Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
2. =Evidence from= _Post-mortem_ =Appearances=.--The morbid
appearances found in cases of poisoning will be treated more in
detail when each poison, or group of poisons, comes to be separately
considered. A caution may be given here against allowing the
_post-mortem_ signs of disease or external injury to exclude the
idea of poisoning; for death may to all appearance be the result
of disease or injury, and yet be caused by poison. An attention to
the _post-mortem_ appearances is important in all cases; for in
many instances, where the symptoms were unknown to the experts at
the time the inspection was made, they were subsequently found to
correspond with the morbid changes which the autopsy revealed. The
normal appearance of the stomach is white or nearly so, except during
digestion, when it is reddened; yet we may sometimes come across cases
in which the mucous membrane of this organ may be found so reddened as
to lead to a suspicion of poisoning. The knowledge of this fact, and
the absence of symptoms, will prevent an error in diagnosis. Ulceration
from disease and from irritant poisoning must be distinguished. In
that due to disease, the ulcers formed are, as a rule, small and
circumscribed; in those from poison, there is diffused inflammatory
redness over other parts of the stomach, and even in the intestines;
and the poison, as in the case of arsenic, may be found adhering to the
sides of the ulcer. Ulceration is more frequently the result of disease
than of the action of poisons. Perforation of the stomach or intestines
may be due to ulceration or to corrosion. The condition of the mouth
and gullet will help the diagnosis. The appearance of the ulcer and
the parts around it, together with the hints just given, must guide
the diagnosis. Of _post-mortem_ softening little need be said, beyond
stating that it very rarely occurs, and is of course not preceded
by symptoms. (For the diagnosis between inflammatory redness of the
intestines and _post-mortem_ staining, see page 45.)
3. =Evidence from Chemical Analysis.=--The objects of a chemical
analysis are to determine: (1) The presence and nature of the poison.
(2) The proportion or quantity of the poison taken. (3) The solution of
certain questions connected with the administration of the poison.
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