ARSENIC
POISONING:
MEDICINE IN THE COURTROOM
Imagine wanting to eliminate a
rival, whether for love or for money. What better way than poison. No violence
needed, just cunning. And so it was in early 19th century Europe,
where poisoning, especially with arsenic, was fairly common. Arsenic was
everywhere - as rat poison, in dyes for paints, clothing, and wallpaper, and in
medications. Sheep dipping required
large amounts and it was even found in flypaper. You could buy it at the local
chemist or grocer. “White arsenic” (arsenic trioxide), the common form, was
odorless and tasteless, ideal for lacing food or coffee.
In the courtroom the decision to send an accused to freedom or to the
hangman often relied on circumstantial evidence rather than science. In 1815
England was shaken when a 22 year old servant, Elizabeth Fenning, crying to the last that she was innocent, was hanged
for poisoning (non-fatally) the family where she worked. Circumstantial
evidence alone convinced the jury, in spite of lack of hard evidence of arsenic in
those affected. Thousands turned out for her funeral and a public outcry ensued, making it clear that better science,
and evidence collection, were needed.
Two years before, in France, a young physician and chemist, Mateu
Orfila, noted that white arsenic powder in coffee or other organic fluids failed
to precipitate with standard reagents. He correctly saw the importance of this
in criminal cases. Orfila, born on the island of Minorca, had studied medicine
in Valencia and
then chemistry in Barcelona and Paris. He was quick, bright,
self-confident, and an excellent lecturer, traits that catapulted him rapidly
into influential chemistry and medical circles. He was helped by a superb
baritone voice (said to be adequate for the Paris Opera) that gained him entry
into select Paris salons. He was a constant proponent of the value of chemistry
to medicine, a theme resisted by many clinicians at the time. Orfila soon was
able to isolate arsenic in organic material and rapidly widened his research. He
published the first full book in years on toxicology, Traité des Poisons, in 2 volumes over 1814-5, a popular book
translated into several languages. In 1819 he was appointed professor of legal
medicine at the Paris Faculty of Medicine, and was consulted frequently in
criminal poisoning cases. Later in life he was president of the Royal Academy
of Medicine.
 |
| Mateu Orfila (from Wikipedia) |
One of Orfila’s students, a
Scot named Robert Christison, on returning to Scotland noticed there an absence
of knowledge of toxicology and published the first English language text on the
subject. He too was frequently consulted on court cases and became professor of
medical jurisprudence in Edinburgh.
 |
| Robert Christison (from Wikipedia) |
Better science soon came. In 1833, John Brodle was accused of poisoning
his grandfather by placing arsenic in his coffee. The coffee grounds and
stomach contents of the victim were sent off to Michael Faraday for testing,
who passed them on to his assistant, James Marsh, whose findings were
inconclusive - Brodle went free. Marsh appreciated
that the usual precipitation methods could not detect arsenic in tiny amounts. He
knew from Carl Wilhelm Scheele, an important Swedish chemist, that the
combination of arsenic, zinc, and nitric acid produced a gas, arsine. He
devised an apparatus (see insert) featuring a tube with a
A few years later, in
1840, in the village of Beyssac, south-central France, a Marie Lafarge was
accused of poisoning her husband. Tests for arsenic on his remains were
inconclusive, and when repeated were negative. The juge d’instruction ordered the body exhumed, 10 months after burial,
for more tests. This time the “Marsh test”, applied to the putrid remains, was negative. But a physician who relied on the clinical picture still doubted
the results so the juge ordered a
fourth assay, appointing experts, including Mateu Orfila, to do the tests.
Orfila’s team found arsenic this time, landing Madame in jail for life. Orfila
claimed that the previous team had performed the test improperly. It was the first criminal trial decided by the Marsh test. Madame
LaFarge’s case was another that evoked a media blitz which
divided the country “as
much as the Dreyfus case”, according to some. LaFarge’s memoirs, written in
jail, were a best seller.
 |
| Madame LaFarge (from Wikipedia) |
Aware of the
sensitivity of the Marsh test, Orfila realized that he could now assay blood
and tissue levels for arsenic at levels unheard of before. He was aware of
experiments done a few years earlier by Francois Magendie on strychnine,
proving that it was absorbed through the venous system and not the lymphatics.
Orfila did similar experiments, now measuring levels in blood and tissues,
something impossible for Magendie who relied on clinical effects. Testing for
organic poisons, such as strychnine and nicotine, soon followed. Forensic
science, and experimental pharmacology, were now established.
“Medical jurisprudence” chairs were established in many of Europe's medical centers in succeeding years. In the U.S., by contrast,
the first full time position in “legal medicine” was not until 1937 at Harvard.
The physician chosen for the position, Alan Moritz, was first sent to Europe for
two years to study at already existing departments. Moritz pushed the AMA to
advocate for physician medical examiners. In 1944 only seven states had medical
examiners - in others the coroners were laymen. The AMA agreed with Moritz and
exerted its influence. Gradually medical examiners replaced lay coroners, and forensic
pathology is now a board specialty in the U.S.
SOURCES:
Bertomeu-Sanchez, JR, and Nieto-Galan, A, eds: Chemistry, Medicine, and Crime. 2006.
Jentzen, JM. Death Investigation
in America. 2009
Stratmann, L. The Secret Poisoner: A Century of Murder. 2016.
Chaille, SE. 1949. “Origin and Progress of Medical
Jurisprudence, 1776-1876”. J Crim Law and Criminology, 40: 397-444.
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