggested to him by his own counsel, and
to repress anything unfavorable. The replies of the witness,
however, should always be given with equal clearness and
precision, to both the counsel for the defence, and for tlve
prosecution.
The cross-examination next follows : this is conducted by
the counsel for the prisoner, and is especially aimed at contra-
dicting and overthrowing, if possible, the witness's previous
testimony. To this end, the counsel plies the witness with
questions which are strongly " leading," and such as may
most strongly suggest any facts or circumstances which
he had previously withheld, and which may appear favorable
to his client. A counsel for the defence is allowed very
considerable latitude in the cross-examination of the witness,
and the latter should always be well prepared to meet the
attack, with conscious strength, and calm and dignified com-
posure. If, however, the advocate transcends, as he is some-
times tempted to do, the bounds of propriety and decorum,
the witness has always the right to appeal to the court for
protection. It is far preferable to adopt the latter course,
than to attempt to argue, or recriminate with counsel, since
the latter has the witness always at disadvantage on the stand.
The rc-cxamination sometimes follows the cross-exam-
ination of the witness, when it becomes necessary to clear
up, or explain any matter that may have been obscured by
the cross-examination.
EXPERTS. 17
After the examination of the State's witnesses, that of the
witnesses for the defence follows. And here the same
general line of examination is pursued as in the former
case. When the medical witness for the defence is put upon
the stand, a most unpleasant exhibition is, not unfrequently,
made, of one expert directly contradicting another expert
on the opposite side, and both of them medical men of
equal standing and worth in the profession, and in the com-
munity. Such professional tilting is sometimes sneeringly
designated as the "war of the experts," and is certainly
deeply to be regretted, as it tends greatly to prejudice
both the court and the public against expert testimony in
general; and this, of course, to the detriment of justice.
It is proper to clearly understand the difference between
an ordinary witness, and an expert witness. The former
testifies only to facts which he has seen, or heard, or learned
from personal observation. The " expert" or skilled witness
(expert us) does not necessarily testify to facts, but gives his
opinion on facts observed by himself, or testified to by
others. An expert witness is supposed to be specially skilled
in the matter on which he is to testify. It is just here, we
believe, that the real cause of difficulty lies in medico-legal
cases involving expert evidence. The so-called "experts"
are usually taken from the ranks of the medical profession.
Such persons, because they are doctors, sometimes, unfortu-
nately, imagine that they are therefore qualified to act as
experts, without any previous medico-legal knowledge, or
training. Of course, there must necessarily be a conflict of
opinion where such an improvised witness is opposed to the
genuine expert, on the witness stand. We believe that if
all the experts were equally skilled, and equally qualified,
and equally honest, there rarely could occur any conflict
of opinions between the opposite sides, since both are
18 MEDICAL JURISPRUDENCE
equally desirous of discovering and testifying to the truth,
and truth is always undivided.
No one should presume to assume the position of an
expert witness who has not devoted his special attention
to the matter under consideration, and who is, therefore,
able really to enlighten the court and jury.
The expert witness has his rights as well as his duties and
responsibilities. One of these rights is his compensation.
It has often been made a subject of just complaint that an
expert witness is placed upon the stand, and his professional
opinions, which may be of the utmost value in the pending
case, extorted from him piecemeal, by the questionings of
counsel, and yet he receives as his compensation merely the
pittance of one dollar and a half a day — the pay of an ordinary
witness! Some high legal authorities contend, very justly,
that the expert is not bound to submit to this imposition,
and that he is entitled to an adequate fee for his services, for
which, however, he should arrange with the party calling him,
before he gives his evidence. The English courts, we
believe, have not yet definitely settled this matter. We are
glad to see that a recent authority * uses the following
pointed language concerning this matter : " No witness can
be compelled to give his opinion in the witness box.
Further, no one is bound to accept a subpoena merely to
state opinions. The witness that can speak to any actual
fact connected with the case must attend the trial, if required
to do so, but the expert, however wide his experience, cannot
be forced to give the court the value of his general or special
knowledge." There can be no question as to the propriety
and justice of this position ; but in this country, the practice
of the courts in relation to the compensation of medical
experts, is by no means settled. In the great majority of
-Tidy's Legal Medicine. Part I. Lond. 1SS2 ; p. 17.
REMUNERATION TO EXPERTS. 19
our States, the laiv allows no additional compensation to the
expert; and it is not an unfrequent practice to subpcena him as
an ordinary witness, and when in the witness box, to use him
as an expert. What shall the expert do in such a case ? How
shall he conduct himself consistently with his own dignity
and proper rights? Certainly, the court would not use a
man's private property — the work of his hands, his skilled
manual labor, or the product of his farm or merchandise,
without adequate compensation ; why, then, should they
exact from him that which is the result of the labor of his
brain, than which nothing can be more exclusively and
definitely a man's own private property ? It is to be regretted
that so few of our American courts and legislatures have
appeared to recognize the true bearings of this subject, so that
with us the old practice still prevails, of affording no legal
protection to the medical expert, in the matter of fees.*
In point of fact, however, it rarely happens, in important
criminal cases, especially in poison cases, that either the
prosecution or the defence would venture to trust their
interests to a reluctant witness; and certainly he would be
a reluctant witness who had been dragged, perhaps hundreds
of miles from his home and business, by a subpcena, which
the law forces him to obey, and who, after spending, it may
be, days in attendance upon the court, is compelled to give,
for the paltry pittance of the wages of a day-laborer, that
which has caused him years of labor and study to acquire,
in the shape of an opinion, on which may turn the question
of life or death to the prisoner ! In all such cases, the
ordinary practice is to arrange beforehand with the expert
for his proper fee; and the witness should be admonished
to look carefully about his interests in this matter. Let
* As far as can be ascertained, only two of our States have legislated on
this subject.
20 MEDICAL JURISPRUDENCE.
him remember that the district attorney, who usually directs
the affair, has no authority to pay his fee ; neither does this
authority lie with the court. The only responsible parties
in the case are the county commissioners, or some other
equivalent county authorities. With these alone ought the
expert to make his arrangements, and always previously to
undertaking the case; and to these alone can he look,
legally, for his fee.
As regards the obligation of a witness to obey a subpoena
when he is to be questioned only as to his opinion, we think
that, in this country, the mandate of the court is obligatory ;
the witness's duty is to obey it, and then, if not previously,
endeavor to arrange about his (compensation, before giving
his evidence.
We venture a word of caution to the medical witness.
Before undertaking any case, or consenting to act as an
" expert " therein, be sure to institute a thorough examina-
tion of all the bearings of the case, — its pros and cons. If
retained by the defence, the expert has the right to examine
the report of the State's expert; and this is of special im-
portance in a poison case. A critical examination of this
report will enable him to determine whether he can consci-
entiously, and on scientific grounds, undertake to contradict
and oppose the conclusions arrived at in this report. It is
a most serious and responsible position for him to assume,
and he ought to assume it only after a deliberate study of
the case, and a strict consciousness of his ability to grasp
it. If he finds nothing in the report that he cannot thor-
oughly endorse, whether the results of chemical or other
experiments, or whether the deductions from these experi-
ments in the shape of opinions, our advice would be for him
frankly to decline the case altogether. He should never go
upon the witness stand as a mere partisan, nor offer his
EXPERT TESTIMONY. 21
professional shrewdness and tact, for pay, to the highest
bidder ! If, however, a careful scrutiny of the report has
satisfied him that the State has not made out its case (so
far as the scientific evidence goes), but that serious blunders
have been committed in the chemical and other experiments
performed, whereby most erroneous conclusions have been
reached, and which may vitally affect the result, then we
are of the opinion that the expert not only need not
hesitate to take the case, but that it is his bounden duty
to do so, in order that he may aid in carrying out the ends
of justice.
This whole matter of expert testimony has long engaged
the attention of some of the ablest minds in both the pro-
fessions of law and medicine, but with no very definite
results. No doubt, our present system of volunteer medical
experts is open to serious objections, which, under our
present laws, cannot be remedied. The only true and
proper system, as it seems to us, is for each State to ap-
point one or more experts, who shall be State officers,
physicians of thorough education and experience, and train-
ing in this particular line, who shall devote their time and
attention exclusively to this duty, and for which they shall
receive an adequate compensation. Such an office, properly
filled, and kept aloof from all political considerations, would,
we believe, be of real benefit to the State. It would, to a
great extent, if not completely, abolish the unseemly con-
tention of the experts in the court-room, inasmuch as the
State expert (whose professional ability and moral standing
should be absolutely unquestioned) would be present at
every important trial, and give to the court and jury the
results of his previous investigations in the case; and, more-
over, since he is to be presumed to be entirely impartial,
without bias to either the prosecution or defence, his
22 MEDICAL JURISPRUDENCE.
opinion would be generally received as final by both sides,
and thus both contention and expense would be avoided.
The above system of medical expert testimony re-
sembles, in many respects, that of Germany, which we regard
as superior to that of other countries.
There are a few practical rules relating to the giving ot
evidence, which it is well the medical expert should observe.
The first of these is, that he should prepare himself thor-
oughly upon all the points bearing on the case, in which he
is called to give evidence. This he should do in order to
further the ends of justice, and also to avoid personal
censure. He should be accurate as to weights, measures,
distances, size, relationship of objects, etc.
Secondly. He should maintain a quiet, dignified and com-
posed demeanor on the stand, not exhibiting any irritability
of temper, however much he may feel provoked by the rude-
ness of the opposing counsel. He should beware of any
display of arrogance, or assumption of manner, or of stub-
bornness, or testiness of behavior, which are sure to make
him appear to disadvantage in the court room.
Thirdly. The witness should give his answers in a clear
and audible tone, addressing himself rather to the jury than
to counsel, since the former are specially interested in his
replies ; and these replies, together with his explanations,
should always be given in the simplest possible language ;
and they should be free from all ambiguity, otherwise they
will require explanation, which is apt rather to weaken the
testimony.
Fourthly. He should never be afraid to say "I don't
know," if he does not know. Nothing is more dangerous
than for a witness to attempt to guess, for fear of being
thought ignorant.
Fifthly. He should particularly avoid the use of all
DYING DECLARATIONS. 23
technical expressions and learned formulae, in giving his
description of the results of an autopsy, or of a toxicological
examination, etc. For example, instead of saying that "the
integuments of the cranium were reflected back, so as to
expose the calvarium," he should simply announce that " the
scalp was thrown back, and the skull, exposed;" and instead
of telling the jury, in grandiloquent phraseology, that, in a
case of assault and battery, he had found that the prosecutor
" had received a severe contusion over the lower portion of
the frontal bone, producing extensive ecchymosis around the
eye, together with considerable infiltration of the subjacent
areolar tissue," he should clear up the matter at once, by
telling them, in plain English, that the man had gotten "a
black eye" (Taylor). All such pomposity and pedantry will,
of course, be avoided by every sensible and well-bred witness,
since it is certain to expose him to well-merited ridicule and
contempt.
Dying Declarations. — By this term is understood such
declarations as are made by a dying person, who, at the time,
believed he was in actual danger of death, and that his
recovery was impossible. Such declarations are received in
evidence without being sworn to. The law presumes that
all such declarations, made at so solemn a crisis as at a
dying moment, must be sincere. They may not, however,
necessarily be true, although sincere, i. c, believed in, at the
time, by the deceased. Dr. Taylor quotes an instance of a
dying woman in St. Thomas' Hospital, who accused a man
of assaulting her. He was found guilty and executed. A
year after the execution, the real murderers were discovered,
and his innocence established. These declarations, more-
over, must relate to the actual circumstances of the death,
and to nothing else.
24 MEDICAL JURISPRUDENCE.
A magistrate, if he can be had, is the proper person to
take down the dying man's declarations, the physician in
attendance merely giving his opinion as to the hopelessness
of the case, and the soundness of the man's mind. In the
absence of the magistrate, the medical man is the best
person to receive the dying declaration, or confession ; and
he should content himself by simply writing down the exact
words of the dying person, without any interpretation of
them by himself. He should then, if possible, make him
sign the declaration, after first reading it over to him.
MOLECULAR AND SOMATIC DEATH. 25
CHAPTER II.
PHENOMENA AND SIGNS OF DEATH.
SECTION I.
MOLECULAR AND SOMATIC DEATH. — THE IMMEDIATE CAUSE <>F
DEATH, IN ALL CASES, TO BE FOUND IN EITHER THE HEART.
LUNGS, OR BRAIN. — CHARACTERISTIC POST-MORTEM EVIDENCES OF
THESE VARIETIES OF DEATH. — THE "SIGNS OF DEATH." — CESSA-
TION OF THE CIRCULATION AND RESPIRATION. — CHANGES IN THE
EYES. — PALLOR OF THE BODY.
By molecular death is to be understood the incessant dis-
integration of tissue which is going on in the body during
the active processes of life ; the waste of material thus
produced being compensated by the never-ending work of
reparation. In youth, the supply is in excess of the waste,
and growth is the result. In advanced age, the reverse is
the case. Somatic death is the cessation of all the vital
functions of the body, or the death of the whole body. The
latter is the popular idea of death ; and the time when it
takes place is generally recognizable. The precise period
when universal molecular death occurs cannot be accurately
determined. No doubt, molecular life may continue some
time after somatic death, as is evidenced by post-mortem
caloricity (via 7 , post.) and by certain acts of nutrition and
secretion, such as the growth of the hair and nails.
Although the outlets of human life are so numerous and
varied, and the phenomena attending the dissolution of the
body are equally diversified, the immediate or actual cause
of death, in every instance, must be referred to an arrest of
the function of one, or other of the three great centres of life
— the heart, the lungs, and the brain. And so intimately
26 MEDICAL JURISPRUDENCE.
are the functions of these three "centres " connected together,
that when one ceases to act, the actions of the other two are
speedily brought to a standstill. Each one of these three
varieties has its own special phenomena or signs ; and each
exhibits its own peculiar or characteristic post-mortem
appearances. We adopt Bichat's classification of (i) death
beginning at the brain, (2) death beginning at the heart,
and (3) death beginning at the lungs.
I. Death Beginning at the Brain — Coma. — Symptoms. —
Stupor, more or less profound; insensibility to external im-
pressions; loss of consciousness ; breathing slow, stertorous,
and irregular; respiration gradually ceases, as the medulla
oblongata begins to be affected. The chest ceases to ex-
pand; the blood is no longer aerated; the pulmonary circu-
lation is arrested; the lungs cease to act, and finally the
heart's pulsations are brought to a stop.
Post-mortem appearances. — 1. Effusion of blood, or serum
in the brain or cavities, caused by (a) apoplexy, (b) rupture
of vessels, from injury or fracture of the skull. 2. Embolism.
3. Concussion from a blow or fall. 4. Abscess, tumor, or
other organic disturbance. 5. Congestion of the vessels of
the brain, caused by (a) disease, (6) narcotic poisons, (c) cer-
tain mineral poisons, as barium and arsenic.
II. Death Beginning at the Heart — Syncope. — The heart
may cease to act, from two distinct causes : (1) from a
deficiency in the quantity of blood, its normal stimulant
(anosmia), and (2) from a defect in the quality of the blood,
or from a loss of heart-power (asthenia).
Ancemia is produced by sudden loss of blood, (1) disease,
as in rupture of an aneurism ; (2) uterine and other hemor-
rhage; (3) sudden discharges, etc.; (4) violence, as from
DEATH FROM THE LUNGS. 27
wounds of heart and large vessels, causing fatal hemor-
rhage.
Symptoms. — A mortal paleness of face ; lividity of lips ;
vertigo; cold sweat ; dimness of vision; ringing in the ears;
slow, weak and fluttering pulse ; gradual insensibility. There
may also be nausea and vomiting, hallucinations, delirium,
jactitations, irregular breathing, sighing, and convulsions
before death. The nervous symptoms are due to want of
brain power, in consequence of a deficient supply of blood.
Post-mortem appearances. — Heart contracted and empty
(if early inspected). If life has been protracted for several
hours, a heart clot may be found.
Asthenia. — Here, the cause of the cessation of the heart's
action is either a defect in the quality of the blood, or some
disorder of the organ producing a loss of heart power: (i)
by disease, as (a) various cardiac disorders, such as fatty
degeneration, etc ; (b) all exhausting diseases, as phthisis,
cholera, cancer, etc. ; (2) starvation; (3) certain injuries, as
blows on epigastrium ; (4) certain poisons, as digitalis,
prussic acid, and upas.
Symptoms. — Coldness of hands and feet; lividity of lips
fingers, toes, nose and ears ; extreme muscular weakness;
feeble pulse ; senses and intellect not affected, but preserved
to the last. This latter is well seen in the collapse of Asiatic
cholera.
Post-mortem appearances. — The heart not contracted ;
its cavities contain more or less blood, or else are dilated and
flabby.
III. Death from the Lungs — Apncea — {Asphyxia). —
Respiration may be arrested (1) by any mechanical impedi-
ment to the ingress of air (oxygen) into the lungs, as (a)
pressure on the thorax ; (b) tetanic spasm of the muscles of
28 MEDICAL JURISPRUDENCE.
respiration, as in tetanus and strychnia poison; (c) paralysis
of the pneumogastric, or phrenic nerves ; (d) exhaustion of
muscular power from debility, or cold ; (e) foreign bodies in
the air passages ; (/) compression of the throat, as in hanging
and strangling ; (g) suffocation ; (h) drowning. 2. By dis-
ease, as pneumonia, phthisis, etc., spasm of the glottis,
cedema of the glottis, pharyngeal abscess, and embolism
of the pulmonary artery. (Strictly speaking, most of these
diseases cause death, through mechanical interference with
breathing.)
Symptoms. — Great dyspncea, lividity of the face, loss of
consciousness, vertigo, and convulsions.
Post-mortem appearances. — The right side of the heart
and the whole venous system are usually filled with dark
blood; the left side, together with the arteries, is generally
empty. Cases are however reported where the right cavities
of the heart were found empty. The lungs themselves are
nearly always gorged with dark blood ; but there are some
exceptions to this, which will be noticed hereafter.
By keeping in mind the foregoing varieties of somatic
death, together with the characteristic post-mortem appear-
ances attendant on each, the examiner will be considerably
aided in arriving at a definite conclusion, as to the real cause
of death, in any particular case.
In every inquest over a dead body four important ques-
tions will present themselves for solution: I. The reality
of the death. 2. The cause of the death. 3. The time that
has elapsed since the death. 4. In the case of the body of
a new-born infant, — was it born alive?
I. The first of these questions comprises the phenomena
and signs of death. How can we distinguish a case of real
from one of apparent death? In the great majority of
SIGNS OF DEATH. 29
instances, of course, there is no practical difficulty; but ex-
ceptional cases do, at times, present themselves in persons
recently dead, where the corpse still retains so much the
appearance of life, as to occasion some doubts about the
reality of dissolution. The natural horror of being buried
alive also suggests the most scrupulous caution in the mat-
ter, although we rarely, if ever, hear of cases of premature
burial in civilized countries; yet instances are not wanting
to show that such may have actually occurred, in places
where a fatal pestilence has prevailed to such a degree as
to produce a panic, and demoralize the community. Dr.
Tidy {Legal Med. p. 30) informs us that Professor Nussbaum,
of Munich, states " that he believes many to have been buried
during the war (Franco-German) that were not really dead,
but merely suffering from an extreme lethargy arising from
loss of blood, exhaustion, hunger, cold and fear" (Jour, de
Med. de Bruxelles, February, 1871).
The following may be regarded as the Signs of Death.
We are, however, of the opinion that no single sign should
be relied upon exclusively, but that several " signs " should
always be present in determining the question.
I. The complete and continuous cessation of the functions
of ciradation and respiration. In some cases of apparent
death these two functions seem to be suspended for a time,
as in syncope, trance, catalepsy, etc.; but the suspension is
not absolute, but only apparent. The absence of the pulse
at the wrist is no criterion of the suspension of the circula-
tion, as this may be going on so feebly, as only to be detected
by a very close stethoscopic examination of the heart, which
should never be omitted in cases of doubt. The condition
of both the circulation and respiration, in such cases of
apparent death simply resembles that of certain animals in
30 MEDICAL JURISPRUDENCE.
the state of hybernation. Thus, M. Bouchut informs us
that in the marmot, while the heart-beats during its state of
activity amount to 80 or 90 a minute, they are reduced
down to 8 or 9 very feeble pulsations during the period of
hybernation. Instances are recorded (like that of Colonel
Townshend, by Dr. Cheyne) of a voluntary suspension of
the heart's action ; but as these cases occurred many years
ago, before the discovery of auscultation, it is, we think,
highly probable that the suspension was not absolute, but
only reduced down to so fine a point as to have escaped
notice. It is certainly contrary to all scientific reasoning
that life can continue many minutes without the circulation
of the blood ; therefore we need have no hesitation as to
the reality of death, if we can be positively certain of the
continuous arrest of this function, say for one hour. The
converse of this proposition, however, is not always true ;
that is, the pulsation of the heart may continue for a brief
space of time after actual death. Duval mentions having
seen the heart of a criminal beat fifteen minutes after decapi-
tation, the left auricle pulsating for an hour. This same
phenomenon, as is well known, is witnessed still more
remarkably in the heart of the turtle, and also of the shark,
which will continue to pulsate many hours after removal
from the body.
This question of the beating of the heart in a still-born
infant being regarded as a valid sign of life, will be dis-
cussed hereafter, under the title of Live Birth.
The same remarks may be made with regard to the func-
tion of respiration. The absolute and continuous cessation
of breathing — say for one hour — may be regarded as a posi-
tive sign of death. In cases of apparent death, as already
remarked, this function may apparently be suspended ; but
it is in reality only reduced down to its minimum of action.
CONDITION OF THE EYES. 31
This likewise should be verified by careful and repeated
auscultation. The common practice of holding a feather
near the nose or mouth may serve, by its movements, to
indicate breathing. So likewise the deposit of moisture on
a mirror, held in the same position, will indicate the feeblest
respiration. But neither of these is an absolutely positive
sign, since they both fail when applied in the case of the
hybernating animal, which we know is really alive.
Another method is to place a small vessel containing
mercury on the thorax of the body lying on its back ; the
slightest respiratory action will be indicated by the move-
ments of a reflected image, made to fall on the surface of the
bright metal.
It may be remarked that in cases of trance, catalepsy,
and other instances of suspended animation, the body never
exhibits either the pallor, or coldness of real death. More-
over, if a ligature be applied around the finger of a corpse,
no change of color will be observed; but if the experiment
be made on a living body, the tip of the finger will become
of a deep red or purple color, in consequence of the arrest
of the capillary circulation at that spot.
II. The Condition of the Eyes. — The changes produced in
the eyes by death consist (i) in the entire loss of sensibility
to light : the pupils neither contract nor expand under this
stimulus. This, however, cannot be regarded as a positive
sign, since the same insensibility to light is witnessed in
certain cerebral affections during life ; it is also the result of
the action of certain poisons. (2) The action of atropia
and other mydriatics to expand the pupil, and of calabar
bean to contract it during life, is lost within a few hours
after death. These agents do, however, produce a visible
effect if applied very soon after the cessation of life, and
32 MEDICAL JURISPRUDENCE.
before the body has become cold, and all muscular irrita-
bility has ceased. (3) The cornea loses its transparency,
and the eyeball its elasticity, very speedily after dissolution.
But these conditions may likewise exist before death, as
the effects of disease. In apparent death, the cornea retains
its translucency ; the papilla of the retina is of a rose-red
color ; and the fundus of the eye is furrowed by the arteries
and veins of the retina. At the moment of death, the
papilla of the optic nerve becomes quite pale, and the cen-
tral artery of the retina disappears (M. Bouchut, La Tribune
Medicate, No. 47, 1868). It should also be remarked that the
eye sometimes retains its lustre after death, as is witnessed
after poisoning by prussic acid and carbon dioxide.
III. The Ashy Pallor of the Body. — This sign is very uni-
form, though not without some exceptions, as in the case
of persons of very florid complexions, and in exceptional
instances where the cheeks retain their pink color for some
days after death, so as to occasion some uncertainty as to
the actual fact of death in the minds of relatives. It is also
wanting in cases of death from yellow fever and jaundice ;
moreover, the red, inflammatory zones around ulcers, tattoo
marks, the spots of purpura, and ecchymoses or bruises, do
not disappear after death. It must also not be forgotten
that a death-like pallor is seen in cases of swooning, and
sometimes in the cold stage of ague and in collapse.
SECTION 11.
SIGNS OF DEATH CONTINUED. — LOSS OF ANIMAL HEAT. — POST-
MORTEM CALORICITV. — RIGOR MORTIS. — POST-MORTEM LIVIDITY,
OR SLGGILLATION.
IV. Loss of Animal Heat. — During life the animal body
possesses the wonderful faculty of maintaining its own
normal temperature (about 98 F.) independently of the
LOSS OF ANIMAL HEAT. 3o
surrounding medium. This is effected as the result of
certain vital processes. When these cease at the moment of
dissolution, the temperature of the body immediately begins
to decline, and it continues so to do progressively until it
attains that of the surrounding medium. It never gets
lower than the latter, unless the temperature of this medium
becomes suddenly increased ; then, for a while, the body will
be really colder than the temperature of the atmosphere.
The sense of touch does not convey an accurate idea of
the actual coldness of the dead body, since the conducting
power of the tissues varies materially. The direct appli-
cation of the thermometer to the body is the only safe
criterion.
The time when the cooling of the body is completed may
be stated to be, on the average, fifteen to twenty-four hours.
Prof. Casper makes it from eight to twelve hours. But it
varies very considerably, according to the condition of the
body itself, according to the medium in which it is kept
after death, and also according to the manner of death.
Thus, fat bodies retain heat longer than lean ones ; the
bodies of young children and of old persons cool more
rapidly than those of adults; whilst the bodies of those who
die from lightning, or suffocation are said to retain heat
longer than others.
The body cools more rapidly if exposed to the air,
unclothed, than if covered up in the bed clothes; also in a
large, airy apartment, than in a small, close room. It will
cool more rapidly in water than in the air. In death from
chronic wasting diseases, and also in cholera, the body cools
very rapidly. According to Dr. Taylor, loss of blood does
not hasten the cooling process.
The interior of the body retains its heat considerably
longer than the surface, so that if an autopsy be made
:;i MEDICAL JURISPRUDENCE.
twenty-four hours after death, or when its exterior feels per-
fectly cold, the abdominal viscera may exhibit a temperature
twenty degrees, or more, higher than that of the surface.
It should not be forgotten that coldness of the body is a
frequent phenomenon of sickness ; it is witnessed in hysteria
and ague, also in cholera. Its value as a sign of death con-
sists in the fact that it is progressive, and continuous, whilst
the coldness of disease is sudden, and not permanent.
Hence, the degree of coldness of the body will often be a
good indication of the time that has elapsed since death.
The singular phenomenon is sometimes exhibited of a
rise of temperature after death, instead of a fall. This excep-
tional condition occurs in the bodies of persons who have
died from yellow fever, cholera, tetanus, smallpox, and some
other acute disorders. The precise cause of this singular rise
of temperature {post-mortem caloricity) is not clearly under-
stood. In some instances the increase of heat amounted to
nine degrees F. Dr. Davy records a post-mortem tem-
perature of 1 1 3 F. in the pericardium. We must suppose
in these cases that, after general or somatic death, there still
lingers some remnant of vitality in the tissues, or rather
that molecular life has continued after the cessation of
somatic life. We know that muscular irritability and con-
tractility continue for many hours (under certain conditions)
after death, and this undoubtedly indicates the continuance
of their molecular activity, up to a certain point.
Another fact to be here noticed is that the rate of cooling
after death, although progressive, is not uniform ; it is
much more rapid during the earlier hours, than later. Dr.
Goodhart's observations show that during the first three
hours after death the loss of heat, per hour, amounted, in
the robust, to 3.5 °, in the emaciated, to 4.7 ; whilst, when
the body was nearly cold, the loss, per hour, was, in the
CADAVERIC RIGIDITY. 35
emaciated, 1.12 and in the robust, 1.26 (Tidy's Leg. Med.,
P- 49).
V. Cadaveric Rigidity, or Rigor Mortis. — By this is under-
stood the stiffening of the body, so generally observed after
death. It usually occurs simultaneously with the cooling
process. It may be stated to be universal in death from
any cause, and to be present in the lower animals, as well as
in man. In some instances, however, it is so transient as
to escape notice. It comes on at very variable periods,
from a few moments, to eighteen to twenty hours after
death. This remarkable variation in its approach is chiefly
due to the condition of the muscular system at the time of
death. Its duration is equally variable, lasting from a few
moments, to many hours, or even weeks. After the rigidity
passes off, the body regains its original pliancy, and decom-
position immediately commences. As a general rule, the
putrefaction of the body is retarded until the rigor mortis
has passed off.
■ It commences usually in the muscles of the eye, which
often become rigid within a few minutes after death ; next
in the muscles of the neck and lower jaw; then in the chest
and upper extremities ; afterwards in the muscles of the
abdomen and lower limbs. The rigidity generally passes
off in the same order; thus the legs frequently remain quite
rigid, after the upper portion of the body has regained its
suppleness.
The seat of the rigor mortis is undoubtedly the muscular
system. That it is in no wise dependent upon the nervous
system, is proven by the fact that all the nerves supplying a
muscle may be divided, and yet the muscle will continue to
act, contracting under the galvanic stimulus. But it ceases
immediately on division of the muscle. Even the removal of
36 MEDICAL JURISPRUDENCE.
the brain and spiral marrow has no effect in preventing the
muscular contraction. Again, the muscles of a paralyzed
limb become equally rigid with those in sound health. The
cause of the contraction is usually ascribed to the coagulation
of the muscular plasma (myosin), an albuminous principle
possessing the property of coagulation to a high degree.
The chemical action of a muscle in rigor mortis is acid
(reddens blue litmus), but it becomes alkaline after the
rigidity passes off. While in the state of rigor mortis, the
muscle is opaque; before this, it is partially translucent.
Brown-Sequard has shown that a current of arterial blood
will restore muscular contractility to a rigid limb.
The duration of rigor mortis is one of its most important
features. As already observed, this is extremely variable,
although, as a rule, it does not set in until the body has
begun to cool ; still, in some of the lower animals, and
notably in birds, it often manifests itself while the body is
still warm. From the observations of Brown-Sequard and
others, it appears that the period after death when the rigor
mortis manifests itself, together with its duration, is de-
pendent chiefly, if not altogether, upon the previous degree
of muscular exhaustion. To properly understand this, it
should be remembered that immediately after death the
muscles are in a state of complete relaxation, giving to the
body perfect pliancy. This condition may last for so brief
a space of time as not to be noticed, though usually it
continues for three or four hours, when rigidity commences.
During this period of relaxation, the muscles have not yet
lost their molecular life, so that they will respond to galvanic
and other stimuli. Hence, although the contraction of a
muscle by electricity is no positive sign of somatic life, still
it will enable us to conclude either that the person is yet
alive, or more probably, that death has very recently
CADAVERIC RIGIDITY. 37
occurred. The cessation of all muscular contractility under
galvanic stimulus is a proof, not only of the death of the indi-
vidual, but it also indicates that the death was not very recent
— hardly within three, or four hours. So long as the muscles
retain their contractility, the rigor mortis is postponed.
It can now be understood that whatever produces ex-
haustion of the muscular system, must thereby hasten the
approach of cadaveric rigidity. Thus, in death from ex-
hausting diseases, as in phthisis or after protracted con-
vulsions, or when the muscular system becomes exhausted
by over-exertion and fatigue, as is seen in over-driven
cattle, or animals hunted in the chase, the rigor mortis
shows itself early, and lasts but a short time ; whereas, if
death occurs suddenly, in a previously healthy person, the
rigidity is postponed for many hours, but when once estab-
lished, it continues for a much longer period. Thus,
according to Brown-Sequard, the bodies of decapitated
healthy criminals were observed not to become rigid until
after the lapse of ten to twelve hours, and the rigidity
lasted over a week, even in warm weather. An experiment
of the above named physiologist very satisfactorily proves
this statement. Three dogs of equal size were poisoned
with strychnia in different doses. One took two grains,
and died almost immediately. The second took half a grain,
and died in twelve minutes. The third took one-fourth of
a grain, and died, after protracted convulsions, in twenty-one
minutes. In the first animal, whose muscular system had
been least exhausted by the spasms, rigor mortis did not
set in before the lapse of eight hours, and the duration was
nineteen to twenty days. In the second, where the muscular
exhaustion was greater, the rigidity appeared after two and
a half hours ; and lasted five days. In the third, in which
the muscular exhaustion was the most protracted, the rigor
38 MEDICAL JURISPRUDENCE.
mortis was developed as early as thirty minutes, and lasted
less than a day.
It has been supposed by some, that the rigor mortis does
not occur in the bodies of persons killed by lightning; this,
however, is a mistake, as experience abundantly proves.
Neither is it interfered with by the previous loss of blood
by hemorrhage. It is, however, dependent on temperature,
at least, so far as regards the duration, which is shortened
by heat and prolonged by cold. Bodies submerged in cold
water retain their rigidity for a considerable length of time.
When a joint or articulation stiffened by rigor mortis (if
this be complete), is forcibly bent, the rigidity is destroyed.
If, however, the rigidity is incomplete, it will be resumed
afterwards. This may serve to distinguish real death from
certain cases of catalepsy, tetanus, and hysteria, accompanied
by rigidity. In all these latter cases, the stiffness will return,
on removal of the opposing force.
Cadaveric rigidity is riot so strong as voluntary muscular
contraction. As a rule, the flexors are more affected than
the extensors, so that the limbs are generally found to be
slightly bent after death.
The fact that the involuntary muscles are likewise subject
to rigor mortis should not be lost sight of, as it might lead
to an error as to the true pathological state of an organ on
making an autopsy. The heart, for instance, may be found
very firmly contracted after death by rigor mortis ; this
might be mistaken by the inexperienced, for a true contrac-
tion of the organ, the result of previous disease.
Closely connected with rigor mortis, if not indeed a modi-
fication of this very state, is the condition described as
cadaveric spasm. This is exhibited in the bodies of persons
who have died by sudden and violent deaths, in whom there
seems to be present a strong will-power just prior to the
CADAVERIC LIVIDITY. 39
death, and producing strong muscular contraction at the
moment of dissolution. This spasmodic contraction, more-
over, appears to pass at once, after death, into the usual
rigor mortis. The best illustrations of this peculiar condi-
tion are afforded in those cases of determined suicides, who
have taken their lives by shooting themselves with a pistol.
Very commonly in such cases, the lethal weapon is found
so tightly grasped in the dead man's hand, as to require
considerable force to remove it. The same thing is some-
times witnessed in the bodies of drowned persons ; fragments
of wood, grass and weeds, or other objects which had been
convulsively seized in the water before death, being found
tightly grasped in the hands ; and where two persons have
perished together by drowning, it is not uncommon to find
them, after death, convulsively clasped in each other's arms.
To a similar reason, doubtless, is to be ascribed the singular
and striking posture which the bodies of soldiers, on a field
of battle, killed in conflict, are noticed to have assumed in
the act of dying. Thus, the attitude of one is described as
" resting on one knee, with the arms extended, in the act of
taking aim ; the brow compressed, the lips clenched — the
very expression of firing at an enemy stamped upon his
face, and fixed there by death. A ball had struck this man
in the neck. Another was lying on his back, with the same
expression, with his arms raised in a similar attitude, the
minnie musket still grasped in his hands undischarged "
(Taylor).
VI. Cadaveric Lividity, or Suggillation. — This term is
applied to those livid, or violet-colored patches, or discolor-
ations, which are observed upon the body at variable periods
after death, usually after several hours. It is the result of
the settling of the blood in the capillaries by gravitation.
}() MEDICAL JURISPRUDENCE.
Hence it is noticed in the most dependent parts of the body,
such as (supposing it to be lying on the back) the back,
sides, and under surface of the neck, calves of the leg, and
under portions of the thighs. These patches, at first isolated,
gradually increase in size, and coalesce, so as to cover a larger
surface of the body. Cadaveric lividity is an unquestionable
"sign" of death. It makes its appearance sometimes much
earlier than at others ; and for this variation no very satis-
factory reason can be assigned.
The most important point connected with cadaveric
lividity is not to confound it with ecchymosis, or bruising,
to which it bears a considerable resemblance. Several cases
are recorded where a body has been found covered with
these death spots, and the mistake has been made of sup-
posing them to be bruises, and consequently attributing the
death to violence inflicted during life. The medical exami-
ner should be particularly cautious not to confound them.
Fortunately, a very simple test will settle the question. If
the scalpel be drawn through a suggillation, no blood will
flow ; the most that will be observed will be a few bloody
points or specks, arising from the division of small veins of
the skin. If, however, the patch be ecchymosis (where the
effused blood has been infiltrated into the cellular tissue),
the incision will either be followed by a flow of blood, or else
a coagulum will be seen. Moreover, whilst the ecchymosis
is sometimes raised above the level of the surrounding skin,
the cadaveric stain never is. These spots are not affected
by age, sex, or constitution ; and they follow upon all kinds
of death, not excepting that caused by hemorrhage.
Suggillation takes place in the internal organs as well as
upon the surface of the body, producing in the former,
appearances strongly resembling true congestion and in-
flammation, for which they are without doubt frequently
PUTREFACTION. 41
mistaken by the inexperienced ; and as it may be a matter
of considerable consequence, in a post-mortem examination,
not to confound these two conditions, the examiner should
be very cautious as to his pathological inferences These
internal suggillations are also termed hypostatic congestions;
they appear chiefly in the lungs, brain, kidneys and intestines.
The fact that they invariably occur in the most dependent
portions of these organs should be suggestive of their true
origin, since a real congestion or inflammation exhibits
itself either throughout the whole organ, or else upon its
upper surface equally with the lower one. Certainly, it is
not confined exclusively to the under portion, as is the
suggillation. When it occurs in the intestines, it may readily
be distinguished from true inflammation, by simply lifting up
several folds of the bowels, when the horizontal line, which
previously had marked the hypostatic settling of the blood,
becomes immediately broken and disjointed, whereas, if it had
been a real congestion or inflammation, the redness would
have involved the whole circumference of the intestines,
and there would have been no broken line of separation.
In the brain, hypostatic congestion might be mistaken, by
the inexperienced, for one form of apoplexy ; and in the spinal
cord it might be confounded with spinal meningitis. In the
heart, true suggillation is not believed to occur; but this
is replaced by the formation of post-mortem clots, called
polypi of the heart.
SECTION III.
SIGNS OF DEATH CONTINUED. — PUTREFACTION — EXTERNAL AND IN-
TERNAL SIGNS. — ADIPOCERE. — MUMMIFICATION. — HOW LONG SINCE
THE DEATH ?
VII. Putrefaction. — This is usually regarded as the most
unequivocal " sign " of death. By this term is understood
those spontaneous chemical changes undergone by all dead
3*
42 MEDICAL JURISPRUDENCE.
animal bodies, resulting in the elimination of fetid gases.
The period after death when putrefaction first manifests
itself varies considerably, being dependent upon several
conditions, some of which are connected with the body
itself, and others extraneous to the body.
Among the conditions inherent to the body itself are:
I. Corpulence. Fat and flabby bodies undergo putrefaction
more speedily than thin and lean ones, doubtless on account
of the preponderance of fluids in the former. 2. Age and
Sex. For the same reason the bodies of new-born children,
and of women dying in child-bed (according to Casper),
decompose more rapidly than others, especially the aged.
3. The manner of death. The bodies of persons dying after
an exhausting disease, especially if the vitality of the blood
has been impaired, as in typhus fever, undergo rapid putre-
faction ; also after death from certain poisons, and especially
poisonous gases, as coal gas and sulphuretted hydrogen ;
also from suffocation from smoke, and, indeed, from suffoca-
tion generally. Putrefaction is also accelerated in bodies
that have been much bruised and mangled by machinery,
or railway and other accidents ; but we must except those
cases where the body remains protected from atmos-
pheric influences, as when buried beneath ruins, etc. On
the other hand, the process is retarded in death by alcohol,
phosphorus, sulphuric acid, arsenic, and some narcotic
poisons. The antiseptic properties of alcohol and arsenic
are well understood. The action of sulphuric, and doubt-
less the other mineral acids, is probably to neutralize the
ammonia as fast as it is formed, rather than actually to
retard the process of putrefaction. Admitting all the above
conditions, and giving them due allowance, there are doubt-
<>ther causes, as yet unknown to us, which influence the
rapidity of putrefaction. Casper adduces the instance
PUTREFACTION. 43
four men, all of about the same age and general physique,
and all suddenly killed in a riot. They were all buried
at the same time, and in precisely similar coffins and
graves ; yet, on subsequent examination, the progress of
decomposition in the several bodies was found to vary very
considerably.
The external or objective conditions influencing putre-
faction are air, moisture and temperature. The influence of
the atmosphere upon animal decomposition is well under-
stood, and is familiarly witnessed in the preservation of
meats and other articles of food in hermetically sealed cans,
for an indefinite length of time. It is undoubtedly the oxy-
gen of the atmosphere that is the destructive agent, since
flesh may be preserved in nitrogen (the other constituent
of air) for a long period. Moreover, the oxygen must
be in a free state, as it exists in the atmosphere, and not in
a compound, as in carbonic acid gas, or nitrous and nitric
oxide. These gases do not act as decomposing agents.
The influence of atmospheric air is not limited to the mere
supply of oxygen, but it modifies putrefaction according to
the amount of moisture it contains. For this reason, per-
fectly dry air, such as that of the arid deserts of Arabia and
Africa, by its rapid desiccating properties, arrests putrefaction ;
the body speedily losing its fluids by evaporation, dries, and
shrivels up into a sort of mummy. The effects of an entire
exclusion of air in retarding the process of decomposition
in a human body are witnessed in the burial of royal per-
sonages in leaden coffins hermetically sealed, and these
afterwards enclosed in marble sarcophagi. When these
have been opened, hundreds of years subsequently, the
remains have been found in a remarkable state of preserva-
tion. On the other hand, bodies naked, or but slightly
clothed, and buried in pine coffins, which soon decay, and
44 MEDICAL JURISPRUDENCE.
in shallow graves, to which the air has easy access, will
undergo very speedy decomposition. The nature of the
soil, and the depth of the grave also materially influence this
process. Thus, a loose, sandy soil and a shallow grave favor
it, by the ready admission of air, whilst one of a stiff, clayey
nature, and a deep grave would retard it, for the opposite
reason. From recent observations, it is highly probable
that the real cause of atmospheric influence upon decompo-
sition is the presence of the bacteria or baccilli which float
in such myriads in the air, and which find their peculiar
habitat in dead animal matter.
The effect of moisture as an agent in animal putrefaction
is to aid it, by favoring solution. The different tissues and
organs of the body undergo decomposition just in propor-
tion to the amount of fluids they contain. In this respect
the brain of the young infant, and the eye contrast widely
Avith the bones and teeth. The human body contains eight-
tenths of its whole weight in fluids; hence its great tendency
to putrefy after death. The bodies of drowned persons
undergo rapid decomposition, unless the water be extremely
cold. In the latter case, the low temperature acts as a
preservative. Likewise, bodies thrown into dungheaps and
cesspools speedily putrefy, from a similar cause, although
the process may also be aided by the warmth of these media.
If a body be completely deprived of its fluids by drying,
putrefaction is arrested, as was remarked under the preceding
head.
The influence of temperature as an agent in putrefaction
is very manifest. The temperature most favorable to this
process is that between yo° and ioo° F. It commences,
however, as low as 50 , but it is completely arrested at 32 ,
below which the body becomes frozen, and also at 21 2°,
when it becomes desiccated by complete loss of its fluids,
PUTREFACTION. 45
through evaporation. As is well known, an animal body
may be preserved for an indefinite period if completely frozen
in snow or ice. It is recorded that the body of a Russian
nobleman that had been buried in the frozen soil of Siberia, on
being exhumed, after a period of ninety-two years, was found
in a state of almost perfect preservation. On the other hand,
the effects of a high temperature as a preservative are wit-
nessed in the mummies of Egypt and adjacent countries.
In this case, however, the dryness of the atmosphere as well
as the high temperature assists in the preservation.
The effect of temperature in the process of putrefaction is
familiarly shown in the influence of the seasons. Thus, in
summer a body will decompose very much sooner than in
winter — a circumstance that should not be forgotten when
giving an opinion respecting the date of death in an unknown
case. According to Casper, the relative rapidity of decom-
position in bodies exposed to the air, kept in cold water, and
buried in the earth, is in the ratio of one, two and eight ; that
is, putrefaction advances as rapidly in one week in the open
air, as in two weeks in the water, and in eight weeks in the
earth (average). It may here be remarked that a body
floating near the top of the water will decompose more
rapidly than when at the bottom ; and when taken out of
the water and exposed to the air, the putrefaction will be
far more rapid than if left in the water.
External signs of Putrefaction. — The following is the
order generally observed, externally, in the progress of
putrefaction of bodies exposed to the open air. In one to
three days in summer (three to six in winter), there first
appears a greenish, or yellowish-green spot upon the
abdomen, three or four inches in diameter, accompanied
with the peculiar odor of putrefaction. The eyeball becomes
soft and yielding within the same period. In a few days
46 MEDICAL JURISPRUDENCE.
more, this greenish discoloration has spread generally over
the whole body, first in spots, which subsequently gradually
coalesce. Dirty red streaks now show themselves
throughout the surface, marking the course of the blood
fc> ' o
vessels. In ten or fifteen days (in warm weather), the
epidermis begins to loosen, forming blebs or blisters con-
taining fluid. Gases now begin to form in the chest and
abdomen, causing these cavities to swell out greatly. The
eyeballs protrude, from the same cause; the face is swollen;
the features so much bloated as no longer to be recog-
nizable. In two or three weeks, the blebs of the cuticle
may have burst open; maggots appear; the formation of
gases increases, so that the body is enormously swollen. If
it be now punctured, the gas which is emitted will frequently
take fire on the approach of a flame (carburetted hydrogen).
Other gases are likewise formed, the result of animal
decomposition, as carbonic acid, sulphuretted hydrogen,
phosphoretted hydrogen, nitrogen, and ammonia. The
nails now loosen ; and in the further progress of putrefac-
tion the cavities burst open, and discharge their contents ;
the softened flesh dissolves off from the bones, which now
become exposed, and ultimately fall apart from the skeleton.
The sexes cease to be distinguishable, except perhaps by
the discovery of a uterus, which appears to be the very last
organ to yield to putrefaction.
The above description is only a very general and average
one, since the process of the external putrefaction of the
body is so very variable, and is influenced by so many
circumstances, all of which are not yet fully understood.
Internal signs of Putrefaction. — The order in which the
internal organs of the body undergo decomposition, being
more regular as to time, affords a rather better criterion as
to the time of death. The first organ of the body that
ORDER OF PUTREFACTION. 47
shows signs of decomposition after death is the lining
membrane of the windpipe (larynx and trachea) ; this
assumes a dirty red coloration simultaneously with the
appearance of the greenish spot upon the abdomen. That
this is not the result of injection of the blood vessels is
proven by the microscope. In the earliest stage of death,
this membrane is always very pale, except when the death
has been caused by laryngitis, or suffocation. The ex-
aminer should be cautioned not to mistake this mark of
putrefaction for congestion. Very soon after this stage of
redness, it becomes of an olive-green color, and the rings
of the trachea separate, and it all falls to pieces and dis-
appears.
The next (2) organ to decompose is the brain of young
infants. The reason of this lies, of course, in the fact that
this organ at such an early age is so very delicate, and is
so little protected, by its bony covering, from the outer air.
When decomposing, it changes into a soft, rosy, pulpaceous
mass, and flows away out of the smallest openings.
Then follows (3) the stomach. This organ is among the
earliest to putrefy after death. The decomposition first
manifests itself in discolorations of the fundus, together
with the formation of dirty red spots in the posterior
portion of the fundus, owing to hypostatic congestion.
These spots soon ramify, and cover the whole lining mem-
brane. There is great risk of mistaking these spots for
signs of congestion or inflammation due to irritant poison-
ing. The examiner should be specially cautioned on this
point, as it is often impossible to distinguish them apart by
a merely ocular inspection. It is quite certain that a post-
mortem redness of the mucous membrane of the stomach
cannot of itself prove a case of poisoning. In the further
progress of putrefaction, the stomach softens, the spots
48 MEDICAL JURISPRUDENCE.
become greenish and gray ; then black, with dark red
streaks (veins) running through them. It is finally con-
verted into a pulpaceous mass, and ceases to be recognized.
Next to the stomach, the intestines (4) follow in the pro-
cess of decomposition. They become discolored very much
as in the case of the stomach ; then they burst open, and
discharge their contents, forming a greasy mass which finally
disappears.
The spleen (5) comes next in the order of putrefaction.
If not diseased at the time of death, it may retain its integ-
rity for two or three weeks. It first assumes a dark red
color, then a greenish-blue, then becomes soft and pulpy, so
that its substance can be rubbed down with the handle of
the scalpel.
Following the spleen, the omentum and mesentery (6) are
the organs next to decay. If there is not much fat con-
nected with them, they will rapidly dry up, and disappear.
The liver (7) resists putrefaction for a considerable time after
death — in adults for several weeks. In infants it decomposes
earlier. It first becomes of a green color, then black ; then
softens, shrivels, and finally disappears. In case of death by
arsenic poisoning, the liver would be likely to resist decom-
position for a very considerable time, in consequence of the
affinity of that organ for arsenic, which would exercise its
preservative influence over it.
The brain of adults (8) does not begin to show signs of
putrefaction until the end of the fourth or fifth week, and
sometimes even later. The process commences at the base,
which softens and becomes bluish-green, and gradually
progresses upward, and then inward. If the brain has
been injured, as by a depressed bone, or by a gunshot
wound, it is affected earlier.
Next in order is the heart (9). This is one of the toughest
ORDER OF PUTREFACTION. 49
of all the organs. The softening here begins in the columnar
carneae, and progresses outward toward the walls of the
organ, which finally deliquesce into an unrecognizable
mass.
It is remarkable that the lungs (10), which are very soft
organs, and are so nearly connected with the outward air,
should resist putrefaction so long. These organs are often
found quite sound for weeks after death, provided they were
healthy and uninjured at dissolution. The first evidence of
their decomposition is the formation of little bladders of air
in the sulci, between the lobes, on the under surface, looking
like a string of beads. These increase rapidly, the lung
structure turning first green, then black, and finally softening
and disappearing.
The kidneys (i i) follow the lungs. They become reddish-
brown, and soften; then they assume a greenish-black color,
and soften and disappear. Next in order (12) follow the
urinary bladder and oesophagus. Next (13) the pancreas,
which, though a soft organ, and located near the stomach,
is among the last to decompose. Then follow (14) the
diaphragm and the arteries ; the tissue of the latter resisting
putrefaction while everything else around them has fallen
into a shapeless mass.
Last of all, according to Casper, is the uterus (15), which
has been found to retain its identity at the end of seven
months after death. This fact is of great medico-legal
importance, where the question arises of the possibility of
pregnancy.
The above description of the progress of putrefaction, both
external and internal, of the human body is taken chiefly
from Pr.of. Casper's work on Forensic Medicine, translated
and published by the Sydenham Society. It is intended to
represent the average, both as regards appearance and time.
50 MEDICAL JURISPRUDENCE.
As already stated, there may be considerable deviations from
the order laid down, depending upon a variety of circum-
stances.
Saponification, or Adipocere. — It sometimes happens, in
the course of the putrefaction of the body, that this process
is interfered with under peculiar circumstances, and gives
place to a new condition, known as the saponification of the
body, or the production of adipocere. This remarkable
condition was first observed by Fouroroy, who discovered,
during the removal of human remains from one of the
public cemeteries of Paris, that a number of the bodies,
instead of undergoing ordinary putrefaction, had been con-
verted into a new substance, which he styled adipocere,
from its resemblance to a combination of fat (adeps) and
wax (ccra).
This adipocere has an unctuous feel, somewhat like
spermaceti, and is of a whitish, discolored appearance. By
the analysis of M. Chevreul, jt was found to be an ammo-
niacal soap — a compound of stearic and oleic acids, united
with ammonium. In the course of putrefaction, the fatty
acids of the body combine with the ammonia, which is the
result of the decomposition of the nitrogenized tissues. It
is interesting to inquire what are the conditions under which
this singular process of saponification replaces the ordinary
decomposition of the body. The presence of water is essen-
tial to it. It only occurs in bodies that have been buried in
wet, or very moist soil. It never happens to those interred
in a loose, or sandy soil. It is frequently the case that when
the grave, after burial, fills with water, the contained body-
is converted into adipocere. The same thing takes place in
bodies which remain in the water for a certain length of
time.
ADIPOCERE. 51
The composition of adipocere is not always precisely the
same. Its base may consist of either ammonia or lime.
The latter takes the place of the former, whenever the sapo-
nified substance remains for any considerable time in water
containing any salt of lime. This was determined experi-
rr.ently by Orfila, who placed an ammonium adipocere in a
solution of sulphate of lime; he found that after a time it
had been changed into the oleo-stearate of lime. Adipocere
is insoluble in water, but partially soluble in alcohol. It
takes fire and burns at a temperature of about 21 2° K.,
emitting a greasy smell. It contains a coloring matter, and
an odorous and a bitter principle. Its odor resembles some-
what that of musty cheese.
From the fact that if a body remain immersed in the
water for any length of time it is likely to be changed into
adipocere, it becomes an important medico-legal question
to establish the period necessary for this conversion. De-
vergie ascertained that the body of a new-born child was
more or less changed into adipocere after remaining in the
water for five or six weeks. We see at once the value of
this knowledge to the legal physician, since the bodies of new-
born infants are frequently thrown into wells, privies and
cesspools, by their unnatural mothers. If such a body be
found under such circumstances, with the process of saponi-
fication only just begun, it is tolerably certain that it could
not have been long in the water, and vice versa. According
to the same distinguished authority, an adult body requires
an immersion in water for one year, before the conversion is
complete; and when it is buried in wet earth, a period of three
years may elapse before the change is completely effected.
An adipocerous body is always heavier than an ordinary
one, because the adipocere is more weighty than the original
fat.
52 MEDICAL JURISPRUDENCE.
Mummification. — This constitutes another process by
which the ordinary putrefaction of the body is interfered
with. By mummification we understand the complete desic-
cation, or drying up of the body. A mummified body is the
result either of burial in an arid and sandy soil of hot coun-
tries, such as those of Arabia and Egypt, or of the exposure
of the body to a constantly cold and dry atmosphere — where,
for instance, it is placed in a vault, through which a constant
stream of dry, cold air is pouring. Such a condition of
things is found at the Hospice of St. Bernard, in Switzerland.
In the charnel house attached to this establishment, the
bodies of those who have perished in the snows are placed.
The atmosphere is so constantly cold and dry, that the flesh
and fat completely dry up. It is quite impossible, from the
mere inspection of a mummy, to venture an opinion as to
the length of time that has elapsed since death. Some of
the Egyptian mummies are from two to three thousand
years old, as is shown by the inscriptions upon their burial
cases.
There are certain agents which retard, and others which
promote, decomposition. The former comprise the various
antiseptics. Lime, although popularly supposed to hasten
putrefaction, in reality retards it, as is shown by a simple
experiment of Dr. John Davy, who buried a piece of raw
flesh that had been first covered over with powdered lime.
It continued sound much longer than another piece that was
buried without the lime. No doubt, the lime here served
the purpose of secluding the atmospheric air. The strong
acids and alkalies, although they do not hasten putrefaction,
promote dissolution through chemical action, and in this
way they aid in the removal of a body.
The period and method of Interment very materially influ-
ence the rapidity of putrefaction. Thus, if decomposition
HOW LONG SINCE THE DEATH ? 53
has already set in before burial, this action will progress far
more rapidly afterwards, than in a body which was interred
before putrefaction was begun. Again, the depth of the
grave and the nature of the soil exercise a very marked
influence on the subsequent decomposition of the body, as
already pointed out. Finally, the cause of death — as from
a wasting disease, more especially when the blood has been
deteriorated, as in typhus fever, etc. — will materially influ-
ence the subsequent rapidity of the decomposition of the
body.
II. Having disposed of the first medico-legal question —
is the death real or apparent ? we may consider the second
important query — how long a time has elapsed since the
death? This is to be determined, in the absence of direct
evidence, solely by attending to the different " signs " or
phenomena of death already described. The inferences may
be drawn, first, from the signs occurring before putrefaction,
secondly, from those occurring after it.
( i ) Inferences from the signs exhibited before putrefaction. —
If the body is only slightly cold, and rigidity is just com-
mencing about the jaws, the eyes glazed, and the eyeballs
sunken ; death has occurred, most probably, from a quarter
of an hour to four or five hours. (The inference can never
be more than approximative.)
Suppose the body to be perfectly cold (externally) and
rigid throughout: it has probably been dead from twelve
hours, to three or four days. If rigidity is complete over
the body, and cadaveric lividity (suggillation) is manifested
over the surface, death has probably occurred from one to
four days.
The importance of attending to the above phenomena, by
the medical jurist, is shown by a case mentioned by Taylor,
54 MEDICAL JURISPRUDENCE.
which occurred in London some years ago. A man named
Gardiner was convicted and transported for killing his wife.
The woman was discovered, with her throat cut, at 8 o'clock
in the morning. She was very rigid throughout the upper
part of her body, and the whole body was cold. The
prisoner was able to prove an alibi between the hours of 4
and 8 A. iff., and his counsel endeavored to show that the
post-mortem coldness and the partial rigidity might have
developed within four hours, which, if true, would have
exculpated the accused. But this point was very properly
overruled by the mass of medical testimony to the
contrary.
(2) Inferences after putrefaction. — Suppose the body
exhibits the greenish discoloration on the abdomen, the
peculiar odor of putrefaction ; the rigor mortis has passed
off, and the body is cold but pliant: death has occurred from
one to three days, in summer, and from three to six or
eight days, in winter.
If the greenish-yellow discoloration extends more or less
over the whole surface, together with greenish-brown stains,
and dark red lines over various parts, along with relaxation
of the sphincter ani muscle, it must have been dead from
eight to ten days, in summer, and from ten to twenty days,
in winter.
If blebs are found over the skin, and some of them
opened, with maggots in the muscles ; if the body is green
all over, and the chest and abdomen are enormously dis-
tended ; the nails loose or falling out ; the color of the eyes
not recognizable; the features very much swollen, then the
death must have occurred from two to three weeks, in
summer, or from four to five weeks, in winter.
If the chest and abdomen have burst open and discharged
their contents, and some of the bones are denuded of their
INFERENCES AS TO TIME OF DEATH. 55
fleshy coverings; the eyes enormously swollen; the body
has been dead, probably, from two to four months.
The above " inferences," it will be remembered, are only
approximative, as already stated. They cannot be positive
under any circumstances; and, moreover, they are predicated
on the supposition that the body under examination has not
been buried, but exposed to the action of the atmosphere.
It is important that the legal physician should avoid giving
a very positive opinion on this question, as it must, at best,
be but conjectural, and dependent on so many contingencies.
56 MEDICAL JURISPRUDENCE,
CHAPTER III.
MEDIO >-LEGAL INVESTIGATE >NS.— THE POST-MORTEM.
RESPONSIBILITY INVOLVED IN MAKING THE POST-MORTEM. — GENERAL
ACCURACY AND .METHOD NECESSARY. — EXAMINATION OF THE SUR-
ROUNDINGS OF THE BODY. — EXTERNAL EXAMINATION OF THE
BODY.— INTERNAL EXAMINATION OF THE BODY. — DETAILS OF THE
EXAMINATION. — MEASUREMENTS AND WEIGHTS. — NOTES.
The physician who undertakes to make a post-mortem
examination in a medico-legal case, assumes a very serious
responsibility. He should, therefore, be fully prepared to
meet the various contingencies that may present themselves,
and he should execute his work so thoroughly as to leave
no cause for subsequent regret. He should, moreover, per-
form his duty with strict impartiality, unbiassed by prejudice,
and untrammeled by fear or favor. Not only should the
examiner be an expert anatomist and pathologist, but he
should also be a close and careful observer of all the sur-
rounding circumstances that might throw light upon the
case.
In all cases where dispute is likely to arise, it is advisable
to have two examiners, so as to avoid an ex parte appear-
ance ; and the suspected person should be represented by
a friend of his own selection. The examination should
always, if possible, be made by daylight, since artificial light
might conceal certain shades of color which it might be
important to recognize, such as the stains of nitric acid.
Where a chemical or microscopical investigation becomes
necessary, the parts required should be carefully put aside
for as early a subsequent examination as possible.
The examination should always be cxliaitstive — leaving
THE POST-MORTEM. 57
nothing undone — so that the examiner may be able to testify
accurately as to the cause of death. For example, the dis-
covery of a disease of the heart (a sufficient cause of death)
should not preclude an examination of the lungs and brain,
in each of which the real cause of the death may be found
located. So, also, the finding of poison in the stomach may
co-exist with a ruptured aneurism, or a clot in the brain.
The examination, moreover, should be conducted according
to method, and all the details carefully recorded in a note-
book.
The post-mortem should be made as early as possible
after the first day subsequent to the death. But it should
never be declined on account of the interval that may have
elapsed, nor even if the body be in a state of putrefaction.
The surroundings should first claim attention, such as the
locality where the body was discovered, as this may aflbrd
a clue to the criminal, especially in a case of infanticide.
Sometimes the body has been dragged by the murderer to
a distant spot, or the victim may have followed his assailant
after receiving the blow, and died at a distance. The
presence of footmarks near by should be noted, together
with their direction; evidences of struggling \ as denoted by
the condition of the grass, or dust, or mud in the road ; the
presence of any weapon, or other missile. If in a room, the
position of the body in reference to articles of furniture, to
any weapon, to glasses, cups, bottles, etc., from which poison
may have been taken. It is also advisable to make a sketch,
or rough drawing of the locality.
As regards the body itself, the examiner should note its
exact position when found : this is especially important if
death was caused by a wound. The clothes should be care-
fully examined, whether torn or cut; whether marked by
blood-stains, or by any acid; if stabbed, whether the cuts
4
MEDICAL JURISPRUDENCE.
correspond with the wounds on the body. The clothes
should then be removed, and the whole body minutely
inspected. It should also now be identified, if possible.
Notes should be made of the sex, height, weight, age and
general development; of scars and other marks; abnormali-
ties ; blood, seminal and other stains ; the color of the skin, and
condition of the eyes and teeth; the temperature and rigidity
of the body; the degree of putrefaction ; lividity and ecchy-
moscs ; matters flowing from the nose and mouth; state of
the tongue ; expression of the countenance. The hands should
be inspected, to ascertain if they hold a weapon — whether
loosely or tightly grasped; or if portions of hair or clothing
are firmly held (denoting a struggle); whether stained with
blood, or blackened by powder (the latter indicating fire-
arms); the presence or absence of foreign bodies in the nose,
mouth, anus and vagina should also be noticed.
All wounds should be carefully examined, as to depth,
extent and direction, and whether they suit the weapon that
may be found near by; the condition of their edges, as
indicating whether recent or not; marks of inflammation,
suppuration or gangrene ; whether any foreign body be
present, as a ball, fragments of clothing etc. The scalpel
may be used, if necessary, to enlarge the wound, with care
not to interfere with its original character. If there is
contusion without solution of continuity, the examiner
should not fail to look for internal injuries.
In fractures and luxations, notice their condition, and that
of the surrounding parts. In case of burns , observe their
degree and extent; whether merely inflamed or vesicated,
and the state of the adjacent parts.
In females, examine the genital organs, in cases of rape,
pregnane};, and recent delivery.
In newborn children, ascertain their length and weight,
INTERNAL EXAMINATION OF THE BODY. 59
condition of the hair, nails, membrana pupillaris and genital
organs, condition of the umbilical cord. The question of a
live-birth will be a subject for future investigation.
The Internal Examination of the Body-. — The following
order should be observed : —
(i) The Head. — After a careful external examination for
wounds or injuries (for which the hair may have to be re-
moved), the scalp should be separated by an incision made
across it from ear to ear, down to the bone ; it should then
be everted in both directions, so as to expose the skull.
Now look for fractures, and do not mistake irregular sutures
for these. Notice any unusual thinness of bone; follow out
any fracture to its whole extent ; observe any extravasation
of blood under the scalp.
The skull should now be carefully sawed around, about
half an inch above the opening of the ear, the calvarium
removed, and the condition of the dura mater noticed. This
membrane should be carefully cut around with a probe-
pointed scissors, and the arachnoid and pia mater closely
inspected
The upper part of the brain can now be examined before
removal — as to congestion of its vessels, laceration, or
extravasation of blood upon its surface. (Remember this
latter is often seen on the side opposite to the external
injury.) The brain is now to be carefully removed, by
inserting the fingers beneath it, and dividing the medulla
oblongata.
The base of the skull should be carefully inspected for
fractures, which otherwise might escape notice.
The brain should now be examined from above, slicing
it horizontally; regarding specially its consistence, color,
presence of extravasated blood or serum, of tumors or
abscesses, disease of blood vessels, or of the membranes.
60 MEDICAL JURISPRUDENCE.
In opening the skull of very young children, a pair of strong
scissors may be used instead of a saw.
(2) The Spinal Column should be opened through its
whole extent, by sawing through on each side of the spinous
processes. The cord, together with the dura mater, should
then be removed and examined. The presence of fracture,
dislocation, or contusion, should be carefully noticed.
(3) The Neck should be carefully inspected for marks of
violence by the fingers (garrotting) ; by a cord (strangling
or hanging) ; ecchymoses ; the great vessels, whether full or
empty; the nerves, whether in their natural state. The
cavity of the mouth and nose. The condition of the larynx,
trachea, pharynx and oesophagus.
The thorax and abdomen may be opened together, by a
single incision, extending from the root of the neck to the
pubes, and a transverse one across the umbilicus. The
thorax should be first examined, except in the bodies of
new-born children, where it is important to observe the con-
dition of the diaphragm ; in this case the abdomen should
first be opened. Moreover, in cases of death from asphyxia,
it is recommended by Dr. Tidy to examine the condition of
the heart before opening the head, because the blood is apt
to escape from the right side of the heart if the head is
opened first.
(4) The Thorax. — The cartilages of the ribs, together with
the sterno-clavicular ligaments, should be carefully divided,
avoiding wounding the large veins of the neck, and the
sternum should be reflected. Notice the condition of the
lungs, whether adherent, collapsed, or emphysematous.
Record immediately the position and color of the thoracic
viscera ; also the presence, and amount, and nature of any
fluid in the pleural cavity. Open the pericardium, and note
the presence and amount of any contained fluid.
INTERNAL EXAMINATION OF THE BODY. (jl
The lungs are removed by passing the hand beneath them
(noticing any adhesions), and cutting through the bronchi
and vessels at their roots. They should be inspected as to
their color, density, etc., as indicating disease ; the condition
of the bronchial tubes and pulmonary artery (embolism);
and the presence of foreign matters in the air passages (in
case of drowning). If blood has escaped into the thorax, it
should be removed by a sponge, so as to ascertain the color
of the parts. The hydrostatic examination of the lungs in
new-born children will be considered farther on.
The Heart should be examined in situ, before removal,
as to its size, and the fullness of the coronary vessels ; the
cavities should now also be opened, and the amount of their
contained blood noted, together with any clots or polypi.
The organ may next be removed by cutting through the
vessels at its base, and examined as to its weight, condition
of its walls and tissue, and state of its valves. Sometimes
a microscopic investigation may be required. The aorta
should likewise be examined, for atheroma and aneurism.
(5) The Abdomen. — On removing the integuments, the
examiner should carefully note all signs of peritonitis, and
of swelling, extravasation, strangulation, or twist of the
intestines, and hernia ; likewise the condition of the liver,
spleen, kidneys, bladder ; and, in the female, the state of the
vagina, uterus and ovaries, the uterus especially, for evidences
of pregnancy, abortion, and delivery.
The Stomach should be examined by first ligating it at
the cardiac extremity, and then by applying two ligatures at
the pyloric end, and cutting between them. Note the general
external appearance, and then open it along its lesser curva-
ture. Examine the contents, as to quantity, character and
odor, and reaction. Carefully inspect the lining membrane
with a lens, for solid particles of phosphorus, crystals, or
62 MEDICAL JURISPRUDENCE.
patches of arsenic, or other mineral poisons, fragments of
leaves or seeds, or other foreign matters. Note any evidences
of inflammation, or ulceration.
The Intestines should next be examined, by removing them
from their attachments, and slitting them throughout with
an enterotome ; looking for inflammation and ulceration of
the glands, and for any foreign matters ; also noting the
condition of the appendix vermiformis. In cases of poison-
ing, the stomach and its contents should be preserved for
chemical examination, in a separate jar. The intestines also
(at least a portion of the small and large bowel, together
with the rectum), and portions of the liver, kidney and
spleen, should be kept for a similar purpose. The jars con-
taining the viscera should be securely stoppered, and sealed
with the private seal of the examiner, with a label affixed,
stating the name of the deceased person, the date of death
and of the autopsy. They should then be delivered per-
sonally, by him, to a responsible party, from whom he
should always take a written receipt.
In case of disinterment of a body, the inspectors should
always view it before it is removed from the coffin; at which
time, also, it should be properly identified by the friends or
relatives of the deceased.
In a medico-legal examination of a body, such as above
described, there should always be present either a second
inspector, or a clerk, to take down the notes as the autopsy
progresses. These notes should comprise the appearances
presented by the different organs, stating only facts, but no
opinions. The notes should be carefully read over by both
examiners before sewing up the body, and, if necessary,
corrected. A report should then be carefully drawn up,
containing the opinion of the case, as deduced from the
ascertained facts, with the reasons therefor, clearly and
succinctly stated, but avoiding all theorizing on the subject.
PRESUMPTION OF DEATH. 63
CHAPTER IV.
PRESUMPTION OF DEATH, AND OF SURVIVORSHIP.
CASES INVOLVING PRESUMPTION OF DEATH, AND OF SURVIVORSHIP.
— FRENCH LAW OF SURVIVORSHIP. — PROBABILITIES AFFORDED BY
AGE, SEX, AND MODE OF DEATH.
Presumption of Death. — This question may be raised when
a person goes away -from home, and is not heard of for many
continuous years. The law will, in that event, regard him
as dead, or presume his death, and his administrator or
executor may proceed to settle his estate. The question
under this form is not unfrequently raised in life insurance
companies, where the party insured has not been heard of
for many years, and his lawful heirs demand the payment
of his policy. It must also be considered in cases where
a husband deserts his wife, or vice versa; or where either
married person leaves the other, and remains continuously
away; or where the party going away without the inten-
tion of remaining, is not afterwards heard of for a succession
of years.
The length of time usually regarded as legally warranting
a presumption of death, in any of the above cases, is seven
years from the time the person was last heard from; so that
in the case of married persons, it is not regarded as bigamy
if the other party should marry again after the expiration
of the seven years of continuous absence, without being
heard from, or being known to be alive. In cases of heir-
ship and property, and in some cases of life insurance, it is
often not considered necessary to wait the whole seven years,
but a settlement has been made by the courts or company
in two years.
64 MEDICAL JURISPRUDENCE.
The presumption of death must depend on general
evidence, being a presumption of fact to be determined by
a jury. There are cases, however, of a special character,
where the courts have decided the presumption of death to
be sooner or later than the period of seven years, as, e. g. t if
the individual concerned was in feeble health when he, or
she, was last heard from. This question would involve
medical evidence as to the probabilities of life, in such a
case.
Presumption of Survivorship. — Questions relating to pre-
sumption of survivorship are much more frequently discussed
in the courts than those pertaining to presumption of death.
There is, however, no general law upon the subject, either
in this country, or Great Britain, every case in which the
question is involved being decided according to its indi-
vidual merits. When two or more persons perish by the
same calamity, in the absence of all testimony, the courts
frequently refuse to assume that one survived the others,
but have decided that all perished together. Yet, very
momentous questions may be dependent upon a legal deci-
sion of the question of survivorship; as when the parties
dying are a father and a son ; if the son survive but for a
moment, " his wife shall have dower, for the lands descended
the instant the father died." So, in the case of a testator
and legatee ; if the latter dies first, the legacy lapses ; but if he
survives the testator, for ever so short a time, his executors
can claim. So, again, the husband of a woman possessed
of freehold property (not specially settled), has a life int<
in her estate, provided she has issue by him, born during
the life of the mother, and which survives her even for a
moment of time {tenancy by courtesy). The old Roman
law upon this subject, upon which are based most of our
PRESUMPTION OF SURVIVORSHIP. 65
modern decisions, enacted that when persons of different
ages perished in battle, those under puberty were deemed
to have died first ; but if the son was above the age of
puberty, and both died together, the son was presumed to
have survived the parent. In the case of husband and wife,
the husband was presumed to be the survivor (Beck).
According to Fodere and Beck, the French law, as con-
tained in the Code Napoleon, is as follows :
" I. If several persons, naturally heirs of each other, perish
by the same event, without the possibility of knowing which
died first, the presumption as to survivorship shall be deter-
mined by the circumstances of the case; and in default
thereof, by strength of age and sex.
"II. If those who perished together were under fifteen
years, the oldest shall be presumed the survivor.
" III. If they were all above sixty years of age, then the
youngest shall be presumed the survivor.
"IV. If some were under fifteen, and others above sixty,
the former shall be presumed the survivors.
"V. If those who perished together were over the age of
fifteen, but under sixty, the males shall be presumed the
survivors, where the ages are equal, or the difference does
not exceed one year.
"VI. If they were of the same sex, that presumption shall
be admitted which opens the succession in the order of
nature. Of course, the younger shall be considered to have
survived the elder."
According to Section IV in the above Code, no distinc-
tion is made between an infant and a man of sixty years ;
yet certainly, it may fairly be supposed (as remarked by Dr.
Tidy) that the latter had a better chance of life than the
former. The Prussian law on this question is about iden-
tical with the Code Napoleon.
4*
GQ MEDICAL JURISPRUDENCE.
Although our laws are not decisive on questions of pre-
sumption of survivorship, but treat them as questions of
fact depending wholly on evidence, and, in the absence of
all evidence, regarding them as matters incapable of being
determined, still, there are certain matters of importance
connected with each case as it presents itself, which deserve
the consideration of the court and jury, in influencing their
decision. These points may be considered under the follow-
ing heads :
(i) Probabilities afforded by the Age. — Between a father,
and a child under puberty, the English civil law decides the
father to be the survivor. Between the ages of fifteen and
sixty, there is no probability. Between a middle-aged man,
and one under fifteen and over sixty, the probabilities are in
favor of the former. Between one under fifteen and one
over sixty, the former is deemed the survivor; but the same
exception might be taken here as in the case of Sect. IV of
the Code Napoleon (supra). Between two under fifteen, the
oldest is considered the survivor. If the question is between
a mother and infant, both dying in childbed, without assist-
ance, the presumption of survivorship is in favor of the
mother, because the child might be still-born, and also
because, if large, its life might be endangered by delay, and
it would be more exposed to danger without assistance,
such as strangulation by the cord, or suffocation in the
discharges of the mother.
(2) Presumption afforded by the Sex. — The presumption
is in favor of the male, when it is a question of physical
strength and courage, as when a man and woman perish
together by drowning, or some other casualty. But in par-
ticular cases, the question of the respective health of the
two persons might have to be considered. When, however,
it is a question of passive endurance, especially where insen-
PRESUMPTION OF SURVIVORSHIP. 07
sibility supervenes, then the presumption is in favor of the
female.
(3) The Cause of Death, as affording a presumption of sur-
vivorship. In death from asphyxia (apncea), as in smother-
ing, or breathing noxious gases, as women require less
oxygen than men, the probabilities are in favor of the
former, other things being equal. Thus, it is stated that, in
Paris, in one year, there occurred three hundred and sixty
cases of poisoning by charcoal vapors ; of this number there
were nineteen instances where a man and a woman were
exposed together, and of these only three survived, and all
were females. Dr. Beck relates the case of a man, wife and
child, who were all asphyxiated while sleeping in a room
which was exposed to the vapors of a coal stove. In the
morning, the man was found dead, the child dying, but the
woman recovered.
In drowning, or shipwreck, the question becomes very
complicated, having to take into the account age, sex,
strength and opportunity. Thus, men, being stronger, more
likely to be able to swim, and, in case of shipwreck, being
more apt to be on deck, and, therefore, in a better position
to escape, have the best probabilities for survival ; but, on
the other hand, the buoyancy of a woman's clothes might
support her in the water, and thus save her life, under pos-
sible circumstances. In case of two or more persons, all
males, equally exposed, a presumption of survivorship can
only be entertained by searching for bodily injuries, or
other weakening causes, which would necessarily interfere
with the individual's exertions to save his life. Here, also,
their respective swimming capacities would have to be con-
sidered.
If the question be on the survivorship, in the case of
several persons exposed to excessive cold, the amount of
(J8 MEDICAL JURISPRUDENCE.
clothing, the physical condition, and the immoderate use
of alcohol, must all be considered before arriving at a con-
clusion. The probabilities would here be in favor of the
strong adult over the very young, or very old person, and
of males over females. The debilitating effects of poverty,
entailing a bad nutrition, and also of intoxication, as being
especially obnoxious to the effects of cold, should not be
overlooked. The perishing of drunken people on a cold
winter's night is a too familiar occurrence. In relation to
the effects of 'heat, it maybe remarked that, while the young
and old suffer more from cold than adults, they seem able
to withstand a greater amount of heat than the latter.
In death by starvation, the general principle that the
young require more food than the aged, will determine the
presumption of survivorship to be in favor of the latter ;
also for the female, rather than the male. Certain circum-
stances, however, should here be considered, such as prox-
imity to water, which would aid in sustaining life for some
time, even without food.
PERSONAL IDENTITY. 69
CHAPTER V.
PERSONAL IDENTITY.
SECTION I.
IMPORTANT MEDICO-LEGAL BEARINGS. — I. IDENTIFICATION OF THE
LIVING. — PERSONAL APPEARANCE. — PECULIAR BODILY MARKS. —
REMARKABLE CASES.
The medico-legal consideration of the subject of personal
identity is much more important than it may appear at first
sight. The question is often raised in trials, both of a civil
and criminal character, and it may constitute the chief link
in the whole chain of evidence. Cases of mistaken identity
are constantly occurring, and proofs abundant might be
adduced to show that innocent persons have frequently
been made to suffer the penalty of death judicially, instead
of the guilty, simply through an error of this nature. Should
an alleged child, or other claimant present his claim to an
inheritance, he must first establish his identity before taking
further steps in the suit. Is an individual assaulted, or
robbed? he will be required to identify his assailant before
he can successfully prosecute him. Or, again, a person,
after many years' absence in foreign climes, returns home to
claim his rightful property or title, but he is so changed as
to be unrecognized by his nearest relatives ; he must be able
to prove his identity before the courts, before his claim can
be sustained. And then, in relation to persons found dead —
whether in cases of recent death, where the body has under-
gone but little change, or years after the decease, where
nothing remains of the body from which to glean the im-
portant information but the bare skeleton — the question of
70 MEDICAL JURISPRUDENCE.
personal identity acquires the most intense interest, more
especially in a trial for murder, where it becomes essential
to establish the identity of the alleged victim as the corpus
delicti.
It is true that the aid of the physician is not so frequently
invoked for proving the identity of the living \ since this
can generally be established as satisfactorily by friends and
neighbors, *as by medical men. Still, there may be occa-
sions of unusual complexity, in which a professional opinion
may become requisite, as, for example, to verify certain
deformities, fractures, scars, and other marks about the
person, when these constitute the evidences on which the
identification may be dependent.
The subject will be considered under the two divisions of ( i)
The Identity of the Living, and (2) The Identity of the Dead.
I. The Identity of the Living. — This may usually be es-
tablished by the direct evidence of witnesses who have
known the individual sufficiently long to have a distinct
recollection of his personal appearance; such is the testi-
mony of relatives, friends and acquaintances. Although
among the myriads of the human family it is very rare to
find two persons exactly alike in all points, yet remarkable
instances do occasionally occur where the personal resem-
blance is so striking as to baffle even the skill of the detect-
ive; and this resemblance has been made still stronger by
the existence of similar marks, cicatrices, or certain peculi-
arities of structure, in both individuals. Some striking illus-
trations might be given of the extreme difficulty — amounting,
at times, to an impossibility — of deciding the question, which
also go to show how easily witnesses may be mistaken in
their evidence on this subject. Only two will be here re-
ferred to.
IDENTITY OF THE LIVING. 71
In the year 1560 the celebrated case of Martin Guerre
and Armand du Tilh was tried before the Parliament of
Toulouse. Martin had been absent from his home for eight
years, when the person named du Tilh appeared, and
represented himself as the long absent man. So strong
was the resemblance, that his statement was universally
accepted by all of Guerre's family, including his wife, four
sisters and two brothers-in-law, among whom he lived
unsuspected for three years. About this time, however,
something occurred to excite suspicions as to the true
character of the supposed husband and brother, when he
was arrested, and brought before the tribunal, on a charge of
fraud. Upon his examination he gave satisfactory answers
to the most minute questions in relation to Guerre's former
life. Some one hundred and fifty witnesses were examined
during the investigation, of whom between thirty and forty
testified, from a life-long acquaintance, that the prisoner was
Martin Guerre ; while about the same number swore posi-
tively that he was Armand du Tilh, whom they well knew;
and over sixty, who knew them both, declared that they
were unable to say which the prisoner was. Finally, how-
ever, the real Martin appeared upon the scene, when imme-
diately he was recognized. The four sisters who had
previously testified that du Tilh was their real brother, now
admitted their error, and acknowledged the distinction.
There being now no doubt of the guilt of the prisoner, he
was condemned, and afterwards executed. (Wharton and
Stille's Med. Jurisp. Vol. II, p. 1092.)
The other instance is afforded in the recent famous
Tichborne case, in which a person named Orton, with
various aliases, undertook to personate an English baronet,
heir to a large entailed estate. So successful was his scheme
that " he was sworn to be Sir Roger Tichborne by eighty-
VI MEDICAL JURISPRUDENCE.
five witnesses, among whom were Sir Roger's mother, the
family solicitor, one baronet, six magistrates, one general,
three colonels, one major, two captains, thirty-two non-
commissioned officers and privates of the army, four clergy-
men, seven tenants of the Tichborne estates, and seventeen
servants of the family." The claimant also gave proof of
" a fish-hook wound on the eye, of a mark of bleeding on
the ankle, and of a peculiar scar on the head," all of which
the genuine Sir Roger possessed. The case, however, broke
down on cross-examination, many circumstances being
proven against the claimant, which need not be here
enumerated. Suffice it to say that a verdict was taken
against him, and that an indictment was since found against
him for perjury.
Now, as a fair inference from the above two instances,
and other remarkable cases, we may assume, that appear-
ances are not conclusive evidences of personal identity ; and,
as a sufficient reason for this we must admit the fact that
" a large proportion of ordinary persons are very untrust-
worthy witnesses to identity, when dependent on appear-
ances alone. They are, from nature or habit, incapable of
appreciating form, and form alone is the unerring proof of
personal identity. The difficulties in the way of identifica-
tion, more especially of the dead, are to them insuperable "
{Loud. Spectator). To this inherent difficulty on the part
of the witnesses, may be added, their want of previous
training as minute observers ; and also, the well-known
fact of the adroitness of criminals at personal disguisement.
A second means of establishing the identity of the living,
especially in a criminal, is by certain peculiarities in the
appearance, which are noticed at the time of the commission
of the crime, and which are, therefore, apt to leave a strong
impression on the senses, — such as (a) size, when the indi-
IDENTITY OF THE LIVING. 73
vidual is very tall or very short, very corpulent or very
slim; whether lame, or otherwise deformed; (//) dress,
when a portion — sometimes a mere shred — of the prisoner's
dress is discovered near the seat of the crime, which ex-
actly corresponds with the rest of the garment found on
his person, or in his own house.
A third means of identification is afforded by the voice.
Peculiarity of the voice (such as depth or shrillness, lisping
or stammering) always makes a strong impression upon
those who hear it, and constitutes a valuable aid in personal
identification.
Fourthly, the presence of certain peculiar marks, either
natural or acquired, about the person, often affords material
aid in establishing identity. These marks comprise moles,
nsevi, scars, cicatrices, deformities, fractures, tattoo-marks,
etc. Such marks are usually well known, and remembered
by relatives and friends of the individual, who can usually
identify them. Some of these remain upon the body
during life; others gradually decline and fade away. In
relation to tattoo-marks, Prof. Casper's experience leads to
the inference that some of them (the red ones) are gradually
obliterated by time, while the black and purple ones are
more permanent. A cicatrix is permanent during life, if
there has been any original loss of substance. It may not
always be distinguished from the surrounding skin, unless
the part be smartly rubbed, when the white scar is immedi-
ately manifested on the red surrounding surface. Caution
should be given against too strong a reliance upon scars as
a means of identity, since these may, at times, be dis-
covered upon another, precisely similar, both as to form
and situation.
Under this head may be mentioned the appearance of
the hands (whether hard and horny, or soft and pliant, or
7 1 MEDICAL JURISPRUDENCE.
whether stained in a peculiar manner), as often indicating
the nature of the occupation of the individual.
Photographs and other portraits of the suspected person
are sometimes useful aids in the identification of the living,
as well as of the dead; but caution is requisite here, since
the art of the photographer in the touching up of the picture
frequently makes it an unfaithful representative of the nega-
tive.
As bearing upon this subject, it may be proper to say a
few words upon vision and hearing. The following remarks
are abridged from Woodman and Tidy's Forensic Medicine.
The limits of normal vision or healthy sight, unassisted by
instruments, in a perfectly clear atmosphere, are as follows :
At a height of 5 feet, the range of distance is 2.96 miles.
" 20 " " " 5.91 "
50 " « " 9.35 "
" « 100 " " " 13.2 "
" u 500 « u u 29#5
" " IOOO - " " 4I.8 "
" " 5OOO " " " 94 "
It follows from this, that a man of ordinary height may be
seen on level ground at a distance of two or three miles, on
a clear day; but this is very different from recognition of the
person, so as to identify him. The effects of age upon the
acuteness of vision is considered by Dr. De Gueret to be as
follows : —
At fifty years it is diminished one-fifth ; at sixty years
one-fourth ; at seventy years, one-third ; at eighty years,
one-half. In other words, if a man of thirty or forty could
distinguish an object at one hundred feet distance, at sixty
years of age he could not recognize it further off than
seventy-five feet, or, at eighty years, at fifty feet.
The recognition of persons at a nearer or greater distance,
is afforded by their stature, gait, complexion, color of the hair
IDENTIFICATION BY SIGHT AND SOUND. / ->
and eyes, and peculiarities of appearance. According to the
above authority, the best-known persons can be recognized
often with difficulty, in broad daylight, at one hundred
metres, or about one hundred and nine yards. Less known
persons may be recognized, in broad daylight, at sixty to
one hundred yards ; and people who are almost strangers,
and who have no personal peculiarities, at twenty-seven to
thirty-three yards. By the clearest moonlight, the best-
known persons cannot be recognized further off than six-
teen or seventeen yards. By starlight, recognition cannot
be effected beyond ten to thirteen feet. The light of & flash
of lightning enabled a lady, on her passage home from India,
to see distinctly the features of a man who was robbing her
trunk in the cabin of a vessel, on a very dark night; and
authentic instances are given where, by the flash of a pistol
or gun, sufficient light was momentarily afforded to enable
not only an assailant to be recognized, but likewise the
color and appearance of his horse The subjective sensa-
tion of flashes of light or sparks, produced by a blow upon
the eyeball, has no effect whatever in aiding recognition ;
since the same sensation is often experienced by those who
are totally blind.
The distance at which sounds (such as the report of a
gun or pistol) continue to be audible cannot be determined
with accuracy, since it depends upon the direction of the
wind, the condition of the atmosphere as to moisture, and
other disturbing sounds. The velocity of sound may be
stated to be, on an average, 1 1 35 feet per second, which is
about 13 miles a minute, or one mile in about 4J/ seconds.
76 MEDICAL JURISPRUDENCE.
SECTION II.
II. IDENTIFICATION OF THE DEAD. — MUTILATED REMAINS. — IDENTI-
FICATION BY MEANS OF THE SKELETON, AS TO AGE, SEX AND
STATURE. — RULES OF PROPORTION. — FRACTURES, DEFORMITIES AND
CALLUS. — AGE OF BONES. — EXAMINATION OF HAIR AND FIBRES.
The Identification of the Dead. — This may have reference
(i) to the body recently dead; and (2) when the soft parts
have disappeared by putrefaction, and the skeleton only
remains, or where detached bones merely have been dis-
covered.
When the death has but recently occurred, and the body
is unmutilated, most of the same general methods of estab-
lishing identity are available as have already been mentioned
in the case of the living, — such as the testimony of relatives
and acquaintances as to the personal appearance of the
deceased, certain marks upon the person, as na^vi, moles,
cicatrices, tattoo-marks, fractures, deformities, etc. Photo-
graphs and other portraits are here also admissible, although
by no means reliable proofs.
If the body has been subjected to mutilation after death,
and the severed portions removed to a distance from one
another, and some of them even destroyed, as is sometimes
done by a murderer with a view to escape detection, the
difficulty* of identification is, of course, very much increased.
Nevertheless, if the disconnected parts can be recovered, or
even a portion of them, it will always be possible for a
skilled anatomist so to readjust them, as to build up again
the bod}-, so to speak, by making the proper allowance for
the missing parts, and comparing these with other average
specimens of a similar kind. Several striking examples of
this character are given in the books. One of these is the
well-known case of Dr. Parkman, who was murdered by
Dr. Webster, in Boston, Mass., about thirty years ago.
IDENTIFICATION OF MUTILATED REMAINS. 77
After the death of his victim, Dr. Webster attempted to
destroy all evidences of the deed by cutting up the body
into fragments, some of which were burned in a grate, some
immersed in chemicals and others packed away in boxes in
distant parts of the building. On the discovery of these
remains, a week after the murder, the portions of the body
were accurately examined by a skilled anatomist. It was
proved that they were human remains, belonging to one
and the same body ; of the male sex ; and that they had not
been dissected for anatomical purposes, but cut and hacked
in different directions, for the object, evidently, of mutilation.
On restoring these disjointed parts in situ, and supplying
the deficient portions, it was found that the proper measure-
ments agreed closely with those of the missing Dr. Park-
man. This circumstance, together with the discovery of
certain marks of identity about the teeth and jaws (the head
had been almost completely destroyed by fire), afforded
sufficient evidence of the personal identity of the missing
gentleman to enable the jury, on the trial of Dr. Webster,
to find a verdict of guilty. Another instance of a somewhat
similar nature is recorded by Professor Taylor, in his Medi-
cal Jurisprudence. A number of years ago a murder was
committed in London, on the river Thames, and shortly
afterward a package containing mutilated human remains
was discovered on one of the abutments of Waterloo bridge.
The murderer had, no doubt, intended to throw the bundle
into the river, but it had lodged on the projection in its
descent. Dr. Taylor was requested to examine and identify
these mutilated remains ; and when, after great difficulty,
the parts were brought together and found to fit, the body
was identified as that of a man who had recently disappeared
from a vessel on the river — a Swedish sailor.
When the question of identity relates to the skeleton
- B MEDICAL JURISPRUDENCE.
merely, or only to portions thereof, the answer cannot be
always satisfactory, and the medical jurist has need of much
caution and reserve before giving a positive opinion.
The very first thing for him to determine is, whether the
bones submitted to his inspection are human bones, or those
of some of the inferior animals. Doubtless, if the entire
skeleton be discovered, there need be no uncertainty about
the matter ; but if only a single bone or two be found, a
mistake may easily be made, except by a practiced anatomist
and osteologist. Indeed, many ludicrous blunders are
recorded, of persons of otherwise good medical education
mistaking the bones of the ox, horse, dog, pig and goat for
those of the human subject. But may not something be
learned by the aid of chemistry, or the microscope ? The
reply must be, generally, in the negative. Certainly the
bones of the aged do contain more calcareous matter than
those of the young, and consequently present a somewhat
different appearance under the microscope. But human
bones have the same general chemical composition as those
of the lower animals. It is also true that the bone-cells or
corpuscles vary somewhat in size in the different orders of
animals, being largest in reptiles, smallest in birds and
mammals, and intermediate in fishes. In this respect there
is an analogy with the size of the blood-corpuscles in these
different orders. But these are only generalizations, and
would be of little practical use in individual instances. To
be sure, the microscope will enable us to determine the fact
of any specimen submitted being bone, or not, by the pre-
sence or absence of the bone-cells ; but it can go no further,
inasmuch as it cannot distinguish the bone-cell of a man
from that of a mouse, or of an elephant.
If the skull is the only portion of the skeleton submitted
for examination, there can usually be no difficulty in recog-
DETERMINATION OF THE AGE. 70
nizing it as human ; the only doubt that might arise would
be the possibility of its belonging to one of the higher order
of (anthropoid) apes ; but even here, there are important
differences which would not be overlooked by one skilled
in comparative anatomy and osteology. The further ques-
tion, whether from the examination of a skull simply, it is
possible to decide to what race the individual belonged —
Caucasian or otherwise — we do not think can be answered
with absolute certainty. Doubtless, well-marked typical
skulls may be identified as belonging to some particular
race, e. g., the negro, or Caucasian ; but we must remember
that the points of distinction, which in well-marked speci-
mens serve to separate these, shade away in many instances,
so as to make it extremely difficult, if not impossible, to
give a medico-legal opinion in an isolated case.
Another important point is to ascertain whether all the
bones submitted for inspection belong to one and the same
skeleton. The mere fact of their being discovered together
does by no means necessarily prove it, since they might
have been so placed either accidentally, or with the design
of eluding detection of some crime.
In the identification of the dead by means of the skeleton,
or by detached bones, the three leading points to determine
are (i) the age, (2) the sex, and (3) the stature.
I. The Age. — This can generally, in young subjects, be
pretty accurately determined by the development of the
teeth, and by the progress of ossification in the different
bones. In the skeletons of new-born children, and before
the teeth have appeared, it may become important for the
medical jurist to be able to decide upon the age, in order
either to rebut or confirm a charge of infanticide. It is
authoritatively stated that in the jaws of a child at full term
MEDICAL JURISPRUDENCE.
there will always be found the rudiments of twenty-four
teeth — twenty primary teeth, and four permanent molars.
Hence, if only the jaws of an infant be discovered, medical
evidence of its probable age may be given. The average
date of the eruption (cutting) of the teeth is, according to
Mr. Bell, as follows : The four central incisors appear from
five to eight months after birth ; the four lateral incisors,
from seven to ten months; the four anterior molars, from
twelve to sixteen months; the four cuspidati, irom fourteen to
twenty months; and the four posterior molars from eighteen
months to three years. Between six and seven years the
jaws contain forty-eight teeth — twenty temporary ones in a
perfect state of development, and twenty-eight permanent
ones imperfectly developed, and placed behind the tempo-
ran' teeth, which they are to replace. According to Mr.
Saunders, the order in which the permanent teeth make
their appearance is as follows: At seven years, the four
anterior molars; at eight years, the four central incisors;
at nine years, the four lateral incisors ; at ten years, the four
anterior bicuspids; at eleven, the four posterior bicuspids;
at twelve to twelve and a half years, the four cuspids ; and
at thirteen to fourteen years, the four second molars — making
the whole number of permanent teeth at this period to be
twenty-eight. The four remaining (posterior molars) teeth —
called denies • sapi entice — do not usually appear until eighteen
to twenty-one years of age. As a rule, the teeth of the lower
jaw are cut first, but there are many exceptions; nor must
it be forgotten that irregularities often occur as to the order
of their appearance. The above description is intended to
apply only to the average cases.
Let us now take one or two examples to illustrate the
medico-legal application of the foregoing rules. Suppose
the skull of a child was discovered, in the jaws of which
PROGRESS OF OSSIFICATION. 81
were twelve permanent teeth — eight incisors and four
molars, we should decide the age to be about nine years.
If the jaws contained twenty-four permanent teeth — eight
incisors, four molars, eight bicuspids and four cuspids, we
should conclude the age to be about thirteen years ; and so
on. It is proper here to remark, that there are two diseases
which affect the growth of the teeth, viz., rickets and
syphilis. In a rickety child, the first teeth do not usually
appear until after the twelfth month, whereas in cases of
congenital syphilis, the teeth appear prematurely — before
the sixth month; but they present a peculiar notched
appearance ; and they are apt to be brittle and to crumble
away easily.
The progress of ossification in the different bones of the
skeleton affords an additional test of its age, especially in
early life. According to Beclard, the degree of ossification
in the lower epiphysis of the femur affords the most certain
criterion of the age of the foetus, and of the new-born child.
Thus, if no ossific deposit can be seen in this cartilaginous
epiphysis, it is certain that the fetus has not attained to the
eighth month of uterine life. If the osseous deposit is as
large as a poppy-seed, it is probably in the ninth month of
foetal existence; and if it has acquired the diameter of a
line and a quarter, to one and a half, it has reached the full
period. If the point of ossification measures three lines or
more, it may be assumed that the child had survived its
birth some little time.
The (average) length of the skeleton of a new-born child
is about sixteen inches. At the end of the first year, ossi-
fication has commenced at the extremities of most of the
long bones ; and this progressively advances from year to
year, until the whole process is completed; and the epiphyses
of all the lone bones are united to their shafts at full
82 MEDICAL JURISPRUDENCE.
maturity, which, in the male, may be considered to be
twenty-four years, and in the female, twenty-two years.
After this period, or when ossification is once completed,
it is difficult to determine the precise age by an examination
of the bones of the skeleton. It should, however, be
remembered that the different bones of the sternum do not
unite until about the fortieth, or forty-fifth year; and union
between the sacrum and os coccygis is not usually com-
pleted until fifty-five, or sixty years of age.
In old age, the bones become lighter in weight, and more
brittle, from the loss of animal matter. They are also
darker in color ; and the flat bones become thinner, from
the absorption of their diploe. In the skull of the aged, the
sutures are more or less obliterated ; and the remaining
teeth present a worn appearance, and a yellowish color. If
the teeth have been lost (as is usually the case, at least in
this country), the alveolar processes become absorbed, and
the lower jaw undergoes a well-marked change in its appear-
ance, consisting of the widening of the angle at its neck, and
the shortening of the vertical diameter of its body, or width,
which imparts the characteristic senile expression to the
mouth of the aged. The discovery of such a jawbone would
positively determine the age to be about seventy years, or
over.
The presence or absence of certain teeth in the head has
frequently been the means of determining the identity of
the body. So also, the presence of artificial teeth, with
their mechanical appendages, has at times furnished the
strongest corroborative evidence in such identification, as
in the celebrated Parkman-YVcbster case, already alluded to,
in which the artificial teeth, discovered undestroyed by the
fire in the grate, where the head had been burnt up, were
positively identified by the dentist, who had manufactured
IDENTIFICATION OF THE SEX. 83
and fitted them some years before. So, likewise, the remains
of the Marchioness of Salisbury, discovered among the
burnt ruins of Hatfield House, were identified by the jaw-
bone having gold appendages for artificial teeth (Guy). The
importance of the teeth as a means of identification is shown
in the case of the late French Prince Imperial, whose body
had been so much disfigured by his assailants, that its iden-
tification would have been extremely difficult but for certain
peculiarities about his teeth (Taylor, Prin. and Prac. Med.
Jurisp., 1884).
II. The Sex. — This can usually be determined from the
skeleton, if entire, without much difficulty. The general
appearance of the male and female skeleton presents many
well defined points of difference, which need not here be
enumerated, as they are described in all anatomical works.
Suffice it to say that the corresponding bones of the two
differ in size, weight, strength, and prominence of their
ridges and protuberances which mark the points for the
insertion of muscles. There are also certain recognized
differences in the head and thorax ; but it is in the pelvis
that the most characteristic distinctions are observed. The
male pelvis is narrower and deeper than that of the female.
In the latter, the ossa il Hi are more spread out, and flatter,
which renders the superior part of the pelvis more capa-
cious ; the sacrum is broader, and turned more backward ;
the arch of the pubis is much wider. The greatest diameter
is the bilateral ; whereas in the male, the antero-posterior is
the greater. The foramen ovale is triangular in the female ;
in the male, it is more oval. Owing to the greater breadth
of the female pelvis, the acetabula are farther apart than in
the male. It is to be understood that these peculiarities
in the female pelvis are not exhibited until the period of
84 MEDICAL JURISPRUDENCE.
puberty, and subsequently. From a fragment of a bone,
merely, it would certainly be hazardous to undertake to
determine the sex; and the medical jurist should exercise
much reserve in giving an opinion in such a case.
III. The Stature. — If the whole skeleton has been pre-
served, and none of the ends of the long bones have been
lost by decay, the original height may be calculated with
tolerable accuracy by arranging the bones in situ, and adding
an inch and a half, to two inches, to the entire length of the
skeleton, to supply the loss of the soft parts. But even here
perfect accuracy cannot be attained, chiefly on account of
variations in the curve of the spinal column in different in-
dividuals. Dr. Dwight* assumes, as the result of numerous
observations, that the total height of the intervertebral carti-
lages is 25.6 per cent, of the entire length of the spine. As
a collateral aid in estimating the stature, we may regard as
correct the generally accepted rule, that the top of the
symphysis of the pubes is about the centre of the body in
average women ; while in men, the centre is a little below
the symphysis.
The attempt has frequently been made to estimate the
height of the body from a study of the individual long
bones of the skeleton ; but no reliance can be placed upon
such comparisons, inasmuch as there is considerable varia-
tion in the length of these bones in skeletons of the same
stature. The so-called " rules of proportion " of certain
writers cannot be regarded as by any means certain, or
authoritative. In case the skull is wanting, the rule laid
down by Dr. Gould is " to find the height of the spine of
the seventh cervical vertebra from the ground, and add to
* The Identification of the Human Skeleton, by Thomas Dwight, II. D.
Boston. 1878.
IDENTIFICATION BY FRACTURES, ETC. 85
this 9.95 inches, which is the average height from this point
to the top of the head."* M. de St. Luca {Cosmos, October
2d, 1863, quoted by Professor Taylor) states that an approx-
imative estimate of the stature may be had by measuring
the length of the third phalanx of the middle finger,
thus: this phalanx is equal in length to one-fourth that
of the whole finger, or one-eighth that of the hand, in-
cluding the carpus. The arm may be divided into five
parts, of which two are included in the humerus, two in
the fore-arm, and one in the hand. The total length of the
hand is, therefore, one-fifth that of the arm. Double the
length of the arm (or the two arms stretched out horizon-
tally), added to the length of the two clavicles, together with
the transverse diameter of the sternum, is equivalent to the
whole length of the body. In applying this rule to practice,
however, we must not forget that the length of the hand,
and especially that of the fingers, varies materially in
persons of the same height; and so trifling a variation
in the third phalanx of the middle finger as the one-thirty-
second of an inch would, according to this method of calcu-
lation, figure up as great a difference in the total result, for
the height of the whole body, as two and a half inches.
The existence of fractures, deformities and callus in a
skeleton sometimes affords valuable aid in its identification,
even many years after death. In relation to the production
of callus, it is well understood that this substance is the
result of the reparative inflammation of bones, and that
its presence on a bone is a certain indication that some time
must have elapsed between the injury and the death of the
individual. On the other hand, the total absence of callus
in a fractured bone, indicating that no time had been given
for the process of repair, would be very good evidence that
* Ibid.
86 MEDICAL JURISPRUDENCE.
the injury was the immediate precursor of death, and if on
the skull, the probable cause of death. An instructive illus-
tration of this is given by Professor Taylor {Med. Jurisp)
in the case of an Englishman who was tried in India for the
murder of a native, who had been beaten by the former with
a stick, with the allegation that his rib had been broken,
thereby causing his death. To substantiate this charge, a
skeleton was produced which had been dug up three months
subsequent to the decease, which was almost completely
denuded of flesh; the bones clean and dry; one rib frac-
tured, with a deposit of callus around the fracture. The
identity of these bones with those of the missing man was
attempted to be established by the prosecution, but unsuc-
cessfully, in consequence of their dry and denuded state — a
condition altogether incompatible with so short a period of
time as three months since death. Moreover, the amount
of callus thrown out made it evident that more than a week
must have elapsed before death took place, which event was
alleged to have occurred immediately after the injury.
Other notable instances might be mentioned of the iden-
tification of the skeleton by means of the above-mentioned
marks, or peculiarities, and even where it was possible to
determine the actual cause of the violent death. In the
year 1823, a soldier living in the south of France suddenly
disappeared, under suspicious circumstances. Two years,
however, elapsed before any investigation was instituted by
the proper authorities. Some human bones were then dis-
covered in digging in the garden of the deceased soldier.
Of course, it became necessary to identify these remains. It
was remembered that the deceased had a singular personal
deformity, in possessing a sixth finger on the right hand, and
a sixth toe on the left foot. On examination, it was ascer-
tained that the fifth metacarpal bone of the right hand was
DURATION OF BONES AFTER BURIAL. 87
shorter and broader than the corresponding bone of the
other hand, and further, that there were two articulating sur-
faces on its digital end, indicating clearly the existence of a
supernumerary finger. In the same way, the fifth metatarsal
bone of the left foot showed two distinct articulating faces
on its digital extremity, indicating the existence of a super-
numerary toe. Besides this, the age, sex and stature of the
skeleton corresponded with those of the missing man. But
even further than this, a close inspection of the skull revealed
the distinct marks of a depressed and radiated fracture of the
temporal bone, which showed no sign of reparation by the
formation of callus. Evidently, then, death had occurred
very soon after the fracture of the skull, and in all proba-
bility, as the direct result of violence. Upon this evidence,
the suspected parties were tried and executed, having pre-
viously confessed their crime.
Sometimes, on the exhumation of bones, the medico-lecral
question arises — how long have they been buried ? It is
quite impossible to give more than an approximative reply
to this question, after all the soft parts have disappeared,
which commonly requires about ten years, on an average.
In a dry soil, bones will resist decomposition for thirty or
forty years after burial. As this process progresses, they
become lighter in weight, in consequence of the loss of
animal matter, and the color externally grows darker. The
ends gradually become brittle, and crumble away, and finally
the shaft of the bone undergoes a similar disintegration, the
mineral matter alone remaining unaltered, and constituting
the "dust" to which the animal body must eventually be
reduced. Devergie states that the bones of King Dagobert
were found in a state of tolerable preservation, enclosed in a
leaden coffin and sarcophagus, at St. Denis, after the lapse
of twelve hundred years; and Dr. Taylor mentions that the
MEDICAL JURISPRUDENCE.
skeleton of William Rufus was found in a stone coffin at
Winchester, nearly perfect, after seven hundred and eighty
years' burial. The bones of Abelard and Heloise were so
well preserved, that after a lapse of five hundred years the
female skeleton could readily be distinguished from the
male.
Even if the bones have undergone calcination, as when a
body has been burned with a view of destroying its identity,
especially in cases of infanticide, it may still be possible to
determine whether the remains are human, provided the
bones preserve their proper form, and have not been reduced
to powder. In the latter case, although a chemical analysis
of the ash might detect the calcium phosphate, this would
not solve the mooted question, since the ash of human and
animal bone is chemically identical.
Other means of personal identification are afforded by a
microscopic examination of the hair, and the fibres of various
sorts of fabrics, such as, cotton, linen, wool and silk Human
hair discovered on a weapon, along with blood stains, affords
strung presumptive evidence of murder, or violence. So also,
fibres of cotton, or of other material, found on weapons
supposed to have caused death, or else on the person of the
accused, suggest a strong suspicion, if these fibres correspond
to the clothes of the deceased. Thus, a case is mentioned
by Prof. Taylor, where the discovery of some cotton fibres,
accompanied by a blood-stain, upon the edge of a razor,
found near a woman whose throat had been cut while in
bed, led to the subsequent detection of the murderer. In
the same manner, the discovery of a few hairs upon the
handle of a knife, on which also were marks of blood,
enabled a London microscopist to declare that these hairs
were squirrel hairs ; which circumstance further led to tin:
identification of the murderess of a child, whose throat had
IDENTIFICATION BY THE HAIR. 89
been cut with a knife, which, in the death wound, had passed
through a victorine made of squirrel fur, worn around the
child's neck.
In case of rape the examination of the hair about the female-
genitals will be likely to show the presence of seminal spots,
and consequently of spermatozoa, which cling to them with
great tenacity.
In all cases, except when hairs arc to be examined
for spermatozoa, they should be washed in warm water, and
then thoroughly dried, afterwards steeped in turpentine, and
finally mounted in Canada balsam. They should then be
examined with a magnifying power of about 200 diameters.
To examine hairs for spermatozoa, moisten first of all with
a drop of ammonia solution, and examine under a micro-
scope after the liquid has evaporated (Tidy).
For the identification of hairs, human or other, it is
desirable to have at hand specimens of various kinds of
these, properly mounted, for comparison. Hairs resist
putrefaction for an indefinite length o[ time, which fact aids
greatly in their examination for medico-legal purposes. It
should also be remembered that hair is affected differently
by different reagents. Strong alkalies dissolve it; acids
roughen it ; alcohol causes it to look clearer ; chlorine
water bleaches, and rots it.
The size of hairs from different parts of the human body,
as well as from different individuals, varies considerably ;
thus, the hairs from the head are finer than the eyelashes,
but coarser than the hairs from the arm. There is also
considerable difference in the size of the hairs of the various
lower animals. The shape and microscopical appearance
of human and other hair are figured in some of the larger
works.
The main medico-legal questions connected with the
5*
90 MEDICAL JURISPRUDENCE.
identification of hairs are : (i) Is the hair human, and from
what part o( the body ? (2) Does it correspond with the
hair of the murderer, or of the victim ? (3) Has its color
been naturally, or artificially changed ? It should be re-
membered that gray hair is not unfrequently found on
comparatively young persons, and that undoubted instances
have occurred of the sudden bleaching of the hair through
fright or grief. As regards the artificial coloring of the
hair, it is well known that this is one of the means of
disguise most commonly adopted by criminals, in order to
elude detection.
The common hair dyes for coloring light or red hair black
or brown, are composed of the salts of lead, silver, or bis-
muth. Hair thus colored may easily be detected by soaking
it in nitric acid, which dissolves out the mineral, which may
then be identified by the appropriate tests. It is more diffi-
cult to bleach or whiten the hair, than to darken it. This is
usually effected by first washing it in an alkali, to remove
the greasy matter, and then soaking it in chlorine water,
which will lighten its tint in a few hours; but, at the same
time, it will render it very brittle, and impart its peculiar
odor to it.
In all artificially colored hair, the fraud can be detected
by closely watching the new growth, which will be of a
different color from the other portions; and also by chemi-
cal tests.
The fibres of cotton, linen, wool and silk all present well-
marked differences, when viewed under the microscope.
The cotton fibre is in the form of a flattened band, with
thickened borders, and is spiral, or twisted upon itself.
Linen consists of round fibres, having a firm consistency,
with jointed transverse markings at unequal distances,
somewhat resembling those on the India cane, and taper-
IDENTIFICATION OF FIBRES. 91
ing to a point. Silk fibre has the appearance of straight,
well-defined cylinders, free from all markings, and refracting
light powerfully. Wool fibre is irregular, wavy, and of
unequal thickness. The fibres of hemp resemble those of
flax (linen), but are coarser; and when boiled in nitric acid
they exhibit no spiral streaks, but swell and become brittle.
The identification of blood stains and seminal spots will be
treated of later.
92 MEDICAL JURISPRUDENCE.
CHAPTER VI.
THE CAUSES rRODUCING VIOLENT DEATH.
These ma)' be considered under the following heads :-
I. Wounds, including Burns.
II. Suffocation.
III. Strangulation.
IV. Hanging.
V. Drowning.
VI. Lightning.
VII. Heat and Cold.
VIII. Starvation.
IX. Poisoning.
section i.
VIOLENT DEATH FROM WOUNDS.
DEFINITION OF A WOUND. — DANGER OF. — EXAMINATION OF THE
BODY. — RESULTS OF THE INJURY. — ABSENCE OF EXTERNAL MARKS
OF VIOLENCE. — WOUNDS MADE BEFORE AND AFTER DEATH.
HEMORRHAGE. — ECCHYMOSES. — CLASSIFICATION.— HOMICIDAL, SUI-
CIDAL AND ACCIDENTAL WOUNDS.
The surgical and the legal definition of a wound are not
identical. The former idea of the term is "a solution of
continuity of the soft parts, occasioned by external vio-
lence." According to this meaning, there must be a rup-
ture of the skin, or the mucous membrane, to constitute a
•wound. But this would evidently exclude internal injuries,
such as rupture of the liver, spleen, or heart, fractures and
luxations unaccompanied by external lesion; hence, the
legal definition of a wound is more comprehensive; it em-
braces all injuries of the body, whether external or internal,
with or without a solution of continuity of the skin, pro-
duced suddenly by external, or mechanical violence. The
latter meaning of the term wound is evidently its proper
medico-legal application, although it may not strictly accord
with the surgical definition.
WOUNDS A CAUSE OF DEATH. 93
A distinction is sometimes made between mortal and uou-
mortal wounds, or between wounds dangerous and not dan-
gerous to life, and the medical witness is asked to give his
opinion on this subject. But he should be guarded in his
answer, since it is well known that many wounds at first
considered as comparatively trivial, subsequently assume a
dangerous, and even fatal character. Of course, in many
cases there can be no difficulty in pronouncing upon the
dangerous or mortal character of a wound, as, for instance,
if the heart or the great vessels have been wounded, in
compound fracture of the skull, in wounds of the internal
viscera, etc. The danger of a wound, it may be remarked,
depends upon a variety of circumstances, all of which
should be considered, such as its position; its locality in rela-
tion to the great vessels and nerves; the kind of weapon
by which it was inflicted; the amount of hemorrhage; the
age, constitution and general health of the subject ; the cir-
cumstances (favorable or unfavorable) for treatment, and
other considerations, all of which must be taken into account
as important factors in the prognosis. Medical testimony
is not usually required, except in case of a fatal termination.
An exception to this may, however, occur in the case of an
assault, where the character of the injury (whether dangerous
or trivial) might decide as to the propriety of accepting bail
for the prisoner.
In case of death from a wound, the medical examiner
should never theorize as to the manner of its causing the
death ; and he should give his opinion only after a very
careful post-mortem examination of the body. Moreover,
this examination should not be confined simply to the
wounded portion of the body, but all the cavities and organs
should be inspected, since it might be affirmed that a natural
cause of death might have existed in that very part which
9-J MEDICAL JURISPRUDENCE.
was neglected by the examiner. Such neglect has often
been the means of securing the release of the prisoner, inas-
much as it occasioned a doubt as to the real cause of death,
in the minds of the jury. It may even be proper to examine
the stomach for poison in all doubtful cases ; as shown by
the oft quoted instance related by Wildberg, of the girl who
was beaten by her father for stealing, and who died shortly
afterwards, apparently from the effects of the blows, but in
whose stomach a considerable quanity of arsenic was found.
She had swallowed the poison soon after committing the
theft, fearing her father's anger. The man was discharged.
In a similar manner, it sometimes happens that a person,
after taking poison with suicidal intent, may destroy himself
by another means, as by a gunshot wound, by drowning, or
by throwing himself from a window or a precipice.
The examination of the wound includes the observation
of its situation, extent and direction ; the presence or absence
of effused blood, whether liquid or coagulated, and the pres-
ence of ecchymoses ; the condition of the edges of the
wound, whether everted or not ; whether adhesion has com-
menced ; the presence of granulation, inflammation, suppu-
ration, or gangrene ; whether it was inflicted before, or after
death ; whether there was loss of substance ; hernia of the
intestinal organs, etc. There should also be an inspection
of the clothes of the deceased, to ascertain if the rents or
stabs in these correspond with the wounds of the body ; and
if a weapon be discovered, it should be carefully compared
with the wound.
It sometimes happens, in cases of severe injury, that
death has resulted from internal lesions, with few or no
external marks to indicate them. According to Casper,
this is of frequent occurrence in severe internal lacerations
occasioned by violence. He cites a case of this character.
WOUNDS BEFORE AND AFTER DEATH. 95
A wagoner, in guiding his team with a loaded wagon down
a hill, was accidentally crushed against a tree on the road.
He was found dead the next morning. The only external
injuries were a slight abrasion upon the left arm, and one
upon the right temple. On opening the body, however, the
most striking evidences of violence were discovered. From
the spinal canal, about a quart of blood escaped. The
spinous processes of the first thoracic vertebrae were broken
off. The left pleural cavity contained about thirty ounces
of fluid blood. The pericardium was torn completely
across, and the heart, severed from its large vessels, lay
almost entirely loose in the cavity of the thorax. The open
ends of the aorta and pulmonary artery were distinctly
visible. The left lung was entirely torn through its middle
portion ; and in the right lobe of the liver was a laceration
two inches long and half an inch deep {GcricJit.Med. I, 122).
The distinction between wounds made before and after
death should be carefully noticed. Wounds inflicted before
death may be recognized by the following signs : (1) Incised
wounds exhibit everted edges, arising from the elasticity of
the skin and subjacent muscles, with considerable hemor-
rhage, usually of an arterial character; the spots of arterial
blood which have spouted on neighboring surfaces are of a
peculiar comet-like shape. Coagula are more or less
abundant in the wound, and around it. The surrounding
tissues are more or less infiltrated with blood. If some
days have elapsed before death, evidences of vital reaction
will be shown, such as partial healing, granulation, suppu-
ration, or sloughing. If the wound was made immediately
after death — within a few minutes — there may be some
retraction of the skin, and some slight bleeding, with few
or no coagula, which are of loose texture. There is little
or no staining of the surrounding tissues, and never any
!><; MEDICAL JURISPRUDENCE.
attempt at repair. If the wound be made ten or twelve
hours after death, there will be no e version of its edges, no
hemorrhage, except of a slight venous character, and no
surrounding infiltration. The experiments of Professor
Taylor and Mr. Aston Key upon amputated limbs con-
firm the above description. The amount of hemorrhage
accompanying an incised wound affords a pretty good
criterion as to whether it was inflicted before, or after death.
Comparatively little bleeding accompanies wounds made
after death, and this is chiefly venous ; the arteries yield
little or none, while in the living, the hemorrhage is chiefly
arterial. In a case of murder reported by Casper, as also
in the case of Greenacre, in England in 1837, where the
head of the victim was severed from the body, the fact that
the head was completely drained of blood led to the con-
clusion that the decapitation had been done during life, and
that there must then have been a copious hemorrhage to
account for the absence of the blood after death.
(2) In lacerated and contused wounds, the distinction is
not so obvious as in incised wounds. Lacerations are not
always accompanied by bleeding, but there will always be
more or less coagula present; and if the person survives a
few days there will be evidences of vital reaction, such as
suppuration and granulation, sloughing or gangrene, all
of which are absent in such wounds inflicted after death.
Co/ttttscd wound* made during life are chiefly distinguished
by the amount of effused blood in the cellular tissue under
the skin (ecchymosis). This arises from the rupture of
small vessels, and is manifested by the well-known "black
and blue" discoloration produced. If the effusion of blood
is rapid, the spot is of a dark red, at first ; if slower, the
discoloration is deep blue, or violet. In some cases of even
violent contusion, there may be no appearance of external
ECCHYMOSES. 97
ecchymosis. Again, it is not always manifested immedi-
ately over the seat of the contusion, but at a little distance
from it, especially if the surrounding tissue is loose. Familiar
illustrations of this are afforded in the case of a blow over
the eye, producing an ecchymosis of the lower lid ; and of
a blow over the lower portion of the abdomen being at-
tended with ecchymosis of the scrotum. The presence of
ecchymoses, then, in cases of contused wounds, may be re-
garded as pretty good evidence of the ante-mortem character
of the injury, while its absence is not necessarily an indica-
tion that the wound was post-mortem. The experiments
of Sir R. Christison upon the dead body go to show that
if the contusion be made very soon after death, and while
the body is still warm, the resulting appearances strongly
resemble those produced by ante-mortem contusion ; with
this difference, however, that the effusion is usually imme-
diately beneath the skin, and not in the areolar tissue ; also,
that there is an absence of coagula, and of swelling.
Ecchymosis is usually superficial, and may appear very
shortly after the injury; or it may be deep-seated, and not
visible at all. In some instances it is not manifested until
after death, as in the case of a man who died from rupture
of the bladder, resulting from the kick of a horse, thirty-five
hours after the injury. No discoloration of the abdomen
was observed until after his death. Neither can the quan-
tity of blood effused, nor the extent of the injury be always
estimated by the amount of the discoloration. This is well
illustrated in the case of the wagoner who was crushed to
death, as mentioned by Casper, and which was alluded to
above.
Another important fact relative to ecchymoses is the
clicDige of color which accompanies them, since this may
serve to indicate the probable date of the contusion. In
98 MEDICAL JURISPRUDENCE.
about twenty-four hours the blue or livid margin of the
bruise becomes lighter, or of a violet color, which gradually
changes to green and yellow. During these alterations of
color, the spot may become larger, but the central portion
remains always darker than the margins. These changes
of color are believed to be due to a dilution of the serum
of the blood by the fluid of the cellular membrane, and its
gradual dispersion throughout the cells. It is finally ab-
sorbed, and the color entirely disappears. In general, it
shows itself within twelve hours after the contusion ; the
violet color within three days; the green from the fifth to
sixth day; the yellow from the eighth to tenth day; and in
healthy persons, the complete disappearance of the spot
occurs from the twelfth to fourteenth day. The changes
are more rapid in the young than in the old, and depend
also on the degree of the contusion. The above changes of
color never appear in contusions on the dead, which cir-
cumstance constitutes another diagnostic mark.
It is also important not to mistake the ecchymosis pro-
ceeding from natural causes, such as scurvy, petechias
and purpura, from that occasioned by blows. The former
may usually be distinguished by being confined to the
superficial layers of the skin, and by their presence also on
the internal mucous membranes, together with the absence
of swelling, and the fluidity of the blood.
According to Devergie, ecchymoses are often concealed
on the bodies of the drowned, when first they are removed
from the water, owing to the sodden state of the skin ; they
may become apparent only after the body has been exposed
for some days, and the water has evaporated.
(3) In punctured and penetrating wounds, the diagnosis
between those inflicted before, and those produced after
death, is usually not difficult. The former are attended with
INCISED WOUNDS. 99
more or less hemorrhage, and often exhibit signs of vital
and reparative reaction, such as inflammation and suppura-
tion, or gangrene. The latter are destitute of all these.
For example, a stab made into the left ventricle of the heart
after death is followed by no hemorrhage.
It is not always possible for a medical witness to state
positively that a wound was caused by a particular weapon ;
but it is desirable, if possible, to establish the relation of the
injury with its supposed cause ; thus, an incised wound would
naturally be referred to a cutting weapon ; a penetrating
wound to a pointed one ; and a contused wound to a blunt
instrument. But caution should be observed in giving an
opinion on this subject, especially in case of contused
wounds.
Incised wounds are characterized by the regularity and
evenness of the cut. This usually serves to distinguish
them from wounds made by glass and crockery ware, or
nails, which are generally irregular and uneven. But in
some instances, the cuts produced by broken glass or china
exactly resemble incised wounds. In stabs, the shape of
the wound may often indicate the character of the weapon,
whether double-edged or not. But where the weapon has
penetrated obliquely through the tissues, and when these
have been stretched, the shape of the wound will not exhibit
this correspondence. So also, a wound made in parts where
the skin is wrinkled may suggest the idea of several distinct
wounds, as in the neck. It must not be overlooked that
superficial incised wounds may give rise to dangerous, or
even fatal hemorrhage. And also, that it is not always pos-
sible, in such cases, to determine the direction of the incision,
i.e., whether made from right to left, or the reverse. And
yet, as remarked by Casper, this fact might have a most
important medico-legal significance in determining the ques-
100 MEDICAL JURISPRUDE1
tion whether the wound, as in cutting the throat, was homi-
cidal or self-inflicted. The attendant circumstances, however,
might throw some light upon it, such as the presence of
blood on the right or left hand, or cuts on certain parts of
the clothing of the deceased.
Lacerated and contused wounds do not afford the same
facility for identifying the weapon as incised wounds. From
simply inspecting them, the medical witness will not gener-
ally be able to indicate the precise weapon, or cause. He
may, indeed, be able to say that it was not produced by a
cutting instrument. But a blow made by a blunt weapon
upon the skull, or over the zygoma, may give rise to a cut
which strongly resembles an incised wound, though, as a
rule, the division of the parts is not as straight and regular
as in the latter, and the angles of the wound are less acute.
Moreover, in the contused wounds there is more or less
swelling, and extravasation of blood into the adjoining
parts ; and, at times, the existence of irregular fracture and
internal hemorrhage.
In the case of a fatal contused wound of the head, it has
been judicially decided that it makes no difference as to the
guilt of the accused, whether he produced the death of his
victim by a direct blow upon the head, or indirectly, by
causing him to fall upon a stone, or other hard substance,
which produced the fracture, or contusion.
As before mentioned, rupture of the internal organs — the
liver, spleen, heart, lungs and kidneys — is a frequent result
of contusions. Fracture of the base of the skull is some-
times caused by severe contusion of the head. Wharton
and Stille (Med. Jurisp., Book V, p. 660) allude to the fact
that spontaneous wounds sometimes occur in the labia and
vagina of pregnant women, which might give rise to suspi-
cion of assault. Also, that in such women accidents of
EXAMINATION OF THE CLOTHES. K) 1
different kinds are frequently attended with profuse hemor-
rhage from the pudenda.
It is evident from what has been said in reference to the
difficulty of always connecting a contused wound with the
precise instrument that caused it, that the witness should
avoid committing himself upon the question. In some
instances, however, the shape of the contused wound, espe-
cially a depressed fracture of the skull, will enable us to
come to a correct conclusion on the subject. Some years
ago the author was called upon, as an expert, to testify as to
the probable cause of a depressed fracture of the temporal
bone of a man who had been struck during a melee. The
question was, whether the injury had been inflicted by the
fist merely (as was alleged), or by an instrument like a
loaded cane, or billy. There was good reason for believing
that the latter instrument, in the hands of another person,
was the real cause of his death, owing to the private con-
fession of a comrade of the prisoner. The fractured bone
was produced in court. The depression was well-marked,
a quarter of an inch deep, exactly corresponding to the
loaded end of the billy ; no radiating fissures (as would
most probably have resulted from a blow of the fist).
Although the opinion of the author, founded on the above
facts, was, that the fatal blow had not been inflicted by a
fist, but by a billy ', two physicians on the other side thought
differently; and the judge dexterously solved the mooted
question by asserting that, in such cases, one expert was
about as good as another ; and inasmuch as, in the present
trial there were two against one, he would decide in favor of
the majority! and so he did, and the prisoner (possibly an
innocent man) was convicted, and sent to the penitentiary
for five years.
The examination of the clothes of the deceased constitutes
102 MEDICAL JURISPRUDENCE.
an important part of the legal physician's duty, as this may
throw light upon the mode in which the wound had been
made, from the character of the cuts, or stabs observed upon
them. So likewise, marks of blood, dirt, grass, or other
substances, on the clothing may afford valuable indications
in the same direction. Contused wounds by bludgeons
may, however, occasion considerable laceration of the
muscles, or even severe fractures, without tearing the dress.
Professor Taylor {Med. Jierisp) mentions an instructive
case, showing the importance of comparing the articles of
dress with the injuries which may have proved fatal. A
woman, aged sixty, was found one morning dead in her bed.
She had been seen in her usual health on the previous
night. On inspection, there were found two indentations in
the right parietal bone, and a large clot of blood in this
situation, beneath the skin, together with a fracture of the
bone, four inches in extent. Beneath the bone, on the dura
mater, were found nearly three ounces of clotted blood.
On the evening before her death, she had been suddenly
knocked down on the public road, by a man accidentally
running against her. She fell heavily on the back of her
head, appeared stunned, was raised upon her feet, and, after
swallowing some brandy, recovered sufficiently to walk
home, a mile and a half, and eat her supper. She was
found next morning dead in bed. There was a suspicion of
murder, in this case, against a fellow lodger; but when the
bonnet worn by the woman was produced at the inquest,
two indentations were discovered on the back part of it,
corresponding to those on the skull of the deceased. The
indentations on the bonnet, moreover, contained dust and
dirt, thereby confirming the statement of witnesses who had
seen her fall, and rendering it highly probable that this fall
was the real cause of the fatal fracture, and effusion of blood.
NATURE AND EXTENT OE THE WOUND. 103
It also illustrates the well-known fact that a person may
receive a fracture of the skull ending in effusion, which may
not prove fatal for many hours after the accident, and which
may not have prevented the individual from walking a con-
siderable distance after the injury.
Was the wound homicidal, suicidal, or accidental? This
important medico-legal question cannot always be settled
by medical testimony alone, though there are man^points
in which it is of the greatest aid to the legal authorities.
These are as follows : —
1. The Situation of the Wound. — Suicidal wounds are
usually inflicted upon the most accessible parts of the body,
such as the head, neck, breast and abdomen. If by fire-
arms, the part usually selected is the head (mouth, forehead
or temple), or over the heart ; if by a cutting instrument, the
throat or heart. The discovery, therefore, of wounds on a
part of the body difficult to reach by the individual himself,
as the back, would certainly not be suggestive of suicide.
But an exception must be made here as regards the insane,
who are well known to destroy themselves by self-inflicted
wounds of the most extraordinary character, on the back of
the head and neck ; by striking the head against some solid
substance ; or precipitating themselves from a height. An
insane person has been known to shoot himself with a pistol
fired from behind the ear. The situation of the wound is,
therefore, only suggestive of its origin, since it is quite pos-
sible that an assassin might inflict a death wound upon his
victim in such a situation designedly, in order to deceive,
and thus elude the suspicion of homicide. Accidental
wounds are usually met with on exposed parts of the body.
2. Nature and Extent of the Wound. — Suicide is rarely
inflicted by contused wounds, but usually by incised or
I'M MEDICAL JURISPRUDENCE.
penetrating ones. Exceptions occur, as when a person
throws himself out of a window, or from a height; and in
some remarkable instances of self-destruction, by butting
the head against a wall, and subsequently chopping it with
a hatchet. In the case of the insane, there is no accounting
for the variety in the nature, and extent of the wounds in-
flicted for the purpose of self-destruction. This fact ought
to be remembered, since, if the bodies of such persons
should afterward be discovered, and nothing be known of
their previous histories, serious errors in relation to the real
origin of the wounds might result.
Incised Wounds of the Throat art usually regarded as in-
dicating suicide; but it is well-known that murderers fre-
quently destroy their victims by cutting their throats. As
to the extent of the wound, it is commonly supposed that a
suicidal incision of the throat does not reach as deeply as a
homicidal one of the same character; but instances are not
wanting where a determined suicide has severed the throat
down to the vertebrae. Again, irregularity in the cut of the
throat has been deemed by some as indicating homicide
rather than suicide, under the idea of resistance on the part
of the victim; but it is evident that the irregularity might
have resulted equally from nervousness, or indecision in
inflicting the wound, on the part of the deceased.
The nature and extent of the wound or injury may serve
to distinguish accident from homicide. Thus, if numerous
wounds or bruises are discovered in opposite sides of a
dead body, the presumption would be in favor of homicide;
and when the accused attempts to ascribe the death of his
victim to a fall, the nature of the wounds might be such as
positively to contradict his assertions.
3. Direction of the Wound. — This will often enable us to
distinguish between a homicidal and an accidental wound,
WOUNDS OF THE THROAT. 105
rather than to decide upon its suicidal character. Thus, if
death has occurred from a stab, inflicted downward from
the upper part of the thorax, and penetrating the heart,
and it was attempted on the part of the prisoner to show
that the wound had been accidentally occasioned by the
deceased falling, while drunk, downward upon the knife
which the prisoner had held in his hand sloping upward,
the direction of the wound would prove the falsity of the
statement. Two other cases are here quoted from Wharton
and Stille's Med. Jurisp., of a similar character. One of a
man discovered dead, with a deeply-punctured wound of
the neck, which, on examination, showed that the weapon
had been partially turned and withdrawn, and again plunged
into the neck in a different direction, after the manner of
the German butchers. This circumstance proved not only
that the death was not accidental, nor probably suicidal,
but indicated the occupation of the murderer. The other
occurred in England, some years since, where a murder
was fixed upon a man from the fact that the wound in the
neck of the deceased had been evidently made by a knife
cutting from within outward, as is done in slaughtering
sheep.
In most suicidal, wounds of the throat, it is found that the
cut has been made from left to right ; in punctured wounds
the direction is commonly from right to left, and downward.
In left-handed persons, the direction would, of course, be
the reverse. These facts, however, can only afford moderate
presumptive evidence, since it is obvious that a murderer
might inflict an incised wound in the throat of his victim
from behind, which would exactly resemble that made by
the suicide. In all such doubtful cases, particular attention
should be directed to the surrounding circumstances, such
as the position of the body, and the weapon, the presence
106 MEDICAL JURISPRUDENCE.
or absence of blood upon the hands and person of the
deceased, etc. If the death has been very sudden, from
hemorrhage (in a case of suicide), the weapon will most
probably have fallen from the hand, on account of the
relaxation of the muscles ; but if it has been caused by a
pistol, the weapon may be found tightly grasped in the
hand of the deceased. If the throat has been cut suicidally,
blood will be found on one or other of the hands; but if
homicidally, and no resistance has been made, the hands
will probably be unstained. As regards the position of the
body, if the death be very sudden, from loss of blood, the
body will be found lying on the back ; if less sudden, the
face and trunk will be turned toward the ground. If the
body be found upon the back, in death from hemorrhage,
and the weapon at a distance from it, the act was, in all
probability, homicidal.
The position of the zucapon in relation to the dead body,
although at times strongly suggestive, can never afford
absolute evidence as regards the question of homicide or
suicide. Thus, Professor Casper mentions the case of a
man who cut his throat with a razor, which was found,
bloody, and closed, two feet distant from the body. Also, of
another suicide by a pistol-shot in the breast, where the
pistol was found in the pocket of the deceased, who after-*
wards terminated his life by drowning himself {Gerielit.
p. 17).
From what has been said above, it is manifest that the
medical jurist can rarely venture to give a positive opinion
as to the homicidal, suicidal, or accidental cause of death,
apart from a consideration of the circumstances accompany-
ing it. These circumstances constantly vary in almost every
case, and they require the utmost experience and tact on
the part of the medical examiner to recognize and apply
GUNSHOT WOUNDS. 107
them in each individual instance. Some of them have
already been alluded to : they include the position of the
body and the weapon; the condition of the ground where
the wound was inflicted ; the presence of footprints, of man
or horse; the condition of the clothing of the deceased; the
condition of the hands, whether showing wounds, or cuts on
their palms (indicating resistance), or the hands holding
portions of hair or fragments of the assailant's clothes; the
adherence of certain fibres to a weapon, such as cotton,
woolen, linen, silk or fur ; marks of blood upon clothing or
furniture ; state of the mouth and throat ; marks of blood
or other matters on the person of the assailant ; rifling of
the pockets, and tearing of the dress, etc. These cannot be
farther enlarged upon here, but their medico-legal import-
ance cannot be too strongly insisted upon.
SECTION II.
GUNSHOT WOUNDS.
DIFFER FROM OTHER WOUNDS. — DEFLECTION OF THE BALL. — WOUNDS
MADE BY SHOT, WADDING AND POWDER. — CAUSE OF DEATH IN
WOUNDS. — WOUNDS OF THE HEAD, NECK, SPINE, CHEST, ABDOMEN.
Gunshot wounds differ from other wounds chiefly in the
fact that the vitality of the part struck is lost, and that there
is a consequent slough, or loss of substance. They are
essentially contusions. They are dangerous to life on ac-
count of their involving vital portions of the body, death
occurring either from hemorrhage, or from shock to the
nervous system. The hemorrhage is seldom great, except
when large vessels are wounded. Often, from the form of
the wound, there may be but little external bleeding, while
a fatal internal hemorrhage may be going on. They differ
much in appearance, according to the distance from which
the piece was fired, and the nature of the projectiles. If the
108 MEDICAL JURISPRUDENCE.
explosion occurs in close contact with the body, the wound
is large and circular, the skin denuded, blackened and
burned by the half consumed grains of powder. The hair
and clothes also in the vicinity of the wound are more or
less scorched. The entrance orifice of the ball is livid and
depressed, and is larger than the point of exit When the
piece is fired from a distance, the blackened and burned ap-
pearance of the skin is not seen, but only the mark of the
entrance of the missile, and sometimes that of the exit.
The aperture of entrance of the ball when fired from a
distance is, according to most authorities, always smaller
than that of exit. Nelaton says that when the wound is
recent, the entrance orifice is depressed and contused, while
the exit aperture is lacerated and everted. In the former,
there is an actual loss of substance; in the latter, there is
merely a solution of continuity. After some days, however,
the contused margins of the entrance wound slough away,
thereby enlarging the orifice, while those of the exit par-
tially adhere, causing the latter wound to appear smaller
than the former. Professor Casper declares that the en-
trance aperture is always the larger. Very possibly, this
discrepancy of views may arise from not distinguishing be-
tween the early and the later stages of the two orifices. If
the ball enters a very fat portion of the body, this often
protrudes between the edges of the wound, and completely
changes its appearance. Again, the character of the en-
trance will depend very much upon the nature of the pro-
jectile, and its velocity, as well as the distance from which
it was fired. If the ball is conoidal, as in the minie rifle,
and traveling with great speed, the wound is linear, and
resembles a puncture, producing little external harm, but
causing very considerable internal injury. A rifle ball
makes a large and ragged wound, caused by the spiral
WOUNDS BY SHOT. 109
direction given to the missile. It is evident that several
wounds may be made by a single ball, as this may chance
to traverse different parts of the body and limbs. It may
also happen that the piece may have been loaded with two
or more balls, which may account for the number of the
wounds.
The deflection of a ball from its straight, or direct course
after entering the body is easily produced by its striking
obliquely against any resisting surface, such as a bone,
tendon, aponeurosis, or even muscle. In this way it often
happens that a ball, striking the chest or abdomen, may be
caused to pass almost entirely around the body, and after-
wards be extracted close by the entrance point. Wharton
and Stille (Med. Jio-isp) relate the case of a German student
who was wounded in a duel by a pistol ball striking him on
the larynx obliquely, and passing around the neck so as to
lodge on the opposite side of the thyroid cartilage. It was
thence removed by simply cutting through the skin. It is
not uncommon for a ball to travel half way around the chest
or abdomen, and lodge in the back, giving the appearance of
having passed directly through the lungs, or intestines.
If the wound be caused by a load of shot, its appearance will
depend chiefly on the distance from which it was discharged.
If fired very near the body, so as to enter it as a single
charge before separating, it will produce a single large
and ragged wound, much contused and blackened by the
powder ; and as the shot diverge after entering the body,
there will be considerable laceration of the parts beneath.
For the opening to be single, the experiments of Dr.
Lachese, of Antwerp, have shown that the charge should
not be fired at a greater distance than ten to twelve inches.
When the distance is so extended as to allow the scattering
of the shot, each grain will make its own individual wound.
110 MEDICAL JURISPRUDENCE.
It is quite possible for a single shot to cause a mortal wound,
as when it happens to strike the heart, or aorta.
Wounds made by the wadding and gunpowder alone may
prove serious or fatal, according to the distance of the piece
from the body. A pistol thus loaded, at twelve inches
distance tore the clothes, and abraded the skin without
penetrating it ; at half this distance, the wadding penetrated
to the depth of half an inch ; at two inches it entered to
the depth of two inches, causing a ragged and blackened
wound ; and at one and a half inches, the wadding entered
the thorax between the ribs, and in one experiment, carried
away a portion of the rib {Phil. Med. Exam., 1846). Taylor
mentions an instance of a man sitting in a gallery of a
theatre at Brighton, in 1SS1, who had the upper half of his
hand completely blown away by a piece of greased news-
paper, tightly rammed, discharged from a small cannon on
the stage of the theatre.
Even gunpowder alone is capable of producing very
serious wounds, if fired close to an exposed part of the
body. The wound will present a lacerated appearance, and
be blackened and burned by the partially consumed powder.
If the grains of powder be coarse, the wound may have the
appearance of having been caused by very small shot.
The question of the homicidal, suicidal, or accidental char-
acter of gunshot wounds must generally be settled by the
appearance of the wounds, and also by the surrounding
circumstances. Thus, if it be on the forehead or temple, in
the mouth or over the heart, and if it be blackened and
lacerated (indicating the close proximity of the weapon), it
may be regarded as a suicidal act. If, on the contrary, the
wound be on the back, or side of the head (except in the
CAUSE OF DEATH FROM WOUNDS. Ill
case of the insane), or of the body, without the blackened
and lacerated appearance above alluded to, it may be con-
sidered as the act of a homicide. Accidental gunshot
wounds bear the marks of near wounds, as they are mostly
the result of the accidental discharge of the piece, either in
the hands of the deceased at the time, or else in close prox-
imity to his person.
Out of 368 cases of suicide by firearms, 297 were from
wounds in the head; of these, 234 were fired into the mouth;
only 71 were from wounds inflicted on the chest or abdo-
men (M. de Boismont, Du Suicide, p. 531).
Cause of Death from Wounds. — In a medico-legal
case it may become important to ascertain the real cause of
death occasioned by a wound — whether immediate, as from
hemorrhage or shock, or remote \ resulting from subsequent
complications. In a trial for murder, this question might
have an important bearing on the result.
When the death is directly traceable to hemorrhage, its
rapidity depends upon the amount and suddenness of thi
bleeding; and this again is dependent on the size and
nature of the vessel wounded. Exhaustion follows much
more rapidly from a sudden hemorrhage than from a more
copious flow of blood if gradually lost. Again, arterial
hemorrhage is more rapidly fatal than venous. It should
also be remembered that some persons have a constitutional
tendency to bleed very easily, from the slightest superficial
wound. Such a tendency is termed a hemorrhagic diathesis;
this is sometimes hereditary; and where it exists, it exposes
the individual to great danger, in case of being wounded.
Age and disease also increase the danger of death by hem-
orrhage from wounds.
Internal hemorrhage, as the result of a wound, is often as
1 12 MEDICAL JURISPRUDI
fatal as the external ; the danger is here further increased
by the pressure exerted by the effused blood upon a vital
organ, such as the brain, as is witnessed in effusion of blood
within the cranium, produced by a fracture of the skull.
It is also exemplified in a wound of the intercostal arteries,
causing effusion of blood into the chest, and producing fatal
pressure on the lungs ; and also in wounds of the throat
resulting in asphyxia, from the flow of the blood into the
windpipe.
Shock is the result of a violent impression made on the
great nervous centres. It often is the immediate cause of
death, after a severe injury, without leaving behind any
trace or lesion discoverable on a post-mortem examination.
Shock is most apt to follow extensive lacerations of the
body, such as result from machinery or railway accidents,
or from extensive burns.
The remote causes of death from wounds are numerous
and varied. The following may be regarded as the most
common : —
1. Tetanus or lockjaw. — This is generally the result of
lacerated and punctured wounds, and especially if inflicted
on nerves, tendons, aponeuroses and fibrous tissues. A very
slight wound in these structures may be followed by fatal
tetanus. Tetanus is always a very serious complication,
and is mostly fatal. It does not usually appear before the
seventh day after the receipt of the wound, though some-
times earlier ; and it rarely supervenes after the twentieth
day.
2. Erysipelas is another complication of wounds, which
may give to them a fatal issue. It is particularly apt to
accompany wounds of the scalp ; and it sometimes assumes
an epidemic character, especially in hospitals, where it may
occasion great mortality among the wounded patients.
DEATH FROM SURGICAL INTERFERENCE. 113
3. Hospital gangrene is another occasional result of
wounds. It likewise often proves fatal, and may assume an
epidemic type. It is, however, rarely seen, except in mili-
tary hospitals, and seems to be connected with faulty
hygienic arrangements.
4. Surgical interference, including the Use of Ancesthetics. —
In wounds dangerous to life, the question of the propriety
of a surgical operation becomes paramount; the patient will
certainly die without the operation, and, on the other hand,
he may die from shock, as the immediate result of the
operation. The question of the legal responsibility of the
death then becomes a serious one, and in the event of a
trial, the counsel for the prisoner, who had originally in-
flicted the wound, will endeavor to show that the death was
not really the result of the wound, but was rather owing to
the surgical operation. Whatever plausibility there may be
in such an argument, it would not likely avail with an intel-
ligent court and jury, unless it could be proved that the
original wound was not of a dangerous character ; and,
secondly, that the surgical interference was unwarrantable,
and unskillfully employed. The same remarks will apply
to the use of anaesthetics (ether and chloroform) in the per-
formance of surgical operations. Their employment in such
cases has now become so universal throughout the civilized
world, that the occasional fatal results attending their admin-
istration should be regarded as exceptions to the universal
rule of safety accompanying their employment, and as in no
wise inculpating the attending surgeon ; consequently, the
fatal result that might happen to follow their use should not
be considered as offering any extenuation for the prisoner, if
the latter has inflicted a dangerous or fatal wound upon the
deceased. The only medico-legal point at issue would be —
was the administration of the anaesthetic a necessary and
6*
114 MEDICAL JURISPRUDENCE.
proper part of the treatment, and was it skillfully adminis-
tered ?
It will be proper to devote a brief consideration to the
subject of Wounds in different regions of the body, inasmuch
as these present certain individual peculiarities, which give
to them special medico-legal importance.
Wounds of the head. — Scalp wounds are not usually at-
tended with danger, except sometimes, when followed by
erysipelas, and when the blow has been so severe as to
produce concussion of the brain. It must not be forgotten
that fracture of the skull may exist without any wound of
the scalp ; also that fatal effusion of blood upon the brain
may be produced by a blow on the head, without causing
either a wound of the scalp, or a fracture of the skull.
Concussion of the brain may result either from a direct
blow upon the head, or from a violent fall upon the feet
or buttocks. Sometimes death ensues immediately from
concussion, leaving behind it no perceptible lesion, though,
doubtless, some molecular change has been caused in the
nerve cells, not recognizable by the microscope. Such fatal
concussion may occur without either fracture of the skull,
or even a wound of the scalp. The symptoms of concussion
are faintness, nausea and vomiting, pallor of face, feeble
pulse, loss of consciousness, either partial or complete, with
subsequent confusion of ideas, and tendency to sleep. Con-
cussion may be confounded with intoxication, compression
of the brain, opium poisoning, sunstroke, etc.
It is particularly important, for medico-legal reasons, to
distinguish between concussion and intoxication. Doubtless,
many cases of supposed drunkards, arrested in large cities at
night by the police, and left unattended in the station house till
morning, are, in reality, cases of concussion, or compression
of the brain, which may prove fatal, simply for want of
COMPRESSION OF THE BRAIN. 1 1 5
timely relief. What adds greatly to the difficulty of the
diagnosis is the fact that the two conditions are so frequently
coincident in the same individual. It is the drunken man
who is most apt to engage in a brawl which results in a
broken head. Generally, the history of the case (if it can
be obtained), and the odor of the breath, will afford us the
best means of diagnosis. In intoxication, the temperature
is usually below 96 F. — sometimes below 90 ; the loss of
power and of sensation are not unilateral, as in compression ;
the bladder is generally full of limpid urine, which will
furnish evidence of the presence of alcohol on distillation.
( Via 1 . Alcohol, /wA) The pupils are sometimes contracted,
and again dilated.
Fracture of the skull is the result either of a direct blow
upon the head, or of a fall upon the head, striking a stone,
or other hard body. The usual consequence of such a
fracture is pressure on the brain by the depressed bone, or
by the extravasated blood from a ruptured vessel, or vessels.
Fracture of the base of the skull is the most dangerous of all.
It is nearly always fatal ; and unless carefully looked for in
the autopsy, it may entirely escape notice.
Compression of the brain may result either from effusion
of blood or serum upon, or within the brain, with or without
fracture, or depression of the bone; also from suppuration,
or tumors in the brain, from congestion of the cerebral
vessels, and likewise from narcotic poisoning. The symp-
toms are essentially those of apoplexy, viz.: loss of con-
sciousness, paralysis (usually hemiplegia), dilated pupils
(except where the effusion is on the pons Varolii, when,
according to Dr. Wilks, the pupils are contracted), stertor-
ous breathing, a full, slow pulse, and coma. It is important
to remember that the effusion of blood resulting from a
blow may be very gradual, so that the person seemingly
116 MEDICAL JURISI'RUDEN'CE.
recovers from the first shock, and may be able even to
resume his ordinary occupation for some hours, or even
days, before the fatal termination takes place. The distinc-
tion between the effusion from violence, and that resulting
from disease, as a rule, is that in the former the extravasa-
tion is nearly always between the skull and dura mater, or
between this membrane and the brain, while in the latter it
is usually in the brain substance. Moreover, in the first,
there is frequently a fracture of the bone, and ecchymosis
of the scalp, either immediately over the effusion or on the
opposite side of the head (contre coup).
Another important medico-legal point is, that a fatal effu-
sion of blood may take place simply from great excitement,
in a quarrel, especially if accompanied by intoxication.
In a trial for homicide this is likely to be urged by the
defence as the probable cause of death in the deceased,
where there has been an assault or pugilistic encounter,
which terminates fatally. In a case of this nature it might
be extremely difficult to decide how far the fatal effusion
was due to natural causes, such as atheroma of the cerebral
arteries (which, in an habitual spirit-drinker, might also be
connected with a diseased liver and kidneys), or how far it
was to be attributable to the effects of violence. We are,
however, of the opinion that, if the assault could be clearly
proven, either in connection with a direct blow upon the
head, or indirectly, by a fall upon a stone or other hard
body, the mere fact of the preexisting disease of the arteries,
or the other organs, would not exculpate the prisoner, nor
acquit him of the charge of homicide. If, however, the
autopsy shows that the effused clot, or serum, were of older
date than the alleged injury, this would certainly be a strong
argument for his acquittal.
Wounds of the Substance of the Brain are not always fatal.
WOUNDS OF THE SPINE. 117
As regards the symptoms of injury to the different portions of
this organ, as indicating the localization of its various func-
tions, the reader must be referred to the writers on this
special department of science. It is well known that con-
siderable portions of the cerebral substance have escaped
through the skull, after fractures, not only without loss of
life, but without any sensible impairment of the mental
powers.
Wounds of the Face are not usually dangerous unless they
involve the orbit ; a penetrating wound of this part may
readily reach the brain, with a fatal result. So also, a
severe blow upon the nose may so injure the ethmoid bone
as subsequently to involve the brain.
Wounds of the Neck are attended with much danger,
owing to the presence of the large vessels and nerves. In
cut throats, the great danger arises from the sudden and
profuse hemorrhage. The section of the larynx and trachea
is not necessarily fatal, the chief danger arising from suffo-
cation from the flowing back of the blood. A division of
the oesophagus is almost necessarily fatal, chiefly because of
its involving the section of the great vessels of the neck.
Wounds of the Spine are dangerous in proportion to the
degree that the spinal marrow is involved. In concussion
of the spine, death sometimes takes place instantly. If the
spinal cord be wounded high up, above the region of the
phrenic nerve, the function of respiration is immediately
arrested, and death ensues. Wherever the injury occurs to
the spinal cord, it is understood that there is a complete
suspension of the functions of the parts below. In fracture
of the vertebra?, the great danger arises from pressure on the
spinal marrow. Sudden death has been produced by the
spontaneous luxation of the second cervical vertebra, aris-
ing from the fracture of the odontoid process, through dis-
118 MEDICAL JURISPRUDENCE.
ease. Sir A. Cooper's case was of this character (Frac. and
Disloc. p. 463). These fractures are justly considered as
having an important medico-legal bearing.
Wounds of the Chest. — The great danger here lies in the
hemorrhage from the heart, great vessels and lungs ; hence,
such wounds often prove rapidly fatal. The hemorrhage in
wounds of the chest is nearly always internal. Wounds of
the lungs, though they may not prove immediately fatal,
frequently so terminate after a lapse of time ; this is especially
true of gunshot wounds, if the bullet or other foreign sub-
stance happens to be retained. Wounds of the Heart nearly
always terminate fatally and rapidly, if the cavities be pene-
trated. Gunshot wounds of the heart do not necessarily
cause immediate death ; cases are recorded where the
patient survived several months ; after death the ball has
been found in the substance of the organ. Even where the
cavities of the heart have been perforated by a cutting
instrument, there have been instances where the person sur-
vived for eleven days (Wharton and Stille, Med. Jurisp. p.
745 ). Rupture of the heart may be the result of a violent
blow upon the thorax, or it may follow any intense excite-
ment or emotion, if this organ happens to be in a diseased
condition, as in fatty degeneration, etc. In a medico-legal
case, where death has resulted from this cause in a brawl,
in which the deceased received a severe blow on the chest,
if the pre-existing disease of the organ can be established,
it would be a question how far the violence, and how for the
disease was to be credited with the result. The case is very
similar to the one where death follows a blow upon the head,
terminating in compression of the brain, and where a dis-
I condition of the cerebral vessels existed.
Wounds of the Abdonien. — Even a superficial wound of
the abdomen may prove fatal, by dividing the epigastric
WOUNDS OF THE GENITAL ORGANS. 119
artery. A severe blow upon the epigastric region has fre-
quently produced immediate death, from shock upon the
solar plexus of nerves. Blows upon any part of the abdo-
men may be followed by peritoneal inflammation, which
often proves fatal. Penetrating wounds may terminate
fatally from the same cause. Wounds of the stomach and
intestines are e'xceedingly dangerous, and are often mortal,
either from hemorrhage, or from inflammation, or both.
Wounds of the Liver are dangerous, according to their
extent and depth. If the gall-bladder is involved, death is
apt to ensue, in consequence of the peritonitis. The danger
from wounds of the kidneys arises from the effusion of urine,
and the consequent inflammation.
In relation to wounds of the bladder, it should be remem-
bered that this organ may be ruptured spontaneously, from
over-distention. It is sometimes ruptured by a blow, or
kick of a horse, upon the lower part of the abdomen. In
a trial for homicide, in a case of death produced by rupture
of the bladder, the defence would probably try to set up the
plea of spontaneous rupture of this organ. Frequently,
there is no external injury to indicate the true nature of the
case, the autopsy alone revealing it, and disclosing, also,
extensive peritoneal inflammation, resulting from the escape
of urine.
Wounds of the Genital Organs are, in the male, usually
self-inflicted, and they are met with most generally among
the insane. They comprise castration — more or less com-
plete, and amputation of the penis — partial or entire. The
danger to life is great in proportion to the hemorrhage, and
injury to the organs. In certain other cases, where the in-
jury has been inflicted by others, and when in a state of erec-
tion, the urethra has been found violently torn across, and
120 MEDICAL JURISPRUDENCE.
the corpora cavernosa and spongiosa divided. In females,
the chief point of medico-legal interest is to discriminate
between wounds of the genitals inflicted by another, and
spontaneous hemorrhages from a ruptured vein in the labia.
Here, of course, a rigid inspection of the injured parts will
be required before arriving at a definite conclusion.
EXAMINATION OF BLOOD-STAINS. 1-1
CHAPTER VII.
EXAMINATION OF BLOOD STAINS.
IMPORTANCE OF THEIR IDENTIFICATION. — THREE METHODS OF IDENTI-
FICATION. — I. THE CHEMICAL TESTS. — 2. THE MICROSCOPIC TEST. —
3. THE SPECTROSCOPIC TEST. — BLOOD-CRYSTAES.
The identification of blood-stains not infrequently con-
stitutes a most important link in the chain of evidence, in a
trial for homicide. It is a very common practice for a
murderer to attribute certain suspicious red stains dis-
covered upon his garments, or implements, to the blood
of some domestic animal or bird. Within a few years past
the resources of science have afforded us material aid in
distinguishing human blood-stains from those of the inferior
animals, so that the legal physician may now feel much
more confident in delivering his testimony in a trial for
homicide, than he could have done in former years.
The appearance of blood-stains to the naked eye will vary
in size, shape and color. Sometimes it may be a mere film
or smear, but generally it presents the form of distinct spots
of different sizes; and if the blood has spurted obliquely
upon a surface, the spots will have assumed a comet-like
shape, terminating in a bulbous tail. The color of the stain
will depend (1) upon its freshness: if recent, it will have a
bright red hue ; if old, the color will be brownish, or brown-
red. (2) Upon its thickness ; being darker in proportion to
the density of the stain. (3) Upon the material on which it
has fallen; if the latter is porous, as soft wood, or linen or
cotton fabrics, the tint will be rather dull, but if on polished
and hard substances, such as metals or polished wood, the
122 MEDICAL JURISPRUDENCE.
spots have a darker and shining appearance, and on drying
they are apt to crack from the centre, and may thus easily
be removed. When dried upon linen or cotton, they usually
have a stiffened feel, like a spot of dried albumen or gum.
If the stains be upon a colored substance, they can best be
distinguished by artificial light; indeed, they may be en-
tirely invisible in bright daylight.
We possess three methods of identifying blood stains :
(i) the chemical; (2) the microscopic; (3) the spectro-
scopic or optical. But previously to employing these
methods, it will be always proper to examine the sus-
pected spot with a good magnifier; the spot, if a blood stain,
will frequently exhibit minute coagula or clots of a shiny
hue, intermixed with the fibres of the material on which it
is fixed.
I. The Chemical Tests. — Before noticing these, it will be
proper to remark briefly on the solubility of the coloring
matter of blood. Modern research has shown that the
coloring matter of blood, when quite recent {hemoglobin or
oxy-hczmoglobin), is very soluble in cold water, but when
old, so as to have changed to a brown color, it is converted
into hecmatin, or deoxidized hemoglobin, which is insoluble in
water. This is a fact of considerable medico-legal interest.
For if a garment, or other article stained with blood, is
immediately washed in cold water, the whole of the blood
will probably be discharged, so as to leave no trace of it
behind. But if (as is usually the case) the garment be
kept for some time before the attempt is made to remove
the stain by washing, the soluble hemoglobin will have
become more or less connected with the insoluble hematin,
and enough of the blood will remain upon the article to
suffice for future identification. Hot water will not remove
Los Annies, OaL
CHEMICAL TESTS FOR BLOOD. L23
a recent blood stain as effectually as cold water, on account
of the action of the heat upon the haemoglobin.
If the blood-spot be recent, the examiner should cut out
a small piece of the fabric stained, and suspend it, by means
of a thread, in a test-tube containing cold, distilled water.
In a few minutes the coloring matter will be observed to
separate from the material, and to descend to the bottom of
the water, forming a bright-red solution. If the stain is a
little older, more time will be required to effect the solu-
tion, which will have a browner hue; and if the stain is very
old, there will be no solution whatever.
If the stain be upon a porous substance, such as wood*
brick, etc., it should be cut or scraped out, reduced to
powder, and then soaked in cold water for some hours, and
afterwards filtered. If the spot be upon a hard metallic
surface, as a knife, sword, etc., it should be carefully dried,
when it will be apt to crack off; otherwise it may be
scraped off with a knife, and the scraping soaked for some
time in cold water, and afterwards filtered. If the solution
should not be complete, a little dilute ammonia may be
added, and if this should fail, Dr. Tidy recommends to use
a trace of citric acid to effect the solution.
Having procured the clear red solution, the next step is
to heat it in a test tube over a spirit lamp. Four results
are thus obtained: (i) the red color disappears ; (2) coagula-
tion takes place ; (3) a brownish-green precipitate is formed.
If there is a sufficient quantity of this precipitate it may be
collected, dried and heated with a weak ammonia solution,
which will dissolve it. The solution will appear dark green
by reflected, and red by transmitted light. (4) A weak
solution of ammonia added to it, either produces no change
of color, or it merely intensifies it. It never changes it to
green or crimson, as it does with cochineal, and red fruit
124 MEDICAL JURISPRUDENCE.
colors. Tincture of galls gives a red precipitate to the
original solution. A solution of chlorine causes no change
in it.
The above tests will suffice to distinguish blood from all
other red solutions, such as cochineal, kino, madder, log-
wood, and the various red fruit juices, none of which coagu-
late by heat, and all of which are changed in color by the
addition of ammonia. The stain produced by lemon or
orange juice on the blade of a knife (citrate of iron) after
exposure to the air, may bear some resemblance to an
old blood stain ; but the test of tincture of galls, or of
tannin, to the solution would immediately detect the differ-
ence. So, the stain from red paint (which contains iron), or
from iron mould, is easily identified by their solubility in
dilute muriatic acid, and by subsequently testing for iron.
The Guaiacum Test. — This constitutes a beautiful and
satisfactory portion of the chemical test for blood. Dr.
Day, of Australia, has experimented extensively upon this
test, and Prof. Taylor has fully confirmed his results. It
depends upon the following conditions : A freshly-prepared
tincture of guaiacum, if dropped into water, precipitates the
resin, which, if exposed to the air, gradually acquires a
bluish color. If it be exposed to a jar of oxygen gas, the
blueing process is more rapid ; and if brought in contact
with ozone, the blue color is instantly produced. Hence,
the blueing must be owing to oxidation. But it is a remark-
able fact, as discovered by Schonbein, that antozone, as found
in the peroxide of hydrogen (in which the oxygen is in the
positive state), has no effect at all in changing the guaiac
resin to a blue color. Moreover, while the resin is blued
by a variety of mineral and organic substances, the coloring
matter of the blood has no effect upon it. The guaiacum
test depends, then, upon the fact that while the blood has no
THE GUAIACUM TEST. 125
power to oxidize, or blue the resin, the presence of peroxide
of hydrogen (antozone), which itself has no power to oxidize
the guaiacum, causes the resin then to be oxidized by the
blood, and the blue color appears. According to Prof.
Taylor, an excellent way of showing the experiment is to
add a few drops of the tincture (freshly prepared) to a small
quantity of water; this will precipitate the resin. Divide
the water suspending the resin into two portions ; into one
of them pour a little solution of red coloring matter of
blood ; to the other, add a few drops of ozonized ether
(peroxide of hydrogen dissolved in ether) ; no change of
color is observed in either portion. Now, to the first por-
tion add a few drops of the ether, and to the second a few
drops of red solution ; in both cases the sapphire-blue color
will soon be seen. In case the solution is turbid, from an
excess of the resin, the addition of a few drops of alcohol
will instantly clear it, and bring out the fine blue color dis-
tinctly. If the simple addition of the blood solution to the
guaiac produces a blue color, we may be certain that some
oxidizing substance is present besides blood, and which
conceals its presence. The force of the experiment consists
in the fact that blood, of itself, will not blue guaiacum, but
in the presence of ozonized ether, the blue color is speedily
produced.
Objections have been raised against this test, on the
ground that other substances beside blood will produce a
blue color in the presence of guaiac and peroxide of hydro-
gen, such as saliva, bile and red wine ; but as regards the
two former, their color should at once distinguish them from
blood, while the latter substance requires some hours' ex-
posure to produce the same result ; whereas, in the case of
blood the effect is immediate. This test is as available for
old, as for fresh blood, for concentrated, or diluted blood;
\2l) MEDICAL JURISPRUDENCE.
hence, for a washed-out blood stain, — wherever, in fact, a
particle of red coloring matter remains. If no blueing
occurs in the presence of the guaiac and the peroxide, it
will be safe to affirm that there is no blood present. In an
old blood-stain, or where it is too small to afford a sufficient
solution, or where there may be some doubt of its presence
on a colored material, a very good plan is to moisten the
spot first with a few drops of water, then with a sufficient
quantity of the guaiac tincture, and afterwards with a few-
drops of the ozonic ether, and then press upon it a piece of
white tissue or filtering paper; immediately there will appear
upon the paper the characteristic blue stain. A number of
such impressions may thus be taken from one spot, by simply
adding a little more of the guaiac and the peroxide, and
repeating the pressure upon the paper.
The chemical tests will not distinguish arterial from
venous blood, nor human blood from that of the lower
animals. The statement of M. Barruel, that if blood be
shaken up with one-third its volume of pure sulphuric acid,
a peculiar odorous principle will be evolved, resembling the
particular animal from which the blood was obtained, has
been disproved by subsequent investigations.
II. The Microscopic Test. — This consists in the identifica-
tion of the blood corpuscles — especially the red ones — by
means of the microscope. To effect this, the stain (unless
too old) should be cut out and placed on the glass, or on a
watch crystal, and moistened with a few drops of pure cold
water,* a glass rod being pressed against it, to effect the
separation ; then cover the specimen over with a thin glass,
* As water alone may cause the corpuscles to swell up, it should be mixed
with one-seventh part of glycerine, or with a small portion of common salt,
or sulphate of sodium.
THE MICROSCOPIC TEST. 127
and examine with a one-fourth inch power, and measure
the corpuscles with a micrometer. If the stain has been
washed, very possibly there will be no satisfactory result;
but the identification of a single red corpuscle would be
proof of the presence of blood. The white corpuscles may
sometimes be detected where the red disks cannot be dis-
tinguished. They are much fewer in number and colorless.
If very abundant in a specimen, they might be owing to pus
rather than to blood, or to disease (leukaemia). If only a
minute speck of dried blood, taken from a weapon or from a
garment, is to be examined, it may be laid upon the glass,
which has previously been breathed upon several times, and
after again breathing upon it, it should be covered with the
thin slide, and examined, as before. The condensed moisture
of the breath serves the place of water in breaking up the
dried clot, without destroying the corpuscles by too much
dilution (Dr. A. Taylor, from Casper).
The human blood corpuscle is a round, bi-concave disk,
without a nucleus. All mammalian corpuscles have the
same form, with the exception of those of the camel tribe,
which are oval. The corpuscles of birds, reptiles and fishes
are oval, larger in size, and nucleated. It is well to remem-
ber that oval corpuscles may becorrTe globular by treatment
with an excess of water. The outlines of dried blood cor-
puscles are irregular and jagged, and more or less stellate.
The average diameter of the human blood corpuscle is
about the 32W of an inch (max. 2oV) by the action of liquor
potassae, which dissolves it without color, while it gives a
black color to calomel and a yellowish-red to corrosive sub-
limate ; (3) moistened with sulphide of ammonium, and
evaporating, produces the yellow sulphide ; (4) put into a
reduction tube along with some reducing agent, as charcoal,
246 TOXICOLOGY.
black flux, or dried ferrocyanidc of potassium, and heated
by the flame of a spirit lamp, it is reduced, and the metal
is volatilized in the form of a brilliant steel-gray ring or
mirror.
In order to effect the sublimation successfully, certain pre-
cautions are necessary. The reduction tube should be small
— about the eighth of an inch in diameter, and three inches
long ; it should be perfectly clean and free from moisture.
The reducing agent should be perfectly dry, and thoroughly
mixed with the arsenious acid, in the proportion of three or
four to one of the latter. After it is introduced into the
tube, this should be wiped out with a wad of cotton or a roll
of filtering paper. The tube should first be gently warmed
just above the contents, and then fully heated in the flame.
This precaution insures a better formed metallic ring.
For the sublimation simply, the above process is to be
pursued, with the omission of the reducing agent.
The obtaining the metallic ring or mirror, by the reducing
process, may be regarded as positive proof of the presence
of arsenic ; but in a medico-legal case this should be con-
firmed by further proofs: (i) the arsenic mirror is wholly
soluble in hypochlorite of sodium ; (2) it is soluble in hot nitric
acid, and the solution, on evaporation, leaves a brick-red
deposit when touched with nitrate of silver solution, due to
the formation of arsenate of silver ; (3) if the closed end of
the tube be broken off, and heat applied to the sublimate, it
will readily volatilize, and, combining with the oxygen of
the air, will condense on the upper portion of the tube, in a
white ring of arsenious acid ; (4) this latter maybe dissolved
in a few drops of warm water, and subjected to the liquid
tests.
II. The liquid tests. — These are the ammonio-sulphate of
copper and the ammonio-nitrate of silver. They should be
ARSENIC — CHEMICAL ANALYSIS. '217
prepared only when required for use. The former is made
by the cautious addition of aqua ammoniae to a somewhat
dilute solution of sulphate of copper, until the precipitated
oxide is barely redissolved. When this reagent is added to
a solution of arsenious acid, it throws down a light green
arsenite of copper (Scheele's green). This precipitate is
soluble in ammonia, and in free acids. If the arsenic is in
very minute quantities, the characteristic color does not
appear immediately.
The silver test is prepared by adding aqua ammoniac to a
strong solution of nitrate of silver until the precipitated
oxide is barely redissolved. When this is added to the
arsenical solution, a. canary-yellow precipitate occurs (King's
yellow), arsenite of silver, which, like the former, is freely
soluble in ammonia and the acids.
These liquid tests are available only in perfectly pure
solutions of arsenious acid ; they are inadmissible in the
presence of organic matter, e.g., the contents of a stomach,
since various organic substances will produce similar colors
with both copper and silver. They may, however, be satis-
factorily confirmed (i) by heating either of the dried pre-
cipitates (arsenite of copper or silver), either alone, or with a
reducing agent, in a reduction-tube ; the former experiment
will yield a sublimate of octahedral crystals, the latter the
metallic mirror. (2) If the blue ammoniacal solution of
the arsenic is poured over a crystal of nitrate of silver, a
film of yellow arsenite of silver is immediately formed
around it.
III. The sulphuretted hydrogen test. — This consists in
passing washed sulphuretted hydrogen gas through the
solution of arsenious acid, slightly acidified by hydrochloric
acid ; a clear, yelloiv precipitate falls — tersulphide of arsenic
(orpiment), which is soluble in the alkalies, and insoluble in
248 TOXICOLOGY.
acids. In very dilute solutions, the precipitate does not
separate until the excess of the gas is driven off by heat.
Fallacies. — Cadmium, tin and selenium yield somewhat
similar precipitates with sulphuretted hydrogen. Practically,
the only one that need be considered is cadmium, which,
however, is easily distinguished from arsenic, as follows :
(i) the arsenic sulphide is soluble in ammonia and insoluble
in the acids; with cadmium sulphide it is precisely the
reverse; (2) when dried and sublimed with a reducing
agent, the arsenic sulphide yields a metallic ring; the
cadmium, a brown oxide.
In a poison case, the sulphide of arsenic should always
be proven by (1) obtaining the metallic ring by subliming it
with a reducing agent; (2) by boiling the sulphide in hydro-
chloric acid, along with a piece of bright copper foil; a steel-
gray deposit shows the presence of arsenic.
IV. Marsk s Test. — The principle here involved is, that
when arsenic comes in contact with nascent hydrogen, it
combines with it to form arseuiureted hydrogen ', a gas which
possesses peculiar properties, by means of which the arsenic
may be recognized with great certainty. Practically, the
simplest and best mode of performing the experiment is to
add to the materials for generating hydrogen (zinc, water
and sulphuric acid), in a wide-mouth flask, the suspected ar-
senical solution. The cork fitted to the mouth of the flask
should have two perforations, through one of which a per-
pendicular glass tube passes down below the surface of the
liquid contents ; through the other aperture a tube bent at
right angles is inserted, out of which the generated gas
issues. A drying tube (containing fragments of fused
chloride of calcium, or of pumice stone moistened with sul-
phuric acid) is fastened by one end to the exit tube, and by
the other extremity to a horizontal tube of hard German
ARSENIC MARSH'S TEST. 249
glass, about a foot long, which may b>2 turned up at the
farthest end, and made to terminate in a small point, for
burning the gas in a jet, as it escapes.
In performing this experiment certain precautions are
necessary. In the first place, the absolute purity of the
zinc and sulphuric acid must be secured, since both of them
are liable to be contaminated with arsenic. Secondly, cau-
tion should be exercised to have the atmospheric air com-
pletely expelled from the apparatus before lighting the jet,
otherwise the mixture of hydrogen and air will produce a
violent explosion. The evolution of the hydrogen should
be rather slow and gradual. After waiting the proper time,
the jet may be lighted ; it will burn, if pure, with a scarcely
perceptible flame. The purity of the materials may now be
tested by applying the flame of a large spirit lamp, or a
Bunsen burner, to the horizontal glass tube until it is red
hot; if no stain or deposit occurs just beyond the heated
spot, the absence of arsenic is certain ; or, if no deposit
forms on a piece of white porcelain held over the burning
jet, the same conclusion may be held.
A small quantity of the suspected solution is now to be
introduced through the upright tube; its decomposition
immediately commences, freeing the arseniureted hydrogen^
which yields the following characteristic results : —
(i) The ignited jet. — As soon as the arsenic combines
with the hydrogen, an immediate change occurs in the
appearance of the flame, which increases in size and acquires
a faint, bluish color, and unless the arsenic be in minute
quantity, it evolves white fumes, and gives out an alliaceous
odor. If these fumes are received into a short, wide glass
tube, they will condense into a white powder, sometimes
crystalline, and may be identified as arsenious acid.
If the jet be made to impinge on a piece of glass or
12
H50 TOXICOLOGY.
white porcelain, held horizontally, and just within the flame,
a deposit of pure metallic arsenic, of a brilliant steel-gray or
brownish-gray color occurs, which may be multiplied to
any extent by changing the position of the porcelain. In
order to procure the finest deposits, the flame should be
steady and not too large. Although these spots may vary
somewhat in color, they are always brilliant and never
sooty.
These deposits may be identified (i) by their immediate
solubility in hypochlorite of sodium: stains of antimony,
which they most resemble, are not thus affected. (2) When
touched with a drop of sulphide of ammonium, they do not
immediately disappear ; antimony stains are instantly dis-
solved. (3) Both metals dissolve in hot nitric acid, and on
evaporation yield white residues ; if now touched with a
drop of strong solution of nitrate of silver, the arsenic spot
assumes a brick-red color, while the antimonial stain remains
unaffected.
(2) Decomposition of the gas by heat. — On placing the
flame of a large spirit lamp, or a Bunsen burner, immediately
below the horizontal tube (which should previously be con-
tracted after heating it in several places), when it becomes
nearly red hot, a deposit of metallic arsenic begins to form
just in advance of the flame, which should be held a little
behind one of the contracted spaces ; the deposit continues
to increase until it may completely occupy the whole of the
narrow space, and even advance beyond it. This constitutes
the arsenical mirror. It may have the steel-gray, brilliant
appearance already described, or even a coppery hue, and it
is highly characteristic of the presence of arsenic. Several
such mirrors may thus be obtained, by moving the flame to
different parts of the horizontal tube, provided there is a
sufficient amount of the poison to operate upon. The tube
ARSENIC — REINSCH'S TEST. 251
may afterwards be filed, so as to separate the mirrors, which
may be retained for exhibition in court, as positive proof of
the detection of the poison.
This mode of experimenting yields even more delicate
results than the jet; but unless the quantity of arsenic is
extremely small, it will always be possible to obtain both re-
sults by Marsh's process.
One fallacy only might interfere with this experiment —
the presence of antimony, which in contact with hydrogen
yields a gas very similar to arseniureted hydrogen, and like
the latter, is decomposed by heat, yielding a metallic deposit.
They may be distinguished as follows: the antimony mirror
is deposited just over the heated spot, and not in advance
of it; it has usually a darker appearance than the arsenical
mirror; the latter is more easily volatilized than the former,
and condenses higher up in the tube, in octahedral crystals.
The two deposits may also be tested by the different reagents
mentioned above (vid. p. 246); also, by dry sulphuretted
hydrogen, which produces with the arsenical gas a yellow
deposit, and with the antimonial gas an orange-red.
(3) Decomposition by nitrate of silver. — If the arseniureted
hydrogen gas be passed through a solution of nitrate of
silver, it immediately blackens it, from the precipitation of
metallic silver, arsenious acid remaining in the solution.
The filtered clean solution will contain, also, free nitric acid,
and any excess of nitrate of silver. On neutralizing with
ammonia, a yellow precipitate will fall — arsenite of silver
(vid. p. 247). The analyst should not rely on the mere
production of the black color, since other gases beside ar-
seniureted hydrogen might cause this, but he should con-
tinue the experiment as above described.
V. Reinsclis Test. — This consists in producing a deposit
of metallic arsenic on bright copper foil. The suspected
9S9
TOXICOLOGY.
solution, acidulated with about one-sixth of its bulk of pure
hydrochloric acid, is first brought to the boiling point, and
a piece of bright copper foil is introduced, and the boiling
continued. The presence of even a very minute quantity
of arsenic is soon indicated by the tarnishing of the copper,
which ultimately assumes a dark steel-gray, or even black,
color. If the quantity of arsenic be large, the deposit is
immediate, and very dark ; it may even break off in scales ;
if the amount of the poison is very small, the stain upon the
copper will be fainter, and merely of a violet, or bluish tint.
Moreover, the deposit on the copper is affected by the de-
gree of dilution ; hence, if the quantity of the water be large,
it may require boiling for half an hour before a visible de-
posit occurs.
This reaction is very delicate and extremely satisfactory.
One great advantage that it possesses over the other tests
is, that it may be practiced in complex organic fluids; hence,
this test is usually employed in toxicological research, as
the trial test.
Certain precautions are, however, required in employing
it. First, the purity of the hydrochloric acid must be
insured; this is easily accomplished by first boiling some of
the acid diluted with water, and then introducing a slip of
the copper. If no stain appears upon the latter after fifteen
minutes, we may be certain of the absence of arsenic or
antimony from the acid. Secondly, the copper must be
both bright and pure. Its brightness is effected by rubbing
it with emory paper, and it maybe regarded as /> tire if, when
boiled in the acid arsenical liquid, it is not dissolved, and
does not impart a green color to the liquid. But, if deemed
necessary to further test its purity, the process of Mr. Abel
may be adopted : Add to pure hydrochloric acid, diluted
with six parts of water, one or two drops of a weak solution
ARSENIC — REINSCH'S TEST. 2-03
of perchloride of iron ; boil the acid liquid, and introduce
into it the copper, well polished ; if it contains arsenic it
soon becomes tarnished ; if pure it remains bright. (Taylor,
Med.Jurisp., 1883, p. 268.)
In applying this test, it is best to use small pieces of
copper successively, removing each fragment as it becomes
coated. By this means the whole of the arsenic may be
removed from the solution. We have ascertained, by actual
experiment, that one grain of arsenious acid dissolved in
the acid solution, and treated by Reinsch's process, will
impart a distinct, dark, steel-gray coating to three hundred
square inches of copper surface. This method will, there-
fore, serve for an approximative quantitative estimate of the
poison.
Another caution to be observed is not to remove the
copper too soon from the liquid, in case no deposit occurs ;
in doubtful cases, the boiling should be continued for half
an hour. But, on the other hand, if the copper be kept in
for an hour or longer, it may acquire a dark film, independ-
ently of any arsenic.
Fallacies. — Other metals beside arsenic will impart a dark
coating to copper by Reinsch's process, such as antimony,
mercury, silver, bismuth, tin, gold, platinum and palladium,
and likewise organic matter, especially if it contain sulphur.
Hence, in the application of this test, the mere production
of a dark deposit on the surface of the copper is not
sufficient to establish the presence of arsenic, but further
corroborative proof is required. This is afforded by wash-
ing a fragment or two of the coated copper, and then
thoroughly drying them between the folds of filtering paper,
(avoiding touching with soiled fingers), and rolling them up
into small coils, and then introducing one or more of them
into a small, clean reduction-tube and applying the heat of
254 TOXICOLOGY.
a spirit lamp. The arsenic will volatilize and condense in
the cool part of the tube, in a white ring of octahedral crys-
tals. The only other metals which could volatilize under
such circumstances are antimony and mercury ; but the sub-
limate from antimony is either amorphous, or else in fine,
acicular crystals, while the mercurial deposit consists of
fine, spherical globules of the metal, easily recognized by a
magnifier.
The attention of the toxicologist should especially be
directed to the fact, that if copper be boiled for some time
in an acid solution of complex organic matters, it will be-
come coated with a decided dark stain, and will, moreover,
yield, when heated in a reduction-tube, an amorphous
sublimate, which may even sometimes show acicular crys-
tals, consisting apparently of a compound of copper. YYe
have repeatedly verified this by our own observations.
Hence, it follows that, for the complete corroboration of
Reinsch's test for arsenic, in a medico-legal case, we can
admit nothing short of the production of the octahedral crys-
tals, and their subsequent identification.
It must also be remembered that the presence of certain
substances in the arsenical solution may prevent the deposit
of this metal upon the copper, viz., a cJdorate, binoxide of
manganese, or other bodies that decompose hydrochloric
acid and evolve chlorine ; likewise strong nitric acid. Con-
sequently, Reinsch's test is //^applicable to the clear solu-
tion obtained by boiling the viscera in hydrochloric acid
and chlorate of potassium (z>id. post)
VI. Bloxanis method. — The principle here involved is the
same as that in Marsh's process — the action of arsenic on
nascent hydrogen ; only, electrolysis is employed to decom-
pose the water instead of zinc. It is a delicate and satis-
factory method, but it should be remembered that the
ARSENIC — TOXICOLOGICAL EXAMINATION. 255
arsenic must always be present in the form of arsenious
acid.
There are some other reagents of inferior importance for
the recognition of arsenic, as lime water, iodide of potassium,
bichromate of potassium, etc., but these require no further
notice.
Toxicological examination. — The analyst should always
first search for particles of solid arsenious acid in the
stomach and the vomited matter, and carefully remove
these for examination. Organic mixtures should be diluted,
if necessary, with distilled water, and acidified with about
one-sixth part of hydrochloric acid and boiled gently for
about fifteen minutes ; when cooled the mixture should be
strained and concentrated by evaporation over a water bath.
A portion may now be subjected to a trial test by Reinsch's
process ; if no deposit takes place after boiling for half an
hour, it is safe to conclude that no arsenic is present. But
if deemed advisable, another portion of the filtrate may be
subjected to Marsh's process, and to the action of sulphur-
etted hydrogen.
The stomach and contents. — This organ should first be
carefully examined as to its pathological condition (vid.
ante, p. 61), and also for the presence of solid particles of
the poison. It should then be cut up into small fragments,
with scissors known to be perfectly clean, and together with
its contents, placed in a clean, porcelain evaporating dish,
distilled water added in sufficient quantity, together with
about one-sixth the bulk of pure hydrochloric acid, and the
whole boiled gently for about an hour, when most of the
solid portions will have become disintegrated. After cool-
ing, the mixture is thrown upon a muslin strainer, and the
solid matters washed several times with pure warm water
and squeezed. The strainer and contents should be pre-
2-3>
TOXICOLOGY.
ante?) According to Wormley, the ioooo of a grain of ve-
ratria may be thus detected.
Other substances give a red color to sulphuric acid — such
as solanine, nareeiue, salicine, piperine, etc., but these are
immediately colored by cold sulphuric acid, whereas veratria
requires the lapse of some time before this change is
effected.
Trapp's test consists in warming the colorless solution of
veratria in concentrated hydrochloric acid, when a persistent
dark red color results.
/;/ organic mixtures, veratria may be separated by a modi-
fication of Stass' process, and the ultimate chloroform extract
tested by sulphuric acid. Dr. Wormley states that by this
test he was enabled to recognize the presence of veratria in
an ounce of blood of a cat which had been killed, in less
than one minute, by two grains of veratria.
Yellow Jessamine (Gelsemium sempervirens). — The root
of this plant is considerably employed in medicine, especially
in the Southern States of our country, in the treatment of
neuralgia, and analogous complaints. It has frequently
produced fatal results, the symptoms somewhat resembling
those produced by veratria. Wormley found it to contain
a powerful alkaloidal principle — gelsemia, one-eighth of a
grain of which killed a rabbit in an hour and a half, together
with another organic principle — gelseminic acid. The above
authority succeeded in detecting both of these principles in
the stomach of a woman who was poisoned by three tea-
spoonfuls of the extract, several months after death (Am.
Jour. Med. Sci., April, 1870).
Poisonous Mushrooms. — As is well known, certain varie-
ties of fungi are edible, while others possess noxious, and
POISONOUS MUSHROOMS. 323
even fatal properties. It is not always possible to distin-
guish between these, inasmuch as climate, season, and
idiosyncracy may occasion the difference. The poisonous
principle of certain fungi appears to be volatile, since boiling
renders them innocuous.
Symptoms. — The effects of poisonous mushrooms on man
are those of the narcotic irritants, causing violent vomiting,
purging, abdominal pain, thirst, anxiety, cold sweats,
together with giddiness, dimness of vision, trembling,
dilated pupils, delirium, illusions, stupor, coma, convulsions
and death.
It is stated that the very same fungi have acted on some
members of a family as vomitants only, and on others as
narcotics.
Generally, the symptoms show themselves within one
hour — especially the narcotic symptoms. Orfila (Toxicol.
II, p. 433) relates the following interesting case of poisoning
of a family of six persons by the Amanita citrina. The
wife, servant and one of the children had vomiting, followed
by deep stupor, but they recovered. The husband had
violent cholera ; he recovered also. The two other children
became profoundly lethargic and comatose ; emetics had no
effect, and death ensued. The individuals who recovered
were not completely well until three weeks after the fatal
repast.
Morbid appearances. — These are imperfectly described ;
they indicate a great tendency to rapid putrefaction, lividity
of the body, fluidity of the blood, absence of cadaveric
rigidity, numerous ecchymoses in the serous membranes
and parenchymatous organs, signs of violent and even
gangrenous inflammation of the stomach, and congestion
of the vessels of the brain, with decomposition of the
tissues.
324 . TOXICOLOGY.
The chief medico-legal interest connected with this sub-
ject is the fact that the symptoms occasioned by eating poi-
sonous fungi might easily be attributed to poisoning —
homicidal, or otherwise. A microscopic examination of the
contents of the stomach and bowels will usually reveal the
botanical character of the fragments of the fungi, if the poi-
soning has been due to them. (See Orfila and Christison
on the subject of Poisonous Fungi)
POISONING BY CANTHARIDES — SYMPTOMS. 325
CHAPTER XXIV.
ANIMAL IRRITANTS.
POISONING BY CANTHARIDES. — POISONOUS ANIMAL FOOD. — SAUSAGE
POISON. — TRICHINOSIS. — CHEESE POISON. — POISONOUS FISH. —
PUTRESCENT FOOD.— POISONED FLESH.
Cantharides. — The Cantharis vesicatoria, or Spanish fly,
is much used in medicine, both externally as a vesicant, and
also internally. In large doses it acts as a powerful local
irritant to the alimentary canal, and also to the urino-
genital organs. It is often used as an abortive, and has not
unfrequently produced fatal effects when employed for this
purpose. It owes its active properties to a crystalline prin-
ciple named canlJiaridin, which exists in the proportion of
about one grain to half an ounce of the powder.
Symptoms. — A burning sensation in the mouth and throat,
with constriction and difficulty of swallowing ; violent pain
in the abdomen, increased by pressure ; nausea and vomit-
ing of a bloody mucus and shreds of membrane, along with
great thirst, and dryness of the fauces. Soon the charac-
teristic impression on the genito-urinary organs displays
itself, in a dull, heavy pain in the loins, an urgent and inces-
sant desire to urinate, which is attended with great pain and
the voiding of merely a few drops of bloody urine, accom-
panied with tenesmus. Priapism frequently occurs in males,
and swelling and heat of the labia in women, together with
abortion, at times, in pregnant females. Purging generally
supervenes, the stools being bloody and mucous, and accom-
panied with tenesmus. Sometimes there is profuse saliva-
tion, and in fatal cases faintness, giddiness, and convulsions.
3-6 TOXICOLOGY.
If the substance has been taken in the form of powder, the
characteristic shining green particles may generally be
recognized in the discharges from the stomach and bowels.
If the tincture has been taken, the above symptoms come on
more rapidly.
All the above symptoms have been produced by the ex-
ternal application of cantharides.
Fatal dose. — Twenty-four grains of the powder, and an
ounce of the tincture, have caused death.
Treatment. — Speedy evacuation by emetics and cathartics
(castor oil) ; opium and stimulants.
Post-mortem appearances. — Intense inflammation of the
mucous membrane of the alimentary canal, from the mouth
downward; also of the ureters, kidneys and bladder. Con-
gestion of the brain has been observed. The peculiar shin-
ing green particles can generally be distinguished in the
stomach and bowels. But if the tincture has been swallowed
it will be necessary to procure the extraction of cantliaridin
from the organic matters.
Cliemical analysis. — The suspected materials should be
dried, and digested in successive portions of ether, until ex-
hausted ; this will dissolve out the cantharidin. The ethereal
solution is to be evaporated until nearly dry, and the residue
should be spread on oiled silk, and a portion applied to the
lips, or on the thin portion of the skin of the arm, when the
resulting vesication would denote the presence of can-
tharides.
Poisonous animal food. — It occasionally happens that
various kinds of animal food, such as sausages, cheese,
fish, mussels, etc., produce poisonous symptoms, either ow-
ing to some idiosyncrasy on the part of those who have
partaken of them, or depending upon some noxious agent
SAUSAGE AND CHEESE POISONING. 327
connected with the food itself, either introduced from with-
out, or spontaneously generated within.
Such cases are often attended with symptoms of a violent
character, which naturally suggest poisoning, and they then
become the subjects of medico-legal examination (vid. post.,
Ptomaines).
Sausage poison. — It was formerly supposed that, under
certain peculiar circumstances, not well understood, sausages
when cured and dried were capable of developing a poison-
ous principle, in the shape of a peculiar fatty acid, named
by Bushner batrolinic acid. But physicians and physiolo-
gists of the present day are disposed to attribute the cause
of the so-called sausage-poison to the presence of an ento-
zoon, named Trichina spiralis, which especially infests' the
muscles of the hog, and which, when the pork is eaten
uncooked, and unless it has been exposed for some time to
a temperature above 21 2° F., very soon penetrates the mus-
cular coat of the intestines, and thence spreads rapidly
through the muscles generally, and which increase in
numbers prodigiously. The sudden liberation of a multi-
tude of these parasites from their cysts, in the intestines and
muscles, produces the irritation of the bowels, and the sub-
sequent loss of muscular power that are so characteristic
of tricliinosis.
It may readily happen that the symptoms thus occasioned
might be attributed to slow poisoning by one of the mineral
irritants. A careful microscopic examination of the sus-
pected food, or of a fragment of a muscle of either a living
or dead subject, will reveal the true source of the disorder.
The symptoms of Cheese poisoning arc very similar to
those of ordinary irritant poisoning. The cause of the
328 TOXICOLOGY.
development of poisonous properties in cheese is by no
means well understood. By some it is ascribed to the pro-
duction of an acrid, oily matter derived from an improper
fermentation of the milk, analogous to caseic and sebacic
acid. Instances of cheese poisoning are more common in
Germany than in this country.
Poisonous fish. — In certain individuals, probably through
idiosyncrasy, many kinds of fish act poisonously, i. e. t they
excite severe gastro-intestinal symptoms, resembling cholera
morbus. It is quite possible that some peculiar organic
change in the food itself may have taken place. Mussels,
which are quite extensively used in Europe as food, occa-
sionally produce most violent and alarming symptoms,
which cannot be ascribed to any rational cause.
These symptoms are not of a uniform character. Some-
times they are those of a simple irritant, such as nausea,
vomiting, purging, pain in the abdomen, cramps, small and
frequent pulse. The fatal cases disclose, on post-mortem
examination, evident signs of inflammation. In other
instances, the gastro-enteric disturbance has been slight,
whilst the nervous symptoms are well marked, such as
delirium, insensibility and coma, with dyspnoea and convul-
sions. Again, the most conspicuous symptoms have been
a peculiar eruption resembling urticaria, along with severe
asthma. The symptoms usually do not appear until the lapse
of twenty-four hours, but there are cases where they come on
very much earlier. In fatal cases, the autopsy usually reveals
nothing that will satisfactorily account for the result.
No rational, adequate cause of this singular poisonous
action of the shell fish has yet been discovered. We must,
therefore, ascribe it to some peculiar animal principle
generated under unknown conditions.
PUTRESCENT AND POISONED MEAT. 329
Putrescent or decayed meat, if eaten by man, will produce
not only gastro-enteric symptoms similar to those described
above, but also those of a typhoid character, or septicemia,
or true blood poisoning. The game that has been kept long
enough to delight the taste of the epicure has produce'd a
severe cholera in persons not accustomed to its use.
Putrid animal matter injected into the blood vessels
proves quickly fatal. Dissecting wounds thus may pro-
duce alarming symptoms, which may terminate in death.
Poisoned meat. — The flesh of an animal or bird which has
become poisoned by arsenic, strychnine, or some other
deleterious substance, may become the cause of poisoning
to man. Thus, the common pheasant of this country
(Tetrao umbellus) which has fed upon the leaves and buds of
the kalmia {laurel), has proved poisonous to persons who
have eaten the birds. It is well known that the milk of
cows and goats that have fed upon the Datura stramonium
may prove poisonous to those partaking of it. In one case
of alleged poisoning by belladonna, the defence was that
the family had eaten a rabbit pie, and that the animal had
fed upon the leaves of the belladonna plant, so that, without
being affected injuriously itself, it had conveyed the poison
to those who had partaken of it.
5*
330 TOXICOLOGY.
CHAPTER XXV.
CLASS II— NEUROTIC POISONS.
This second division of Poisons embraces those whose
effects are displayed chiefly on the great nervous centres —
the brain and spinal marrow. Their symptoms are drowsi-
ness, headache, giddiness, stupor, delirium, convulsions and
paralysis. They produce little or no irritation, or inflam-
mation on the mucous membrane of the alimentary canal.
Their morbid effects are not very distinctly marked. These
consist of more or less fullness of the cerebral vessels, rarely
effusion of serum; more rarely still, effusion of blood in the
brain. Hence, it is quite impossible to diagnose a case of
neurotic poisoning by these lesions exclusively.
ORDER I.— CEREBRAL NEUROTICS.— (i) NARCOTICS.
SECTION L— POISONING BY OPIUM.
NATURE OF OPIUM. — POISONOUS SYMPTOMS. — FATAL PERIOD. — FATAL
DOSE. — TREATMENT.: — MORPHIA. — PROPERTIES. — TESTS- — MECONTC
ACID. — TESTS. — TOXICOLOGICAL EXAMINATION IN OPIUM POISONING.
Opium and its preparations constitute a very large pro-
portion of poisoning cases, both in this country and Great
Britain.
Opium is the dried juice of the capsules of the poppy
(Papaver somniferum). It has a very complex composition,
containing numerous active principles, the chief of which
arc morphia, mcconic acid, narcotina, codeia, narccitie, thebaine
and papaverine. In a medico-legal view, the only important
ones are morphia and mcconic acid, since, in an analysis for
POISONING BY OPIUM SYMPTOMS. 331
the detection of opium in a case of suspected poisoning, the
investigation is narrowed down to the discovery and identi-
fication of these two substances.
It should be remembered that different specimens of opium
differ considerably in their contained amount of morphia,
this varying from two to thirteen per cent. The average
may be taken at eight per cent, in Smyrna opium. The
tincture (laudanum) of the shops is far from being of a uni-
form strength, owing to this variation in the amount of the
active principle in the opium, and also to fraudulent dilution.
Average laudanum should contain about five grains of opium
to the fluid drachm, which is equivalent to one grain to
twenty-five drops. The black drop (Acetum Opii) is about
double the strength of laudanum. Wine of opium {Syden-
ham's laudanum) is about the strength of laudanum.
Symptoms. — These vary according to the size of the dose.
A large, but not fatal dose occasions, at first, general excite-
ment of the system, as evinced by increased fullness and
frequency of the pulse, flushed face, brilliancy of the eyes,
and increased activity of the brain. This is soon followed
by calm repose, which in turn gives place to profound sleep.
In proportion as the amount of opium is increased, the first
period of excitement is shortened, the more characteristic
soporific effects manifesting themselves sooner. In such a
case there will be giddiness and drowsiness, rapidly passing
into profound sleep or stupor, from which it will be difficult
to arouse the patient; this stupor gradually ends in coma.
The pupils are contracted. At first the pulse is full and
slow; subsequently it becomes weak. The respiration is
generally slow and stertorous ; the skin warm, and the face
flushed. As the case advances, the countenance becomes
pale, the lips livid, the skin cold and clammy, the respiration
very slow — we have noticed it reduced down to five or six
332 TOXICOLOGY.
in a minute; the muscles are relaxed; convulsions some-
times occur just before death, but these are more common
in children than in adults. Sometimes there is vomiting,
which is to be regarded as a hopeful sign; and occasionally
also there may be purging. At times, the skin is bathed in
a profuse perspiration.
Certain variations in the above symptoms should be
noticed. The pupils are usually strongly contracted ;
towards the termination of the case they may sometimes
be dilated. Occasionally one pupil may be contracted, and
the other dilated. The contracted state of the pupils is
usually regarded as a diagnostic sign of opium-poisoning,
but Dr. Wilks has shown that this same condition of the
eyes occurs in apoplexy of the pons varolii, and that two
cases of this latter disease were mistaken for opium-poison-
ing (Med. Times and Gaz., 1863, I, p. 214). The same con-
traction of the pupil occurs also in uraemic poisoning, in the
course of Bright's disease.
First appearance of symptoms. — This will depend on the
size of the dose, the form of administration, and the condi-
tion of the stomach at the time. As a rule, the symptoms
usually commence within an hour after swallowing the
poison. But, if taken in the liquid form and in full quan-
tity, they may manifest themselves in a few minutes. We
have often seen full narcosis produced in five to ten minutes
by the subcutaneous injection of a quarter of a grain of
morphia. On the other hand, cases are reported where the
symptoms were delayed, even after swallowing very large
doses, for many hours. Sometimes a partial remission of
the symptoms occurs, and the patient gives hopes of
recovery; but they return again only to terminate in death.
There seems good reason to believe that alcohol tends to
postpone the development of the usual symptoms of opium.
POISONING BY OPIUM EXTERNAL APPLICATION. 333
Fatal period. — The average duration of a fatal case is
from seven to twelve hours. Cases are reported where the
symptoms appeared in thirty-five minutes, and death in
three-quarters of an hour; whilst, on the other hand, death
has been, in some instances, delayed for twenty-four to forty-
eight hours.
Fatal dose. — Four or five grains may be regarded as the
minimum fatal dose for an adult. Children are particularly
susceptible to the action of this drug; in very young infants,
fatal effects have resulted from taking two or three drops of
laudanum. An infant may be narcotized by the milk of a
nurse who has taken opium.
On the other hand, recoveries constantly take place from
very large doses — even up to several ounces. It is noto-
rious that the human system soon acquires a remarkable
tolerance for this narcotic by habit. De Quincey thus
brought himself to the daily use of nine ounces of lauda-
num, which is equivalent to about three hundred and sixty
grains of solid opium.
Occasional instances of idiosyncrasy occur, in which the
susceptibility to the narcotic influence of opium is greatly
augmented; and also, on the other hand, where there seems
to be a natural tolerance for the drug. As regards the
opium habit, we think there can be no doubt of its ultimate
deleterious effects upon the human system.
The external application of opium, especially to an
abraded surface, may prove highly dangerous, and even
fatal, especially in the case of infants. Christison relates an
instance where a laudanum poultice, applied over the abdo-
men of an infant to relieve pain, produced fatal narcotism
in some hours ; and where, at the autopsy, a strong odor of
opium was exhaled from the body, showing how completely
the poison had been absorbed.
334 TOXICOLOGY.
Post-mortem appearances. — These are neither certain nor
characteristic. There is usually some fullness of the vessels
of the brain ; occasionally, extravasation of serum into the
ventricles; very rarely of blood. Sometimes there is con-
gestion of the lungs and other vascular organs. The blood
is apt to be fluid. The stomach and bowels may be per-
fectly natural in appearance. The odor of opium may be
observed in opening the body. It is hence impossible to
diagnosticate a case of opium-poisoning from the post-
mortem appearances exclusively.
Treatment. — Remove the poison from the stomach as
speedily as possible, by the stomach-pump, or by a prompt
emetic, as sulphate of zinc, or mustard water. The next indi-
cation is to overcome the increasing lethargy, by rousing
the patient, dashing cold water over the face and chest, and
making him walk about between two attendants. He should
swallow some strong coffee. Atropia should now be care-
fully administered hypodermically, every half hour, watch-
ing its effects upon the pupils. Electro-magnetism should
be employed, if the other remedies fail.
As regards the antagonism of morphia and atropia, our
own experiments confirm those of Dr. John Harley, on the
lower animals (dogs and cats), viz., that in these animals
there is no real antagonism between these drugs. In the
human subject, however, we think the accumulated testi-
mony of physicians as regards their mutual antidotal
operation cannot be disregarded ; our own experience in
their employment also confirms this opinion {vid. ante,
P . 185).
Morphia. — When pure, morphia is in the form of color-
less rhombic crystals, very bitter to the taste, very slightly
soluble in water, soluble in alcohol, especially when hot,
almost insoluble in chloroform and pure ether, very soluble
POISONING BY MORPHIA. 335
in acetic ether. It is slightly alkaline, forming; salts with
acids. Its solutions, in common with the other alkaloids,
are precipitated by tannic acid. Its salts are soluble in
water and diluted alcohol, but insoluble in chloroform,
ether, amylic alcohol and pure acetic ether.
The symptoms produced by morphia resemble those of
opium, except that they ordinarily manifest themselves
rather earlier, and possibly tend to produce convulsions
rather more frequently than opium. Occasionally, these
convulsions were of a tetanic character, suggesting the
presence of strychnia.
Fatal dose. — One grain has, on several occasions, occa-
sioned death. We have known a case where three-quarters
of a grain administered hypodermically proved fatal to a
gentleman within twenty-four hours. On the other hand
(as in the case of opium), enormous doses have been swal-
lowed with impunity. Dr. Norris reports a case {Am. Jour.
Med. Set, 1862, p. 395), where a druggist took, with
suicidal intent, seventy-Jive grains of sulphate of morphia.
No marked symptoms appeared for an hour and a half. He
then became unconscious, but under active treatment,
including extract of belladonna, he entirely recovered on
the second day after the occurrence.
The external application of morphia to an abraded sur-
face has been attended with fatal effects.
There are no characteristic post-mortem lesions produced
by morphia. The general appearances are similar to those
caused by opium.
CJiemical analysis. — There is no chemical test for opium,
as such ; it is identified by its sensible properties, and by its
physiological action on animals. The only mode of identi-
fying it chemically is by detecting the presence of its mor-
phia and meconic acid.
336 TOXICOLOGY.
Detection of ' morphiW^{i) In the solid state. — Strong nitric
acid dissolves it with effervescence, evolving red fumes, and
gives an orange-red solution, slowly fading to yellow.
Nitric acid also produces a deep-red color with brucia, which,
on the addition of protochloride of tin, changes to a bright
purple; whereas no change is produced in the case of mor-
phia. (2) Strong sulphuric acid dissolves it without change
of color; if now a crystal of bichromate of potassium be
added, it acquires a green color. (3) Neutral perchloride
or persulphate of iron imparts a deep blue color to it,
changing to green if added in excess. For this experiment
no free acid must be present. (4) Iodic acid added to a
fragment of morphia, along with freshly-made starch, pro-
duces the characteristic blue color from the liberated
iodine.
2. /;/ the liquid state. — (1) Nitric acid, in excess, gives
an orange-red color, which becomes light yellow on boiling.
(2) Neutral perchloride or persulphate of iron acts as on
solid morphia. (3) Iodic acid in bisulphide of carbon added
to a solution of morphia causes a precipitate of a pink or
red color, consisting of iodine dissolved in the bisulphide.
(Taylor). (4) Sulpho-tnolybdic acid, made by dissolving five
or six grains of molybdate of sodium or ammonium in two
drachms of strong sulphuric acid. A drop of this reagent
in contact with a fragment of morphia dissolves it, producing
a beautiful violet color, changing soon to green and ulti-
mately to a sapphire-blue. (5) If morphine be mixed with
a little cane-sugar, and treated with concentrated sulphuric
acid, a wine-red color is produced. (Weppen).
The other tests mentioned in the books, such as tcr-
ehloride of gold, iodine in iodide of potassium, bromine in
hydrobromic acid, etc., are of less importance
Mcconic Acid. — As this acid is peculiar to opium, its dc-
OPIUM TOXICOLOG1CAL EXAMINATION. 337
tection affords positive proof of the presence of that sub-
stance. In its pure state, it occurs in the form of colorless
crystals, tolerably soluble in water, more so in alcohol.
Tests. — (i) Perchloride or persulphate of iron imparts to
either the solid or liquid form a blood-red color, which is
not removed by a solution of corrosive sublimate. The
only fallacy likely to occur in a medico-legal case is from
the presence of some sulplw-cyanide in the material examined,
as the slliva, which yields a similar color with the iron salt;
but the red color in the latter case is instantly discharged
by corrosive sublimate.
Strong acetic acid, or its salts, likewise give a red color
with the ferric salts ; and this color, moreover, is not re-
moved by corrosive sublimate. But if the acetate be pre-
viously boiled with dilute sulphuric acid, it gives no color
with the iron salt. (2) Acetate of lead yields a yellowish -
white precipitate of meconate of lead. (3) Chloride of
barium yields a white crystalline deposit of a peculiar form.
(4) Nitrate of silver gives a yellowish-white precipitate,
which becomes red on adding a persalt of iron.
Toxicological examination. — Sometimes on opening the
stomach the strong odor of opium is readily detected, and
also in the matters vomited. The discovery of this poison in
the stomach is often unsuccessful, owing, probably, to its de-
composition, and absorption in the body. This is especially
true in the case of infants, in whom a very few drops suffice
to destroy life. The highest authorities unite in declaring
that the analyst will fail to discover this poison in the
stomach after death, in the majority of the cases. It is
much more likely to be found in the vomit.
The stomach should be cut up in small fragments, adding
water with a little alcohol, and acidulating with pure acetic
acid, and the whole exposed to a gentle heat, for about one
338 TOXICOLOGY.
hour. After cooling, it should be strained through muslin,
and the solid residue washed with strong alcohol and
pressed, and the washings added to the first liquid. The
liquid should then be evaporated over a water-bath to a
small volume, and when cooled filtered through paper. To
the clear filtrate, acetate of lead is to be added in excess, to
precipitate the mcconatc of lead. The morphia remains in
the solution as an acetate. These are to be separated from
one another by filtration, and the solid matter washed with
water.
(a) The solid portion (meconate of lead) is to be diffused
through water, and treated with sulphuretted hydrogen gas,
which precipitates the black sulphide of lead, and leaves
the filtrated meconic acid in solution; this latter is concen-
trated by a gentle heat. A trial test on a small portion of
this liquid, by the iron-salt, may be made; if a deep red
color is imparted, meconic acid may be suspected ; to the
remainder of the liquid, the other tests may now be applied.
If present in sufficient quantity, meconic acid will crystal-
lize out, on evaporation of the liquid. If the quantity, how-
ever, be minute, the liquid should be carefully concentrated
to a small volume, and the characteristic tests employed.
(b) The liquid portion, containing the morphia in the
form of acetate, together with the excess of lead acetate, is
to be treated with sulphuretted hydrogen in order to
remove the lead ; then filtered, and the filtrate concentrated
by gentle heat to dryness. The residue is then treated with
a few drops of warm distilled water, and a portion of it ex-
amined for morphia by the nitric acid and iodic acid tests.
The remaining liquid should then be made alkaline by pure
potassium carbonate (diluting, if necessary, with water) ; it
is next to be shaken up with an excess of absolute ether,
which wili take up the impurities, leaving the morphia
OPIUM DETECTION IN THE TISSUES AND BLOOD. 339
unaffected. The ethereal solution is removed by means of
a pipette, and reserved for future examination. The re-
maining alkaline solution is now to be thoroughly shaken with
two or three times its volume of, either a mixture of two
parts of absolute ether and one of alcohol, or of two or
three volumes of hot arnylic alcohol, or of a similar bulk of
acetic ether. By either of these processes, the morphia is
taken up by the solvent, which floats upon the top of the
mixture, and which may be removed by a pipette and
allowed to evaporate spontaneously on watch glasses.
Ordinarily, the morphia thus recovered is amorphous, and
may require resolution in hot alcohol, and to be crystallized
therefrom by evaporation.
In cases of poisoning by morphia alone (or one of its
salts) the above process may be employed, omitting the
acetate of lead, inasmuch as no meconic acid is present.
Detection in the tissues and blood. — There is generally a
failure to detect this poison in the organs and tissues, or in
the blood. Yet, on the other hand, cases are reported where
it has been discovered in the body several months after
death. We can account for this discrepancy only on the
supposition either that opium (morphia) undergoes some
decomposition in the living organism, which interferes with
its detection by chemical analysis, or else that life has been
prolonged sufficiently long to allow of its diffusion through-
out the body so thoroughly, as to render it impossible to
detect it in any one particular organ ; this would be
especially the case if the dose had been comparatively
small, as where an infant had died from a few drops of
laudanum. There is some doubt about the detection of
these principles in the urine, inasmuch as the results
alleged to have been produced by certain reagents, and sup-
posed to indicate the presence of morphia, or meconic acid,
340 TOXICOLOGY.
have since been proved to be due to substances existing
normally in the urine.
The toxicologist should be cautioned against a too hasty-
conclusion as to the presence of opium, or its alkaloid, in a
medico-legalcase, based upon the color alone. Orfila tells
us {Toxicol., II, p. 232) that Mm. Ruspini and Cogrossi found
that a decoction of a calf's intestines, although no morphia
was present, acted upon iodic acid and starch like that alka-
loid. In another case, morphia was pronounced to be
present in the urine, by reason of the action of the extract
of this secretion on iodic acid ; the effect was found to be
really, due to uric acid and urate of ammonia.
Inasmuch as the symptoms of opium-poisoning strongly
resemble those of apoplexy, it could readily happen that a
case of the latter disease, attended with suspicious sur-
roundings, might be mistaken for the former, and the con-
tents of the stomach might even probably reveal a red
color, when treated with nitric acid. But, if no morphia
(nor meconic acid) was actually separated, we think the
examiner would not be authorized to pronounce upon the
presence of this poison simply from the one single reaction
above mentioned. Prof. Taylor cites an instructive illus-
tration of this hasty conclusion, in which a certain distin-
guished (?) chemist made oath of the discovery of " distinct
traces of morphia " in the stomach ; whereas, in reality, no
morphia had been taken at all (as was proved by an analysis
of the medicine taken by the deceased) ; but the death was
due entirely to natural causes.
POISONING BY ALCOHOL SYMPTOMS. 341
SECTION II.
POISONING BY ALCOHOL.
ACUTE ALCOHOLISM. — SYMPTOMS. — POST-MORTEM LESIONS. — CHEM-
ICAL ANALYSIS. — DETECTION IN THE TISSUES.
The poisonous effects of Alcohol are of a twofold char-
acter — acute and chronic. The former are witnessed in
those cases where a large quantity of spirits is taken at a
single draught, as in a silly bravado, or for a wager, and
also accidentally by young children. The latter are illus-
trated in the common dram drinkers, and by a train of
symptoms with which we are, unfortunately, but too familiar.
The former only will be discussed here.
Symptoms of acute poisoning. — These come on usually in
a few minutes after the ingestion of the poison, if the amount
is large. They are, first, giddiness, confusion of ideas, un-
steadiness of gait, incoherent talking, followed by stupor
and coma. The features have a vacant, ghastly expression,
or they may be suffused and bloated ; the lips are livid ; the
pupils usually dilated and fixed ; the conjunctivae are red;
an alcoholic exhalation from the breath is perceived; con-
vulsive movements of the limbs ; respiration, at first sterto-
rous, becomes more and more difficult ; a bloody froth may
appear on the lips; involuntary evacuations occur, and death
may ensue in half an. hour, or even earlier, after the fatal
drink (Tardieu). In other instances, the person may appa-
rently recover from the first effects, and then suddenly be-
come insensible, and die in convulsions. If free vomiting
occurs, followed by a prolonged sleep, recovery is apt to
take place. The sensibility of the pupil to light may also
be regarded as a favorable symptom.
The rapidity with which the symptoms show themselves
will depend upon the previous habit of the individual, and
S42 TOXICOLOGY.
the strength and quantity of the spirit taken. The very
large quantities seem to destroy life by shock.
Acute alcoholism may be mistaken for opium-poisoning
and concussion of the brain. Usually, the odor of the
breath is sufficient to reveal the case; also, the dilated
pupil ; but this condition of the eye is not invariably present.
In concussion, there are often marks of injury in the head;
the face is pale and cold ; there is also an absence of the
alcoholic odor.
Post-mortem appearances. — There is generally a remark-
able absence of putrefaction in the body. The stomach
exhibits marks of intense congestion, in the deep-red color
of its lining membrane, either diffused or in patches. More
or less congestion of the brain and its membranes, with
serous effusion under the arachnoid, and in the ventricles.
Sometimes, there is a true apoplectic extravasation of blood.
The lungs are almost invariably congested. Usually, a
strong alcoholic odor is perceived from the different tissues
of the body; but the organs for which the poisonous fluid
displays the greatest affinity are the brain and liver.
Alcohol is very rapidly absorbed into, and eliminated from
the system ; so that, if the person has survived several
hours, all traces of it may have been removed from the
body.
Treatment. — Immediate evacuation by means of the
stomach pump, or by an active emetic ; affusion of cold
water over the head ; a free supply of fresh air ; if there be
asphyxia galvanism may be tried, also ammonia and the
liberal use of coffee as a drink.
Chemical analysis. — If the case has not been too pro-
tracted, the alcohol may be recovered from the stomach and
its contents by distillation in a capacious retort, on a water-
bath, with a good condensing apparatus. If the materials
ALCOHOL — DETECTION IN THE TISSUES. 3^13
are acid, they should first be neutralized by carbonate of
potassium or sodium. The distillate should be mixed with
chloride of calcium, and re-distilled. The second distillate
is to be shaken with an excess of carbonate of potassium
(which absorbs the water) and set aside. The stratum of
alcohol which rises to the top may then be separated by
means of a pipette, and submitted to the following tests :
(i) Its taste is hot and pungent; its odor is characteristic.
It burns with a pale blue flame, leaving no carbonaceous
residue, but yielding carbonic acid and water ; if burnt
under the mouth of a test-tube moistened with lime or lead
water, the carbonic acid will produce a white film upon the
sides of the tube. (3) It dissolves camphor. (4) On adding
a solution of bichromate of potassium and sulphuric acid,
the peculiar odor of aldehyde is developed, along with the
green color of chrome oxide. In performing this latter test,
Prof. Taylor recommends conducting the vapor from the
retort in which the distillation is going on into a glass tube
containing a few fibres of asbestos moistened with a mix-
ture of a strong solution of the bichromate and sulphuric
acid, when the merest trace of alcohol vapor will be
sufficient to impart the green coloration.
Both ether and pyroxylic spirit (wood spirit) will produce
this last effect, and likewise yield most of the results of
alcohol. Ether may be distinguished by its odor, and by
the yellow color of its flame ; also by its smoky deposit on
porcelain. Pyroxylic spirit may be recognized by its
peculiar odor, and by its smoky flame on burning.
In the tissues. — The proof of the absorption of alcohol is
afforded in its detection in the blood, urine, and different
tissues of the body. If there is a failure to discover it in
the stomach, it should be looked for in the brain and liver.
Buchheim has devised an exceedingly delicate process for
detecting it in small quantities in the blood and tissues,
344 TOXICOLOGY.
based upon the conversion of the vapor of alcohol into
aldehyde and acetic acid when passed over platinum-black.
As much as possible of the material, neutralized first by-
carbonate of potassium, should be distilled from a capacious
retort, on a water-bath. The neck of the retort should be
slightly inclined, and be wide enough to hold a platinum
tray about two inches long and half an inch wide, containing
the platinum-black. Hanging over each end of the tray is
placed a slip of moistened litmus paper, and touching the
platinum-black. The tray is now pushed toward the body
of the retort. As soon as there is any escape of alcoholic
vapor by the distillation, it will be manifested by the red-
dening of the litmus paper at the farthest end of the tray, in
consequence of the production of acetic acid, while the
paper nearest the body of the retort will remain blue. If
no reddening of the paper occurs, no alcohol can be present ;
if the reddening rapidly occurs, the tray should be removed,
and the vapor should be condensed in the usual way.
As both ether and wood spirit produce a similar effect on
platinum-black, this process offers no advantage over the
chromic process above described, except when putrefaction
has taken place, in which case the sulphuretted hydrogen
evolved might reduce the chromic acid, but it would not
affect the platinum-black (Taylor On Poisons, p. 643). But
we may remark it is hardly supposable that the analyst
would undertake to separate alcohol from a putrefied 'body.
A new test for alcohol is given by Lieben (Phar. Jour.
1869). A few grains of iodine and a few drops of solution
of caustic soda are introduced into a test-tube, along with
the suspected fluid. It is then heated without boiling, when
iodoform is precipitated. It is stated that one part of
alcohol in two thousand of the mixture can thus be de-
tected ; also, that it may thus be discovered in the urine
after drinking, by first distilling it.
POISONING BY ETHER. 345
CHAPTER XXVI.
(2) AN/ESTHETICS.
This subdivision of Cerebral Neurotics comprises those
substances that display their power chiefly by producing
insensibility to pain, and unconsciousness. The Anaesthetics
here noticed are Ether and Chloroform. Under this head
also it will be convenient to speak of CJdoral Hydrate,
although its action differs somewhat from that of the
others.
section 1.
POISONING JiV ETHER, CHLOROFORM, AND CHLORAL
HYDRATE.
Ether. — Generally known as Sulphuric ether, because pro-
cured by the distillation of alcohol and sulphuric acid. It is
a limpid, colorless liquid, of a peculiar odor, and hot, pungent
taste; highly volatile and inflammable; sp. gr. 0.735 ; boils
at 95 F.; burns with a bright yellow flame, depositing
carbon on a cold porcelain surface. Sparingly soluble in
water ; very soluble in alcohol.
Symptoms. — In large doses, it produces much the same
effects as alcohol. There is, usually, a short period of
delirious excitement, followed by coma and other symptoms
of narcotism, similar to those caused by alcohol.
Post-mortem appearances. — On account of its less solu-
bility in water, ether is a more powerful local irritant than
alcohol. The mucous lining of the stomach and duodenum
of a dog poisoned with ether were found to be violently
inflamed ; the lungs deeply congested, and the heart full of
black blood (Orfila, Toxicol., II, p. 531).
16
346 TOXICOLOGY.
The inhalation of ether, as is well known, produces rapid
anaesthesia, on account of its prompt and speedy action on
the brain. Its immediate effect, when inhaled, is the pro-
duction of a transient excitement ; this is soon followed, if
the dose be sufficient, by stupor and insensibility. This
last condition may be prolonged for a considerable time by
continuing the inhalation. Occasionally, the excitement is
of a violent character, along with a stubborn resistance to
the anaesthetic influence ; and again, there may be nausea
and vomiting. These exceptional symptoms must be
ascribed to the constitutional peculiarities of the patients.
Although, in a few instances, the inhalation of ether has
been attended with fatal consequences, we are of the opinion
that it is a much safer anaesthetic than chloroform.
Chemical analysis. — Ether is recognized by its odor and
taste, by its mode of combustion and volatility, and by its
action on sulphuric acid and bichromate of potassium — the
same as in the case of alcohol.
From organic mixtures, as, e. g. t the contents of the
stomach, it is to be separated by the same process as that
described for alcohol {vid. p. 343).
Chloroform. — A colorless, limpid liquid, very volatile,
giving off a dense vapor; sp. gr. 1.497; boiling point, 142 F.
It has an agreeable characteristic odor, and a smart, pungent
taste. It is nearly insoluble in water, in which it sinks in
globules. It is not inflammable, like ether and alcohol. It
is a powerful solvent of many organic substances, the alka-
loids among others. At a red heat, its vapor is decomposed
into chlorine and hydrochloric acid.
Symptoms. — A large dose produces local irritation to the
stomach, with, at first, a general stimulation of the whole
system, soon followed by decided narcotism, as shown by
POISONING BY CHLOROFORM. 347
insensibility, stupor, convulsions, dilated pupils, flushed face,
full and oppressed pulse, and frothing at the mouth. Cases
are reported where the pupils were contracted.
Dr. Taylor reports a case where a boy, aged four years,
died in about three hours, after swallowing one drachm of
chloroform. It has often caused death in quantities of half
an ounce and upward.
When taken by inhalation, its impression is more speedy
than that by ether. There is, moreover, an absence of the
previous excitement attendant on the latter, the patient
almost immediately passing into insensibility. It appears
to act as a depressant from the first, and if not properly
diluted with atmospheric air, it may rapidly produce death.
In one case, the fatal result took place in one minute after
breathing only thirty drops in the state of vapor ; and, in
another instance, only fifteen drops proved fatal in a very
short time. It is, undoubtedly, a far more dangerous anaes-
thetic agent than ether, and instances of its fatal effects are
being constantly reported in the medical journals. The
immediate cause of death from chloroform vapor appears to
be, in the majority of cases, syncope, or the cessation of the
heart's action ; in others, asphyxia.
Post-mortem appearances. — In death from liquid chloroform,
the characteristic odor may usually be recognized, together
with slow putrefaction of the body, and persistent rigor
mortis. There is also much irritation of the stomach, some-
times accompanied with softening, and in one case with
ulceration.
In death from inhalation, there is very often no lesion
discoverable. At times, there will be found considerable
congestion of the lungs and bronchial tubes, and likewise
of the vessels of the brain, together with a dark and fluid
condition of the blood.
348 TOXICOLOGY.
Treatment. — In poisoning by liquid chloroform, the
stomach should be immediately evacuated by the stomach-
pump, or by a prompt emetic, and stimulants afterward
administered. If inhalation has caused the danger, the
chloroform should be immediately withdrawn, and fresh air
freely admitted; cold affusion should be applied to the»face
and chest ; the tongue should at once be drawn out of the
mouth, to facilitate respiration ; artificial respiration, and the
direct galvanic current should also be practiced.
Chemical analysis. — The odor will usually be present in
organic mixtures, such as the contents of the stomach.
These should be distilled on a water-bath, and the distillate
re-distilled along with chloride of calcium, and the product
subjected to the proper tests, as odor, taste, solubility, etc.
Toxicological examination. — The contents of the stomach,
or the organs properly divided along with distilled water,
should be put into a large flask, the neck of which is fitted
with a cork perforated to contain a hard glass tube, bent at
right angles, and from twelve to fifteen inches long. The
flask is gradually heated on a water-bath, and at the same
time the middle of the horizontal tube is heated red-hot by
a Bunsen flame. At a red heat, chloroform is decomposed
into chlorine and hydrochloric acid. A slip of moistened
litmus paper placed at the mouth of the tube is first red-
dened, and then bleached ; starch paper wetted with iodide
of potassium is rendered blue; and if the end of the tube be
made to dip into a solution of nitrate of silver, the white
chloride of silver will be precipitated. The absence of any
free hydrochloric acid in the original material should be
first insured, by the addition of carbonate of sodium.
It is important to remember that if hydrate of chloral had
been taken by the patient just previous to death, and the
alkali be added to the mixture for examination, the chloral
POISONING BY HYDRATE OF CHLORAL. 349
would be decomposed into chloroform, and produce all the
above reactions.
There are certain important medico-legal questions con-
nected with the administration of chloroform as an anaes-
thetic, with which the legal physician should be familiar,
such as whether persons asleep may be chloroformed with-
out their being awakened, and thus robbed or otherwise
maltreated. It has been ascertained by direct experiment
that this effect can be produced if the sleep is profound, but
not if it is slight or partial.
Hydrate of chloral. — A solid, crystalline body, result-
ing from the action of chlorine on alcohol. It has a peculiar,
disagreeable, pungent taste and smell ; is tolerably soluble
in water; not inflammable. Potassa added to its boiling
aqueous solution instantly converts it into chloroform and
formic acid. It decomposes a salt of copper, like grape
sugar.
Symptoms. — Chloral has been introduced into medical
practice within comparatively few years, as a hypnotic. Its
indiscriminate use has led to many fatal results. Care
should always be exercised not to repeat the dose too fre-
quently, as there appears to be a tendency to accumulation,
and a sudden and dangerous action of the drug. In
moderate doses, it acts on the brain as a hypnotic ; in large
doses, it produces a powerful depressant action on the gan-
glia at the base of the brain, and the spinal cord, causing
feeble action of the heart and lungs.
A full dose usually occasions deep sleep, followed, if the
quantity be very large, by fatal coma. The pulse is usually
very slow and feeble ; the face pale ; respiration slow, the
heart being ultimately arrested in diastole.
Much discrepancy of opinion exists as regards the fatal
350 TOXICOLOGY.
dose of chloral hydrate. Numerous instances are reported
where ordinary doses of thirty grains have occasioned
alarming, and even fatal effects ; while, on the other hand,
enormous quantities — over an ounce — have been swallowed
with comparative impunity. As a rule, thirty grains may
be considered as a safe maximum dose, and not to be
repeated oftenerthan every six or eight hours.
The opinion of Liebreich, of Berlin, is that chloral, while
circulating in the blood, undergoes decomposition into
chloroform and formic acid, through the agency of the
alkalies of the blood.
Chemical analysis. — The principle involved is the conver-
sion of the chloral into chloroform, through the agency of
an alkali, as explained above. The solid matters, properly
divided, should be diluted with distilled water and rendered
alkaline by caustic potassa, and heated in a flask, and the
experiment conducted after the manner described under the
head of Chloroform.
POISONING BY NUX VOMICA. 351
CHAPTER XXVII.
ORDER II.— SPINAL NEUROTICS OR TETANICS.— POISONING
BY NUX VOMICA.— STRYCHNIA.
POISONOUS DOSE OF NUX VOMICA. — EFFECTS OF STRYCHNIA. — FATAL
DOSE. — TREATMENT. — POST-MORTEM LESIONS. — DIAGNOSIS. —
CHEMICAL ANALYSIS. — INTERFERENCES. — PHYSIOLOGICAL TEST. —
TOXICOLOGICAL EXAMINATION.
Nux Vomica is by far the most important poison included
under this order of Neurotics. It is the seeds of the Strych-
nos nux vomica, a tree growing in India. Several seeds are
enclosed in a yellow fruit. These seeds are circular disks,
an inch or less in diameter, concavo-convex, of a light
brown color, covered over with short, whitish, silky hairs,
extremely tough and difficult to pulverize ; excessively
bitter to the taste. They contain two powerfully poisonous
alkaloids — strychnia and brucia, in combination with stryeJi-
uic or igasuric acid. The amount of contained strych-
nia is estimated at one-half to one per cent, of the seed.
The smallest fatal dose of nux vomica is thirty grains
(about the weight of one seed), and three grains of the alco-
holic extract. The symptoms, treatment, etc., are precisely
similar to those described under the head of Strychnia.
Strychnia. — Exists in several species of St/ ycluws besides
the 5. nux vomica ; it is the poisonous principle of the
5. Ignatia, or St. Ignatius bean ; it is also found in False
Augustura bark.
Strychnia is a very frequent cause of poisoning, whether
accidental, homicidal, or suicidal. The celebrated Palmer
352 TOXICOLOGY.
case, which occurred in England, in 1S56, brought it prom-
inently before toxicologists.
Symptoms. — These vary somewhat in the time of their
appearances, according to the form of their administration.
The first effect is a feeling of restlessness and general un-
easiness, with a sense of impending suffocation, and want of
air. Very soon, twitching of the muscles and jerking of the
limbs and head come on. These are followed suddenly by
a violent tetanic convulsion, which pervades the whole
body ; the legs are stretched out stiffly, and widely sepa-
rated ; the feet arched, and usually turned in ; the arms are
flexed, and tightly drawn across the chest ; the head is bent
back rigidly, and the whole body flexed backwards so as to
rest upon the head and heels {opisthotonos). As the muscles
of the chest and abdomen are spasmodically contracted, the
respirator}^ movements become arrested; the face is livid
and congested, especially around the lips ; the eyes promi-
nent and staring; pupils widely dilated; the muscles about
the mouth contracted so as to produce the expression de-
nominated visits sardonicus ; the pulse is very rapid and
feeble. Sometimes, there is foaming at the mouth, and the
froth ma} f even be tinged with blood. The intellect remains
perfectly clear, while the patient is experiencing the most
intense suffering, gasping for breath, and seeking in vain for
relief in asking to be turned over, or moved, or held. The
iaws are not always fixed during a paroxysm ; the patient
may hence be able to speak ; and as there is often great
thirst, he may ask for water, but the effort to swallow is apt
to intensify the spasm, as in hydrophobia, and cause him to
bite upon the vessel.
The paroxysm may last from half a minute to several
minutes, when a complete relaxation occurs ; the patient
now feels exhausted, and is bathed in perspiration; the
POISONING BY STRYCHNIA. 353
pupils may now become contracted. In a short time — vary-
ing from a few minutes to half an hour — the fit returns. It is
i sually preceded by an apprehension of the impending
danger, the special senses being exceedingly acute. The
spasm may be brought on by the slightest cause, as the
opening of a door, a sudden noise, a current of air, or an
attempt to move. In some- instances, the violence of the
spasm is so great as to jerk the patient out of bed. Should
the case prove fatal, the paroxysms increase in frequency
and violence, until at last death ensues, either from asphyxia,
the patient dying in a paroxysm, or from pure exhaustion,
during an interval.
Although the intelligence continues unimpaired during
the progress of the disease, it may happen that it becomes
clouded just before the fatal termination, in consequence of
the asphyxia causing a deficiency of aeration of the blood,
and the consequent accumulation of carbonic acid. As a
rule, when the paroxysms are once established, they progress
either to a fatal termination, or toward a cure, within two
hours of the seizure, though there may be some exceptions
to this rule.
The time of the first manifestation of the symptoms varies
from a few minutes, to some hours; the average is fifteen'
minutes, to half an hour. Dr. G. H. Barker reports (Am.
four. Med. Sei., October, 1864) the case of a young, healthy
woman, who took six grains of strychnia, in whom violent
symptoms were manifested in three minutes, and death took
place, in a convulsion, in half an hour. In Dr. Warner's
case, who took, it is supposed, less than half a grain, the
symptoms appeared in five minutes, and death occurred in
about eighteen minutes. In a case mentioned in the Ann.
d' Hygiene, 1861, I, p. 133, convulsions came on in five
minutes. On the other hand, this interval may be pro-
16*
354 TOXICOLOGY.
tracted for several hours. Dr. Anderson reports {Am. Jour.
Med. Sei., April, 1848) the case of a gentleman who took,
by mistake, three and a half grains of strychnia, and expe-
rienced no particular symptoms for two hours and a half,
when he suddenly fell backward; but, on being raised, he
was able to walk home, and finally recovered. Undoubtedly,
the form in which the poison is administered has much to
do with the rapid development of the symptoms. This is
shown in a case cited by Dr. Taylor (Prin. and Prac. of Med.
Jurisp., 1873, p. 405), of a boy aged twelve years, who swal-
lowed a pill containing three grains of strychnia, in whom
no symptoms were manifested for three lionrs ; they then set
in with their usual violence, and death took place in ten
minutes. This pill had been prepared with mucilage eight
months before, and was consequently hard and difficult to
dissolve. In the Palmer case, Cook took two pills con-
taining strychnia. No symptoms were observed for an
hour and a quarter, after which death occurred in twenty
minutes.
It must, however, be admitted that there are cases where
the unusual delay cannot be thus accounted for, but where
it must be referred to some individual peculiarity of the
patient. Dr. Worm ley [Micro. CJiem. of Poisons, p. 40) men-
tions a case where the remarkable postponement of the
symptoms for twelve hours appeared to be owing to the
effects of a large dose of opium that had been taken simul-
taneously. Three grains of strychnia, a drachm of opium,
and an indefinite quantity of quinine were taken at the
same time (ind. ante., p. 184). Other equally remarkable
instances might be adduced, showing the same apparent
antagonism between strychnia and opium. Nevertheless, in
some experiments of the author, made on animals with
strychnia and morphia combined, the latter poison, so far
POISONING BY STRYCHNIA FATAL PERIOD. OOO
from antagonizing the former, appeared rather to intensify
it (vid. ante., p. 185).
The subcutaneous injection of strychnia, as also its ex-
ternal application to a healthy mucous surface, produces a
still more speedy manifestation of its peculiar symptoms.
Some clinical experiments of Dr. Chisholm, of Baltimore,
made on amaurotic patients, would seem to show that the
human system acquires a tolerance of strychnia (Am. Jour.
Med. Set., April, 1872).
Fatal dose. — There is great difference as to the suscepti-
bility to the action of strychnia. The average medicinal
dose is about the one-sixteenth of a grain, though it is cus-
tomary to commence with a smaller quantity. The above
dose has proved fatal to a child between two and three years
old. Dr. G. B. Wood mentions the case of a lady who
wast hrown into alarming spasms by one-twelfth of a grain
(Thcrap. I, p. 834). The author has seen the case of a
gentleman who had decided spasms after taking about
one-twentieth of a grain.
The smallest fatal dose for an adult recorded is half a
grain, which proved fatal to Dr. Warner. Dr. Ogston reports
a case where three-quarters of a grain destroyed a man in
three-quarters of an hour. A fatal dose for an adult may
be stated to be half a grain, to one grain.
On the other hand, numerous instances are recorded of
recoveries after enormous doses of this poison — ten, twelve,
and even forty grains. In all these cases early vomiting
was produced, which, doubtless, removed the strychnia
before it was absorbed to a fatal extent. Besides, it is quite
possible that the poison was not of full strength.
Fatal period. — This, like the fatal dose, is liable to con-
siderable variation. Dr. Warner's case terminated fatally in
eighteen minutes. Dr. Taylor mentions two cases in which
356 TOXICOLOGY.
death occurred in ten and fifteen minutes respectively ; in
another case, in five minutes ; in two others, in thirty
minutes each.
On the other hand, life has been prolonged, even after
large doses, for several hours. In Cook's case, death
occurred in an hour and a quarter after swallowing the pill.
In the case of a woman examined by the author, death did
not occur for six hours after swallowing about six grains of
strychnia {Am. Jour. Med. Sei., Oct., 1861, p. 409). Sir R.
Christison reports a case in which a man died in fifteen
minutes after swallowing a dose of nux vomica.
Treatment. — Prompt and free emesis is of the greatest
importance. Copious draughts of warm mustard water, or
a mixture of ipecac and sulphate of zinc should be given.
The stomach pump may be used if the spasm of the jaws
will permit. Chloroform, by inhalation, appears to have
been attended with the happiest results. The patient should
be constantly kept under its influence, carefully watching its
effects. YVe would strongly advise its early administration.
Bromide of potassium has also been given with the best
results — sixty to eighty grains every hour, or half hour.
Hydrate of cliloral has also proved an efficient remedy in
several cases, and nitrite of amy/ has been recommended,
from its known physiological effects. Atropia has also
proved efficacious as an antidote in a case where chloroform
failed, and where the paroxysms were very severe (Ed.
Med. Jour., Sept., 1873).
As regards the remedial effects of tobacco, tincture of iron,
tincture of iodine and aconite, we deem them of no value.
We have experimented with them all on dogs that were
poisoned with strychnia, but in no case did any of them
exhibit antidotal powers.
Post-mortem appearances. — These are by no means char-
POISONING BY STRYCHNIA DIAGNOSIS. 357
acteristic, nor are they always similar. Probably, the lesions
most commonly observed are congestion of the brain and
membranes, and of the spinal cord, with engorgement of the
lungs, and a dark and fluid condition of the blood. The
heart is sometimes contracted and empty, and at others full
of blood. The rigor mortis is usually prolonged; in one
case, we found it existing six weeks after death. There is
also frequently noticed a livid appearance about the mouth
and tongue, and also of the fingers and toes. It should be
remembered that certain disorders of the brain and spinal
cord, attended with tetanic convulsions, will leave precisely
similar lesions to those just referred to as following death
by strychnia.
Diagnosis. — The importance of a clear diagnosis, in a
medico-legal case of strychnia-poisoning, cannot be too
strongly urged, inasmuch as there may be, in such a case,
a complete absence of all chemical proof. In the celebrated
Palmer case, this question was most thoroughly sifted on
both sides. Indeed, this very case affords an apt illustration
of just the sort of difficulties that present themselves in
forming a correct appreciation of the symptoms. In the
Palmer case, the defence brought forward an immense array
of diseases, which, as remarked by Tardieu, " have but a
faint resemblance to, and often a complete diversity from,
the characteristic phenomena of strychnia-poisoning." The
only disease whose symptoms can possibly be confounded
with those occasioned by strychnia, is tetanus, in its varie-
ties of idiopathic, traumatic and hysterical, and possibly
some forms of epilepsy.
If the expert were obliged to decide solely from the con-
vulsion — apart from its mode of invasion and seizure, its
duration and termination, the condition of the intervals
between the paroxysms, in fine, apart from the whole history
35 S TOXICOLOGY.
of the attack — he might probably be unable to discriminate
between a case of strychnia-poisoning and one of tetanus ;
but where a careful examination of all these attending
circumstances has been instituted, there can be no possible
difficulty in reaching a satisfactory conclusion. The dis-
tinctive characters are the following: (i) In traumatic
tetanus, the history of the case, as being connected with
some injury, such as a lacerated, contused, or punctured
wound, involving tendons, nerves and fasciae, will always
throw sufficient light on the case to admit of an easy diag-
nosis, although it must not be forgotten that the most trifling
injury, such as the insertion of a splinter of wood beneath
the fascia, and which may have entirely escaped recollec-
tion, may, after the lapse of several days, give rise to this
frightful disorder ; and such a case might be mistaken for
idiopathic tetanus. But as regards the latter form of the
disorder, besides its extreme rarity in temperate climates,
its mode of invasion (as likewise that of traumatic tetanus),
the duration of the attack and the character of the symptoms,
are entirely different from those of strychnia-poisoning. In
the former there are always manifested certain prodromes,
such as chills, faintness, insomnia, headache, vertigo, and
painful tension about the diaphragm, which may last for
several days. These, of course, are entirely wanting in
poisoning by strychnia, and they never can be mistaken for
the general uneasiness which precedes for only a few minutes
the sudden outburst of convulsions, in the case of the poison.
(2) The first symptoms in tetanus are a painful stiffness of
the neck and jaws, with a difficulty of moving the head;
after this, there is a gradual spreading of the rigidity over
the muscles of the other parts of the body, usually the trunk
first, then the limbs. In some instances the contractions
reach their greatest intensity in the course of a few hours ;
POISONING BY STRYCHNIA DIAGNOSIS. 359
in others, several days may elapse. To contrast this with
a case of strychnia-poisoning : in the latter, instead of the
gradual invasion of the rigid spasms, commencing in the
neck or jaws, there is a sudden tetanic seizure of all the
muscles of the body simultaneously, producing the violent
jerking of the body, and the arching of it backwards. Again,
while the muscles of the neck and jaws are never the first
to be affected by strychnia, but are often the last, the re-
verse is the case in the disease — the trismus being the first
indication of its approach. (3) A third distinction is founded
on the progress of the two cases : whilst the violent par-
oxysm produced by strychnia lasts only from half a minute
to one or two minutes, and is succeeded by a complete re-
laxation, in tetanus, on the contrary, the rigidity is generally
permanent, or if there be any remissions, these never ex-
hibit the character of the complete intermissions character-
izing the action of strychnia. (4) The termination of the
cases is widely different ; idiopathic tetanus never terminates
fatally in two or three hours, but usually several days
elapse; whilst in the case of the poison, death often occurs
within half an hour, to two hours. Some cases of traumatic
tetanus are reported, which proved fatal within twelve hours ;
and one remarkable case, quoted by Watson (Lectures, art.
Tetanus)^ of a negro who lacerated his thumb by the acci-
dental fracture of a china dish ; he was seized with convul-
sions almost instantly, and died with tetanic symptoms in a
quarter of an hour.
As regards the hysterical form of tetanus, although its
very existence has been denied by some, especially in the
male, it is admitted by numerous competent authorities ;
and, inasmuch as among other forms it may assume that of
tetanic spasms, and might occasion doubt, under peculiar
circumstances, the examiner should ascertain the previous
360 TOXICOLOGY.
history of the case, which will serve to clear up the diag-
nosis.
In relation to epilepsy, there ought to be no difficulty in
the diagnosis ; the mode of seizure, the unconsciousness,
and the peculiar clonic movements, are wholly different from
the characteristic tetanic spasm of strychnia-poisoning.
Again, the deep stupor which terminates an epileptic attack
contrasts widely with the complete relaxation and perfect
intelligence that follow the strychnia spasm.
Cliemical analysis. — Strychnia occurs in the form of a
white powder, and also in crystals, usually prismatic. It is
almost insoluble in water — one part in seven or eight thou-
sand. Absolute alcohol dissolves one part in about two
hundred ; amylic alcohol, one in one hundred and twenty ;
pure ether, one in about fourteen hundred ; commercial ether,
one in about one thousand ; chloroform, one part in eight.
It is insoluble in the fixed alkalies, and very sparingly so
in ammonia.
The salts of strychnia are very soluble in water and
alcohol, but very slightly so in ether.
The taste is intensely and permanently bitter. This is one
of its characteristic qualities. In fact, it is the bitterest sub-
stance known. As the result of numerous experiments, we
have found distinct bitterness yielded by a solution of one
grain of strychnia in several gallons of water. This bitter
taste we regard as one of the strongest corroborative proofs
of the presence of strychnia in a medico-legal case. Unless
the ultimate extract obtained by the manipulation has a bitter
taste, we need hardly expect to prove the presence of the
poison by the usual chemical tests. But, of course, the mere
presence of bitterness is not evidence of strychnia, since this
quality pertains to numerous other substances, such as
morphia, quinia, aloes, colocynth, quassia, picrotoxia, etc.
POISONING BY STRYCHNIA THE COLOR TEST. oGl
The strong mineral acids produce no coloration with
strychnia, provided the latter is pure ; if it contains brucia,
it will impart a reddish color to nitric acid. Heated on
porcelain, it melts slowly into a brown liquid, and is decom-
posed, giving off dense white fumes, and leaving carbon.
It may be sublimed by heat, depositing crystals of pennate
forms on a cold glass surface (Guy).
I. The Color test. — This is so named on account of the
beautiful succession, or play of colors, that is developed by
it. It consists in the application of a drop of pure sulphuric
acid to a small fragment of strychnia, on a white porce-
lain surface, or on a watch glass over white paper. If the
strychnia be perfectly pure, it will dissolve in the acid with-
out any coloration. If now a fragment of bichromate of
potassium, biuoxide of manganese, bin oxide of lead,ferrocya-
nide of potassium, or permanganate of potassium, be stirred
in contact with the solution, by means of a pointed glass
rod, this play of colors is instantly manifested. At first, it is
of a rich, deep blue; this soon passes into violet and purple,
which, in its turn fades into a pink, and finally into a red.
The relative duration of these shades of color depends
on the quantity of strychnia operated on, and also on the
relative amounts of acid and the other substance. Thus, if
the amount of strychnia be extremely minute, the blue
color may flash out but for a moment, leaving only the
violet or purple, which quickly passes into the red.
The principle involved in the color test is 'the action of
nascent oxygen (developed by the sulphuric acid on the
various oxidizing substances above named) on the strychnin.
For the success of the experiment, it is immaterial which
one of these oxidizing bodies is employed, providing it is
pure. Different authorities evince a preference for one or
another, according to their individual tastes. As a rule, the
362 TOXICOLOGY.
pure crystal of bichromate of potassium will yield satisfac-
tory results.
It is very important for the medico-legal student to have
clear and definite ideas about this color test for strychnia. I
It is not the mere production of a blue color that is of
diagnostic value, for this might result from the application
of permanganate of potassium to various organic bodies in
the absence of strychnia ; but it consists in the regular suc-
cession of colors — from blue to violet, pink, and red, the last
continuing for some time, and ultimately changing to a dirty
green. So far as is known at present, strychnia is the only
substance that answers to the above requisition. There are
others that react somewhat similarly, which will be noticed
hereafter.
The exceeding delicacy of the color-test deserves special
notice. If the strychnia be perfectly pure, and the manipu-
lation be properly performed, so minute a quantity as the
one-millionth of a grain can be detected, as we have repeat-
edly verified in our own experience, and as is corroborated
by other experimenters. It depends altogether on the
delicacy of the experiment. These minute quantities of
strychnia are best obtained by first making a solution of the
alkaloid in pure water, with the addition of acetic acid, of a
definite strength. This may readily be reduced by the
addition of more water. Fractional portions of the solution
may be obtained by using a pipette drawn out to a capillary
point, which will deposit minute droplets on a warmed,
clean porcelain surface. The object here is to concentrate
the quantity to be experimented upon into as small a space
as possible. The drop should then be evaporated to dryness
spontaneously. A small drop of pure concentrated sul-
phuric acid is then applied to the deposit, by means of a
finely-pointed glass rod, and then a minute crystal of the
STRYCHNIA THE COLOR TEST 363
bichromate of potassium (or one of the other oxidizing
bodies) is placed alongside of the acid solution, and then, by
means of the rod, is drawn through the solution and gently
stirred in it.
Interferences. — As above mentioned, the color-test, pro-
perly applied, will detect exceedingly minute portions of
pure strychnia, but there are many organic substances
whose presence will considerably modify and even com-
pletely disguise this test. This fact has been known to
chemists since 1850, when it was first announced by Brieger
(C/iem. Gaz., VIII, p. 408). His results have been con-
firmed, and the list of interfering bodies has been extended
by subsequent experimenters. According to Lyman (N.Y.
Med. Gaz., Mar., 1871), permanganate of potassium is the
only reagent that will develop the color-test with strychnia,
when the latter is mixed with either morphia or quinia in
excess. The most important of these interferences, con-
sidered medico-legally, is probably morphia, inasmuch as
this substance might be likely to be given to allay the
severity of the strychnia spasms, and would consequently be
associated with the strychnia extracted from the body after
death. A large number of experiments made by the author
{Am. Jour. Med. Sci., Oct., 1 861, and April, 1862) clearly
confirm the fact of the interference of morphia with the
usual color-test for strychnia, both in the pure state and
when mixed with organic matters. One experiment only
will here be mentioned : A small cat was poisoned " with
one-twentieth of a grain of strychnia and one-tenth of a
grain of morphia. The ultimate extract obtained from the
stomach by Stas' process entirely failed to yield the color-
test, although the bitterness of the extract, and the fact that
its solution produced the characteristic tetanic convulsions
in a number of frogs, distinctly proved its existence."
364 TOXICOLOGY.
Admitting, then, the fact of these interferences, it is well to
remember that, practically, they may be avoided, in a medico-
legal investigation, by the employment of chloroform in-
stead of ether, as the solvent to extract the strychnia from
organic mixtures, — morphia and other interfering substances
being insoluble in this menstruum.
Fallacies. — Exception has been taken to the color-test, on
the ground that other substances besides strychnia will
yield colors similar, if not identical, when similarly treated ;
but a careful attention will readily avoid all difficulty. The
substances alluded to are enrarine, veratrine, cod-liver oil,
salicine, santonine, aniline, pyroxanthinc \ narceine, papaverine
and solanine ; but in relation to most of these, a radical ground
of distinction is that they are colored by sulphuric acid alone,
which is not the case with strychnia. A salt of aniline is
not colored by the acid alone, but only in the presence of
one of the above mentioned oxidizing bodies; but there is
this difference between it and strychnia : the former is first
colored green, then a very persistent blue, and finally black.
Curarine has many points of resemblance to strychnia; it
is very bitter; it yields a succession of colors with sulphuric
acid and bichromate of potassium ; but it is colored by sul-
phuric acid alone ; it is nearly insoluble in chloroform, and
readily soluble in potash. Its physiological effects are the
opposite of those of strychnia.
Cod-liver oil, when treated with sulphuric acid alone,
affords a play of colors somewhat like those presented by
strychnia.
2. The galvanic test of Dr. Letherby acts on the same
principle, of presenting nascent oxygen to the strychnia ;
but in this instance it is evolved by galvanism. A drop of
a dilute solution of strychnia is placed in a small depression
made on platinum foil, or in a platinum capsule, allowed to
POISONING BY STRYCHNIA TESTS. 365
evaporate to dryness, and then moistened with a drop of
sulphuric acid. The foil (or capsule) is connected with the
positive pole of a single cell of Grove's battery, and the acid
is touched with the platinum terminal from the negative
pole. Instantly, the violet color will flash out on the metal,
and on removing the pole from the acid, the tint will remain.
3. Potassa and ammonia precipitate the alkaloid from a
somewhat concentrated solution, in the crystalline form.
The best method is to expose a drop of the solution on a
glass slide, to the vapors of ammonia, and place it under
the microscope; the beautiful formation of the long stellate
prismatic crystals can easily be distinguished ; these can be
identified by touching them with a drop of sulphuric acid
and a fragment of bichromate of potassium, when the play
of colors will take place.
4. Bichromate of potassium. — A solution of this salt
throws down from a strychnia solution a bright yellow pre-
cipitate, which soon becomes crystalline. Placed under the
microscope, these crystals appear in groups, mingled with
octahedral plates. When dried, these should be verified
by touching them with a drop of sulphuric acid. This is a
satisfactory test.
5. Carbazotic (or picric) acid. — A solution of this acid
precipitates strychnia from its solution in the form of
abundant yellow crystals. The best mode of showing it is
to add a drop of the solution to one of strychnia, on a glass
slide, and view the reaction under the microscope. The pre-
cipitate which first forms soon assumes the appearance of tufts
of yellow crystals, of a peculiar claw-like form. These, as
in the former experiment, may be subjected to the color-
test, by the same method.
Besides the above tests, there are others of inferior value
— as corrosive sublimate, ferrocyanide of potassium, bicldorate
366 TOXICOLOGY.
of platinum, iodated iodide of potassium, and sulplw-cyanide of
potassium.
Tardieu considers chlorine gas to be a very delicate test j
for strychnia. When a small stream of this gas is slowly
passed through a dilute solution of strychnia, each bubble
of the gas becomes surrounded by a white film, and ulti-
mately, quite a copious, white amorphous deposit takes
place, which is soluble in ammonia. According to the
above authority, no other alkaloid gives this reaction with
chlorine.
The physiological or frog test. — The extreme susceptibility
of the frog to the action of strychnia was first employed
by Dr. Marshall Hall, as a test for this poison. It may be
applied either by immersing a small frog in the strychnia
solution, or else injecting it either into the throat of the
animal, or preferably, under the skin. We have repeatedly
resorted to this test, and uniformly with satisfactory results.
One of these experiments demonstrates very clearly the ex-
treme susceptibility of the frog to the influence of strychnia.
" The one five-hundredth of a grain of strychnia was put into
the throat of a middling-sized frog; it was convulsed and
died in about thirty minutes. The extract obtained from
the stomach by Stas' process, although it afforded no per-
ceptible color-test, had a bitterish taste, and produced
tetanic spasms in several small active frogs."
Our experiments in this line further demonstrate the fact
that while morphia, when present in excess, with strychnia
in small quantities, has the power to disguise the color-test,
it affords no obstacle to the employment of the frog-test. Two
experiments only will be quoted under this head: "A frog
weighing thirty-five grains was immersed in a solution con-
taining one grain of strychnia and thirty-two grains of mor-
phia in six pints of water ; it was convulsed in twenty
STRYCHNIA — TOXICOLOGICAL EXAMINATION. 367
minutes. Another animal, rather smaller, was convulsed in
five minutes." (In these experiments only a small portion
of the solution was used — less than a fluid drachm — put
into a conical glass, in which the hind-quarters only of the
animal were immersed). " A cat was poisoned with one-
twentieth of a grain of strychnia and one-tenth of a grain of
morphia. The stomach, on examination by Stas' process,
failed to yield the color-test ; but the watery solution of the
extract produced most decided tetanic convulsions in eight
frogs, generally resulting in death."
To xicological examination. — The stomach properly divided,
together with its contents, and a sufficient quantity of dis-
tilled water, should be made distinctly acid with acetic acid.
If the elaborate process of M. Stas is to be employed, the
strongest alcohol must be used instead of water. In either
case, the mass should be digested on a water-bath for several
hours. A high temperature is objectionable, as it dissolves
out the starchy matters. After cooling, it is strained through
muslin, and the solid matters washed with dilute alcohol and
pressed. The liquid should next be concentrated by evapo-
ration, and filtered through paper. It should now be
evaporated to dryness. The residue will contain any
strychnia usually present in the form of acetate, mixed with
organic matter. This residue should now be 'thoroughly
mixed with a small quantity of distilled water containing a
few drops of acetic acid, then filtered through paper, and the
filtrate poured into a glass tube or flask, and an excess of
solution of potassa or soda (or ammonia) added, which
liberates the strychnia from its combination. Pure chloro-
form, slightly in excess of the mixture, is now added, and the
whole briskly shaken together for some minutes. The
chloroform dissolves out the alkaloid, and from its gravity
settles to the bottom of the mixture, after the lapse of some
time.
368 TOXICOLOGY.
In order to separate the chloroform from the supernatant
liquid, we have found that the easiest practical method is t<
transfer the whole mixture to a stoppered glass funnel, 01
what answers equally well, a glass syringe of proper size
after removing the piston, and having previously contractec
the nozzle to a fine point by means of the flame. Before
introducing the liquid, this small aperture should be pluggec
with a splinter of wood, and about half a drachm of pure
chloroform first poured into the syringe, so as to about fill
the narrow portion. The mixture is now to be carefully
poured in, and a sufficient time allowed to elapse for the
chloroform to separate and settle to the bottom.
By placing the thumb over the larger aperture of the
syringe, and withdrawing the wooden plug, it will be very
easy to control the flow of the contents. A few drops may
be allowed to fall successively, as each one dries, into a
warmed watch glass, or porcelain capsule, for a trial test, by
means of sulphuric acid and bichromate of potassium (vie/.
p. 361). The whole of the chloroform is then permitted to
flow out into one or more capsules, or watch glasses, great
care being taken not to allow any of the other mixture to
escape along with it. The remaining alkaline liquid may
be shaken up with an additional portion of chloroform, and
the separation again made as before. All the chloroform is
now permitted to evaporate spontaneously to dryness. The
contained strychnia, if of notable quantity, will be found in
the deposit, in an amorphous — not crystalline — form, ac-
cording to our experience.
A portion of this extract should now be examined by the
taste, for bitterness ; by the color-test (although this may not
be veiy satisfactory, on account of the mixture with organic
matter) ; and by the frog-test. The remaining portion of
the extract is to be dissolved in a minute quantity of water,
STRYCHNIA DETECTION IN THE TISSUES. 369
acidulated with acetic acid, filtered, and subjected to the
usual tests (vid. p. 361).
The main difficulty in conducting this experiment arises
from the presence of organic matters in connection with the
strychnia. If the chloroform extract has a ye 1 low color
(denoting its impurity), a few drops of strong sulphuric acid
should be added to it and thoroughly stirred with a glass
rod. This destroys and carbonizes all the organic matter,
but merely converts the strychnia into a sulphate ; add a
few drops of water. After standing a short time, the dark
liquid is filtered, solution of potassa is added in excess, then
pure chloroform, as explained above. The second extract
thus procured is generally sufficiently pure for all practical
purposes.
It not unfrequently happens, when operating on complex
organic mixtures by the chloroform process, that difficulty
is experienced in getting the chloroform to separate from
the alkaline solution; the whole mass forming a sort of
emulsion. In such a case, the tube may be immersed in hot
water for some time ; and if this does not answer, nothing
remains but to agitate the mixture several times successively
with about half its volume of pure water, allowing it to rest
each time, and separating the chloroform as before directed.
The method of dialysis has been recommended by some
authorities, but we do not consider it as exhaustive and re-
liable as the one just described.
Detection in the tissues and blood. — Strychnia is absorbed
into the circulation, and deposited in the various organs, just
like the mineral poisons. The rapidity with which the ab-
sorption takes place is shown in a case mentioned by Taylor,
where a man took five grains of the poison by mistake, and
died in half an hour. Strychnia was discovered in the
stomach in the quantity of one grain ; it was also detected
17
370 TOXICOLOGY.
in the liver and the tongue. This case shows that within
half an hour, four-fifths of the poison had been removed from -
the stomach (or could not be detected there by chemical re-
search), and had been diffused throughout the body. There
are, however, other cases, where the circumstances were
apparently just as favorable fur the absorption and diffusion I
of the poison, but where there was a total failure to detect
it in the organs, after death.
The process is the following : the organs are to be finely
crushed and digested in strong alcohol, acidulated with sul-
phuric acid, in the proportion of eight drops to the fluid
ounce of the mixture; this should be heated below 212° F.
for about an hour; when cool, it is to be filtered and con-
centrated, as before directed. The residue is then nearly
neutralized by liquor potassae, care being taken to maintain an
acid reaction, then filtered, and evaporated nearly to dryness.
To the cooled residue a drachm or two of strong alcohol is
added, and thoroughly stirred with it ; this dissolves out the
sulphate of strychnia, and leaves the sulphate of potassium
and the organic matters. The alcoholic solution is now
filtered, evaporated almost to dryness, the residue stirred
with pure water, rendered alkaline by potassa, and finally
agitated with chloroform, which deposits the alkaloid, if
present, on evaporation.
Dr. Taylor recommends acetic, instead of sulphuric, acid;
and ammonia instead of potassa, in these cases.
The method of Rodgers and Girdwood is somewhat sim-
ilar, and they employ hydrochloric acid and ammonia as the
reagents, along with chloroform.
Strychnia may be recovered from the blood by a similar
process. In some experiments of Dr. Wormley, he detected
the poison in the blood of dogs and cats, where death took
place in three and six minutes respectively after its admin-
POISONING BY BRUCIA. 371
istration. This shows the extreme rapidity with which it
is absorbed.
Detection in the urine. — The urine should be evaporated
to a syrupy consistence, acidulated with acetic acid, mixed
with an ounce of strong alcohol, filtered, and evaporated to
near dryness. The residue is to be stirred with pure water,
filtered, if necessary, liquor potassae added in excess, and
agitated with chloroform.
Failure to detect. — It must be admitted that the most care-
ful analysis sometimes fails to discover this poison in the
body after death, and that, too, where the circumstances
were apparently favorable to it. This failure may sometimes
be ascribed to the smallness of the dose, and again, possibly,
to some interference not well understood. Mere putrefaction
of the body is no obstacle to its detection, since it has been
recovered months after death, and where the body was in an
advanced state of decomposition. Christison, Taylor and
other well-known authorities have at times been foiled in
their efforts. In a case that occurred to the author, some
years ago, when a woman was poisoned (as was alleged)
with six grains of strychnia, and where death was postponed
for the unusually long period of six hours, there was a sim-
ilar failure to detect the poison eight weeks after death, al-
though the body was well preserved.
Brucia. — This alkaloid is generally found associated with
strychnia. It occurs either in the form of a white powder,
or in colorless prismatic crystals. It is more soluble in
water and alcohol than strychnia. It is freely soluble in
chloroform and alcohol. It has an intensely bitter taste.
Concentrated sulphuric acid dissolves it, giving a faint rose
coloration. Nitric acid gives a characteristic blood-red
color.
372 TOXICOLOGY.
Its poisonous properties are similar to those of strychnia,
though less intense. As the symptoms of poisoning by
brucia are similar to those caused by strychnia, the toxi-
cologist should guard against being deceived in a medico-
legal investigation, in the event of not discovering strychnia
by the usual color test. In such a case, it would always be
proper to search for brucia.
Tests. — The characteristic reagent is nitric acid, which
instantly produces a blood-red color, with a speedy solution
of the alkaloid. If heated, the color changes to yellow.
If, after cooling, a drop of the solution of protocliloride of
tin be added, the color changes to a beautiful purple. The
somewhat similar red color produced on morphia by nitric
acid is not changed by protocliloride of tin.
(2) Sulphuric acid and nitrate of potassium. — Touch the
fragment of brucia with a drop of strong sulphuric acid, a
faint rose color is produced ; then add a small crystal of
nitre, when the color changes to a deep orange-red.
(3) Ammonia produces, with a drop of brucia-solution, a
beautiful crystallization, viewed by the microscope. Other
tests of less importance are sulpho-cyanide of potassium,
bichloride of platinum and corrosive sublimate.
The frog-test is equally applicable to brucia, allowing for
its comparative inferiority in strength to strychnia.
The toxicological examination for brucia is conducted in
the same manner as described for strychnia. The ultimate
extract is to be tested by nitric acid and protochloride of
tin. Brucia has been detected in the blood of animals
poisoned by it.
POISONING BY BELLADONNA. 373
CHAPTER XXVIII.
ORDER III.— CEREBROSPINAL NEUROTICS.
(i) DELIRIANTS.
This subdivision of Cerebro-spinal Neurotics has received
the name of Deliriants, because of the active delirium that
constitutes one of their prominent symptoms. They also
produce other effects in common, such as illusion of the
senses, dilatation of the pupil, heat and dryness of the
throat, a flushed face, and frequently a redness of the skin.
They all belong to the same natural order of plants, Sola-
nacecz. From their physiological property of dilating the
pupil, they have received the name of Mydriatics. They
comprise Belladonna, Stramonium, Hyoscyamus, and dif-
ferent species of Solanum.
SECTION I.
POISONING BY BELLADONNA— ATROPIA.
SYMPTOMS. — ATROPIA. — FATAL DOSE. — TREATMENT. — POST-MORTEM
APPEARANCES. — CHEMICAL ANALYSIS. — TOXICOLOGICAL EXAMINA-
TION.
Belladonna (Deadly Nightshade). — The leaves, berries
and root of Atropa Belladonna are violently poisonous. The
leaves and root -are used in medicine. Children are fre-
quently poisoned by eating the berries.
Symptoms. — A sense of heat and dryness in the mouth
and throat, difficulty of swallowing, nausea, vomiting, giddi-
ness, extreme dilatation of the pupil, loss of vision, flushed
face, sparkling eyes, delirium of an excited, maniacal char-
374 TOXICOLOGY.
acter, spectral illusions, convulsions, followed by stupor and
coma. Irritation of the urinary organs frequently occurs, such
as strangury, suppression of urine and hematuria. A scarlet
eruption is often observed over the skin. Some of these
effects have been produced by the external application of
belladonna, in the form of a plaster or liniment. The
symptoms of belladonna-poisoning usually show themselves
from half an hour to two hours, occasionally sooner. They
do not generally terminate fatally. Death, when it occurs,
usually takes place within twenty-four hours.
In case of death from the leaves or seeds of belladonna,
these can usually be distinguished in the alimentary canal,
by their botanical characters.
Atropia. — This alkaloid is the active principle of bella-
donna, and is a very active poison, producing symptoms
similar to those above described, only more speedily. The
application of a weak solution to the eyes has occasioned
symptoms of belladonna-poisoning. Used hypodermically,
even in doses of one-fiftieth to one-tenth of a grain, it occa-
sions, at times, violent symptoms. Employed in this man-
ner in combination with morphia in excess, its activity
appears to be modified. Death has resulted from the ex-
ternal use of a strong ointment of atropia.
Fatal dose. — One-half to three-quarters of a grain may be
regarded as a minimum fatal dose for an adult. The crim-
inal administration of this poison is very rare. Dr. Taylor
records a case where a surgeon of a workhouse was fatally
poisoned by a nurse, by administering it in milk. The
diagnosis is not always easy, since the same symptoms are
produced by hyoscyamus and stramonium. There appears
to be a special tendency to its elimination from the system
by the kidneys. Prof. Guy states, on the authority of Dr.
John Harley, that the presence of atropia in the urine can
ATROPIA TESTS. 375
be readily proven within twenty minutes after the injection
under the skin of one-forty-eighth to one-ninety-sixth of a
grain, by the action of the urine on the eye. Twelve drops
will largely dilate the pupil, and maintain it in that state
for several hours (Foren. Med., p. 512).
Treatment. — The immediate evacuation of the stomach
by an active emetic, or by the stomach-pump. There is no
chemical antidote. The physiological antidote is morphia,
which should be carefully and repeatedly administered (via 1 ,
ante p. 334).
Post-mortem appearances. — These are not characteristic.
There may be congestion of the vessels of the brain, with
some red patches of the stomach and oesophagus. When
the poisoning has resulted from eating the ripe berries, the
whole lining membrane of the alimentary canal may be
dyed of a purple color, and portions of the berries and seeds
may be discovered in the intestines, or in the stools. The
blood is usually fluid, and dark-colored.
Chemical analysis. — Atropia, when pure, occurs in white
crystalline tufts. Its taste is acrid and bitter ; slightly
soluble in cold water, very soluble in alcohol, ether and
chloroform. It sublimes at 200° F. Its color is not
changed by either of the mineral acids. It has alkaline
properties, neutralizing acids, and forming salts.
The alkalies throw down a precipitate from a salt of
atropia, which ultimately becomes crystalline. That pro-
duced by ammonia remains amorphous. It is also precipi-
tated by chloride of gold, and by carb azotic acid. Worm ley
considers bromine in hydrobromic acid to be the character-
istic test for atropia. The precipitate is at first amorphous,
of a yellow color; but it soon becomes crystalline. It is
insoluble in acetic acid, and but slightly so in either of the
mineral acids. The one-ten-thousandth, to one-twenty-five
376 TOXICOLOGY.
thousandth of a grain will give satisfactory results with this
reagent (Micro- Chan, of Poisons, p. 631).
Toxicological examination. — We should first of all en-
deavor to discover any seeds, or remains of the leaves or
berries of the plant. The vomit and stools should, if
possible, be also examined for these. The stomach, with
its contents, and other organs, properly comminuted, should
be treated after a modification of Stas' process, alcohol
being used as the solvent, along with sulphuric acid. After
heating, straining, evaporating, purifying by pure ether, re-
moving the ether, and adding solution of potassa in excess,
the ultimate extract is obtained by chloroform and tested,
first, with the bromine -test, which, if successful, may be
followed by the other tests.
The physiological test consists in applying a portion of the
ultimate extract to the eyes either of a man, or one of the
lower animals, as the rabbit. The minutest quantity will
produce the characteristic dilatation of the pupil. It must,
however, be remembered that other members of this class
of vegetables will produce a similar result.
The rabbit evinces a remarkable tolerance for belladonna
and its alkaloid. It will live exclusively on the former for
many days, and tolerate enormous doses of the latter, either
by the stomach or subcutaneously, without perceptible
effects.
SECTION 11.
TOISONING BY STRAMONIUM, HYOSCYAMUS AND SOLANUM.
Stramonium (Thorn Apple, Jamestozvn Weed). — The Da-
tura stramonium is a very common plant, abounding in this
country, and also in Europe. It grows freely on waste
grounds ; other varieties occur in India. All parts of the
plant are poisonous, especially the seeds and fruit. Its
active alkaloid principle is named daturia.
POISONING BY HYOSCYAMUS. 377
Cases of poisoning by stramonium are usually accidental,
and chiefly occur in children, from eating the seeds.
Symptoms. — Very similar to those produced by bella-
donna, such as dryness of throat, with difficulty of swal-
lowing, dilated, insensible pupil, violent and incoherent
delirium, nausea, vomiting, headache, vertigo, ringing in
the ears, spectral illusions, followed by stupor and coma.
Sometimes there are convulsions and paralysis, together
with a scarlet efflorescence on the skin. The external appli-
cation of the bruised leaves has occasioned symptoms of
poisoning.
In India, the Datura is employed by the Thugs for the
purpose of drugging their victims.
Post-mortem appearances. — Very similar to those result-
ing from belladonna. There is nothing characteristic. The
seeds and remains of the leaves may be discovered in the
alimentary canal, if these have been the cause of death.
Treatment. — The same as that recommended for bella-
donna poisoning.
Analysis. — The seeds are of a black or brown color,
kidney-shaped, with a wrinkled surface. They are much
larger than those of belladonna or hyoscyamus. According
to Prof. Guy, it requires one hundred and twenty henbane
seeds, and ninety of belladonna to weigh one grain, but only
eight of stramonium. There is no known test to distinguish
daturia from atropia ; these two alkaloids are now generally
regarded as identical.
The method of procuring daturia from the stomach and
organs is the same as that above described for atropia
(P- 332).
Hyoscyamus {Henbane). — The Hyoscyamus niger grows
both in America and Europe. All parts are poisonous.
17*
o<8 TOXICOLOGY.
The root is tapering, resembling that of the parsnip, for
which it has often been mistaken. The medicinal prepara-
tions from the plant are extremely variable and uncertain,
depending very much on the mode of growth, collection
and preparation.
The symptoms, in general, resemble those of belladonna
and stramonium.
Analysis. — It can only be identified in the matters vomited,
or in the stomach and intestines after death, by the
botanical characters of the seeds or fragments of the leaves
discovered.
Hyoscyamia, the active alkaloidal principle, occurs in
white, silky crystals, inodorous when pure, but as usually
found, possessing a disagreeable smell ; taste acrid. It is
difficult to isolate. There is no proper chemical test for it.
It dilates the pupil, like atropia and daturia. It speedily
passes into the urine, when swallowed.
Solanum. — Three species of the genus Solatium are
usually referred to in the books, as possessing poisonous
properties : these are S. dulcamara, or Bittersweet, or
Woody Nightshade; S. nigrum, or Garden Nightshade;
and 5. tuberosum, or common potato. These all contain an
active alkaloid principle — Solania.
The vS. dulcamara is a native of Great Britain, and is cul-
tivated in our gardens as an ornament, for its purple flowers
and bright red berries. The latter are frequently eaten by
children, occasioning poisonous results. The dried stems
are used medicinally.
The S. nigrum produces white flowers and black berries.
The latter, like the fruit of the S. dulcamara, have frequently
proved poisonous to children who have swallowed them.
They are more powerful in their effects than the others.
POISONING BY SOLANIA. 379
S. tuberosum, or common potato. — The berries and young
shoots have proved poisonous, the former fatally, in the case
of a young girl reported in the Lancet, June, 1858. Chris-
tison quotes from Dr. Kabler, of Prague, an instance where
four persons of a family were seized with alarming symp-
toms, such as vomiting, coma and convulsions, after eating
potatoes that had commenced to sprout and shrivel.
The general symptoms produced by solania are very
similar to those resulting from the other mydriatics. It is
much less powerful than the other alkaloids of this class.
When pure, solania is in the form of delicate acicular
crystals ; nearly insoluble in water, soluble in alcohol, less
so in ether, insoluble in chloroform. It is also soluble in
amylic alcohol. Cold sulphuric acid first changes it to an
orange-yellow, and then dissolves it, the solution becoming
brown. Nitric acid dissolves it, the solution being at first
colorless, and subsequently changing to a rose-red tint.
The former acid is the best test for it. Other reagents do
not give characteristic results.
Solania is separated from organic mixtures by a modifica-
tion of Stas' process ; alcohol and sulphuric acid being em-
ployed as the solvent, and warm alcohol to separate the
final extract.
380 TOXICOLOGY.
CHAPTER XXIX.
(2) DEPRESSANTS.
Under this subdivision of Cerebro-spinal Neurotics, are
conveniently included several active poisons, which agree
in the property of causing great depression of the muscular
system, although in some other respects they may differ
from one another. By thus grouping them together, it is
not intended to imply that they all produce the same phy-
siological effects.
SECTION I.
POISONING BY TOBACCO AND LOBELIA.
EFFECTS OF TOBACCO— POST-MORTEM LESIONS — NICOTINA — PROPER-
TIES — CHEMICAL REACTIONS — TOXICOLOGICAL EXAMINATION —
LOBELIA.
Tobacco. — The dried leaves of Nicotiana tabaaim, a plant
belonging to the natural order of Solanacea?. It owes its
activity and poisonous properties to a volatile, liquid alka-
loid, of an oily consistence, named ?iicotina, which some-
what resembles conia, and which exists in different propor-
tions in different specimens of the leaves, varying from two
to eight per cent.
Symptoms. — A large dose of tobacco (or even a small
one to those unaccustomed to its use) produces very decided
symptoms. Very soon after taking it, either by swallowing
or by enema, it occasions nausea, giddiness, a sense of con-
fusion of the head, vomiting, severe retching, great prostra-
tion, heat in the stomach, frequent and very feeble pulse,
cold, clammy skin, trembling of the limbs, and sometimes
severe purging. Respiration is difficult, and urination invol-
POISONING BY TOBACCO. 381
untary. In some cases, there is violent pain in the abdo-
men ; in others, there is great sense of depression, and of
impending death. The pupils are not always similarly
affected. Taylor states that they are dilated. Percival
speaks of it as differing from belladonna in contracting
them; also by the absence of delirium, and of dryness of the
throat. Wharton and Stille {Med. Jurisp. f 1873, II, p. 609)
state that the pupils are but slightly affected.
The external application of tobacco, either to the sound
skin, or to abraded surfaces, produces alarming, and even
fatal effects. A wet leaf put around the throat in spasmodic
croup often relieves the spasm, but it should be used with
great caution on a young child. A decoction applied to the
skin of a man for an eruptive disease, caused death in three
hours (Am. Jour. Med. Sei. f January, 1865).
Its fatal effects, when administered by the rectum, are
well known. It was formerly much used in this manner,
to aid the taxis in strangulated hernia ; but it is always a
dangerous remedy. Even tobacco smoke, diffused through
water and swallowed, has caused the death of a young
infant.
Tobacco smoking has been known to produce violent and
even fatal effects, when carried to great excess, although
there is considerable diversity of opinion as to whether
nicotin is present in tobacco smoke, or not. Respectable
authorities are found on both sides.
The rapidity of the effects of tobacco on the human
system varies with the dose, and mode of administration.
In one case, snuff swallowed in whiskey caused death in
one hour. In another instance, quoted by Beck, an enema
of tobacco, used to expel worms, produced violent convul-
sions and death in fifteen minutes. Christison gives another
case, where a tobacco enema proved fatal in thirty-five
382 TOXICOLOGY.
minutes. The application of nicotina to the tongue of an
animal caused death within two minutes.
Post-mortem appearances. — There is no characteristic
lesion. A diffused redness over the mucous surface of the
stomach and bowels, with an empty heart, and congestion
of the vessels of the brain, liver and lungs, are about all
that will be found. The blood is usually very dark and
liquid. If the leaf or powder has been swallowed, these
may be recognized by microscopic examination. In a case
of suicidal death, examined by Dr. Taylor, there were gen-
eral relaxation of the muscular system, staring eyes, bloated
and livid features, the vessels of the brain and scalp, and
also of the lungs, gorged with black blood, and the heart
empty, except its left auricle. There was intense conges-
tion of the mucous membrane of the stomach and of the
liver. The blood was black and liquid, and in some parts
had the consistence of treacle. No peculiar odor was per-
ceptible {On Poisons, p. 66 1).
Nicotina. — This alkaloid, when pure, is a colorless, oily
liquid, which, on exposure, becomes light yellowish, and
thicker in consistence. It produces a greasy, volatile stain
on paper, like conia. It is usually said to possess an acrid,
unpleasant odor, but, if perfectly pure, the smell is ethereal
and agreeable. It has a strong, alkaline reaction, and a
density of 1.048. It is freely soluble in water, alcohol,
ether, chloroform, turpentine, and the fixed oils. Ether and
chloroform will extract it from its watery solution. Its taste
is very pungent and acrid, even when much diluted, causing
a peculiar sensation in the throat and air passages. It
slowly distills at about 295 ° F., and boils at about 470 F.
Heated on platinum, it burns with a bright flame, emitting
a thick black smoke.
Nicotina is one of the most rapidly fatal poisons known,
NICOTINA — CHEMICAL REACTIONS. 383
even rivaling prussic acid. A single drop destroyed a rabbit
in three and a half minutes. In Wormley's experiments,
one drop, placed in the mouth of a full-grown cat, produced
immediate prostration, continued convulsions, and death in
seventy-eight seconds.
In the celebrated case of Connt Bocarme, who was exe-
cuted in Belgium, in 1 851, for poisoning his brother-in-law,
Gustave Fougnies, nicotina was the agent used. An un-
known quantity was forcibly put into the throat of the
victim, the Countess assisting her husband as an accomplice
in the murder. Death was believed to have taken place
within five minutes. The poison was detected by M. Stas
in the tongue, throat, stomach, liver and spleen of the
deceased, and also from stains on the floor, near where the
act was committed. From the excellent report of the ex-
amination of M. Stas, we may note the following particulars :
The appearance of the tongue indicated the action of some
highly acrid agent ; it was swollen, blackened, softened and
friable; the epithelium was easily detached. This was also
the condition of the mucous lining of the mouth and
pharynx ; it was reddened, as if cauterized, and easily sepa-
rated. The lining membrane of the stomach was intensely
injected, exhibiting large patches, which were livid and
black. The vessels were filled with a black coagulum,
resembling blood that had been treated with sulphuric acid.
The duodenum was also highly injected. There were no
ulcerations or perforations of the stomach and bowels. The
lungs were gorged with black blood, and exhibited the usual
character of asphyxia. The heart was normal, its cavities
contained black, liquid blood. No odor was observed in the
body (Orji/a, Toxicol., II, p. 498).
Chemical reactions. — If a drop be put into a watch glass,
and this be covered with another glass, inverted, containing
384 TOXICOLOGY.
a drop of either nitric or hydrochloric acid, the glass will
become filled with white fumes, not so dense as from conia,
nor do they give rise to the formation of crystals. The
strong acids applied directly to it produce no characteristic
effects.
Nicotina unites freely with acids, forming salts, which
retain the peculiar taste of the alkaloid, but are destitute of
odor. They are mostly soluble in water and alcohol, but
not in ether or chloroform.
(i) Bichloride of platinum throws down a yellow precipi-
tate, which becomes crystalline, seen under the microscope,
which is soluble in hydrochloric acid. (No precipitate is
caused by conia.)
(2) Corrosive sublimate gives a white crystalline precipi-
tate, changing to yellow. These crystals assume a peculiar,
beautiful appearance, in groups of various patterns. These
are distinguished from the precipitates caused by this same
reagent with ammonia and the other alkaloids, by the fact
that the latter are amorphous, except that of strychnia, but
which last is wholly unlike that produced by nicotina. This
is a very delicate test.
(3) Terchloride of gold yields a yellow amorphous pre-
cipitate, but not characteristic. The same is true of iodide
of potassium, and of bromine in hydrobromic acid.
(4) Carbazotic acid gives a yellow, amorphous precipitate,
which ultimately assumes the form of a crystalline tuft, to be
viewed by the microscope.
Toxicological examination. — The stomach and other organs,
properly prepared, may be subjected to the process of Stas.
In fact, it was the very process employed by its originator
in the Bocarme case above alluded to. Other good authori-
ties have somewhat simplified his process. Water may be
employed as the solvent, instead of alcohol; and either
POISONING BY LOBELIA SYMPTOMS. 385
acetic, sulphuric, or tartaric acid may be used. After proper
concentration and filtration, it should be supersaturated
with potash or soda, and shaken up with chloroform or
ether, and these solutions, when properly separated, allowed
to evaporate spontaneously on watch crystals, when the
nicotina, if present, will be seen in the form of drops or
oily streaks, having the peculiar odor of the alkaloid, which
is rendered more distinct by heating. This should be dis-
solved in a few drops of water, and the appropriate tests
applied. A drop or two may also be given to a small
animal. Nicotina inserted under the skin of a frog pro-
duces peculiar muscular movements, slowing of the heart's
action and of respiration.
Lobelia. — The Lobelia inflata, or Indian tobacco, is a
native of this country, belonging to the natural order
Lobcliacece. It is extensively used both here and in Great
Britain as the standard remedy of the Thomsonian or Botani-
cal Doctors. According to Dr. Letheby, thirteen cases of
poisoning by this substance had occurred in England within
three or four years, and Dr. Beck states that " thousands of
individuals in the United States have been murdered by the
combined use of capsicum and lobelia, administered by
the Thomsonian quacks" {Med. Jnrisp., II, p. 736). The
leaves and seeds are the parts employed. They owe their
activity to a fixed alkaloid named lobelina.
Symptoms. — In small doses lobelia acts as an expectorant ;
in large doses, as an emetic and depressant. In poisonous
doses it produces distressing nausea and vomiting, some-
times purging, extreme relaxation, cold sweats, small, feeble
pulse, great prostration, contracted pupils, stupor, occasion-
ally convulsions, coma and death — symptoms strikingly like
386 TOXICOLOGY.
those caused by tobacco. A drachm of the powdered
leaves has proved fatal.
The post-mortem appearances are very similar to those
caused by tobacco.
Lobelina, the active alkaloid principle, is a yellowish
liquid, lighter than water, of a somewhat aromatic odor, and
acrid, persistent taste ; soluble in water, more so in alcohol
and ether ; has an alkaline reaction, forming soluble salts,
with acids. Tannic acid precipitates it from its solutions.
It resembles nicotina in most of its properties. On animals,
lobelina seems to produce the narcotic, but not the emetic
effects of the plant.
No case is recorded of death from lobelina. In the in-
vestigation of a case of death from lobelia, the diagnosis
would be materially aided by the discovery of fragments of
the leaves, or of the seeds. (For the report of two interest-
ing trials for fatal poisoning by lobelia, under the "botanical
treatment," see Wharton & Stille's Mcd.Jurisp., 1873, II, pp.
586 and 963.)
SECTION 11.
POISOXIXG BY HEMLOCK— CONIA.
SYMPTOMS. — POST-MORTEM APPEARANCES. — CONTA. CHEMICAL RE-
ACTION'S. — TOXICOLOGICAL EXAMINATION.- — OTHER POISONOUS HEM-
LOCKS.
The Conium maculatum, or Spotted Hemlock of Great
Britain and America, is believed to be the same plant as
the Cicuta of the ancient Greeks, the one that furnished the
celebrated State poison by which Socrates perished. It be-
longs to the natural order Umbellifcrcz, which also includes
many other poisonous plants. All parts of this plant are
poisonous ; the leaves and root are employed in medicine,
in the form of fresh juice and extract.
POISONING BY CONIA. 387
Poisoning by hemlock is generally the result of accident,
the fresh leaves being used in soup in mistake for parsley,
which it somewhat resembles. Its action on man appears
to be very variable — at least the different accounts are very
diverse.
Symptoms. — Headache, imperfect vision, dilated pupils,
difficulty of swallowing, drowsiness, a tingling sensation
along the muscles, gradually complete paralysis of the ex-
tremities; this extends finally to the muscles of respiration,
and the patient dies, at last, from apncea. If death be de-
layed for some time, there may be convulsions, coma, violent
delirium, accompanied with salivation, and involuntary dis-
charges from the bladder and bowels. Death usually takes
place in one to three hours. One drop of conia is considered
to be a poisonous dose. The treatment consists in a prompt
evacuation of the stomach by emetics, or, the use of the
stomach pump, followed by castor oil and stimulants.
Post-mortem appearances. — These are not at all character-
istic; redness of the mucous membrane of the stomach and
congestion of the lungs being usually observed. Fragments
of the leaves and the seeds (if these have been swallowed)
may often be recognized in the stomach and bowels, with
the aid of the microscope. If the leaves be rubbed in a
mortar with liquor potassae, they emit a peculiar mousy odor.
Conia. — This alkaloid exists most abundantly in the seeds.
It is one of the most powerful and fatal poisons known.
Christison states that a single drop, applied to the eye of a
rabbit, killed it in nine minutes ; and three drops, applied in
the same manner, killed a strong cat in a minute and a half.
In Wormley's experiments, a single drop placed upon the
tongue of a large cat, caused the animal at first to stand
still ; in two minutes and a half it fell upon its side, voided
urine, had violent convulsions of the limbs, with trembling
388 TOXICOLOGY.
of the body, when it died in three and a half minutes from
the time of administration.
Treatment. — Prompt emesis, to get rid of the poison, and
active stimulation. Strychnia has been suggested as a phy-
siological antidote, but it is too dangerous a substance to
deserve to be employed for this purpose.
Chemical properties. — When pure it is a colorless, vola-
tile, oily liquid ; the odor is peculiar, repulsive and suffoca-
tive, resembling that of a stale tobacco pipe. Diluted with
water, it emits an odor resembling mice. It gives a greasy
stain to paper, burns with a bright, smoky flame ; taste dis-
agreeable and permanent. Exposed to the air, it becomes
yellowish and resinoid. It is partially soluble in water,
freely so in alcohol, ether and chloroform ; the two latter
will separate it from its aqueous solutions.
Tests. — A drop is placed in a watch glass, and covered
over with a precisely similar glass, holding a drop of pure
hydrochloric acid on its under surface ; both glasses imme-
diately become filled with dense white fumes, and the drop
of conia is converted into a mass of beautiful, delicate crys-
talline needles, which do not deliquesce in the air. Sul-
phuric acid imparts to it a pale red color. Nitric acid
causes with it dense white fumes. Strong hydrochloric
acid imparts to it a faint tint, which gradually becomes much
deeper, and on evaporation, needle-shaped crystals appear.
Like the fixed alkaloids, it yields precipitates with tannic
acid, corrosive sublimate, terchloride of gold, bichloride of
platinum, iodide of potassium, etc. Its liquid, oily condi-
tion, together with its peculiar odor, will distinguish it from
all other bodies except nicotina ; and the points of differ-
ence between the two are mentioned under the head of
Nicotina (p. 383).
Toxicological examination. — Search first for any remains
POISONING BY CONIA. 389
of leaves, or of seeds, in the stomach and intestines, and
avoid mistaking the leaves of parsley for those of hemlock.
Rub the leaves in a mortar, with potassa, to develop the
peculiar mousy smell. Then distill, and examine the dis-
tillate before employing the more elaborate process of Stas.
Water and acetic acid may be employed as the proper sol-
vents ; evaporate the filtered solution to a syrupy consist-
ence, mix with strong alcohol and a few drops of acetic
acid, filter again and evaporate to near dryness ; add a little
distilled water, supersaturate with solution of potassa, and
agitate with ether, repeating the process several times. Re-
move the ether, and allow it to evaporate spontaneously.
Dilute the alkaloid, and subject it to the appropriate tests.
The toxicologist should guard against too strong a re-
liance upon the supposed odor of conia. Dr. Harley justly
observes that potassa may often develop an odor from or-
ganic substances which might possibly be mistaken for that
of conia, when the latter was not present. Nothing short
of the isolation of this principle, in a search for the poison,
should satisfy us.
The other hemlocks, viz., Cicuta virosa, or water hemlock,
CEnanthe crocata, or hemlock water-dropwort, and sEtliusa
cynapium, or Fool's parsley, or lesser hemlock, are all very
poisonous ; this is especially true of the QiuantJie, which is
one of the most poisonous of the umbelliferae.
390 TOXICOLOGY.
SECTION III.
POISONING BY ACONITE AND CALABAR BEAN.
PROPERTIES OF THE PLANT. — EFFECTS. — POST-MORTEM APPEAR-
ANCES. — ACONITINE. — FATAL DOSE. — TREATMENT. — CHEMICAL
ANALYSIS. — TOXICOLOGICAL EXAMINATION. — CALABAR BEAN. —
ESERINE.
Aconite. — The Aconitum napellus (Monkshood, or
Wolfsbane) is indigenous in Europe, but is cultivated in this
country. It grows from two to four or five feet high, and
has a spike of rich blue flowers. All parts of it are poison-
ous, the. root most so, depending on the presence of the
alkaloid aconitia or aconitine. The root is tapering, carrot-
like, two or three inches long, having a number of curly
fibres passing off from it. This root has frequently been
mistaken for the root of the horse-radish, from which, how-
ever, it differs essentially in appearance; the latter being long
and cylindrical and truncated, not tapering, of a light
brown color externally, white internally, and of a sweetish,
hot and pungent taste, totally distinct from that of aconite,
which imparts to the lips, tongue and fauces a peculiar
tingling, numbing sensation, which is very persistent.
There is considerable diversity in the activity of different
specimens of aconite, depending, doubtless, on the time and
modes of collecting and drying of the plant, and probably
also on the place of growth. This may account for the dis-
cordant results obtained by different investigators.
Aconite root has been administered criminally in at least
one recorded case, where the powdered root was mixed
with pepper, and sprinkled over the greens used for dinner
by the deceased {Dub. Jour. , July, 1841).
Symptoms. — On animals, according to Dr. Fleming, there
are weakness of the limbs and staggering, respiration slow
and labored, paralysis, loss of sensation, increased difficulty
POISONING BY ACONITE FATAL DOSE. o ( Jl
of breathing, and after a few spasmodic twitches, death by
asphyxia. In a few instances there were decided convul-
sions, and even opisthotonos. The pupils were generally
contracted. The heart continued beating after death. There
was great congestion of the venous system, with distention
of the right side of the heart.
On i}ian. — There is first a dryness of the throat, accom-
panied with tingling and numbness of the lips, throat and
tongue, followed by nausea and vomiting, with pain and
tenderness of the epigastrium. The numbness and tingling
now become more general, with diminution or loss of sensi-
bility of the surface, vertigo, dimness of vision, tinnitus
aurium, with occasional deafness, frothing at the mouth,
sense of constriction of the throat, great muscular prostra-
tion, inability to walk, a slow, feeble pulse, difficulty of
breathing, a cold, clammy skin, dilated pupils, features pale,
perhaps a few convulsions, followed by death. The mind
usually remains clear to the last. Delirium is rare. Death
is apt to be sudden, either from shock, asphyxia, or syncope.
Post-mortem appearances. — There is nothing character-
istic. There is usually general venous congestion of all the
organs, especially the brain, lungs and liver. There maybe
redness of the lining membrane of the stomach. The blood
is generally fluid, and dark in color. The heart may con-
tinue beating for a little while after death, indicating that
this was caused by asphyxia. In other cases, the death
may be ascribed to syncope.
The fatal dose is undetermined, in consequence of the
diversity in the strength of the different preparations of
the drug. The medicinal preparations are the tinctures of
the leaves and root, and the alcoholic extract. The latter is
apt to be inert. The tincture of the root is the strongest,
and most reliable. Twenty-five drops of this preparation
392 TOXICOLOGY.
have proved fatal. An excise officer in England died in a
few hours after merely tasting Fleming's strong tincture.
Pereira speaks of a case where two doses of six drops
each, taken at an interval of two hours, produced most
alarming symptoms in a young man; and Wormley alludes
to an instance in which five drops of Thayer's fluid extract
of the root produced most serious effects, which continued
for two hours. Half a drachm to a drachm may be con-
sidered a fatal dose.
The symptoms may come on almost immediately, or be
delayed for an hour or two. Death generally occurs within
three or four hours ; but it may be deferred, as in other
poisons, for twenty-four hours.
Aconitia (Acomtine), — The active alkaloid principle,
abounding most in the root, of which it constitutes about
one-tenth, to one-fifth of one per cent. In its pure state, it is
probably the most powerful poison known. Pereira states
that one-fiftieth of a grai)i nearly proved fatal to an elderly
lady. Much of the aconitia, as sold in the shops, is totally
inert and worthless. The only reliable article is that of
Morson, of London, and probably some of the German
manufacture. One-tenth of a grain may be considered a
fatal dose. This poison has lately been brought promi-
nently into notice in the case of Dr. Lamson, who used it in
destroying his brother-in-law, in England, about a year ago.
Treatment. — There is no chemical antidote. The stomach
should be immediately emptied by the stomach-pump, or an
active emetic. Animal charcoal is recommended by Head-
land, also tannin, or astringent infusions. Slight galvanic
shocks are recommended to be passed through the heart, in
order to arouse its action, also the employment of artificial
respiration. Possibly, the inhalation of oxygen might be of
some advantage.
POISONING BY ACONITIA TESTS. 393
As strychnia and aconitia appear to be mutually antago-
nistic, it might be well to employ the former, cautiously, in
the treatment of poisoning by the latter. A case of a child
is quoted, from Am. Jour. Med. Set., January, 1862, in which
the recoveiy was apparently due to two doses of tincture
of nux vomica, administered twenty minutes apart.
It would also appear that digitalis possesses an antidotal
power over aconitia. Dr. J. M. Fothergill discovered that
digitalis administered to frogs that were under the influence
of aconite .relieved the heart from the depression produced
by the latter poison, recalling its normal movements. A
case is reported, in the Brit. Med. Journal, December, 1872,
where recovery took place in a man who, when intoxicated,
had swallowed an ounce of Fleming's tincture. The patient
was apparently dying, when twenty minims of tincture of
digitalis were injected subcutaneously, and after twenty
minutes the patient had recovered sufficiently to swallow,
when a fluid drachm of the tincture was given, along with
brandy and ammonia, and was twice repeated within an
hour. The above statement certainly warrants the employ-
ment of this remedy in a case of aconite-poisoning.
Chemical analysis. — Aconitia, when pure, is in colorless,
transparent crystals. Taste, at first, acrid, soon followed by
tingling, and numbness of the lips and tongue. Its solution,
applied to the skin, occasions a feeling of heat and numb-
ness. So active is this poison that, according to Stevenson,
one two-thousandth of a grain of Morson's aconitine will
destroy a mouse. This same quantity causes tingling and
numbness of the lips and tongue, when applied to the tip
of the latter organ ; and one-hundredth of a grain, dissolved
in spirit and rubbed into the skin, causes a loss of feeling,
lasting for some time.
It has strong basic properties, forming salts with acids,
18
394 TOXICOLOGY.
which are mostly soluble. It is very slightly soluble in
water, quite soluble in alcohol and chloroform, but in-
soluble in ether. None of the mineral acids change it in
the cold, but warm sulphuric acid imparts to it a brown tint.
There is no characteristic chemical test for it. Its presence,
in a medico-legal case, can only be satisfactorily established
by the physiological test — the peculiar tingling, benumbing
sensation imparted to the mouth and tongue when a minute
fragment of the ultimate extract is tasted, or by a similar
application to the skin, attended with similar results; to-
gether with its introduction into some small animal, hypo-
dermically.
If the poisoning has occurred from swallowing the leaves
or root of the plant, a careful microscopic inspection of the
stomach and bowels, and of the matters vomited and purged,
should be instituted, in order to identify their botanical
characters.
Toxicological examination. — A modification of Stas' pro-
cess should be employed, similar to that described for nico-
tine (p. 384). Chloroform is preferable as the ultimate sol-
vent. The residue thus obtained should be dissolved in a
few drops of pure water, slightly acidified with acetic acid,
and submitted to the physiological tests above described.
If these afford no satisfactory results, no mere chemical
tests can be relied on; but if they give evidence of the
presence of the poison, then the solution should be sub-
jected to all the known reactions, such as carbazotic add,
bichloride of platinum, chloride of gold, and the bromine test.
Calabar Bean. — The Ordeal Bean of Calabar (Physos-
tigma venosum) is a large leguminous seed, from an inch
to an inch and a half long, of a brownish-black color. It is
used by the natives of the West Coast of Africa as the
POISONING BY CALABAR BEAN ANTIDOTE. 395
ordeal test for witchcraft — the suspected person being com-
pelled to drink a decoction of the poisonous beans. It owes
its activity to the alkaloid physostigmia, also named eserine,
which resides in the cotyledons. These, when touched with
nitric acid, assume an orange tint, and with perchloride of
iron, a brown one. The alkaloid is a colorless, crystalline
solid, bitter to the taste, very slightly soluble in water ;
soluble in alcohol, ether, chloroform and benzol.
Bromine in bromide of potassium produces with it a red
color. It gives this color with less than tsW of a grain
(Dragendorff). According to Dr. J. B. Edwards (Med.
Times and Gaz., 1864), it reacts with sulphuric acid and bi-
chromate of potassium very much like strychnia — producing
the play of colors; this, however, needs further confirma-
tion.
The action of this poison upon the lower animals is that of
a spinal depressant, causing, at first, tremors, and then
paralysis, with muscular flaccidity; contraction of the
pupils ; respiration slow, irregular and stertorous ; some-
times there are convulsions. The heart is found to beat
for some time after death. Consciousness is preserved
throughout.
The effects on man are similar to the above. They are
the opposite to those produced by strychnia, which is a true
spinal excitant. For this reason it has been employed as a
remedy for tetanus, and also as an antidote for strychnia.
Its most characteristic physiological action is the property
of contracting the pupil, which at once distinguishes it from
belladonna, as also from conia and curarin, which it
resembles in some particulars.
The true physiological antidote is atropia, used hypoder-
mically, and repeated until expansion of the pupil is mani-
fested. From the experiments of Dr. Fraser and others,
396 TOXICOLOGY.
there can be no doubt of the mutual antagonism of atropia
and eserine.
The most satisfactory test is the physiological one — its
power to contract the pupil. A drop or two of the suspected
fluid is put into the eye of a rabbit, or other small animal,
and in the course of fifteen or twenty minutes the charac-
teristic impression will be observed.
Dragendorff has succeeded in separating it from the
tissues by a modification of Stas' process, employing
benzol, instead of ether, as the ultimate solvent.
Six of the beans, when eaten, proved fatal to a boy, aged
six years (Lancet, Aug. 27, 1864).
POISONING BY HYDROCYANIC ACID. 397
CHAPTER XXX.
(3) ASTHENICS.
This subdivision of Cerebro-spinants comprises those
Neurotics which destroy life by asthenia, or failure of the
heart's action. It is not intended to assert that they may
not prove fatal in some cases, in another manner, as e. g.,
through shock, or asphyxia. But as the most strongly-
marked symptoms are those of heart failure, this name
answers sufficiently well for grouping together those neu-
rotic poisons that especially display this property. The two
most important members of this group are Hydrocyanic
Acid and Digitalis. Cocculus Indicus is considered under
the same head, for the sake of convenience.
section 1.
POISONING BY HYDROCYANIC ACID.
NATURAL OCCURRENCE IN VEGETABLES. — PURE AND OFFICINAL
ACIDS. — SYMPTOMS. — FATAL PERIOD AND DOSE. — TREATMENT.—
POST-MORTEM APPEARANCES. — TESTS. — TOXICOLOGICAL EXAMINA-
TION. — CYANIDE OF POTASSIUM. — OIL OF BITTER ALMONDS. —
CHERRY-LAUREL WATER. — N1TRO-BENZOLE.
Hydrocyanic, or Prussic Acid, is one of the most
energetic and rapidly fatal poisons known. It occurs as a
natural product in the bitter almond, the kernels of the
peach, apricot, plum and cherry, the pips of apples, and the
flowers and leaves of the peach and cherry-laurel. From
the latter, a very poisonous water {cherry-laurel water) is
distilled. It also exists in the root of the mountain ash.
Properly speaking, hydrocyanic acid does not pre-exist in
398 TOXICOLOGY.
these vegetable substances, but is the product of the reaction
of water upon two principles which they contain, viz., amyg-
dalin and emulsin, at a certain temperature.
Prassic acid, in its pure, anhydrous state, is a compound
of cyanogen and hydrogen, HCy. It is a colorless, limpid
liquid, extremely volatile, and having the odor of bitter
almonds. It is one of the most active and rapidly fatal
poisons known. A single drop placed upon the tongue of
a large dog caused death in a few seconds. The anhydrous
acid is rarely met with except in the laboratory of the
chemist. It possesses no medico-legal interest. It is the
dilute or medicinal acid that is so frequently the cause of
death. This latter is merely a solution of the anhydrous
acid in water.
It occurs in the shops under two different forms : (i) The
officinal acid, of the average strength of two per cent. ; and
(2) Scheeles acid, of the average strength of five per cent.
But the strength of both varieties varies considerably, and
it is not uncommon to find some specimens totally inert.
This may probably arise from the liability of the acid to
undergo decomposition when exposed to the light. The
dilute acid is colorless, and has the odor of bitter almonds,
and a hot, pungent taste.
Symptoms. — These vary with the size of the dose. A
large dose — half an ounce to an ounce of the diluted acid —
may produce symptoms in the act of swallowing, or in a few
seconds after. They are seldom delayed beyond one or two
minutes. Tardieu describes them as " coming with lightning-
like rapidity." There is .an immediate loss of muscular
power, with giddiness ; the person staggers and falls to the
ground ; the respiration becomes hurried and gasping ; the
pulse imperceptible; the eyes glassy and protruding; the
pupils dilated and insensible to light; the extremities cold;
POISONING BY PRUSSIC ACID — FATAL DOSE. 399
and sometimes, convulsions occur. Toward the last, the
breathing is performed convulsively, in sobs. Sometimes
the bladder and rectum are evacuated involuntarily. As
regards the peculiar cry or shriek, such as is often heard in
animals poisoned by prussic acid, the experience of all
observers is against its existence in the human subject. The
face is livid or pallid, the jaws spasmodically closed ; there
is frothing at the mouth, occasionally bloody ; often the
peculiar odor of the poison can be detected in the breath ;
death occurs sometimes in a violent convulsion; at others it
is preceded by coma, with stertorous breathing. This latter
symptom (stertorous breathing) is of considerable medico-
legal importance, since it might easily lead to a mistaken
diagnosis for apoplexy.
Fatal period. — Death generally occurs within ten or fifteen
minutes after swallowing the poison. Rarely is it protracted
for half an hour. One case is recorded where an hour
supervened. Insensibility is not, however, always imme-
diate.; instances are recorded of persons, after swallowing
very large and fatal doses of this poison, performing many
voluntary acts, such as walking into another room, opening
drawers, going down stairs, etc.
The symptoms attendant on a large, but not fatal, dose,
are confusion of head, giddiness, a sense of weight upon the
brain, great muscular debility, nau'sea, vomiting and possibly
convulsions, oppressed breathing. Several days may elapse
before complete recovery takes place.
The external application of this acid to the^ skin,
especially if abraded, may occasion serious, and even fatal
consequences. Christison reports a case where the liquid,
applied to a wound in the hand, caused death in one
hour.
Fatal quantity. — The minimum fatal dose for an adult
400 TOXICOLOGY.
may be taken to be about fifty minims of the officinal acid,
which is equivalent to nine-tenths of a grain of anhydrous
acid. The largest dose from which there was a recovery
was reported in the Lancet (January 14, 1854), in which one
drachm of Scheele's acid, equivalent to 2.4 grains of anhy-
drous acid, was swallowed by mistake. Other instances are
reported of recovery after taking doses equivalent to two
grains, and under, of the anhydrous acid, in all of which
prompt and vigorous measures were adopted.
The inhalation of the vapor is exceedingly dangerous,
and has even proved fatal.
Treatment. — So rapid are the poisonous effects of hydro-
cyanic acid that there is scarcely any opportunity for the
employment of remedies. The cold affusion, by dashing
cold water over the face and chest, should be at once
employed. This should be followed by the cautious inha-
lation of diluted ammonia and chlorine vapors, along with
stimulants, applied both internally and externally. As a
chemical antidote, a mixture of ferrous and ferric sulphates,
followed by a solution of carbonate of potassium, has been
proposed; this would produce, with hydrocyanic acid in the
stomach, Prussian blue — an inert compound. The experi-
ment has proved successful in animals.
Post-mortem appearances. — The face is pale, or livid ; the
eyes often glistening and staring, with the pupils dilated ;
the lips blue ; jaws firmly set, with, at times, a bloody froth
issuing from the mouth. The blood is of a dark blue color,
and fluid. The cerebral vessels are congested. Tardieu
alludes to effusions of blood and serum at the base of the
brain, as an occasional occurrence, which might suggest the
presence of apoplexy, which, however, is negatived by the
absence of hemiplegia, and by the rapidity of the death.
There is congestion of the lungs and liver; and the mucous
HYDROCYANIC ACID — TESTS. 401
membrane of the stomach, especially about the cardiac
extremity, is apt to be much reddened.
The exhalation of the peculiar odor is one of the most
important post-mortem characters. This odor is sometimes
perceived even before the body is opened, in recent cases,
but it is particularly noticeable in opening the abdomen and
thorax, and even the brain, but especially the stomach. But
as the poison is very volatile, it may easily happen that the
odor will have disappeared in a few hours or days, if the
body has been much exposed. There is a singular variation
in this respect in different cases. Moreover, the odor may
be disguised by other more powerful smells, such as tobacco,
mint, etc. The mere absence of odor is, therefore, no proof
of the non-existence of the poison.
CJiemical analysis. — There are four recognized tests for
hydrocyanic acid, which may be briefly designated as the
silver, iron, sulphur and copper tests. The first three are
characteristic ; and they may be applied to the acid cither
in its form of liquid, or vapor.
I. The Silver test. — A solution of hydrocyanic acid, or of
a cyanide, gives with a solution of nitrate of silver a white
crystalline precipitate, distinguishable from the white chloride,
as follows: (i) By its crystalline characters (prisms or
needles) ; the chloride is amorphous. (2) Its sparing solu-
bility in ammonia; the chloride is very soluble. (3) The
permanence of its color when exposed to the light ; the
chloride becomes dark-colored. (4) Its solubility in boiling
nitric acid ; the chloride is insoluble. (5) When perfectly
dried, and heated in a small reduction-tube, the cyanide of
silver is decomposed, evolving cyanogen gas, which burns
with a characteristic roseate flame. (6) By adding to the
cyanide of silver hydrochlork: acid and persulphate of iron,
Prussian blue will be formed.
18*
402 TOXICOLOGY.
Another mode of identifying the cyanide of silver, re-
commended by Orfila and Tardieu, is, after thoroughly
washing and drying it, to introduce it into a small glass tube,
closed at one end, from five to seven inches long, and con-
taining in its closed extremity a rather less quantity of pure
iodine. On heating this end of the tube very gently, beau-
tiful snow-white crystals of iodide of cyanogen are deposited
upon the cool portion of the tube. These crystals may be
preserved indefinitely in sealed tubes ; and they may be used
for developing Prussian blue, by dissolving them in a solution
of potassa, and adding a mixture of a ferrous and ferric
salt.
The silver test is particularly delicate when applied to the
acid in a state of vapor. For this purpose the material con-
taining the suspected poison is put into a beaker, or wide-
mouthed flask, and a watch glass containing on its concave
surface a drop or two of nitrate of silver solution is inverted
over the mouth of the flask, which should be gently heated
by immersion in warm water. The vapor of the acid im-
mediately rises, and coming in contact with the silver salt,
forms a white, opaque spot of cyanide of silver, which can
easily be recognized by a lens, and by the other tests men-
tioned above. If, however, the material should be in a state
of putrefaction, this vapor-test cannot be applied, since the
black sulphide of silver resulting from the sulphuretted
hydrogen of decomposition, would completely obscure the
white cyanide.
The silver vapor-test is considered to be the most delicate
of all the tests. It is stated that tWoo^ of a grain of the acid
may thus be distinctly recognized. Prof. Guy {For. Med.,
p. 575) mentions that a single apple pip, bruised and mois-
tened with water, and placed in a watch glass, over which
was inverted another glass moistened with the silver solution,
HYDROCYANIC ACID — TESTS. 403
yielded twenty-two distinct reactions — each spot exhibiting,
by the microscope, crystals of cyanide of silver.
2. The Iron test. — This consists in adding to the suspected
solution a little liquor potassae, and then a mixture of ferrous
and ferric sulphates ; a dirty greenish-blue precipitate is
thrown down, which, on addition of a few drops of pure hydro-
chloric acid, becomes clear Prussian blue. If the amount of
the poison be very minute, there is no immediate precipitate,
although the solution has a blue (or at first, perhaps, a
green) color; but in time, a blue precipitate will subside.
In a medico-legal case, where great precision is necessary,
if the quantity is very small, it is recommended to throw
the liquid upon a white paper filter, after adding the hydro-
chloric acid ; the blue deposit on the paper, after washing
with very dilute acid, will show very distinctly upon the
white ground ; the paper when dried may be preserved for
exhibition, if needed.
In manipulating with this test, caution should be used not
to employ an excess of the reagents, as this materially
interferes with the success of the experiment.
The iron test may also be used as a vapor test. Moisten
the watch glass with a drop of potassa solution, and
after exposure to the suspected vapors, add a drop or two
of the mixed iron salts, and develop the Prussian blue by a
drop of dilute hydrochloric acid.
3. The Sulphur test (Liebig's test). — If sulphide of ammo-
nium be added to a solution of hydrocyanic acid, and gently
heated to dryness, a white sulpho-cyanide of ammonium is
formed ; when this is touched with a drop of perchloride,
or persulphate, of iron, there is instantly produced the
blood-red sulpho-cyanide of iron, which is characteristic of
the presence of prussic acid, in the absence of meconic acid
{vid. Opium, p. 337).
404 TOXICOLOGY.
The sulphur test is best applied as a vapor test. Moisten
a watch glass with a drop or two of sulphide of ammonium,
and invert it over the vessel containing the prussic acid,
gently warming the latter, as above directed. The vapor
will rise, and form the sulpho-cyanide of ammonium on the
glass. When this is allowed to dry by evaporation, it
appears as a white spot, and when it is touched with a drop
of the iron salt it immediately assumes the characteristic
blood-red color. If the evaporation should not have been
complete, so as to thoroughly dry it, the application of the
iron salt may produce a black stain (sulphide of iron), which
will obscure the result.
The sulphur test, moreover, may be applied to confirm
the silver test. For this purpose, the spot of cyanide of
silver should be moistened with a drop of sulphide of am-
monium, and, when thoroughly dried, touched with a drop
of the persalt of iron. The characteristic blood-red color
may be distinguished, in spite of the black sulphide with
which it is associated.
4. The Copper test'. — The liquid is first made slightly
alkaline by liquor potassae, and a dilute solution of sulphate
of copper is added ; a greenish-white precipitate is thrown
down, which becomes nearly white on the addition of a
little hydrochloric acid.
This test may be used, also, as a vapor test. The watch
glass is moistened with a drop of the copper solution, made
slightly alkaline, and, after exposure, a drop of dilute hydro-
chloric acid is added.
As regards the relative delicacy of the above tests, experi-
ments show that for the liquid hydrocyanic acid, the iron
and sulphur tests exceed the silver test; but, when in the
form of vapor, the latter far surpasses all the others.
Toxicological examination. — The stomach, together with
PRUSSIC ACID TOXICOLOGICAL EXAMINATION. 405
its contents, and other viscera (having first been carefully
examined for the peculiar odor) should be distilled in a glass
retort, at a moderate temperature, care being first taken to
ascertain if the material is acid or alkaline. Unless distinctly
alkaline, no acid must be added, otherwise it will be impos-
sible to determine whether the prussic acid found in the
distillate was originally present in the free state, or whether
it might not have resulted from the action of the acid used
upon a cyanide, a ferrocyanide, or a sulpho-cyanide, that
might have been present in the material. Therefore, in a
medico-legal case of suspected poisoning by prussic acid,
we deem it very unadvisable to employ any acid in the dis-
tilling process, since, by so doing, the examiner puts it out
of his power to determine whether the poison was really
present in the free state, or whether he may not have actually
manufactured it out of the sulpho-cyanide of potassium,
which is known to exist in human saliva, and which would
be very likely to be present in the stomach of the deceased.
Of course, if cyanide of potassium has been the poison
employed, the contents of the stomach would give an alka-
line reaction, in which case the addition of sulphuric, or
some other acid, would be perfectly proper.
In the celebrated case of Dr. Paul Schceppe, in Carlisle,
Pa., in 1868 and 1872, this was made a capital point by the
defence. The allegation at first had been that the deceased
(a lady of fifty-four years) had been poisoned by prussic
acid. It was afterward contended that the death was due
to a mixture of prussic acid and morphia. The analyst
employed the distillation process, along with sulphuric acid,
and testified to his having only obtained faint traces of
prussic acid by his process. It was very justly contended
by the defence that these " traces " of the poison could
readily be accounted for by the faulty process employed in
4 OB TOXICOLOGY.
the analysis, being, in fact, the result of the action of the
acid upon the sulpho-cyanide of potassium which is often
found in the saliva. Moreover, there was an entire absence
of the characteristic symptoms of the alleged poison before
death. At the second trial, the evidence of the prosecution
completely broke down, and the prisoner was acquitted.
The source of the poison found in the distillate, where an
acid is employed, may be determined by treating a portion
of the original material with a few drops of hydrochloric
acid, stirring the mixture for a short time, and adding the
perchloride of iron. If the liquid contains either a ferro-
cyanide, or a sulpho-cyanide, the former will be indicated
by the formation of Prussian blue, and the latter by the red
sulpho-cyanide of iron ; whereas, a simple cyanide, as cya-
nide of potassium, will not give any reaction under the
circumstances.
As regards the question whether prussic acid can be
generated spontaneously, by the distillation of putrescent
animal matters, although Orfila appears to have inclined to
this belief, it is not held by later authorities. Still, we are
of the opinion that, in an important medico-legal case, in-
volving the life of the accused, something more should be
insisted on as proof of poisoning than the finding of "mere
traces " of prussic acid, since these might possibly be the
result of some spontaneous animal decomposition, brought
about under conditions not yet perfectly understood. Espe-
cially should this be insisted on, where the symptoms pre-
ceding death did not agree with those characteristic of the
alleged poison {vid. t Ptomaine \r, post).
Period after death when the poison may be found. — On
account of its volatility and ready decomposition, all traces
of prussic acid may disappear very shortly after death. The
most skillful analysts have failed to discover it in twenty-six
POISONING BY CYANIDE OF POTASSIUM. 407
hours after death, in some cases; whilst in others it has
been detected as late as twenty-three days after.
The mere fact of putrefaction is no obstacle to its detec-
tion, although in such a case it will not be discoverable,
either by distillation, or by the vapor tests. It would have
all been converted into sulpho-cyanide of ammonium by
the sulphide of ammonium resulting from the putrefaction.
In such a case, the material should be rendered slightly
alkaline, and then acted on by alcohol, which dissolves the
sulpho-cyanide ; filter, and evaporate to dryness ; dissolve
the residue in water, and test by a persalt of iron.
Quantitative determination. — Free hydrocyanic acid is
precipitated 'by nitrate of silver ; the resulting cyanide is
washed, dried, and weighed. Every ioo parts represent
20.15 parts of anhydrous acid.
Cyanide of Potassium. — This salt is very much employed
in photography and electrotyping, and is a frequent source
of poisoning to artisans engaged in the above employments.
It is a powerful poison, causing death in doses under five
grains.
It is a white, deliquescent salt, very soluble in water, less
so in alcohol, the solution giving off the prussic odor; it
has an alkaline reaction.
The symptoms, post-mortem lesions and treatment are
similar to those described under Hydrocyanic Acid.
Chemical analysis. — i. It is decomposed by all acids, set-
ting prussic acid free, which is readily recognized. 2. It
gives, with nitrate of silver, the white cyanide of silver.
3. The potash is precipitated by tartaric acid, and bichloride
of platinum. 4. The iron and copper tests may be used, as
for prussic acid, but withotit the liquor potassae.
In organic mixtures, the prussic acid may be obtained by
408 TOXICOLOGY.
neutralizing with sulphuric acid, and distilling at a low
temperature.
Oil of Bitter Almonds. — This does not pre-exist in
the bitter almond, but results from the reaction of water
upon its amygdalin and emulsin. It is obtained by distilla-
tion of bitter almonds, reduced to a pulp, along with water.
It contains a variable proportion — seven to fourteen per
cent. — of anhydrous prussic acid, together with hydrate of
benzole, benzoin and benzoic acid. When entirely freed
from prussic acid, the oil is innocuous.
Properties. — It has a light yellow color, pungent, prussic
odor, and a bitter, aromatic, pungent taste. It is heavier
than water, in which it is but slightly soluble; soluble in
alcohol and ether. It is highly poisonous. The liquid sold
as essence of bitter almonds is a solution of this oil in alcohol ;
it is a very dangerous substance for domestic use.
The symptoms, post-mortem lesions and treatment are the
same as those described under the head of Hydrocyanic Acid.
The fatal dose is about twenty drops.
Cherry-Lacrel Water, obtained by distilling the leaves
of the cherry-laurel (Prunus-lauro cerasus) contains a por-
tion of an essential oil similar to the oil of bitter almonds.
It o\Yes its poisonous properties, like the latter, to the
prussic acid contained. Cherry-laurel water has occasion-
ally proved fatal. It is specially identified with the cele-
brated Donallen case, who poisoned his brother-in law, Sir
Theodosius Broughton, in 1782.
The kernels of the peach, apricot and cherry have all
proved poisonous, especially to children who have swal-
lowed them. The symptoms are very similar to those pro-
duced by a moderate dose of prussic acid.
POISONING BY DIGITALIS. 409
Nitro-Benzole, or Essence of Mirbane. — This substance
is the product of the action of nitrous acid on benzole. It
is a pale yellow liquid, with a strong odor of bitter almonds.
It is used in perfumery and confectionery as a cheap substi-
tute for the oil of bitter almonds. It is a powerful narcotic,
producing effects resembling those of prussic acid, although
much slower in its operation, requiring four or five hours
before death occurs, which is usually preceded by coma, as
in apoplexy. This poison operates more rapidly and power-
fully when inhaled in the form of vapor.
In a fatal case it may be generally identified by its strong
odor.
Chemical analysis. — It is distinguished from the oil of
bitter almonds, which it so closely resembles in smell, by
pouring a few drops of each upon a plate and adding a drop
of strong sulphuric acid ; the oil of bitter almonds acquires
a rich crimson color, with a yellow border, while the nitro-
benzole is not affected. It gives none of the reactions of
hydrocyanic acid with the usual tests of this acid.
When associated with organic substances, as the stomach,
etc., it may be separated by first adding sulphuric acid, and
distilling.
SECTION II.
POISONING BY DIGITALIS.- DIGITALINE.
SYMPTOMS. — POST-MORTEM LESIONS. — FATAL DOSE. — DIGITALINE. —
CHEMICAL ANALYSIS. — TOXICOLOGICAL EXAMINATION. — CASE OF
DE LA FOMERAIS.
The purple Foxglove {Digitalis purpurea} is a native of
Europe, but cultivated in our gardens. All parts of the
plant contain the poisonous, active principle, digit aline,
which, however, abounds most in the leaves of the second
year's growth.
410 TOXICOLOGY.
Symptoms. — Cases of digitalis poisoning are comparatively-
rare. Until recently, its action was generally regarded as a
direct cardiac depressant, reducing both the force and fre-
quency of the heart's action. Modern therapeutists are dis-
posed to consider it as a direct heart stimulant, asserting
that, while the pulsations of the heart are diminished in fre-
quency, they are increased in power.
The poisonous impressions in man are nausea and vomit-
ing, purging, with severe abdominal pains, a sense of heat
in the head, vertigo and disordered vision, dilated pupils, the
pulse full and slow in the horizontal position, but rapid and
feeble on sitting up. Prostration then comes on, with a ten-
dency to syncope ; the eyes very prominent and 'fixed, the
sclerotic coat acquiring, according to Tardieu, a peculiar,
characteristic blue color. Sometimes there is salivation and
suppression of urine ; delirium, stupor and convulsions
are apt to occur just before death, which does not, as a rule,
occur within twenty-four hours. Tardieu mentions a case
who died in three-quarters of an hour after swallowing, by
mistake, a very large dose.
Digitalis is a cumulative poison, showing a tendency to
break out with great violence after taking a number of
moderate doses. The most diagnostic sign of the action of
digitalis is the peculiar enfeebled, intermittent pulse, which
varies so notably between the supine and the erect position
of the patient.
Post-mortem appearances. — Nothing very characteristic.
Turgescence of the vessels at the base of the brain, together
with redness of the lining membrane of the stomach.
Fatal dose. — Not accurately settled. As much as a drachm
of the powder, and half a fluid ounce of the tincture, have
been taken with impunity ; but a far less quantity has pro-
duced decided effects on the heart's action. The usual dose
POISONING BY DIGITALINE TESTS. 411
is one to two grains of the powder, and ten drops of the
tincture, to be repeated.
Digitaline. — A neutral principle, generally occurring as
an amorphous powder, of a pale yellowish color ; sometimes
in the crystalline state. There seems to be much diversity
of opinion concerning the percentage of digitaline in the
leaves ; some authorities giving it at about ten per cent.,
whilst Blaquart asserts that there are ten to twelve per cent,
of the crystodlizable variety.
There seems to be a true antagonism between digitaline
and aconitine. It is stated that when the heart of the frog
has almost ceased to beat, under the influence of digitalis,
its movements are restored by aconitine ; and a case is re-
ported {Brit. Med. Jour., Dec, 1872) of recovery after the
ingestion of an ounce of Fleming's tincture of aconite, ap-
parently due to the hypodermic injection of twenty minims
of tincture of digitalis, and the exhibition by the mouth of
three doses of one drachm each, within an hour, together
with brandy and ammonia (//. C. Wood's Tlierap., p. 125).
As yet, no case of digitalis-poisoning in man has been re-
corded, in which the antidotal virtues of aconitine have been
tested.
Chemical analysis. — Both the amorphous and crystalline
varieties have a very bitter taste ; very sparingly soluble in
water, also in pure ether ; but very soluble in ether con-
taining alcohol. Chloroform is its best solvent. It has no
alkaline reaction. Cold sulphuric acid imparts to it a
brownish color, which gradually changes to a red. If
warmed, the color passes to a brown. If to the cold brown
solution an excess of water be added, the color changes to
a green, depositing a green powder, and the liquid gradually
assumes a yellowish tint(Tardieu). Strong nitric acid dis-
solves it with effervescence, giving off red fumes and
412 TOXICOLOGY.
imparting an orange-red color, which gradually becomes
fainter. Hydrochloric acid imparts to it a light-greenish
tint. It is stated that if the brown sulphuric acid solution
be exposed to bromine vapor, it assumes a violet hue, but
Tardieu denies that this test is at all characteristic.
Toxicological examination. — In a suspected case the ex-
aminer should first carefully search for remnants of the
powdered leaves in the matters vomited, and in the ali-
mentary canal. If the tincture has been swallowed, the
interior of the stomach might present a greenish color and
emit a suggestive odor. If digitaline granules have been
taken, a careful post-mortem inspection might possibly reveal
the presence of some of them remaining in the stomach.
The viscera, properly comminuted, should first be heated
on a water-bath, with strong alcohol, for a considerable time.
After cooling and straining, and proper concentration by
evaporation, part of the extract may be used as a trial test
on a small animal. The rest of it should be further purified
by another solution in alcohol, filtration and evaporation,
and the physiological test again repeated.
All authorities unite in saying that, in a medico-legal
case, it is impossible to determine the existence of the
poison by any chemical tests, neither by the post-mortem
lesions ; our reliance must be solely on the physiological
test — injecting hypodermically some of the ultimate extract
into a small animal, as the frog. It seems well established,
by numerous experiments, that death takes place by a
sudden cessation of the heart's action, with a decided
rigidity of the ventricles at the moment of death. In frogs,
this stoppage occurs always in the state of strong systole of
the ventricle.
By observing, then, the action of the suspected poison,
introduced under the skin of the frog, the gradual irregu-
POISONING BY COCCULUS INDICUS. 413
larity and slowness of the heart-beats, together with the
manner of its final stop, and experimenting at the same
time, with digitaline itself, upon another animal, we may be
able to arrive at a satisfactory conclusion.
The most noted, if not the only, instance of homicidal
poisoning by digitaline is that of de la Pomerais, a homceo-
pathic practitioner of France, who was tried and convicted
for killing his former mistress, after having insured her life
in various offices for his own benefit. After one of his
visits to her she died, after suffering from violent vomiting
and great depression of the heart's action and debility, in
twenty-four hours. Her body was examined thirteen days
after death, suspicion having been aroused against the
prisoner. The examiners, Tardieu and Roussin, failing to
discover any poison by chemical research, resorted to the
above-mentioned physiological test, employing the extract
obtained from the stomach and bowels and one procured
from the scrapings of the floor on which the deceased had
vomited, which responded also to all the known chemical
reactions. A strong circumstantial evidence of the guilt of
the accused was the finding in his possession an unusually
large amount of digitaline — a substance that had only lately
been discovered, besides a number of other deadly poisons.
In short, he had the motive, the means and the opportunity
for accomplishing his purpose. He was condemned and
executed (Tardieu, Sur /' Empoison., p. 694).
Poisoning by Cocculus Indicus. — Cocculus Indicus
{Levant nut) is the fruit of the Anamirta cocculus, a tree
growing in the East Indies. The kernel of the berry is the
only poisonous part. It has an intensely bitter taste, and
contains a highly poisonous principle called Picrotoxine. It
is chiefly employed as a fish poison, and also in Great
414 TOXICOLOGY.
Britain for the malicious destruction of game. It is also
popularly believed to be used for adulterating malt liquors,
by imparting to them a bitter flavor, with a diminished
amount of hops and malt. It is also used for the destruc-
tion of vermin.
The symptoms are somewhat singular, indicating an action
on the cerebro-spinal centres. There is loss of voluntary
power, but not of consciousness, the sufferer lying in a sort
of nightmare. There may also be nausea, vomiting and
severe abdominal pains. The late Dr. Fish, of Philadelphia,
reported several cases of accidental poisoning by a decoction
of this substance, of six persons in the Philadelphia Hos-
pital. Two of these died in about half an hour. The
remaining four were seized with violent symptoms within
half an hour after swallowing the poison, and recovered
after several hours. Their symptoms were faintness, con-
fusion of mind, giddiness, dimness of vision, nausea, ex-
cessive thirst, severe abdominal pain, and in one case,
insensibility. The pulse was much weakened and the
respiration slow and labored.
The external application has been followed by violent and
even fatal effects.
Picrotoxine, or picrotoxia is generally regarded as an alka-
loid. It constitutes about one per cent, of the kernel. It
crystallizes in colorless, silken, slender, six-sided prisms.
Sparingly soluble in water, very soluble in alcohol, ether,
chloroform and amylic alcohol. Cold sulphuric acid does
not affect it ; the hot acid imparts to it an orange-yellow
color, which becomes pale on cooling. Strong nitric and
hydrochloric acid do not affect it. It acts like grape sugar
when boiled with sulphate of copper and potassa, and is said
to belong to the glucosides.
It may be separated from organic liquids, such as beer,
POISONING BY CYTISINE, ETC. 415
or ale, by first acidulating with hydrochloric acid, and then
shaking up with ether, which holds the poison in solution,
and deposits it in crystals. By this same means it may be
separated from the stomach, in case of poisoning.
There are several other vegetable poisons of minor im-
portance; among them may be mentioned the bark and
seeds of the Laburnum {Cytisus laburnum), a very common
tree or shrub of Great Britain. It contains an active poi-
sonous principle, cytisine, whose effects are those of an
irritant narcotic. Death has frequently resulted from taking
both the bark and seeds of this plant.
The leaves and berries of the Yew (Taxus baccatd) act
powerfully as an acrid, irritant narcotic, even in small quan-
tities. So, likewise, do the Privet (Ligistrum vulgare) ; the
Guelder Rose {Viburnum opulus); and the Holly {Ilex
aquifoliuni).
416 TOXICOLOGY.
CHAPTER XXXI.
THE ALKALOIDS OF PUTREFACTION— PTOMAINES.
Within the past few years the attention of toxicologists
has been called to the existence of a certain class of bodies,
to which Selmi has given the name of Ptomaines, resulting
from the decay of organic substances — chiefly animal.
These bodies strongly resemble the vegetable alkaloids in
their chemical and physiological actions. Some of them are
very poisonous, some are inert, and others again seem to act
antagonistically to certain poisonous alkaloids.
There is, as yet, considerable uncertainty and vagueness
about these bodies, so that we are not qualified to speak
positively concerning them. It has long been known that
putrescent meat will occasion severe, and sometimes fatal
symptoms in persons who partake of it. These symptoms
are of a narcotic-irritant character, and strongly resemble
those produced by certain familiar poisons. Similar effects
are also known to occasionally result from cheese, sausages
and certain shell-fish, particularly from mussels {yid. ante,
p. 328); and, in some instances, from canned vegetables.
These anomalous symptoms have been attributed to various
causes, but hitherto no very satisfactory explanation of them
has ever been offered. If the existence of the cadaveric
alkaloids, or ptomaines, should be positively demonstrated,
the natural inference would then be that these were the true
cause of the morbific symptoms above alluded to.
It has been further stated that decomposed maize con-
tains a poisonous alkaloidal principle, which is capable of
producing tetanic symptoms, and which are sometimes
PTOMAINES. 417
attended with narcosis ; and Ranke contends that the
proper physiological action of the impure strychnia ex-
tracted from a putrefied body, may be masked by ptomaines.
If this observation is correct, the fact may serve as a very
plausible explanation of the occasional failure to discover
strychnia and other alkaloids in a putrescent body. A con-
venient process for obtaining these bodies, according to H.
Maas (Am. Jour. Med. Sci., July, 1884, from Gaz. Hebdom),
is to treat the putrefied mass with alcohol and acetic acid
for several days; filter, and repeat the process. Reduce
the alcoholic extract on a water-bath, and concentrate the
aqueous extract to a syrup. This may be employed for
experimentation on animals. By treating this acid solution
with ether, or amylic alcohol, or chloroform (first adding
soda), several different alkaloids have been separated, which
exhibit different physiological effects on frogs — one acting
like morphia, another like strychnia, and a third paralyzing
the heart and decomposing the blood.
Some ptomaines strongly resemble, in their properties
and effects, the alkaloid aconitine ; others act very similarly
to veratrum, morphia and codeia; and they might easily be
confounded with them in a medico-legal investigation.
Methods of discriminating between them have, however,
been devised, in the use of potassium ferricyanide and
silver bromide, as reagents, the former being reduced to the
ferrocyanide in the presence of a ptomaine ; while no such
reduction occurs if an alkaloid is present. Selmi and others
have succeeded in extracting poisonous bases from the urine
of patients suffering from tetanus, progressive paralysis and
miliary fever; one of these resembled nicotina in its general
character, showing a special tendency to act upon the spinal
marrow and heart ; the other base resembled conia in odor.
Still later researches go to prove that animal fluids, such
!9
418 TOXICOLOGY.
as fresh blood and albumen, before undergoing putrefactio
give precisely similar reactions, with the reagents employe
to those that are afforded by these same reagents wit
ptomaines extracted from a dead animal body.
It will be inferred from all that has been stated about tl
so-called ptomaines, that the whole matter may be regarde
as being still sub judice ; and in the language of Dr. Stevei
son (from whose article in Taylor s Prin. and Prac. of Me,
Jurisp., 1883, much of the above is taken), " the existence <
poisonous cadaveric alkaloids in human viscera, even whe
putrid and diseased, is, to say the least, very rare." Neve
theless, it cannot be doubted that their alleged existence wi
be constantly employed by counsel in defending a crimin,
charged with poisoning with one of the vegetable alkaloid. 1
urging strongly before the jury the possibility that tl
alleged poisonous alkaloid was in reality one of these spoi
taneously generated ptomaines. Such a course is stated t
have been actually taken at the late Lamson trial, whic
occurred in London, in 1883.
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