Treatise on Poisons by Sir Robert Christison

on the part of the prisoner during the illness of the person poisoned. Under this head it is necessary merely to state what I conceive to be, with reference to the present branch of the proof, the duty of the medical practitioner who happens to attend a case of poisoning. In such a conjuncture he is undoubtedly placed in a situation of some delicacy. But on considering the matter attentively, good reasons will appear why he should adopt the course, which, I believe, our courts of justice will expect of him, and keep some watch over the actions of any individual who is suspected of having committed the crime. On the one hand, no one else is by education and opportunities so capable of remarking the motions of the different members of the family dispassionately, without officiousness, and without being observed. And on the other hand, it is undoubtedly a part of his private duty as practitioner, to protect his patient against any farther criminal attempts, as well as part of his public duty to prevent the vomited matter and other subjects of analysis from being secretly put away or destroyed. No one can be so occupied without many accessary particulars coming under his notice. And certain it is, that on several trials the practitioner has contributed, with great credit to himself, a considerable part of the pure moral proof. For an example of discreet and able conduct under these trying circumstances, the reader will do well to refer to that of Dr. Addington, the chief crown witness, both as to medical and moral facts, in the case of Miss Blandy.[134] It is almost unnecessary to add, that in acting as now recommended, the physician must conduct himself with circumspection, in order to avoid giving unnecessary offence, or alarming the guilty person. 7, and 9. On the seventh article, which respects the conduct of the prisoner after the death of the deceased, and on the ninth, which relates to the existence of a motive or inducement to the crime, nothing need be said here. But on the 8th article of the moral evidence,—comprehending the death-bed declaration of the deceased, his state of mind, his personal circumstances and other points which prove the possibility or impossibility of voluntary poisoning—a few remarks are required, because an important and little understood part of the practitioner’s duty is connected with this branch of the proof. The question as to the possibility of the poisoning being voluntary is one upon which the medical attendant will be expected to throw some light, and into which he will also naturally inquire for his own satisfaction. In doing so his attention will be turned to circumstances purely moral, which may not only decide that question, but may also criminate a particular individual. His inquiries must therefore be conducted with discretion, and for obvious reasons should be confined as much as possible to the patient himself. They are to be conducted not so much by putting questions, as by leading him to disburden his mind of his own accord; and it is well to be aware, that there is no one of whom a patient is so ready to make a confident on such an occasion as his medical attendant. If disclosures of consequence are made, and the attendant should feel it his duty to look forward to the future judicial proceedings and to the probability of his appearing as a witness, he ought to remember the general rule is, that his account of what the patient told him is not evidence in the eye of the law, unless it was told under the consciousness of the approach of death. Of late, however, the rigour of this principle in law has been occasionally departed from in Scottish practice; and in regard to medical facts ascertained in the way here mentioned, many strong reasons might be assigned for such relaxation. Evidence of the kind is technically called the death-bed declaration of the deceased, and is justly accounted very important. Here it is right to take notice of a part of the death-bed evidence, although it does not properly belong to the question of suicide, because it should always be collected if possible by the medical attendant, and with much greater care than is generally bestowed on it even by him—I mean the history of the symptoms previously to his being called in. On this part of the history, including particularly the time and manner in which the illness began, medical conclusions of extreme consequence are often subsequently founded: On a single fact or two may depend the fate of the prisoner. It is not enough, therefore, in my opinion, that such evidence formed a part of the death-bed declaration. If a fact derived at second hand from the deceased, and stated too by him from memory, is a material element of any of the medical opinions on the trial, it is of much importance that the information be procured by a medical man; and that the person who procured it, whether professional or not, was aware at the time of the probability of its becoming important. Such evidence, although not collected with these precautions, is admissible; but I have so often had occasion to witness the carelessness with which the previous history of cases is inquired into both in medical and medico-legal practice, that I do not see how it is possible to put trust in evidence of the kind, unless it bear marks of having been collected with care, and under an impression of its probable consequence. These statements are well illustrated by the following example:—On the trial of Mrs. Smith for poisoning her maid-servant with arsenic, it was proved that some drug was administered by the prisoner in a suspicious manner on a Tuesday evening. Now it appeared at the trial improbable that this drug contained a fatal dose of arsenic, because to her fellow-servants, of whom one slept with her, and others frequently visited her, the deceased did not appear to be ill at all for eight hours after, or seriously ill for nearly a day. On the contrary, however, a surgeon, who was called to see her on the following Saturday, a few hours before her death, deposed that, according to information communicated by herself, she had been ill with sickness, vomiting, purging, and pain in the stomach and bowels since the Tuesday evening. This evidence, if it could have been relied on, would have altered materially the features of the case, as it would have gone far to supply what all the medical witnesses considered defective, namely, proof of the administration. But at the time the surgeon made his inquiries, he did not even suspect that the girl laboured under the effects of poison. Neither he therefore nor his patient could have been impressed with that conviction of the importance of the information communicated, which was necessary to insure its accuracy, particularly as it related to a matter usually of so little consequence in ordinary medical practice as the precise date of the commencement of an illness; and it would consequently have been rash to adopt it in face of more direct and contrary evidence. Any one who examines the details of this trial as I have reported them, will at once see how much the case turned on the point now alluded to.[135]