« AnteriorContinuar »
XVII. On the Gastric Juice as a Solvent of the Tissues of Living Animals. By F. W. Pavy, M.D.-Dr. Pavy gives the results of experiments of the following nature:—Through a fistulous opening which he had established into the stomach of a dog, he introduced, during digestion, the hind legs of a living frog, and the ear of a living rabbit. In both instances the parts introduced underwent digestion after two or three hours. Similar experiments, in the case of the frog, have been often performed on the Continent. From these experiments Dr. Pavy argues, that the capability of resisting its own digestive powers, possessed by the walls of the stomach during life, and which ceases with death, is not due, as John Hunter thought, to its being endowed with “ the living principle," but to its epithelium and mucus being constantly reproduced as soon as digested.
XVIII. On Poisoning by Strychnia, with Comments on the Medical Evidence given at the Trial of William Palmer. By ALFRED S. TarLOR, M.D., F.R.S.—This paper, which extends over 134 pages, and which, with an Appendix, has also appeared in a separate form, constitutes a most complete refutation of the personal attacks which were made upon the author during Palmer's trial, both by the counsel for the defence and by a portion of the public press; and also contains much valuable information concerning the deadly drug by which Cook was poisoned. It would be out of place here to enter into the details of the circumstantial evidence, which alone was sufficient to convict the prisoner ; but we shall confine our attention, for the most part, to a few medico-legal questions of great importance, and to the investigation of which Palmer's crime may be said to have first directed us; and first
1. What are the differences between tetanus produced by strychnia and that resulting from natural causes ?
It will be recollected that it was urged for the defence, that the tetanic convulsions of which Cook died, might have been due to idiopathic tetanus, or have been of a traumatic character caused by sore-throat. It became, therefore, a matter of the highest importance to ascertain, what are the differences in the physiological phenomena of tetanus produced by strychnia and that resulting from natural causes. Fortunately such differences exist in a marked degree, so that the secret murderer need no longer flatter himself that, by employing strychnia, he will escape detection. These differences are so important, that every practitioner should be acquainted with them; and we think we cannot do better that give the following extract in Dr. Taylor's own words:
“Tetanus, which implies a general spasm or cramp of all the muscles of the body, that are usually under the power of the will, may arise from-1. poison ; 2. wounds (lacerations, severe bruises) (traumatic); 3. exposure to cold and wet (idiopathic).
"As to poisons----arsenic, antimony, and other irritant poisons, may occasionally produce tetanic spasms of the muscles; but then there are always other symptoms which precede or follow, of a totally different kind.
“Strychnia is the only poison (with the exception of brucia) which produces tetanus in a pure and unmixed form.
“In Cook's case there was no wound or personal injury; hence it was not a case of what is called 'traumatic tetanus.'' “There was no exposure of the deceased to wet or cold.
“DIFFERENCES. “ Idiopathic Tetanus from Exposure
“Tetanus from Strychnia. to Cold and Wet. "1. Symptoms have no connexion "1. Some solid or liquid taken with. with any liquid or solid swallowed. in about two hours or less of com.
mencement of symptoms. “2. Symptoms commence slowly, “2. Symptoms commence suddenly and progress slowly; difficulty of with great violence. Nearly all the swallowing; stiffness of jaws, of voluntary muscles of the body are neck; after some time, the body, the simultaneously affected. Arms and legs, lastly the arms; hands not hands spasmodically clenched at the commonly affected.
same time as body and legs. Jaw not primarily affected, not always fixed.
“(N.B.--Cook was able to swallow and speak within ten minutes of his
death.) “3. Opisthotonos, or body bent “3. Opisthotonos a very early back in the form of a bow, resting on symptom, in a few minutes commonly. head and heels; does not come on until after many hours or days from the attack.
“4. Paroxysms, or fits of spasm, “4. When symptoms are once may be severe, and the person may clearly established, they progress to die from exhaustion. Patient com- death or recovery. They occupy only monly recovers after some days or minutes. In from ten minutes to weeks.
two hours after commencement the person dies or recovers, according to the severity of the paroxysms and
strength of his constitution. “5. In idiopathic or traumatic 5. In tetanus from strychnia, if the tetanus there is no intermission in the dose should not be sufficient to prove symptoms, merely a remission of the fatal, the effects pass off; patient paroxysms. The patient is always recovers ; there is a complete interunder the influence of the morbid mission in the symptoms. cause, which remains until he dies or “(N.B.-This was a remarkable recovers.
feature in Cook's case.)
“ Post-mortem Appearances. “There is nothing of a peculiar character in these appearances, whether the tetanus depend on disease or on strychnia.”
Dr. Taylor proceeds to consider each of the above differences individually, with reference to the case of Cook, and whether the symptoms in his case might have arisen from some natural disease. He brings forward all the cases of poisoning by strychnia which have been communicated to him, or which he has been able to find recorded, (26 in number, including those of the appendix,) and shows that the symptoms during life, and the contracted, empty condition of the heart found after death, were quite consistent with strychnia poisoning in the human subject. It was argued in the defence, that the length
of time which elapsed before symptoms came on in Cook's case (1 or 14 hour), was inconsistent with strychnia poisoning. From experiments on sixty animals, Mr. Nunnely deposed on oath, that this interval varied “from two to thirty minutes," and was “more generally five or six.” Dr. Taylor observes, that Mr. Nunnely's animals must have been singularly susceptible of the effects of strychnia; and he himself cites cases of animals in which the fatal tetanic symptoms did not supervene for five, eight, or eleven hours after the administration of strychnia ; and he mentions one case of a man in whom the symptoms did not appear for two hours and three-quarters.
The next question to which we shall briefly allude, is,
2. Can a person die from strychnia and no trace of that poison be found by chemical analysis in the body? Every endeavour was made in the defence of Palmer to show that no man can die from poison, except poison be found in his body, and to throw mistrust upon symptoms and appearances as evidences of death from poison. Who under such circumstances would be safe? There are many vegetable poisons, such as the ordeal bean of Africa and laburnum seeds, for which chemistry as yet possesses no tests. There are poisons of such a nature, that
“While no chemical tests can reveal their presence in the body, their unlawful use may be surely and satisfactorily indicated by the suddenness, intensity, and peculiarity, as well as the fatal rapidity, of the symptoms which they produce."
Physiological and pathological phenomena, therefore, must not be rejected in cases of poisoning; and, as Dr. Taylor observes,
“Let it be remembered, that if the physician, as a pathologist or physiologist, may be deceived by symptoms, the chemist may be equally deceived by his tests. He may, and often has, pronounced poison to be present when it was not, and he has overlooked it when it was present.”
It was argued by Sergeant Shee, that if roogth of a grain of strvchnia “had entered into the human frame at all, it could be, and must be, detected by tests which are unerring ;” and Mr. Herapath avowed on oath, that if this poison had caused death, he could detect it up to the time that the body had become “completely decomposed ;" in fact, when it was converted into a “dry powder”! Dr. Taylor proves, and proves most clearly, the utter groundlessness of such assertions. Cases are adduced (p. 356) of deaths from strychnia, in which that substance could not be detected after death. In one case, although two scruples had been taken, and the patient died in one hour and a half, no strychnia could be found either in the stomach or blood. Another case is mentioned of a man who swallowed four grains of strychnia; one hour after, the stomach was emptied by the stomach-pump; the contents were examined by Dr. Stenhouse, of St. Bartholomew's Hospital, but “ he did not detect any of the strychnia." Moreover, Dr. Taylor has had recourse to experiments on animals, but of six instances of animals poisoned by strychnia, and in which it was searched for after death, in two it could not be found in the contents of the stomach, and in none was it found in the blood or tissues. These facts speak for themselves.
Dr. Taylor also considers the reasons for the non-detection of strychnia in the bodies of persons who have died from its effects; under the heads of-1, the quantity taken ; 2, the time which has elapsed after taking the strychnia, until the symptoms commence ; and 3, the careful preservation of the stomach and its contents. In Cook's case, the stomach, before being sent to Dr. Taylor for examination, had been “cut open and turned inside out,” and “there were no contents."
3. What becomes of the strychnia in a case of poisoning in which it cannot be detected by chemical analysis ?
Strychnia is not easily destroyed by putrefaction. This Dr. Taylor admits. The advocates of Palmer maintained that it was indestructible as the diamond, and therefore ought to have been detected; while at the same time they endeavoured to persuade the jury, that the whole body had been searched for it, and not the stomach only. Now experiments have shown that strychnia may be absorbed from the stomach with great rapidity. Dr. Macadam has detected its presence in the urine of animals nine minutes after it had been swallowed. At the same time there is reason to believe that strychnia “partially undergoes some change in the blood.” Thus, Dr. Harley was unable to detect it in the blood of a dog, poisoned by the injection of 1, th of a grain (of acetate) into its jugular vein. Here the poison must have undergone some change, for according to Mr. Herapath, there are tests which would have demonstrated the presence of zo booth part of a grain. Moreover, Drs. Harley and Macadam have ascertained that animals may be fed on the flesh of others poisoned by strychnia, and exhibit no tetanic symptoms. Here again it seems probable that the strychnia, on entering the system, undergoes some change, so that it no longer possesses a poisonous action on animals.
We repeat, in conclusion, that Dr. Taylor has fully exonerated himself from the "imputations of rashness, ignorance, and prejudice," which were attributed to him, and has justified on every point the evidence which he gave at the trial of William Palmer.
XIX. Analysis of the water of the Great Geyser, Iceland. By ALFRED S TAYLOR, M.D., F.RS — The peculiarity of this water consists in the large amount of silica which it contains (almost fortyeight grains in one inperial gallon). This is kept in a state of solution by carbonate of soda, and the high temperature of the water (190° .).
XX. Ranares on the Physiologia. Efects of Strychnia and the Wendi Pose By F. W, PATT, A.D.-These two virulent poisons ANY produed by two plants strychnos nux vomica, and strychnos toxiters, belonging to the same botanical genus. Dr. Pavy's experiments would show, that both produce death by arresting the respiration ; strychnia, by inducing spasm of the respiratory muscles;
woorali poison, by inducing paralysis. He states," under the influence of both, the heart remains perfectly free.” These results, as regards strychnia, are opposed to those arrived at by Dr. Harley (Lancet, June 14th, 1856).
REVIEW XI. Traité de l'Angine Glanduleuse, et Observations sur l'Action des Eaux
Bonnes dans cette Affection; précédés des Considerations sur les Diathèses. Par NOEL GUENEAU DE Mussy, Médecin de l'Hôpital de la Pitié et de l'Ecole Normale Supérieure, Professeur Agrégé
à la Faculté de Médecine de Paris. pp. 269. 1857. Treatise on Angina Glandulosa, with Observations on the Action of the
Waters of Eaux Bonnes in the Complaint; preceded by Remarks on Diathetic Affections. By NOEL GUENEAU DE MUSSY, Pro
fessor, &c. The scrutinizing spirit of modern medicine which has brought to light so much of the morbid actions and products of different parts of the body, has of late years been very successful in making known the disorders of the laryngo-pharyngeal mucous membrane; which if not wholly unobserved by nosologists and the earlier writers, are at least unrecorded by them. Many important examples of disease in these parts have been carefully noted, and arranged in groups, according to the tissues affected, the diathesis, or the disease with which they are associated.
M. Chomel had for some years in his clinical lectures described certain affections of the throat, consisting chiefly of an enlargement of the glands of the laryngo-pharyngeal mucous membrane, common amongst speakers, readers, and singers, and associated, as he believed, with what he has termed a herpetic diathesis. But at the same time Dr. Green, of New York, as every one is aware, published his wellknown work upon the diseases of the air-passages, including clergymen's sore-throat, &c. From that time the subject has received much attention in this country, and the topical medication recommended by Chomel and Green has had many advocates. Topical medication has extended to other diseases, such as hooping-cough; and other local agents besides those recommended by the above writers have been advocated in this country. Dr. de Mussy is, we believe, the first French physician who has devoted a separate treatise to the consideration of these maladies. His work discusses glandulous angina, but we have no doubt that under this title he has comprised examples of disease which would be more properly regarded as cases of chronic inflammation of the laryngo-pharyngeal mucous membrane ; for the implication of the glandules, or, as Dr. Green less correctly regards them, of the follicles, is so slight, compared with the morbid condition of the membrane, in some cases, as by no means to justify the title. Membranous inflammation, with slight glandulous complication in its simple form, acknowledges the same causes, symptoms, and conduct