Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/59

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cause of death. For death may have arisen from a totally different cause, such as poisoning. This remark is not, as some may imagine, the offspring of hypothetical refinement, but a necessary caution, drawn from actual and not unfrequent occurrences. Thus, for example, the following cases will show, that there may be found in the dead body diseased appearances, arising from pleurisy, hydrothorax, or peripneumony, sufficient to cause death, or to account for death in ordinary circumstances; and that nevertheless the disease may have been completely latent, and death have arisen from poison. In Rust's Magazin is related the case of a German apothecary, who poisoned himself with prussic acid, and in whose body the lower lobe of the left lung was found consolidated and partly cartilaginous.[1] In Corvisart's Journal an army-surgeon has described the case of a soldier, who died of a few hours' illness, and whose right lung was found after death forming one entire abscess; yet to the very last day of his existence he daily underwent all the fatigues of a military life; and in fact he died of poisoning with hemlock.[2] In Pyl's Memoirs and Observations, there is a similar account of a woman who enjoyed tolerable health, and died during a fit of excessive drinking, and in whose body the whole left lung was found one mass of suppuration.[3] Under the next section will be mentioned other equally pointed cases of death by poison, where the apparent cause of death was external violence.

The conclusions to be drawn from these facts are that, at all events, the medical inspector in a question of poisoning, must take care not to be hurried away by the first striking appearances of natural disease which he may observe, and so be induced to conduct the rest of the inspection superficially; and likewise, that he should not so frame his opinion on the case, as to exclude the possibility of a different cause from the apparent one, unless the appearances are such as must necessarily have been the cause of death. It may be said, that in requiring this condition for an unqualified opinion, a rigour of demonstration is exacted, which can rarely be attained in practice. But, on the one hand, it must not be forgotten, that an unqualified opinion is not always necessary; and on the other hand, although it were, I think it might be shown, if the subject did not lead to disproportionate details, that we may often approach very near the rigour of demonstration required. At present no more need be said, than that the inspector should be particularly on his guard in those cases, in which the appearances, though belonging to the effects of a deadly disease, are trifling; and still more in those in which the appearances, though great, belong to the effects of a disease, whose whole course may be latent. And I may add, that, from what I have observed of medico-legal opinions, the caution now given is strongly called for.

It may be right to allude here also to another purpose which may

  1. Magazin für die gesammte Heilkunde, xiv. 104.
  2. Journal de Médecine, xxix. 107.
  3. Aufsätze und Beobachtungen aus der gerichtlichen Arzneiwissenchaft, v. 103.