The chief characteristics of poisoning mentioned by authors of repute are, that the symptoms commence suddenly after taking any substance or fluid into the stomach, the individual being in a state of health; that they increase steadily, and are uniform in their nature throughout their course; and that they prove rapidly fatal. There are many exceptions to these rules. Thus if the stomach be loaded the appearance of the symptoms will often be delayed some few hours. Sleep, according to Dr. Christison, may retard the action of some agents; so that if a person fall asleep soon after swallowing arsenic or strychnia, for example, no effect may ensue for four or five hours. Intoxication will mask the effect of narcotics. Again, the individual poisoned may possibly be suffering from disease, and an agent may be given which will only aggravate existing symptoms. The fact When poison is administered with a criminal intent it is generally in such a dose as to take immediate effect, although this is by no means necessary, as there are numerous substances which accumulate in the system, and when given in small and repeated quantities, ultimately prove fatal. It must also be remembered that there are many diseases, as malignant cholera, internal hemorrhage, &c., which commence suddenly, and rapidly run to a fatal termination. In inflammation of the stomach or intestines the symptoms often set in suddenly, and might be mistaken for poisoning; such is also the case in intestinal obstruction, and especially in ulceration and perforation of the bowels. So also in organic diseases of the heart, where the symptoms may have remained latent for some time, death often occurs suddenly from syncope. The diagnosis of the effects of irritant poisons is not so difficult as it is in the case of narcotics or other neurotics, where the symptoms are very similar to those produced by apoplexy, epilepsy, tetanus, convulsions, or disease of the brain. Generally speaking, a person may be supposed to be suffering under the effects of a poison, if soon after taking food or drink, he be seized with violent pain, vomiting, disorder of the alimentary canal, and convulsive movements: or if he be attacked under the same circumstances with vertigo, delirium, or great drowsiness. It must not be forgotten, however, that poisons may be introduced into the body, not only by the mouth, but also by means of suppositories and enemata, or in females The post-mortem appearances, however, except in a few instances, are not very characteristic; nevertheless they may be of great negative value in proving that a certain poison has not been administered, or that the patient died from the effects of disease. Two symptoms, excessive lividity of the body and early putrefaction, formerly supposed to indicate death by poison, are now known to frequently follow other modes of death. It may nevertheless be remarked, that the appearances after death which may be produced by poisons are, in one great class, the signs of inflammation of the alimentary canal; in another, the signs of congestion of the nervous system; and in a third, a combination of the two. The detection of poison in some of the food which has been left untaken or in the matters vomited would seem to be conclusive evidence of the administration of poison; but it is to be recollected that designing persons have mixed noxious materials with food or rejected matters, in order to feign poisoning, or to cast unjust imputations upon others. When called to a case of supposed poisoning during life the practitioner’s duty is two-fold. His first aim must of course be to preserve life (see next chapter); his second, to forward the interests of justice. But if he reaches the spot too late to save life his duties are undivided, for he has but Any suspicious conduct on the part of those surrounding the poisoned individual should be carefully noted. Acts of this kind arrange themselves in three heads, as occurring before, or during the fatal illness, or after death. With the first category the practitioner has ordinarily nothing to do, but his attention to those coming under the second and third is often of essential service to the ends of justice. The kind of acts will suggest themselves to every one, and need not be further referred to here. |