the other hand, which is of more consequence, the symptoms on which so important an opinion is founded, must be strongly marked and well ascertained by a competent person. The signs of irritation in the mucous membranes must be really general and unequivocal; and those of a disorder of the nervous system must be likewise developed characteristically. Care must be taken in particular to distinguish symptoms of the latter class from others which approach to them in nature, and are the ordinary sequels of natural disease: for example, the true palsy caused by arsenic must not be confounded with the numbness and racking pains in the limbs, which occasionally succeed cholera.
With these precautions the evidence from symptoms may in certain cases be decisive of the question of poisoning with arsenic. And it is of moment to observe, as has been already hinted, that, although such cases are numerous, they are precisely of the kind in which it is most essential to the ends of justice that the symptoms should, if possible, supply evidence enough to direct the judgment; for the characteristic symptoms referred to occur chiefly when the patient either recovers or survives many days, and where consequently the chemical evidence, usually procured from the examination of the contents of the stomach, is almost always wanting.
Section III.—Of the Morbid Appearances caused by Arsenic.
The morbid appearances caused by arsenic will next require some details. In treating of them the same plan will be pursued as in the preceding section: the various morbid appearances left by it will first be mentioned in their order; and the subject will then be wound up with some remarks on the force of the evidence from these appearances, as they are usually combined in actual cases.
In the first instance, there are some cases in which little or no morbid appearance is to be seen at all. These all belong to the second variety of poisoning, which is characterized by the absence of local imflammation, and the presence of symptoms indicating an action on the heart, or some other remote organ. In such circumstances death takes place before a sufficient interval has elapsed for inflammation to be developed.
Several examples of the absence of diseased appearances in the dead body are to be found in authors. Thus in Chaussier's case formerly quoted (p. 243), in that related by Metzger (p. 242), in another related by Etmuller, which was fatal in twelve hours,[1] and in a fourth related by Professor Wagner of Berlin, where life was also prolonged for twelve hours under incessant vomiting,[2] there was positively no morbid alteration at all. Such was also the state of the whole alimentary canal in the extraordinary case related by Orfila (p. 243). In the case quoted from the Medical and Physical Journal (p. 242), there was merely a slight redness at the pyloric end of the
