PATHOLOGY AND PRACTICE OF MEDICINE.
Case of Poisoning with .Arsenic. Death in thirty-six hours—Influence
of Arsenic on Digestion—Remission of Symptoms. By A. G. Greaves,
Surgeon to the Derby Dispensary.—On the 26th of February, 1847,
Mrs. Ann W-----, aged 24, in the ninth month of pregnancy, was taken
ill at half past 9 a. m., with sickness and vomiting, having an hour pre-
viously partaken of a breakfast of tea and bread and butter. The vom-
iting continued at intervals during the day, the matter thrown up con-
sisting principally of bile. No medical assistance was called in, de-
ceased saying that she thought her illness was owing to her pregnancy.
27th.—Mrs. W. vomited once at 9 a. m., and then felt very much
better. She cleaned her house thoroughly during the morning, took
some gruel at half-past 12, and at 1 p. m. left home, as she said for a
walk. She returned at 2 p. m. and stated that she had been obliged to
call at the house of a friend about two hundred yards from her home,
having again been sick. At half-past two she again threw up a quanti-
ty of what, from the description given, I supposed to be bile. At half-
past 4 I was called in, and found her seriously ill, complaining of vio-
lent pain in the stomach and abdomen, with diarrhoea and tenesmus, and
great difficulty of breathing. She sank rapidly, and died at a quarter
past 7 p. M.	x	,
I ascertained that deceased had felt the movement of the child a very
short lime before her death, and 1 therefore urged the friends to al-
low me at once to open the uterus and remove the foetus ; but they ob-
jected.
Post-mortem 22 hours after death.
Head.—Brain and the membranes perfectly healthy.
Chest.—Lungs contained a considerable quantity of dark blood. The
heart was very flaccid, and both ventricles were filled with fluid blood
of a very dark character.
Stomach contained about a pint and a half of bloody fluid, on pour-
, ing off which I found a very large quantity of exceedingly viscid al-
buminous secretion containing numerous patches of a white powder,
which analysis proved to be arsenic. The mucous membrane wasVnuch
inflamed.
The duodenum was also inflamed, and contained one or two patches
of the same white powder. In the caput coli was found a considerable
quantity of undigested soup, containing several patches of undissolved
arsenic, precisely like those in the stomach.
The bladder was empty and healthy. The uterus contained a fine
healthy child, but there was no evidence of labor being near. The
membranes were entire, and everything in a normal state. A careful
analysis by myself and my friend, Mr. Bernays, shows most
unequivocally the presence of a large portion of arsenious acid in the
contents of the stomach, but by whom administered there was no evi-
dence to show, beyond a remark of the deceased, “that it would be a
shocking thing if she and her husband should be found dead in bed.”
This led to a suspicion that it was an act of suicide.
We have unfortunately, no satisfactory data to form a conclusion as
to when the fatal dose of arsenic was taken. There can be no doubt
that some of the poison had been administered on the 26th, thirty-six
hours before death, but whether that was the dose of which she died is
uncertain. It is interesting to remark how large a portion of arsenic
remained in the stomach, notwithstanding the continued vomitings the
deceased had for five hours before death.
There are some circumstances connected with this case which are of
interest in a pathological view. It appears that the deceased partook of
of a quantity of soup about seven hours before her death ; and yet, al-
though this long period had elapsed, it was found in the caput coli in
an undigested state, and mixed with a quantity of arsenic. But for this
fact being well known, it might have been inferred that deceased had
taken a large dose of arsenic in soup three or four hours before death.
This appears to show that the action of arsenic materially interferes with
the process of healthy digestion.
Another circumstance worthy of notice is, that there was so complete
a remission of the symptoms after the poison had been swallowed, that
the deceased was able to occupy herself in her usual avocations, and to
go for a walk.—Medical Gazette.