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Medical Jurisprudence

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715 they cannot give a decided opinion, however unsettled the question. From such inflictions the other two learned profes- sions are usually exempted. Impartial observers must acknow- ledge that sometimes medical practitioners are treated with great injustice, and without due allowance being made for their frequently difficult, and hence, very unenviable positions. Science having of late accomplished great discoveries, and overthrown many a long-cherished theory, it now becomes necessary to speak with more reserve on various subjects than formerly. Seeing, for example, that DE VILLE has ex- tracted aluminium from clay or its products ; and that HOFFMAN, by means of mercury, procures, from volatile am- monia the metal ammonium, in a semi-solid amalgam resembling butter in tenacity, with a strong metallic lustre, who can say what may not yet be discovered ? If chemistry can thus obtain solid metals from soft and liquid substances, it seems not impossible that other processes shall so alter animal and ve- getable compounds, if not even metalloids, that their original combinations may altogether disappear, and new products be the consequences. Such phenomena are not beyond the sphere of probability; and, therefore, before condemning scientific men for any discrepancies of opinion which prevail, in regard to various important questions, contingencies like these should never be overlooked. If medical men-truly cultivators of the progressive sciences-could always appeal to maxims as immutable as many orthodox dogmas, or to numerous legal precedents which for ages have been unchanged, like the laws of the Medes and Persians, then would fewer contradictory assertions be promulgated, less uncertainty prevail, and sel- domer unmerited obloquy be cast upon medical testimony. Medical Jurisprudence. INQUESTS AND MEDICAL TRIALS. DEATHS FROM POISONOUS VEGETABLES. 1. ACCIDENTAL POISONING BY THE LEAVES OF MONKSHOOD (Aconitum, Napellus). IN TnE LANCET for 1855, vol. i., p. 467, we recorded a case of fatal poisoning by the tincture of aconite: the following is an instance in which death was occasioned by the ingestion of a portion of the plant itself. H. A. M-, a child two years and seven months of age, and who had resided with his parents at Isleworth, became the subject of an inquest there on May 17th, 1854. A neighbour living in the next cottage deposed that on the Friday previous, about five o’clock in the afternoon, she was sent for, and found the child in his mother’s arms, apparently in great agony, and very sick, vomiting much "phlegm." Dr. Mackinlay, of Isle- worth, was sent for about half-past five, and his assistant, Mr. Cocksedge, was shortly afterwards in attendance. He found the child retching violently, and suffering intense pain in the stomach. The pupil was at this time found to be contracted. Having discovered stalks and leaves of aconite strewed about in front of the cottage, Mr. Cocksedge suspected that some portion of this plant had been eaten, and administered an emetic of mustard, which brought away the dinner that had been taken by the child, together with some green vegetable matter-pieces of leaves. Fearing to augment the inflamma- tion of the stomach and intestines, which evidently existed, by any repetition of the mustard emetic, Mr. Cocksedge now made the patient take a demulcent, composed of white of egg and gum arabic, with a view to sheathe and involve the poison- ous matter, if more still remained in the stomach. Mustard poultices were applied to the abdomen. The child continued to roll about on a bed, screaming with pain for some time; and the vomiting persisted till eleven o’clock at night, after which collapse set in, the limbs became flaccid, and patchy spots and discolorations were observed upon them. On the next morning, when the surgeon again saw the child, he was almost comatose; brandy failed to revive him; and he died shortly after nine o’clock in the same forenoon. Whilst sensible, the child acknowledged that he had eaten the leaves of some plants in the garden, and it was afterwards clearly discovered what these leaves were. The father, in his evidence, stated that the child had become fretful about three o’clock in the afternoon of Friday, and that he remained so for about an hour, when some warm tea was given to him, after which he became rapidly ill and the vomiting commenced. He denied that the child had been out of the house after having had his dinner at one o’clock; so that the death probably occurred from twenty to twenty-one hours after taking the poison. The quantity of the leaves which had been eaten could not be ascertained. At the post-mortem examination, sixty hours after death, the abdomen was found externally much discoloured; patchy discolorations were also visible on the thighs and legs, but the spots there were not so apparent as during life. The sto- mach was found highly inflamed throughout its whole extent; it contained a little fluid of a lightish-brown colour, but no food, nor any traces of leaves or other vegetable matter. In various parts of the small intestines were patches of intense inflammation, in some places approaching to gangrene. The large intestines presented nothing particular. The bladder was full of urine; the spleen somewhat congested. The peri- cardium contained about half an ounce of bloody serum. The heart was full of uncoagulated blood, and all the blood through- out the body was thin and fluid. These were the principal appearances worthy of remark. In the last edition of Thomson’s " Dispensatory" it is alleged. in reference to poisoning by aconite, that "dissections of fatal cases have not displayed any particular marks of inflammatory action." In the case just detailed, however, no doubt existed that the death had been occasioned, by the leaves of aconite, and such appearances were extensively manifested. II. ACCIDENTAL POISONING BY THE BERRIES OF WOODY NIGHTSHADE (Solanum Dulcamara). J. J. C-, a little boy four years of age, and living with his parents in the immediate neighbourhood of the metropolis, on the afternoon of September 12th, 1853, went out to play with some other children, amongst whom were his two sisters, respectively two and four years older than himself. About five o’clock he had some tea and bread and butter, and in the course of the evening he ate a ripe pear which was given him by a relative. About half-past eight he had some more bread and butter. He went to bed perfectly well, and remained un- disturbed in health during the night. At length, about six o’clock next morning, he was attacked with purging and vomiting, and subsequently with convulsions, upon which medical assistance was sought by the parents. Mr. Ede, of Barnsbury Park, Islington, attended. He found that the child had been already placed in a warm bath, and that the convulsions had at the time of his visit (eleven o’clock) sub- sided ; but they returned, and continued at intervals during ’ the day, leaving the child between the access of the fits coma- tose and insensible. Vomiting of dark-greenish and bilious matters persisted; and about seven o’clock in the evening the child was attacked with convulsions, which remained perma- nent until his death, shortly after eleven o’clock the same night, September 13th. During the day, a mustard poultice was placed over the abdomen; but the nature of the case was quite obscure to the medical practitioner. He could only sus- pect that some injurious vegetable or other substance had been eaten, from the fact that the sister of the child next older than himself had also been sick and purged; from which condition. however, she recovered without more serious enects. On the day after the death, it was ascertained from the other children that whilst at play they had plucked and eaten some red and black berries growing in a hedge; that the deceased was known to have eaten two and his next sister one of the red berries; the eldest sister had eaten two, but she escaped without any ill consequences. It was thought that the deceased child might very probably have swallowed more than two of the berries, but this could not be determined; the matters ejected from the body were not sufficiently scrutinised to throw any light on the subject. A twig of the plant from which the children stated the berries had been plucked was produced in the inquest-room: it proved to be the solanum dulcamara, or woody nightshade, and no doubt existed that the child had met his death from eating the berries of that plant.
Transcript

715

they cannot give a decided opinion, however unsettled thequestion. From such inflictions the other two learned profes-sions are usually exempted. Impartial observers must acknow-ledge that sometimes medical practitioners are treated withgreat injustice, and without due allowance being made for

their frequently difficult, and hence, very unenviable positions.Science having of late accomplished great discoveries, and

overthrown many a long-cherished theory, it now becomes

necessary to speak with more reserve on various subjectsthan formerly. Seeing, for example, that DE VILLE has ex-tracted aluminium from clay or its products ; and that

HOFFMAN, by means of mercury, procures, from volatile am-monia the metal ammonium, in a semi-solid amalgam resemblingbutter in tenacity, with a strong metallic lustre, who can saywhat may not yet be discovered ? If chemistry can thus obtainsolid metals from soft and liquid substances, it seems not

impossible that other processes shall so alter animal and ve-

getable compounds, if not even metalloids, that their originalcombinations may altogether disappear, and new products bethe consequences. Such phenomena are not beyond the sphereof probability; and, therefore, before condemning scientificmen for any discrepancies of opinion which prevail, in regardto various important questions, contingencies like these

should never be overlooked. If medical men-truly cultivatorsof the progressive sciences-could always appeal to maximsas immutable as many orthodox dogmas, or to numerous legalprecedents which for ages have been unchanged, like the lawsof the Medes and Persians, then would fewer contradictoryassertions be promulgated, less uncertainty prevail, and sel-domer unmerited obloquy be cast upon medical testimony.

Medical Jurisprudence.INQUESTS AND MEDICAL TRIALS.

DEATHS FROM POISONOUS VEGETABLES.

1. ACCIDENTAL POISONING BY THE LEAVES OF MONKSHOOD

(Aconitum, Napellus).IN TnE LANCET for 1855, vol. i., p. 467, we recorded a case of

fatal poisoning by the tincture of aconite: the following is aninstance in which death was occasioned by the ingestion of aportion of the plant itself.H. A. M-, a child two years and seven months of age,

and who had resided with his parents at Isleworth, became thesubject of an inquest there on May 17th, 1854. A neighbourliving in the next cottage deposed that on the Friday previous,about five o’clock in the afternoon, she was sent for, and foundthe child in his mother’s arms, apparently in great agony, andvery sick, vomiting much "phlegm." Dr. Mackinlay, of Isle-worth, was sent for about half-past five, and his assistant, Mr.Cocksedge, was shortly afterwards in attendance. He foundthe child retching violently, and suffering intense pain in thestomach. The pupil was at this time found to be contracted.Having discovered stalks and leaves of aconite strewed aboutin front of the cottage, Mr. Cocksedge suspected that someportion of this plant had been eaten, and administered anemetic of mustard, which brought away the dinner that hadbeen taken by the child, together with some green vegetablematter-pieces of leaves. Fearing to augment the inflamma-tion of the stomach and intestines, which evidently existed, byany repetition of the mustard emetic, Mr. Cocksedge nowmade the patient take a demulcent, composed of white of eggand gum arabic, with a view to sheathe and involve the poison-ous matter, if more still remained in the stomach. Mustardpoultices were applied to the abdomen. The child continuedto roll about on a bed, screaming with pain for some time;and the vomiting persisted till eleven o’clock at night, afterwhich collapse set in, the limbs became flaccid, and patchyspots and discolorations were observed upon them. On the next

morning, when the surgeon again saw the child, he was almostcomatose; brandy failed to revive him; and he died shortlyafter nine o’clock in the same forenoon. Whilst sensible, thechild acknowledged that he had eaten the leaves of someplants in the garden, and it was afterwards clearly discoveredwhat these leaves were. The father, in his evidence, statedthat the child had become fretful about three o’clock in theafternoon of Friday, and that he remained so for about anhour, when some warm tea was given to him, after which hebecame rapidly ill and the vomiting commenced. He deniedthat the child had been out of the house after having had hisdinner at one o’clock; so that the death probably occurredfrom twenty to twenty-one hours after taking the poison. Thequantity of the leaves which had been eaten could not beascertained.At the post-mortem examination, sixty hours after death,

the abdomen was found externally much discoloured; patchydiscolorations were also visible on the thighs and legs, butthe spots there were not so apparent as during life. The sto-mach was found highly inflamed throughout its whole extent;it contained a little fluid of a lightish-brown colour, but nofood, nor any traces of leaves or other vegetable matter. Invarious parts of the small intestines were patches of intenseinflammation, in some places approaching to gangrene. The

large intestines presented nothing particular. The bladderwas full of urine; the spleen somewhat congested. The peri-cardium contained about half an ounce of bloody serum. Theheart was full of uncoagulated blood, and all the blood through-out the body was thin and fluid. These were the principalappearances worthy of remark.In the last edition of Thomson’s " Dispensatory" it is alleged.

in reference to poisoning by aconite, that "dissections of fatalcases have not displayed any particular marks of inflammatoryaction." In the case just detailed, however, no doubt existedthat the death had been occasioned, by the leaves of aconite,and such appearances were extensively manifested.

II. ACCIDENTAL POISONING BY THE BERRIES OF WOODY

NIGHTSHADE

(Solanum Dulcamara).J. J. C-, a little boy four years of age, and living with

his parents in the immediate neighbourhood of the metropolis,on the afternoon of September 12th, 1853, went out to playwith some other children, amongst whom were his two sisters,respectively two and four years older than himself. Aboutfive o’clock he had some tea and bread and butter, and in thecourse of the evening he ate a ripe pear which was given himby a relative. About half-past eight he had some more breadand butter. He went to bed perfectly well, and remained un-disturbed in health during the night. At length, about sixo’clock next morning, he was attacked with purging andvomiting, and subsequently with convulsions, upon whichmedical assistance was sought by the parents. Mr. Ede, ofBarnsbury Park, Islington, attended. He found that thechild had been already placed in a warm bath, and that theconvulsions had at the time of his visit (eleven o’clock) sub-sided ; but they returned, and continued at intervals during

’ the day, leaving the child between the access of the fits coma-tose and insensible. Vomiting of dark-greenish and biliousmatters persisted; and about seven o’clock in the evening thechild was attacked with convulsions, which remained perma-nent until his death, shortly after eleven o’clock the samenight, September 13th. During the day, a mustard poulticewas placed over the abdomen; but the nature of the case wasquite obscure to the medical practitioner. He could only sus-pect that some injurious vegetable or other substance had beeneaten, from the fact that the sister of the child next older thanhimself had also been sick and purged; from which condition.however, she recovered without more serious enects. On theday after the death, it was ascertained from the other childrenthat whilst at play they had plucked and eaten some red andblack berries growing in a hedge; that the deceased was knownto have eaten two and his next sister one of the red berries;the eldest sister had eaten two, but she escaped without anyill consequences. It was thought that the deceased child mightvery probably have swallowed more than two of the berries,but this could not be determined; the matters ejected fromthe body were not sufficiently scrutinised to throw any lighton the subject. A twig of the plant from which the childrenstated the berries had been plucked was produced in theinquest-room: it proved to be the solanum dulcamara, or

woody nightshade, and no doubt existed that the child had methis death from eating the berries of that plant.

716

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Remarks.—In Thomson’s" Materia Medica" it is mentionedthat these berries, "which ripen in September and October,are oval, scarlet, very juicy, bitter, and poisonous : they excite

, violent yomiting and purging;" but a remarkable assertion ismade by tha editor of the last edition of that work, that " hefinds that the berries arc by no means poisonous, even in large- doses." This assertion is made only on the ground that apatient suffering from psoriasis took half a pound of the berries

. daily for some time, which removed that troublesome and fre-quently intractable disease-a fact worth knowing by medical

. practitioners. Professor Taylor quotes authorities stating that180 ripe berries of duloamara were given to a dog without anyill effects resulting; but, on the other hand, that thirty of the

berries killed another dog in three hours. ("Med. Jiirisp., " last’edition, p. 175). Dr. Lindley says decisively that the berriesof solanum dulcamara" are by no means safe, although it does-appear that in some cases they have been taken into the sto-mach without, inconvenience." (" Vegetable Kingdom," p, 620.)He adds, " So’lanum nigrum, a very common weed in all partsof the world except the coldest, is more active." This plant,. called garden nightshade, bears t white flower and a blackberry, and is found in hedges and other places along with thewoody nightshade. It is most likely that the " black berries"mentioned in our narrative above were those of this plant, andnot of the atropa belladonna, or deadly nightshade, which israre in the neighbourhood of London. It is not, however,alleged that the deceased child ate any black berries, but onlyred ones, the source of which was clearly enough made out.Idiosyncracy, and the locality in which the solanum dulcamara agrows, may have much to do with rendering its berries poison-ous, or otherwise, to individuals. But that a person under- disease has been enabled to swallow large quantities of themivith a salutary effect does not prove that the berries are in-noxious. The case we have detailed—where not only a deathwas occasioned, but symptoms of poisoning were apparentlyproduced in another child by a single berry—sufficiently indi-cates that the fruit of the woody nightshade cannot be eatenby healthy children with impunity.

III. SUSPECTED POISONING DY CHAMPIGNONS.

. A man who had lived at a public-house as a potboy forfifteen or sixteen months, but whose only known cognomenwas

" John," was taken, ill about midday on the 28th of August,1852, and went to bed. As it was a season when cholera wasmuch feared, medical assistance was promptly procured. Mr.Keen, of Shepherd’s Bush, accordingly saw him about half-pastiiwo o’clock, and found him perfectly sensible, quite free from’fever or pain, except; that there was slight tenderness felt on.pressure over the stomach, which appeared somewhat puffed,.and bulging out the epigastric region. The tongue was tolerably,clean there was no thirst, nor acceleration of pulse, but someagitation of the hands was observable. Knowing him to be aconfirmed drunkard, (his ordinary allowance of beer, inde-pendently of other stimuli, being at least a gallon per diem,)the surgeon considered he was suffering from a bilious attack,prescribed six grains of calomel, and left him. At about teno’clock the same night he was informed that his patient was,dead.

It seems that after being prescribed for, the man got up and- continued about his work until evening, when he made into astew some champignons, which had been gathered in a fieldtwo days before, and of which he had eaten during two succes-sive evenings. On the 26th, after eating them, he had com-plained of pain in his bowels. On the 28th he complainedabout half-past nine o’clock that his stomach ached, and heagain went to bed. A man who slept in the same room shortlyafterwards found him better, as he said, and wishing for a glassof giu-aaucl-w ater, which was supplied to him. Before teno’clock this man found him dead in his bed, where he had ex-pired apparently without a struggle or intimation of hisdecease.

Mr. Keen, who made a post-mortem examination on the31st, the day of the inquest, found the body then in a state ofdecomposition, which, for the time that had elapsed since thedeath, was quite extraordinary. The abdomen externallyappeared greatly distended. The intestines were generallyhealthy, as was the peritoneum, except in one place--namely,at a portion of its duplicature, reflected to form the greatomentum near to the great curvature of the stomach, wherethere appeared some injection of the vessels. The mucous

. membrane of the stomach, however, was highly congested,especially at its larger end, where it was of a dusky-red colour,indicating an intensely inflamed condition; and the cesopliagus

was also found inflamed. The liver displayed that mottledappearance very common in persons addicted to intoxication.The opinion of the surgeon was, that the champignons had,by their poisonous tendency, augmented a chronic inflammationof the stomach induced by the habitual use of stimuli, and sohad been the immediate cause of death. Two other per-sons, of less dissipated and irregular habits than the deceased,who had also partaken of the champignons, had escaped with-out any serious results.

THE MILITARY SURGEON.

" Iclonxen2n thus addressed Nestor:—Haste to your chariot: let Machaonride by your side, and drive him to the fleet. His lire is precious; , for one goodphysician (and sueh is 2iael-iaon) is worth a whole ariily."-Ilon2ees Iliad,Hook xi." Lc roy (Charles IX.) n’en voulut jamais sauver aucun, si-non maitre

Ambroise Paré, son premier chirurgien, et le premier (le la chrestienté, et1’envoy-a quéric et venir le soir daiis sa ehambro et gard-robe, luy comman-dant de n’en bouger: il (lisoit qn’il n’etoit raisonuable qu’un qui pouvoitservir à tout un petit monde fut aiusi massacré: —Branôme, La Haye, 1750,tome ix., page 427.

IF war devclopes the latent ferocities of human nature, italso elicits all the finer feelings of humanity. Amid the din ofbattle, traits of eharacter straggle into light-like gleams ofsnnshine bursting through the blackness of a thunder-storm-which show that the heroism of the warrior is often blendedwith the pitying tenderness of a woman ; and that be whosestrong right arm has cloven a lane through the ranks of theenemy often stoops to staunch the wounds, or moisten the

parched lips of a fallen foe.It is our purpose to show that Medicine-which ever scatters

her benefits with a lavish hand, unthanked and unrewarded-carries her blessings into the camp and the battle-16-eld; andthat no class of men exhibit more nobly all the holier attri-butes of human nature than these men-our soldier-surgeons-whom the officials of a Government or an army, (oftentimesinsolent and ignorant,) are ever prone to treat with an un-merited hauteur and neglect. * "

Machaon was the surgeon of Nestor; and all our readers whoare familiar with the Homeric story, know how much and howfondly the bard dwells upon his courage in the battle, and hisskill in his art. We are proud to think that such men do not liveonly in the " Iliad," but that in every age there have been, andin the present day there are, many who are equally skilful andequally brave. Paré, Baron Larrey, Desgenettes, Becourt, theFrères Paulet, Guthrie, and Ballingall, are names which beara historic lustre as the ministrants of mercy and hope to thewounded; and Levy, Pontier, Thomson, and Wilson, are menof the present day-formed of the same stern and sterling stuff.In reading, we recently met an article written by Colonel

Ambert, of the 4th Regiment of French Dragoons, in which thewriter bears testimony to the bravery and heroism of the armysurgeons.’ * The picturesque eloquence of the Colonel’s styletempts us to translate a few passages for the benefit of thereader.

" We look," says he, " with pleasure at a regiment on itsmarch. Our hearts are thrilled by the martial music, and weregard with deep interest its mounted generals who have turnedgrey in the service of their country, leaving home, comfort, andriches, for the hardships of the tented field. The soldiers whofollow on foot, ranged in companies, are their natural successors.These crosses, these epaulettes, and that authority, will becomethe heritage of those men, who, with burdens on their backs,silently obey." ,

Would to God we, in England, could say as much ! Littleinducement have our soldiers to become skilful in their art,since the merest booby who has a weighty purse, or an aris-tocratic relation, may be placed over the heads of the bravest,best, and wisest men in the service. Must these things con-tinue ? Truly they manage things much better in France!But to revert again to the words of Colonel Ambert :-’’Following these long files of soldiers, we observe a man,

modestly clad, and walking on foot. Like them he is on theroad to battle; but he is not, like them, on the road to gloriousrenown and fortune. His duties will be unattended with éclât;his vigils will be unremembered; and even though he shouldprove a hero, as did Bécourt at the field of Eylau, he will pro-bably not, like him, be personally rewarded by the Emperor.But an hour will come when this man will be the chief amongst

* Col. Ambert’s admirable article, originally published in the Constitutionnel,lies before in the number cf L’ Union Médicale for Oct. 31st, 1855.


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