and vomiting recurring in frequent fits, and in seventeen hours with extreme tenderness, tension of the muscles, coldness of the skin, and failure of the pulse. She expired in twenty-four hours; and after death the hepatic duct was found torn across, a gall-stone lay at the opening of the cystic duct, the peritonæum was here and there inflamed, and three pounds of blood and bile were effused into the cavity of the abdomen.[1]—The nature of such cases will be always apparent on dissection, but by no means always from the symptoms.
In like manner rupture of the uterus or its appendages may in certain circumstances occasion similar symptoms, and so be mistaken for the operation of poison. A striking example of the kind once came under my notice. A middle-aged woman much addicted to drinking, and on that account living on indifferent terms with her husband, was suddenly seized at two in the afternoon with pain in the belly, afterwards with vomiting and purging, then with extreme exhaustion and coldness of the extremities; and at ten in the evening she expired. A suspicion of poisoning having arisen in the neighbourhood, a judicial inspection was ordered by the sheriff of Linlithgowshire, where the case happened; and the examination was entrusted to her medical attendant, Mr. Robertson, and myself. On inquiry, it was found that she had taken nothing whatever after breakfasting at eight in the morning, six hours before; and farther, that the pain had begun violently in the lower part of the belly. These two circumstances alone were almost, if not altogether, incompatible with the idea of irritant poisoning having been the occasion of death. But all doubt was completely removed by the inspection of the body; for the lower part of the belly was filled with a great quantity of clotted blood, which had proceeded from the rupture of a Fallopian conception.
5. The next accident which may be noticed on account of its being liable to be mistaken for the effects of poison is sudden death from drinking cold water.
In Britain the most common form of death from this cause appears to have been instant death, arising from the impression on the stomach. It is not an uncommon thing for people to drop down instantaneously and die on the spot, in consequence of drinking freely of cold water or other fluids while over-heated.[2] There is an interesting report on a case of this kind by Pyl in his Memoirs and Observations. The individual had been quarrelling with a companion, and in the height of a fit of violent passion swallowed a glass of beer; when he dropped down senseless and motionless, and died immediately. His wife suspecting the administration of poison, demanded a judicial inquiry; but nothing was found in the body to account for death. Pyl therefore came to the conclusion that the man died from the sudden impression caused by the cold beer.[3] Dr. Currie, after quoting several instances of the like kind, relates the following remarkable case which
