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DIAGNOSIS OP POISONING                                             43§


This has to be made in the living, as well as in the dead.

I. In the Living. — A medical practitioner's task becomes very difficult
in diagnosing a case of poisoning as, in order to avoid police investigation,
nobody is willing to supply him with a true and correct history of the case.
However, he can, to a certain extent, diagnose a case of poisoning from the
following characters of the symptoms exhibited by the patient : —

1.    The   onset  is  usually  sudden   in  a  previously  healthy  individual
except in chronic poisoning, where the symptoms develop gradually, and
may be easily mistaken for disease.   At the same time it must be remem-
bered that in some diseases, such as cholera, apoplexy, gastro-enteritis, etc.,
the symptoms may appear suddenly.

2.    The  symptoms usually commence within about an hour after the
poison has been taken in a particular kind of food, drink, or medicine ; but
the poison will have no connection with the food, drink or medicine, if it is
not administered by the mouth but by some other channel.

Moreover, the symptoms of some diseases, such as cholera, apoplexy and
rupture of the stomach, may appear all of a sudden soon after taking a meal
or drink. In this connection it may be mentioned that a criminal may take
the advantage of some epidemic disease occurring at the time, and may
administer a poison producing the symptoms almost similar to those of the
epidemic, so that the death may be attributed to it. I have seen cases in
which arsenic was administered, and the death was attributed to cholera
raging in the locality at the time. But post-mortem examinations revealed
the signs of irritant poisoning, and the Chemical Examiner detected arsenic
in the viscera.

3.    The  symptoms are uniform in , character, and rapidly increase in
severity followed either by death or early recovery.   Sometimes, remissions
may occur as in opium poisoning, and certain poisons may leave sequelae of
long duration.

4.    Persons partaking at the same time of the same kind of food or drink
containing poison suffer from similar symptoms, of poisoning at or about the
same time.                                                      **

5.   The detection of poison in food, medicine, vomit, urine or faeces is
strong proof of poisoning.   Hence, in suspicious cases, these articles must be
preserved in. clean glass-stoppered bottles for chemical analysis.

n.   In the DjeacL— Diagnosis in the dead has to be made from —

A.    Post-mortem appearances.

B.    Chemical analysis.

C.    Esq>erirnent& oaa. anfrmgjlg-

D.    Moral and circumstantial evidence.


A.   POST-MOBTEM APPEARANCES                       H^

1            '                                                     ,     '                                                    ».             ,                                                                      ^                x'jiji %

In order to make a probable guess of the poison and to look fcr its

characteristic post-mortem, appearances, it is advisable that a medical offcer^
"before commencing a po^-poiortem ex&mina^on on the body of a susped|eJ
case of poisoning, should >ead the" police report and endeavour to gelt
mu dfa ihf ofMafefemi as possible from fee relatives of the deceased
the quality ^ad (quantity jrf'lifce poison administered, the
symptoms, ^fc ^jEere^e: 4* |feeir OT®e4 and, the time


duration 'of fbe &JH^>1tf/tpfc <i% tie
death.   P© ^iA 'fed 'ib&t m, motst eases the