POISONING BY ERGOT 
•# 
IN ATTEMPTING 
CRIMINAL ABORTION; 
WITH REFLECTIONS UPON SOME OF THE 
CAUSES OE SUDDEN DEATH 
BY MYDDLETON MICHEL, M. D., 
LECTURER ON ANATOMY AND PHYSIOLOGY, CHARLESTON, SOUTH-CAROLINA. 
Extracted from the Charleston Medical Journal and Review, for Sept’r, 1850. 
CHARLESTON, S. C., 
PRINTED BY C. CANNING, 29 PINCKNEY STREET. 
1850. POISONING BY ERGOT, 
IN ATTEMPTING C RIM IN AL ABORTION. 
Felonious attempts at. criminal abortion are sometimes 
made the subject of judicial investigation, when malice or 
avarice has destroyed life by substances that popular repute 
invests with a fancied or real power to expel the child. 
Abortion is seldom attained but by the use of medicines 
involving the life of both parent and offspring; and when 
substances, acknowledged even the most appropriate, have 
been ignorantly and feloniously administered, the mother, 
too often, perhaps, has been destroyed, when the only de- 
sire was to shelter her from harm and secure her from 
shame. But inasmuch as, in such a case, the intent con- 
templated is criminal, for the accidental murder of the 
mother the law holds the defendant responsible ; and medi- 
cal witnesses are then required to determine the nature of 
the death, and must of necessity answer the question whe- 
ther that death was the result of poison. The influence of 
circumstances in complicating the particulars, may singu- 
larly embarrass the best directed medico-legal investiga- 
tion : the pregnancy may not be suspected; the secrecy, 
perhaps suddenness, of the death may exclude all informa- 
tion concerning the previous symptoms ; the therapeutical 
action of the substance suspected to have been adminis- 
tered may not be well understood, and the morbid changes 
it induces may be entirely unknown, even if revealed -by a 
carefully conducted examination after death. These are 
difficulties which have recently been connected with a 
most instructive case of murder, occasioned by a criminal 
attempt to procure abortion, the first of the kind known to 
have occurred in this, or I believe any of the United States.* 
The following, without the associated train of circumstan- 
tial evidence, is the brief history of the case, which, as 
one of the medical witnesses, I have been requested to de- 
tail, and which I present with imperfections observable 
* I have since become acquainted with a similar case, though here the oil of Savin 
ras used; it occurred in Massachusetts. Vide Amer. Jour. Med. Sc. 1837. V.21,p.345. 4 
throughout, and requiring all the indulgence which the 
reader can extend towards them : 
On the 2d of May, at one in the afternoon, I was called to a patient of mine, 
whom I had hitherto regarded of honest and correct deportment, and found her 
lying dead, in the house of a stranger, who it is now known lived in adultery 
with her. The only intelligence obtained, was, that as some particulars con- 
cerning her pecuniary affairs were announced, she placed her hand upon her 
heart, was suddenly overcome, • lay down and died. No medicines were dis- 
covered in the room. The deceased was lying on her back upon a bed, without 
her shoes on, and with no under clothes but her shift; her head and shoulders 
elevated by pillows, her legs stretched out and separated, and her arms extended 
on each side of her person. The surface of the body was warm, but presented 
nothing remarkable, the countenance placid, and the pupils somewhat dilated. 
Three hours after death, I witnessed great yellowness and lividness of the face, 
and an abundant froth, of a crimson color, at the mouth and nostrils, re-appear- 
ing as often as it was wiped away, while the fingers of both hands were of a 
dark livid hue to the knuckles. 
As foul play was suspected, (though of this I was not informed) on the next 
day I was urged by the family to make a post-mortem examination, which was 
performed reluctantly, and in a hurried manner. 
On exposing the body, the discoloration was found to be general. A jaun- 
diced yellow pervaded the entire surface, and large livid blotches existed on 
the inside of her thighs, over the chest, on the arms and sides of the abdomen. 
The face was now much swollen and discolored, and the same deep colored 
f rothy mucus from the nostrils and mouth was in such a quantity as nearly con- 
cealed it. The abdomen was considerably enlarged, and on being opened al- 
lowed the escape of a gas of a remarkable fetor, and exhibited the gravid uterus 
reaching to the umbilicus. The venous congestion of all the abdominal viscera 
at once attracted my attention. The peritoneum was highly congested; the 
whole tract of the intestines was covered by a net-work of venous capillaries ; 
the liver dark, and spleen gorged with blood; the uterus, participating in the 
general condition of vascular turgescence, was through the distended veins 
most completely injected, a very dark, blackish appearance; the 
bladder was of the natural dimension. During the removal of the uterus the 
common iliac vein and artery were accidentally cut, and the blood which gush- 
ed into the pelvis was very fluid. The uterus appeared to be the seat of six 
months gestation,—weighed nearly five pounds; the os uteri presented no 
marks of violence; the organ was carefully incised, the decidua reflexa and the 
membranes of the foetus were untouched, and the amniotic liquid was abundant. 
I satisfied myself that these structures had suffered no actual violence, whatever 
eke might have been attempted. The fetus, which was a male, I first an- 
nounced to be five months old, but while arranging it for preservation, I found 
it had reached the seventh month. It weighs two pounds and a half—was not 
accurately measured—presents short black hairs on the head; eye-lids not ad- 
herent ; eye-brows visible ; nails nearly, though not quite, attaining the ends of 
the fingers; pinna perfectly detached, and well formed ; sexual organs well de- 
veloped, testicles neither in the scrotum nor inguinal canals ; body slightly cov- 
ered with an unctuous induitus; and the epidermis peeling off in some places, 
from prolonged contact with the amniotic liquid. 
Not anticipating any further trouble in the matter, and regarding this a case 
of accidental suicide while attempting abortion, I here ended my examination, 
without opening either thorax or cranium, which should first have been ex- 
amined, could I have foreseen what was to have followed. 
These cadaveric appearances, especially the external signs, were sufficient 
for me to determine a death by poison : for she had been seen in perfect health 
on the morning of her death, at 10 o’clock, as well as by myself pn the day 
previous, and therefore died neither of yellow fever nor high bilious congestive, 
—the only two kinds of death which I am aware could possibly have determined 
such external discolorations. Before a jury of inquest, her pregnancy and 
death by poison I was obliged to announce, when the stomach, secure at both 
orifices, was submitted for analysis to Prof. Hume. On opening this organ, its 5 
mucous membrane was decidedly hypertrophied but not softened, abraded in 
several spots, intensely congested in a portion of its extent, with the gastric 
glands considerably enlarged,—a condition of things to which we must again 
presently advert. 
It occurred to me while reflecting on the subject, that these combined appear- 
ances might result from the exhibition of the sulphate of copper, or some medi- 
cinal fungus, such as ergot, for I had once before witnessed such an appearance 
of the viscera and the same external lividity,—with much less yellowness, how- 
ever,—in one who being pregnant died from taking an inordinate quantity of 
ergot, which had ruptured the uterus. 
Being then informed by Dr. Hume that he could discover none of the min- 
eral poisons, nor opium in any shape, I suggested that he should search for ergot, 
which he was very soon able to detect. This was confirmatory testimony of 
the most satisfactory character, which the deposition of another witness was 
destined to strengthen: the apothecary who sold the ergot, testified that the 
prisoner had purchased some ounces from him, and told him “ it was for 
a horse which had the hots.” 
Suspicion resting upon him who purchased the ergot, who occupied the 
known relation of husband towards the deceased, and in whose house she was 
found dead; he was arraigned for trial and capitally indicted : 1st, for having 
feloniously administered, or caused to be administered, a quantity of ergot to 
provoke abortion on , then a pregnant woman, whereof she died; and 2d, 
for being an accessory to the fact qf the suicide of , by means of ergot ta- 
ken to procure abortion. 
To support this indictment, it was necessary to prove that the defendant 
had ever administered, or caused to be administered, the ergot in question, or 
whether being administered, it actually caused her death, beyond a reasonable 
legal doubt. These doubts were predicated, as might have been expected, 
upon the incompleteness of the necropsy ; and the benefit of the same, through 
a wise and humane law, is always given to the prisoner. The judge, therefore, 
regarded the case as one of suspicion, rather than proof against the prisoner,, 
who was accordingly acquitted. 
And now I beg leave to invite the reader’s attention to 
the considerations by which I maintained that the deceased 
died poisoned by ergot, that he may judge for himself if the 
observations be correct or not, and base upon them a pro- 
fessional opinion. 
And first, I should remark that the presumed suddenness 
of the death was against the supposition of poison, since 
the only agents which would probably act with such fear- 
ful rapidity, would be hydrocyanic or oxalic acid, neither 
of which was taken, nor would have produced the de- 
scribed appearances. The difficulty which the counsel for 
the defendant very naturally required that I should recon- 
cile with my opinion of ergot producing death, consisted 
in the distinction between deadly and slow poisons, and 
“ whether ergot was not a slow poison.” Any substance is a 
poison, which, to use the accustomed definition, induces 
death when taken internally or applied externally, without 
acting mechanically ; thus, table salt has destroyed life in 
a few hours, in a case where a young lady was known to 
have taken half a pound of that substance—brandy is a 
poison—ergot is undoubtedly a slow poison, the word dead- 
ly is never attached to it by any one. So also arsenic has 
never been known to destroy life sooner than two or three hours: is this any reason why it or ergot-may not act under 
certain circumstances with greater rapidity ? The endeavor 
here seems to have been to prove ergot very a slow poison, 
or no more a poison than any other substance to which the 
term is not attached. This indeed seems too generally to 
be the entertained opinion. It is affirmed that it has been 
given in large quantities without producing any ill effects. 
In a recent and valuable work of Professor Meigs, such an 
opinion wTill lind a support from the author’s experience, 
he states that he is “ not au-are of any poisonous power it 
can exert,”* and cites Dr. Lee’s case of Mrs. R., who, 
through the space of a month, took seven ounces without 
injury or abortion. Prof. Meigs refers for a full account 
of the substance to the work of my friend INI. Cazeaux, 
but this author speaks very differently of its effects. Re- 
ferring to the conditions which contraindicate its use, he 
says it should not be given “ to irritable females, who have 
been subject to convulsions, either during pregnancy or de- 
livery, for,” he continues, ergot often produces a state of 
nervous exacerbation reaching even unto frenzy.” f It is 
forgotten that ergot is ranked among the narcotico-acrid 
poisons by every authority, and even among those acquaint- 
ed with the fact, there appears to be a very inadequate 
idea of its specific action. It is spoken of as only eventu- 
ating in the production of gangrene, and we find so high 
an authority as M. Velpeau observing, “that to apprehend 
ergotism, its use must be continued for a long time in large 
doses” J Here no such restriction is imposed upon the 
administration of the drug as is carefully enjoined by M. 
Cazeaux, because no ill consequences seem to be appre- 
hended but the development of gangrene. 
Need 1 mention that in the determination of a question 
of this importance, we are not to take cognizance of indi- 
vidual cases, recorded for the illustration of other purposes, 
of isolated opinions expressed through misapprehension of 
the subject, or even the circumstance of no similar case 
being recorded. Were this otherwise, I could repeat that 
through the space of a month, 1 iij., and in twenty days, 3x. 
of the decoction were given, without the induction of la- 
bor, vomiting, or any other inconvenience ;§ that and 
3ij. were administered in five days, twenty hours and 
twenty-five minutes, without even producing nausea ;|| and 
* Obsteti-ies, the Science and the Art. C. Meigs, M.D., p. 593. 1849. 
f Aux femmes tres irritables qui ont deja ete affectees »’.e convulsions, soit pendant 
la grossesse, soit pendant leurs accouchements antecedents ; ear le seigle ergote cause 
souvent un etat d’agaoement nerveux qui va quelquefois jusqu’a la fureur. Traite l>e 
l’Art des Accouehemonts. 2d ed : p. 455, 1846. 
J II faudrait done pour faire craindre l’ergotisme, cn continuer long-temps l’usage, a 
des doses considerables. Traite des Accouchements, vol. 2, p. 66. 1835. 
2 halesque, Jouru. Hebd. etUnivcr., p. 245, vol. xii. 
|J. l'aterson, M.D. bond Med. (Jaz., dune,p. 337, 1839, vide alsoAmcr. Journ. Med- 
So., vol. 25, p. 237, 1839, and Dunglison’s New Remedies, 4th Ed., p. 266,1843. 7 
that for amcnorrhcea, Dr. Randall exhibited in decoction si. 
per diem, for four days consecutively, without the desired, 
or even any effect ;* and imitating a practice so justly in- 
veighed against by the prudent and learned Dr. Meigs, I 
might, fearless of any harm to parent or offspring, and 
with reckless disregard of every rule, proceed to drive 
the child through the rigid, undilated and ergotised cervix, 
before its presentation is fixed, or its position adjusted in 
the pelvic excavation; and finally, if the sway of prece- 
dents is always to influence our opinions, then would we 
have searched in vain for the few cases of poisoning by 
Savin which chance has recorded. The diversity of cir- 
cumstances influencing the action of a remedy, the quan- 
tity and mode of its exhibition, its purity or adulteration, 
the peculiar idiosyncrasies of the system, are too frequent 
to enumerate, and often too multiplied and combined to 
permit of generalization,—we must regard the physiology 
of its action, wherever that has been foreshadowed by well 
conducted experiments, and caring little how it has acted, 
be ready to affirm how it may and will act. 
Before, therefore, entering upon these particulars, I 
would observe that I hold it as a fact uncontroverted that 
the subject of this narrative died poisoned. This truth 
was written in characters as plain as death itself. The 
defence, it is true, pleaded that as neither the thorax nor 
the cranium were opened, there was no certainty that she 
had not died of rupture of the heart, or apoplexy; but, 
whatever cogency such objections may, and undoubtedly 
do possess, in a majority of instances, it is equally true that 
they may have little or no weight in others. There is a 
method of reasoning by exclusion, which, though not as 
accessible to every intelligence as would be actual demon- 
stration, and therefore not admitted by the law, is never- 
theless as infallible, when accompanied by a studious ap- 
preciation of facts. Upon a similar method of investiga- 
t on is based the entire plan of medical practice, and this 
process of inquiry alone is afforded for the detection of 
disease, where often life and death are involved. 
The absence of any reliable information of the symp- 
toms in this case, would be regarded as a lamentable point 
for the divergence of medical testimony, but for such evi- 
dence as I think points with fidelity to the truth. None 
with greater circumspection than myself would adduce the 
particulars of an imperfect post-mortem as evidence of 
death by poison, nor incautiously maintain that external 
features, upon which we arc taught no reliance can gen- 
erally be placed, are to be regarded as proof; but when 
♦Dr.i'rost’s Elem. Mat. Med. i>. o27, IS!:.'., 8 
those peculiar changes have occurred after death, andean 
only be ascribed to certain poisons, then they become suf- 
ficient to countenance an opinion, requiring but the testi- 
mony of the chemist to give it its full and important 
weight; therefore, had the above-mentioned objections 
been in themselves correct, they could haVe proved nothing 
with respect to this particular case, the necropsic appear- 
ances of which they could not have explained. 
There is no error more universally accredited, than that 
a sudden death must result from apoplexy, yet the highest 
authorities, and Rochoux among them, disprove the asser- 
tion. It is, indeed, so rarely the case, and so much more 
frequently to be imputed to disease of the heart, that ma- 
ny deny it altogether as a cause of sudden death. Christ- 
ison observes, that Devergie is the only late author of re- 
pute who maintains that it may destroy suddenly, sustain- 
ing his opinion by a case of immediate dissolution with 
apoplectic symptoms.* That apoplexy does, however, 
produce rapid death, must be admitted, particularly if the 
medulla oblongata be the seat of disease, then death may 
occur instantaneously, f It may be instantaneous when 
the hemorrhage occurs even in the anterior lobes of the 
brain,J but the patient generally lingers several hours or 
even days. Apoplexy does not develope the combined yel- 
lowness and excessive lividity of the entire body, with the 
appearances presented in this case by the abdominal vis- 
cera, particularly the stomach ; and it must be remember- 
ed, that had the brain been examined and found congested, 
this would not have been an unequivocal affirmation of 
death by apoplexy, for it is just what we would expect 
from a narcotic poison. But it may be argued, that extrava- 
sation caused the death, and that the apoplectic cell might 
have been discovered; this would have been strong pre- 
sumptive evidence, but would it have been proof of a natu- 
ral death ? Undoubtedly not. Extravasation has repeat- 
edly occurred from poisoning by opium,§ and what is well 
worthy of notice, in a death from poisonous fungi, a clot 
was also met with in the brain.|| Consider now the other 
side of the question. Had no recognizable alterations of 
structure been detected in the encephalon, would it be a 
justifiable inference that it was not apoplexy? Indubita- 
* Devergie relates the case of an elderly gentleman, complaining of headache, he 
coming pale, hanging down his head and dying suddenly, presenting no morbid lesions, 
but congestion of the cerebral membranes.—Christisnn on Poisons, Am. Ed, p. 514, 1845. 
See also Seance de VAcademie de Medicine, du Juin, 12,1838. 
fOllivier examined a man, who haying walked some distance, sat down, fell oyer and 
died in Uvo hours. The pons yarolii presented at its centre an apoplectic cell, which ex- 
tended upwards beneath the quadrigemina, downwards into the olivary and pyramidal 
tract, tearing and almost completely destroying the oblongata.—Arch. Gen. Med, v. 1, i‘. 
275,1833. 
+ Arch. Gen. Med., vol. 27, p. 467, 1831. 
g Loud. Med. Thys. Journ., Feb. 1816, and Loud. Lancet, 1136 to ’37, p. 271. 
|ChrUtw>on on Faisons, p. 709, 1815, 9 
bly not. For so far as the morbid appearances of the 
brain are concerned, death might have resulted from sim- 
ple or nervous apoplexy, noticed by Abercrombie,* Louis,f 
LobsteinJ of Strasbourg, and others, leaving not the slight- 
est vestige of morbid action in any part of the body ; 
though this disease, as we know, seldom terminates in 
death sooner than five hours; and it should also be stated 
that even these negative signs often coincide with indispu- 
table cases of narcotic poisoning.^ 
The difficulties likely to be raised upon the circumstance 
of the necropsy, being incomplete, compel me now to pass 
in review those morbid changes producing instantaneous 
dissolution, which may invade either the encephalon, lungs, 
heart, or large blood-vessels, calling to mind the invariable 
absence in each instance, of the marked characters of poi- 
soning presented by my patient. 
I shall just allude to a phenomenon which, though not 
immediately connected with either of the organs forming 
the tripod of life, claims attention here, as becoming the 
source of instant death, and accounting for the apparent 
absence sometimes of any necropsic indications of the 
cause of such a termination—I mean the spontaneous de- 
velopment of a gaseous fluid within the blood, distending 
the venous half of the heart, interrupting circulation and 
producing death. The morbid appearances are general 
paleness and rigidity of the body; brain and membranes 
healthy; abdominal organs in their normal state; no ab- 
dominal tympanitis ; the lungs presenting no other morbid 
alteration, than the mechanical congestion which some- 
times follows death ;|| the right half of‘*the heart distended, 
as it were inflated and tympanitic; left heart, empty and 
normal; cerebral vessels containing air; and the physical 
characters of the blood unchanged, flfuch is this rare phe- 
nomenon, bearing every resemblance to the introduction 
of air into the veins, and as rapidly fatal, which some 
years since particularly fixed the attention of Ollivier.^I 
* Patholog. and Pract. Researches on Diseases of the Drain, p. 211. 
fRecherches Pathologiques. 
+ Arch. Gen, Med., p. 260, rol. 23, 1830, 2d Serie. 
gin a case examined judicially by Christison, there was neither congestion nor effu- 
sion.—Christison, idem, p. 563. 
|l The lungs, after death, are always filled with fluid ia their dependant parts, which 
become denser and darker than the rest; this, however, is no engorgement following 
death, ner indicating the position in which the body has lain, as was supposed, but is 
known from experimental investigation to occur immediately before death. Those who 
die upon the side, or while sitting, present the engorgement at the side or base of the 
lur g—the dependant part at the time of death ; notwithstanding the bodies may have 
lain on the belly for some hotirs. This I mention as important in a medico-legal point 
of view, as well as exhibiting the predominant influence of physical laws at the decline 
of the vital powers. 
Hippocrates was certainly aware of the effects of an admixture of air with the 
blood, and though he cites no instance of the spontaneous production of such a cause 
followed by death, says, in his Lib. De Platibus : Syderationes corporis, apoplexie dicte, 
ex flatibus oriuntur, si multi flatus totum corpus permeant, totus homo attonitus red- 
ditur, si vero partem aliquant, pars ilia. And further on he continues: cum spiritu oo- 
yioso per totum corpus universo sanguini permixo, obstructiones multe inultifariasw 10 
The supervention of death by the lungs is sometimes as 
rapid as if the medulla oblongata had been severed. The 
experiments of Leroy d’Etoilles* demonstrate this fact, had 
we even no pathological evidence of their correctness. 
From the exquisite structural delicacy, and important rela- 
tions and office of these organs, we are readily disposed to 
infer the instantaneousness of death upon the occurrence 
in them of spontaneous lesion, as'these must at once in- 
terrupt the circulation; yet it is subject of surprise that 
few have devoted any time to the appreciation of this 
point of pathology, as connected with legal medicine ; Lan- 
cisi, Dionis, Ollivier d’Angers and Lebert, form the few 
who dwell at all discursively upon the subject. Now it is 
deserving of notice that, in the opinion particularly of the 
two last mentioned authors, with whom we are not willing 
to join issue, sudden death is more frequently to be imputed 
to a disturbance of the functions of the lungs, than of the 
heart, or its blood-vessels. It is matter of notoriety that 
the ingress of air or any fluid in or about the cells of these 
organs, whether from without, or developed spontaneously 
within them, may interrupt, suspend or destroy the respi- 
ratory function, and with it life. The first of these phe- 
nomena, and by far the rarest in producing any injury to 
health, is interlobular emphysema. 
Emphysema lobulare.—Of this disease, the accounts by 
Lacnnec, as among the earliest, are.also among the best. It 
differs from vesicular in being developed suddenly during 
violent muscular exertion; moral emotion, or rather the 
instant suppression of passion, has given rise to it. A vi- 
olei t inspiration fills every cell to the utmost, the rima 
glottidis closes, and an equally violent expiratory effort 
ruptures the structures, driving the air into the interlobular 
spaces, sometimes flP%m thence through the areolar tissue 
of the mediastinum, along that of the neck, and thus into 
the sub-cutaneous cellular tissue of the entire body. Not- 
withstanding the strictures of Meriadec Laennec, who 
endorses his illustrious namesake’s remark, that he had 
never seen any one die of this affection ,f several genuine 
circa venas contingunt: cum igitur in crassiores et sanguine abundates venas copiosus 
aer prorupit, progressusque immoretur, sanguinis pirtransitus prohibetur atque liic 
quidem sistitu , ibi vero tardius permeat, alibi autem citius. Morgagni however attri- 
butes a death to this cause, having found air in the blood-vessels; but the abdomen 
was tympanitic, gangrene seems to hare been present, and it might have been due to 
commencing putrefaction.—Morgagni,De Sed: et Caus: Mtrborvm Lib. I. 1ip. 1'. jj IS. 
In the same chapter Morgagni relates three other instances on the authority of Pechlin, 
Groetz andHuyscb; the last two are particularly interesting. Ollivier eiles three ex- 
amples,—a child, convalescent from scarlet fever; a robust man, hitherto in perfect 
health; and a young girl 22 years old. These all died suddenly, revealing in the two 
first examples, general emphysematous infiltration of the cellular tin ue soon after 
death.—Diet, de Med. V. 2 p. 65, and Arch- Gen. V. 1, p. 43, 1838. 
Ilichat opened the body of one who died suddenly, and detected blood, frothy and full 
of air in che vessels of the head and neck, hut in this ease, the air entered the jugular 
vein during a surgical operation. Kech. pliys. sur la vie et ia Mort. (Euv. Comp. V. 2, p. 
273. 1832. 
* Itecherches cxperimentalcs sur l’Asphyxic; Paris, 1829. 
t Traite de L’Auscultation Mediate, 4th P.d. 1837. Vol. 1. p. 413 11 
and authentic cases are recorded. Morgagni not only ob- 
serves, non omnes circa nostri initium sceculi repentinas mov- 
ies ab apoplexia fuisse, sed plures etiam a. syncope, quasdam 
a suffocatione,* but relates an interesting case, which has 
all the appearance of being a death from emphysema. It is 
shortly as follows :—A sportsman, habitually short-breath- 
ed, returning from divine worship, partook of some food, 
was compelled to lie down, and scarcely had he time to 
call his wife, before he expired. The integuments were 
pale and cachetic n appearance, the abdominal organs 
healthy, the lungs inordinately distended with air, scarcely 
any effusion in the pericardium, the heart flaccid but very 
large.f As death in this instance was imputed by Mor- 
gagni o disease of the heart, I have thought proper to 
cite the entire case in the note, as most worthy of the rea- 
der’s attention. 
Piedagnel selects from among many others of the same 
hind, two cases occurring in 1820, at the hospital St. An- 
toine, in which the lungs were the only organs diseased, 
being emphysematous and crepitous.J Another instance, 
signally exemplifying the influence of excitement, and the 
suppression of passion over the development of this affec- 
tion, is related by Ollivier: a man slapped another, who, 
prevented from resenting it, turned away to recover his 
composure, fell upon his face and died. Death was owing 
to the spontaneous production of emphysema in both lungs.§ 
Again, Pillore cites three deaths from this disease; two 
were old men, one G9, the other 70. The necropsy dis- 
closed no other cause for the death but an emphysematous 
condition of the lungs.|| Breschet notices a case of the 
same kind belonging to Magendie.Tl Devergie recites two 
instances in which the affection was manifestly due to a 
preternatural exacerbation of nervous excitement—these 
were observed by M. M. Jadelet and Roger: a female, 
lively and exceedingly fond of singing, retired with her 
lover to bed, after a hearty supper; symptoms of suffoca- 
tion suddenly overwhelmed her during sexual embrace, 
and she died after a short, but violent agony ; pulmonary 
* Loco. cit. Lib. 1; Ep. 2, No: 4. 
t Venator, qui erat quasi assidue brevispirus; liac enim voce uti juvat; cum dies jam 
octo se minus valere, diceret, sed destomaeho dumtaxat quereretur, tandem, cum Sacris 
iuterfuisset, paucumque cibum sub meridiem sumpsisset, coactus se in lcctulum recli- 
nare, uxore vix advocata, vivere desiit. Cadavcris cute, quae crat cachecticis colore 
similis. tenuissimaque Adiposa membrana incisis, mox Venter et Thorax aperti sunt. In 
illo saua omnia. In hoc vero pulmones are erant maxime turgidi, et undique cum.vicinis 
partibus, si modo supremas excipias, conncxi, et propemodum connati, magna ut vi opus 
frucrit qua acostis, a diaphragmate, a mediastino avellerentur. Intra pericardium hu- 
inoris erme nihil, cor vero liaccidum, sed perquam magnum.—Loco: cit: Lib. 2, Ep. 
srviii. No. 14. 
J llecherches anatomiques et physiologiques sur i’cmphyseme du poumon. Paris, 
1829, p. 12. 
$ Arch. Gen. Med. 1833. Vol. 1, p. 229, 2d serie. 
II These Maladies Observecs al’hopital dcs Souveaux—nes, et a l’hospice dc la vieillcese 
1834. 
If Diet, dcs Sci. Med. 12 
emphysema with serous congestion, and froth in the tra- 
chea and bronchi®, disclosed the cause of death. A cart, 
in the second case, passed over the thigh and calf of a 
man, fracturing the femur, the chest sustaining no injury, 
but on dissection, the lungs were found generally emphys- 
ematous.* Finally, Prus has observed as many as eight 
cases at the Bicetre and Salpetriere.f 
Jn one of the three kinds of cedema of the lungs, recog- 
nized by Andral, the serous infiltration occurs so rapidly, 
as to induce symptoms like those of oedema of the glottis, 
and speedy death. Lebert believes that such a circum- 
stance might prove instantly fatal. He, however, I think, 
attaches undue importance to the case recorded by Andral. J 
Those laboring under pulmouary affections, do sometimes 
suddenly expire when neither brain, heart nor lungs offers 
any appreciable explanation of such an event. But these 
instances, seemingly dependent upon a nervous spasm of 
the glottis and bronchial ramifications, are almost invaria- 
bly sequels to diseases of a spasmodic character, such as 
asthma, hooping cough,—and though in one instance, An- 
dral saw life extinguished in twenty-four hours, the patient 
previously in perfect good health, with the exception of 
an ulcer on the leg,§ yet there will be little danger of such 
* Annales D’Hygiene. Avril, 1841. 
t Bulletin de l’Acad. Roy. de Med. May 24, 1842. There will he little reason, we 
hope, to apprehend the reader’s remaining in doubt, whether emphysema can produce 
sudden death. M. Prus mentions the importance of this determination to the medical 
jurist, stating that a person was found dead on the highway, no lesion existed but pul- 
monary emphysema; the physician judicially examined, was undecided as to the suffi- 
ciency of the cause to produce death, and conferring with a friend in Paris, learned that the 
question even there was not yet determined. Lamnec, M. Lasnnec and Louis affirm that 
pulmonary emphysema is never fatal. Ferrus seems also to believe that wc must look 
t» a nervous lesion, in such cases, for the cause of death; but on such a principle every 
spontaneous lesion and sudden death may be ultimately referred to disorder of the ner- 
vous system; besides, emphysema does not always require this condition for its develop- 
ment; no such cause obtained in Morgagni’s case of the sportsman, already mentioned, 
nor in many others which occurred at Bicetre and Salpetriere among the old. Emphy- 
sema is regarded as always coexistent with other affections, such as disease of the heart, 
which latter produces the death, but this is by no means proved. Neither Roehoux nor 
Royer Collard subscribes to this opinion; the latter inquired particularly of the physi- 
cians of the hospitals of Paris, who all denied any decided relations between these dis- 
eases. The array of authorities is considerable which hold that emphysema can, and has 
destroyed life, suddenly; these are Van Swieten, Magendie, Breschet, Picdagnel, Andral, 
Leroy d’Etoilles, Ollivier, Devergie, Bouvier, Prus, Poisseuille, Ilochoux, Floyer, Storck, 
and Lebert. Mr. Bouillaud never has seen the most apparently dangerous attacks prove 
mortal, but refers such an event, when it does happen, to traumatic emphysema; and in- 
deed, we believe that this opinion will at once reconcile all conflicting sentiment, and al- 
low of our ranking even Lmnnec and Louis among our list, as from the causes which 
produce the disease, we cannot fail to recognise a" traumatic lesion as the result, as 
when, for example, it follows moral excitement, violent efforts, &c., <fcc.; and even when it 
occurs among the old, who have suffered from chronic bronchitis, it is the sudden ingress 
or expiration of air through the narrow and obstructed tubes, which again ruptures the 
vesicles, and establishes the disease. Now how is death produced by this affection ? M. 
M. Poisseuille and Bougery observe, that emphysema diminishes the ferial surface of the 
lungs, the disappearance of the septa of several vesicles resolves these into a single one, 
whose a;rial surface is less than the sum of the surfaces of the vesicles from which it was 
formed; sanguification is thus interrupted, and death follows more or less rapidly accor- 
ding to the extent of the lesion. The air passing into tho intervosicular and interlobu- 
lar tissue, compresses the blood-vessels, and arrests the flow of blood. Death, then, is 
induced by diminution of the respiratory area, and obstruction of the capillaries. As 
Piedagnel supposes the air may pass sometimes into the arterial system. 
t Andral records a case in which the patientdied unexpectedly, in a few days, with pro- 
Tious pulmonary disturbance, expectoration, lungs cedematous with melenotic infiltra- 
tion.—Clinique Medicate. II 3, p. 231. 
\ Loc. cit: V. 3, p. 225. 13 
cases becoming the subject oi‘ judicial inquiry, as they are 
not examples of death supervening suddenly in perfectly 
healthy constitutions. 
Pulmonary Congestion..—Lebert, to whom we have par- 
ticularly referred on this subject, considers three stages of 
pulmonary congestion exempt from inflammation, properly 
so called, as ending sometimes in immediate death ; these 
are: sanguineous congestion and exhalation on the inner 
surface of the bronchial tubes without pulmonary engorge- 
ment, congestion with engorgement, and pulmonary ap 
oplexia.* These conditions in robust constitutions, ap- 
pearing as idiopathic, and causing death, are neither gen- 
erally known nor admitted. Watson observes that pul- 
monary hemorrhage, strictly idiopathic, has been more fre- 
quently affirmed than proved.f Such cases, however, may 
sometimes occur, as Lebert, Andral, and others have shown. 
Andral met with a death from pulmonary hemorrhage, un- 
accompanied by tubercles ;J and, as no mention is made of 
the heart, this organ was doubtless perfectly health*. Le- 
bert relates the following case: A soldier died suddenly 
from the same cause, after a copious meal; the heart and 
all the other organs were sound, but the bronchial ramifi- 
cations, on one side, filled with reddish and frothy 
blood.§ He also cites another, occurring again after a 
meal, in a scrofulous patient, but here there were tubercles. 
Simple hemoptysis, with or without tubercles, may there- 
fore produce sudden death. The second kind of congestion 
is a stasis of the blood, within the pulmonary parenchyma, 
rendering the lungs dense and heavy. This is effected 
either rapidly or slowly. Innumerable instances of rapid 
death from such a cause might perhaps be multiplied, but 
we will only mention those referred to by Lebert. 
Spontaneous pulmonary congestion will arise at times 
among the robust and plethoric in those addicted to in- 
temperance, or from a metastasis of some habitual hemor- 
rhage. Morgagni records two exemplifications of this dis- 
ease, occurring among women. In one of these the con- 
gestion was due, in his opinion, to a metastasis of the cata- 
menia to the lungs.ll Dionis gives the history of a ser- 
vant, who, while in attendance upon the Duke of Bour- 
gogne, fell dead; both lungs wrere in that state of engorge- 
ment termed splenization: and that of the Marquis de 
Louvoir, who, in the act of reading a letter to the King, 
was obliged to desist, and died in a quarter of an hour.*ff 
* Arch. Gen. Med., v. 1,1838 p. 389. 
f Lectures on the Principles and Practice cf Physic. 1847, Am. Ed. p. G09. 
tLoc. Cit.v. 2,154. 
| Arch. Gen., v. 1, pp. 396 and 398. 
j| Loc. Cit. Ep. xix., No.51, and Kp. xxxyi. No. 17. 
Dissertation sur la mort. subite. 2d Ed.. 1718. 14 
Lebert interprets several of Andral’s cases, and one of 
Louis’, as additional examples of the kind. Ollivicr fur- 
nishes us another in the person of a robust and perfectly 
healthy individual, who, rushing in a burst of passion 
against his landlord to strike him, turned pale, tottered, 
and fell into the very arms of him whom he threatened. 
This becoming the subject of legal inquiry, Ollivicr insti- 
tuted an examination, and demonstrated that pulmonary 
congestion was the cause of death. Both lungs were re- 
markably dense and hard, presenting a dark red color when 
incised, and the ramifications of the pulmonary arteries 
and veins were filled with clotted blood.* 
Of the second kind of congestion, in which the engorge- 
ment is of a chronic formation, but not revealed by any 
symptoms whatsoever, the patient appearing in perfect 
health, Lebert has collected two cases, as happening at the 
Hotel Dieu. The subjects of these were old persons, af- 
flicted with diseases of the urinary organs. They were 
seized suddenly with dyspnoea and suffocation, and died, 
one in twenty, the other in a few minutes.f 
In pulmonary apoplexy, properly so called, the sanguine- 
ous congestion is restricted, as it were, to circumscribed 
spots, where the blood is some time extravasated ; the tis- 
sue immediately surrounding these apoplectic centres be- 
ing perfectly healthy, though sometimes itself containing 
infiltrated blood. This condition of things is often accom- 
panied by laceration of the tissues, and of one or more 
blood-vessels. I need mention no examples of this affec- 
tion producing instantaneous death, for they are numerous, 
and every one is acquainted with the fact. 
Closely allied to these cases is the development of in- 
flammatory congestion, which, singularly inexplicable as 
it may appear, Lebert informs us, not unfrequently takes 
place without any signs disclosing its existence, but such 
as become at once the precursors of death. In other words, 
latent pneumonia may produce immediate death, and the 
necropsy expose the several degrees of the disease, whe- 
ther acute or chronic, demonstrating thereby that it was 
latent, and not engendered spontaneously. This extraor- 
dinary event seems almost always confined to the aged, 
for, at the Salpetriere, they were regarded as sudden 
deaths from old age, until Mr. Hourmann,J conjointly with 
* Arch.Gen. vol. 1, 1833, p, 233. There is another example of death, apparently from 
this cause, recorded in the Lancette Prancaise, vol. 2, No. 80, and in the Archives, vol xxii 
lt30, p. 111. A student of law, about eighteen or twenty, at one of the public balls, 
while waitsing continuously for a length of time, fell senseless and expired. Theiutegu 
ments of the lower extremities, thirty-six hours after death, were scarlet red, livid 
blotches on the chest and arms ; no blood issued front any of the orifices of the body ; 
the brain was somewhat congested, but the lungs were perfectly livid, conveying, when 
pressed in the hand, the sensation of a mass of cotton, 
t Arch. Gen., 1838, vol. ii, p. 57. 
J Arch. Gen., 1830, vol. xii, p. 164. 15 
Dechambre, examined into their nature. They describe 
two cases, one particularly interesting: the patient, an old 
woman, eighty-five, was chewing a biscuit at the time of 
her death ; the inferior lobe of the right lung was at the 
suppurative stage through its entire thickness, and no for- 
eign body was discovered in either the trachea or bron- 
chia).* Lebert details, from his personal observation, four 
others: two of these individuals were 75, one 60, the other 
78. In them the several stages of pneumonic inflamma- 
tion were discovered. To these Lebert associates the 
well known case of Ollivier, to show that instances of 
instances of the kind manifest themselves in the young 
also. A woman, 22 years old, at the fifth month of preg- 
nancy, had complained for some time of general uneasi- 
ness, but particularly so on the morning of her death ; she 
got up at eight o’clock and dressed, and at nine was found 
lying dead on the floor of her chamber. This was the re- 
sult of pleuro-pneumonia, of recent development. 
If we have referred at considerable length to death by 
the lungs, it is on account of its great importance to the 
Medical Jurist, and the imperfect knowledge generally en- 
tertained upon these points of pathology, and not from any 
resemblance which such cases present to a death from nar- 
cotico-acrid poisons. Marshall Hall would have us leave 
the lungs out of consideration altogether in every case of 
sudden death, referring the event to arrested circulation in 
the coronary vessels of the heart, or to lesion of the me- 
dulla. f Diseases of the heart are more familiarly recog- 
nized as eventuating in instant death, and we shall do little 
more than enumerate them, as they are severally treated 
at length in all works on practice ; we only remark that 
they are not always preceded by premonitory symptoms, 
but may seize an individual in apparent good health. 
Rupture of the heart, or of either of the large vessels im- 
mediately at their exit from the organ, fills the pericardi- 
um with blood, compresses the heart, and generally pro- 
duces instant cessation of its action ;J the face and gene- 
ral surface become very pallid; the vessels of the neck 
and head have, nevertheless, been found sometimes dis- 
tended and the depending parts livid. 
An inevitable sentence of death is a malady which Jen- 
ner termed Syncope anginosa, the angina pectoris of authors? 
the seat of this affection is the heart; the coronary ves- 
sels have been found ossified or cartilaginous; the organ 
*Arch. Gen. Med. v. xxii. p. 164. 
f Gulstonian Lectures. London. 1842. 
t Morgagni died of rupture of the heart, and so did George the II., and the Dutchess of 
Brunswick. M. Ollivier records the remarkable concurrence of rupture of the pulmo- 
nary artery and pericardium just at the instant that an individual received a wound in 
the neck; so extraordinary a coincidence gave rise to judicial inquiry, and M. Ollivier 
demonstrated the true cuase of death. Arch. Gen. Med., 1838,vo-l 1, p. 36. 16 
loaded with fat, and the aorta diseased; no other signs 
present themselves ; it is essentially a disease of old age, 
and altogether remediless.* Hypertrophy, softening and 
ulceration of the heart, may produce sudden extinction of 
life. In one instance of softening and ulceration, cited by 
Dr. James Andrew, he observed considerable lividity of 
the head and neck, but which did not extend to other parts ; 
the face on the contrary, showed a life-like aspect, and 
possessed a tint of a rosy hue.\ Metastasis of disease of 
the heart, hydatids, etc., are additional causes for the same 
fatal accident; and Winslow reckons spasm of the heart 
another. J 
Asphyxia idiopathica§ is a morbid disturbance of the 
functions of the heart, which destroys life with terrible ce- 
lerity, but of its pathology, we really know little more 
than that the heart is found entirely empty and flaccid; 
this llaccidity is not invariable, for Rochoux has in one 
instance met the auricles full of blood ;|| the patient turns 
pale, and swoons away into a mortal syncope, from which 
there is scarcely time to attempt, if there were means to 
procure, a recovery. Inasmuch as the disease is peculiar 
to parturient women from the sixth month to after delive- 
ry, and rarely met with among men, it particularly com- 
mands attention here, as it may be supposed to present an 
embarrassing resemblance to the concurrent circumstances 
of the case which I have here recorded. Idiopathic As- 
phyxia has been confounded with what I think is very im- 
properly regarded as the apoplectic convulsions of preg- 
nant women. I am reluctant to award any such special 
malady to pregnant females, and am strongly disposed to 
believe that the phenomenon is nothing more than ordi- 
nary apoplexy, occurring during gestation. The affection 
of which we speak is therefore entirely different from apo- 
plexy, which rarely, if ever, proves as rapidly mortal. 
Denman has cited several instances of death from what 
must be certainly regarded as the asphyxia of Cheva- 
lier : a female, previously complaining of pain in her head 
and impaired vision, endeavored to change her posture 
while in labor, and instantly expired, in the act of moving; 
another, as the child was about to be born, threw herself 
back and died immediately; and again, another female af- 
ter delivery sat up in bed to take nourishment, fell back 
* John Hunter died of this disease. 
-j- Lancet, 1845, vol. 2, p. 264. 
J London Lancet, 1840, Nov. 
£ Chevalier assigns this appellation to a d sease which he regards as a morbid insuffi- 
ciency on the part of the capillaries to propel the blood, whereby the heart, expelling its 
contents, receives no fresh supply, aud dies flaccid. Without expressing an opinion as 
to the correctness of this explanation, I will only remark that the above phraseology 
sanctions a physiological error, for though the capillaries are muscular, they exert no 
agency over the propulsion of the blood. 
|| Keehereli, sur l'Apoplexic, p. 159. 17 
■and died. Dr. Jenner made the necropsy, and found the 
heart flaccid, and not a drop of blood in either the auricles 
or ventricles.* 
In our patient, the actual condition of the stomach, the 
bright yellowness of the entire body, particularly that of 
the face, the crimson froth at the nostrils and mouth, and 
the lividity of all parts of the body, especially the fingers, 
admit the affirmation that neither of the several pathologi- 
cal conditions which we have been reviewing, caused her 
death ; caertinly not idiopathic asphyxia, which leaves no 
such concomitant phenomena; and from what has been 
said of apoplexy, few would admit this either, without its 
accompanying symptoms. If any evidence of an apo- 
plectic or epileptic state was present, and was known to 
be the effect of natural causes, and not unlawful means, 
why are we kept ignorant of what interest alone would 
have scrupulously noticed and faithfully recited ? Nor is 
the yellowness of the corpse to be referred to the jaundice 
of pregnant women ; this is a vital phenomenon, which ex- 
ists prior to death, whereas, in the present instance, it was 
developed a few hours after. Such a combination of ab- 
normal appearances are never the sequels of any of those 
diseases likely to produce sudden death, nor has an exten- 
sive acquaintance on my part, with the changes after 
death, frequently as late as fifteen days before and after in- 
humation, ever displayed them. The exhibition of nar- 
cotic poisons, on the contrary, almost always induces such 
an assemblage of morbid indications, and ergot, (though the 
fact be not generally known,) does develop the most per- 
nicious, the most poisonous effects in any constitution, snd 
especially in those manifesting a peculiar idiosyncrasy; 
and of such appeared to be this patient, to whose previous 
history I will now allude. 
Mrs. had been a widow seven years, and was the 
mother of a healthy boy, having passed through her preg 
nancy without anytmtoward symptom; of a highly nervous 
temperament, easily excited and readily impressed, she 
was in the enjoyment of a fair share of health, though 
sometimes inconvenienced by the consequences to which 
her natural liability exposed her ; thus it was that about 
a year and someTnonths past, at the death of her father, I 
was called to witness in her a severe attack of hysteria, 
which was only relieved by chloroform. Before resorting 
to this remedy, I remained a passive observer of the in- 
tensity of the attack, during which the eyes were fixed 
with a ghastly stare, the opisthotonotic contractions of the 
muscles were so continued and violent, that for half a 
♦Introduction to Midwifery, p. 427, 18 
minute at times, her body was completely arched, so as to 
rest only upon the occiput and heels ; no froth at the mouth , 
nor contortions of the countenance, breathing hurried, pulse 
full and irregular, and no groans. And on another oc- 
casion, a month before her death, some of these symptoms 
were again repeated, with no re-appearance of convul- 
sions, but a desire to retch, and after a slow return to con- 
sciousness, she complained of vague uneasiness in her legs, 
feet and hands, requesting that the latter should be put 
in vinegar and water. This is her history up to my last 
attendance, at which time, neither her family nor myself 
suspected her actual position. 
After a careful review of the causes operating sudden- 
ly upon life, I am still willing to maintain t hat poison was 
the cause of the fatal accident which has befallen this un- 
fortunate woman ; and that ergot was that poison, I have 
every reason to believe, and will enter into such particu- 
lars as may, perhaps, satisfy the scrutiny of the most 
sceptical. 
It is not generally remembered, as we have already 
intimated, that ergot is a poison. As such, however, it is 
ranked authoritatively, by its acknowledged effects. In- 
deed it is more than seven hundred years since this fact 
was well attested by Sigebert de Gremblour,* and for up- 
wards of five centuries it. was recognised as possessed of 
no other properties than those of a decided acro-narcotic 
poison. Camerariusf was the first at this period of its 
history, to announce its peculiar action over the uterus, 
and the unfavorable, reception it then met. in its newly as- 
sumed character of an ecbolic, sufficiently attests the dif- 
fidence and reluctance which accompanied the use of a 
substance fraught with the most pernicious influence upon 
the human constitution. Wc speak of it here in its char- 
acter of a narcotico-acrid poison, and we shall only allude 
to its therapeutical action so far as may conduce to the 
more perfect apprehension of our subject. 
A parasitic fungus invading the rye, engenders a disease 
in its growth: the fungus, developed within the grain, be- 
tween the teguments and the perisperm, increases in size, 
bursts the envelop of the grain, protrudes between the pa- 
le® and is pushed forward by the perisperm. These ex- 
crescences, from offering a fancied resemblance to the spur 
of a cock, have suggested for the spurred rye the officinal 
name of Ergot. As an article of food, spurred rye is not 
always attended with deleterious effects, but under the in- 
fluence of conditions not justly appreciated, they may 
burst with uncontrollable violence upon an entire commu- 
*Recueil dos Histoires des Gauls et de la Francs. ol. 3, p, 259. 
j- Ramsbotham’g Process of Parturition, 1845. A .A. 19 
nity. Epidemics of llie kind have raged at variou-s peri- 
ods at Sologne, Blois and Montarges in France, in Germa- 
ny, Switzerland, Denmark, Sweden, Bohemia, and other 
parts of the continent of Europe ;* and at no very remote 
period in Germany again, f Yet these consequences are 
the result of a simple admixture of rye with the food ; 
how much greater may we anticipate will be its action, 
when the medicinal agent is separately exhibited as an 
article of the materia medica ? 
The poisonous effects of ergot are developed by two 
separate trains of phenomena, differing in nature accor- 
ding to the amount of the substance taken, and the length 
of time its use has been continued, and to these collective 
symptoms the term of ergotism has been applied. When 
persisted in for some time as an every day food, it dete- 
riorates the entire system, emaciating and inducing a ca- 
chetic habit, accompanied by a sensation of formication or 
the creeping of insects over the body, which the Germans 
express by the word Knebelkrankheit. This impaired vi- 
tality of the constitution termiimtes in the manifestation 
of gangrene in the extremities, and sometimes in sponta- 
neous sloughings, and this constitutes gangrenous ergotism. 
Of this we have no more to say. 
When under other circumstances it is resorted to for a 
short time, and even in smaller quantities, the superven- 
tion of another and more dangerous order of symptoms oc- 
curs, which often proves fatal, and invariably so in epilep- 
tic individuals, or such as are in any wise predisposed to 
similar nervous The powerful agency of 
ergot over the nervous centres, is especially exemplified in 
this phase of the disease. Here, dimness of sight, vertigo, 
nausea, but not always vomiting, violent cardialgia, and 
numbness of the limbs appear in rapid, but irregular suc- 
cession, followed with increased heaviness of the head, 
and a return of sensibility in the limbs which gives rise to 
the sensation of formication, and sometimes of a burning 
heat; there is not unfrequently .aberration of the intel- 
lectual faculties and entire loss of sight, and finally, opis- 
thotonos declares itself by the most violent and painful 
contraction of all the muscles of the body, during the con- 
vulsive efforts of which incredible force is required to ex- 
tend the spasmodically flexed limbs and fingers; the tongue 
is sometimes lacerated during the convulsive movements 
of the jaw, and a yellowish, greenish or bloody froth ap- 
pears at the mouth; the pupils are either dilated or con- 
tracted, and the face yellow with purple blotches over the 
* Tissot. Philos. Trauti. vol. 55, p. 108. 
+ Christison. Lee. Cit. p. 717. 
J Tide Orfila, Mod : Legale. Y. 3, p. 483, 3d Ed: 1838. 20 
surface; yellowness invades the integuments, which also 
become livid after death ; and the pulse remains regular, 
but is somewhat depressed, often small and imperceptible ; 
a comatose state very soon supervenes, and the scene 
closes in death in twenty-four or forty-eight hours, though 
it may last a week or even months, and such are the fear- 
ful results of the use, in certain seasons, of rye-bread. It 
must be observed that this state of nervous erythism most 
frequently precedes the sopor and coma of complete nar- 
cotism, but these primary symptoms are sometimes of so 
short duration, and so slight, as to pass unobserved, or are 
often wholly wanting—the rapid supervention of narcosis, 
being the only evidence which is furnished of approaching 
danger ; this we shall see has occurred from the use of the 
ergot in substance. Much depends upon the freshness and 
integrity of the ergot in producing such effects, and these, 
when most acute, exhibit a strong resemblance to the ac- 
tion of many other fungi. Christison observes, that poi- 
sonous fungi also sometimes produce narcotic symptoms 
alone, and cites several examples: a man by mistake stew- 
ed a number of the Agaricus campanulatus, and not above- 
ten minutes after he began to eat them, he was suddenly 
made dim of sight, and giddy, lost his recollection, trem- 
bled, and was weak—he walked two hundred and fifty 
yards, when his countenance expressed anxiety, he reeled 
about as if intoxicated, and could hardly speak ; a youth 
from eating another variety, was seized in a similar man- 
ner, with the addition of convulsive spasms, furious de- 
lirium, and dilated pupils; after the use of emetics, the 
stomach pump, and stimulants, they both recovered.* 
There is, indeed, an endless variety in the symptoms of 
these aero-narcotic poisons, all of which induce a de- 
praved condition of the system, altering the nature of the 
blood, and very soon effecting a change in the color of the 
skin, which becomes yellow and livid. Christison says 
that the morbid appearances in those poisoned by these 
substances, are but imperfectly known; but this much is 
ascertained, however,—the body turns as we have said, 
yel ow and livid ; the blood is fluid, so as to flow from the 
natural openings in the dead body; the abdomen is dis- 
tended with fetid air; in some places the stomach is gan- 
grenous and far advanced in decomposition; the lungs 
gorged with blood as also the vessels of the brain ; the 
sinuses of the dura-mater are found exceedingly distended, 
the membranes highly injected, and the substance itself 
of a scarlet color ; sometimes extravasation occurs, for 
Picco met a clot in the cerebellum, the size of a bean.f 
•Chrlstipon. Loc. cit. p. 706. 
+ Christison. Eoc. cit. p. 709. 21 
With such examples before us, it ought at once to be in- 
ferred that the noxious principle itself must act even more' 
rapidly and violently, particularly when the special sort 
of effect depends upon idiosyncrasy. The peculiarities 
of temperament must vary and modify the action of these 
poisons astonishingly; in certain individuals,the simple odor 
of the most fragrant plants may be regarded as relatively 
poisonous, and when endured but fora few minutes devel- 
ops cephalalgia, palpitations, syncope, convulsions, vertigo, 
aphonia, and finally asphyxia the most delicious kinds of 
fishes exert a very deleterious effect upon many; and of the 
class of poisons of which we speak, the best and most es- 
culent mushrooms may very rapidly prove injurious. On 
the authority of Christison we will mention that Sage re- 
lates a man’s death in a few hours from eating the tuber 
cibarium, or common truffle.f Under similar circumstances, 
we should be prepared to witness the separate symptoms 
of irritation, or narcotism, or the rapid transition from one to 
the other during the administration of ergot, even if no 
instances of the kind had ever been indicated; but fortu- 
nately, amidst the imperfection of our knowledge on this 
point, there is sufficient evidence of the sort, as we will 
now show. 
Various degrees of the severity of the action of ergot, 
when administered even in comparatively small doses, 
have been recorded, the effects not being referred to any 
peculiar constitutional proclivity obnoxious to such mani- 
festations, and doubtless many more are to be found, had 
we the space and leisure for such a purpose. 
In a thesis of M. Flaubert on ergot, in contending 
against uterine inactivity, we find the relation of a case 
in which Mrs. A experienced a violent pain in the 
right thigh, followed by complete numbness of the limb 
and foot, which were pale and cold ; her slipper fell off 
several times without her being conscious of it, and she 
remained in this condition for fifteen days after her con- 
finement. % An English physician, Dr. Michell, seems also 
to have noticed this distubrance in the nervous system, 
when he says the effect of ergot on the mother, is to cause a 
deadness of all the parts of the body.|| The same author men- 
tions that the impression on the nervous system is such, 
that a woman inquired what had been given her, exclaim- 
ing, “/ am dying.!” A pregnant woman, according to Mr. , 
Smith, a few minutes after taking ergot demanded, “ What 
have you given me ? it flies all over me like lightning.”^ 
* Orfila. Loc. cit: V. 3, p. 483. 
+ Loc. cit. p. 703. 
+ These, Paris, 032. Obs: 13, pp. 22, 23. 
P Wright, Edin. Med. Burg. Joura. V. 63, p. 13,1840. 
i Wright. Loc. Cit- p. 26. 22 
On the authority of Drs. Maunsel and Cusack, other in- 
stances of the kind are mentioned; the former says that 
two drachms of ergot, administered to a certain parturient, 
woman, were sufficient to render her delirious in half an 
hour. Half a drachm given in two doses on another oc- 
casion, produced in fifteen minutes intense headache, de- 
pressed pulse, and stupor; and again, two doses of one 
drachm each, produced muttering delirium, coma, and livid 
lace.* Dr. Cusack relates that when 3jss. were given, the 
pulse sunk from 120 to 90, and considerable stupor super- 
vened and on three other occasions half drachm doses in- 
duced symptoms of anapoplect ic kind, the pulse not exceeding 
40 in the minute.J Dr. Simpson, of Edinburg, informed Dr. 
S. Wright (to whose valuable essays on the subject we are 
indebted for some of these references) that small doses, in 
one instance, induced symptoms of Dr. 
Charles Hooker, of New Haven, speaks of the narcotic 
properties of ergot, and in a highly interesting article, re- 
lates his experiments as demonstrating that the ecbolic 
and narcotic properties may be entirely separated, so that 
it may be used to promote the uterine contractions, with- 
out inducing narcosis, which, he says, it is liable to do.|| 
In another order of cases which have come under my 
notice, much more decided effects have resulted from even 
the infusion of ergot, convulsions and complete narcosis 
being produced, and the patients escaping only through the 
sufficiency of such remedial agents as were called into re- 
quisition. 
Dr. Isaac Hull,“[I U. S. N., has described the results of 
an overdose of ergot, in a lady of delicate constitution, 
with a peculiar idiosyncrasy against all narcotics. The 
ergot, he states, had lest some of its activity from age, and 
of this, he exhibited twelve ounces of the infusion made 
with one drachm every half hour, he soon perceived that 
his patient was in a state approaching insensibility. The 
pulse was feeble, about G5, and the limbs covered with a 
cold sweat. Shortly the palpebrse began to swell, likewise 
the lips and fauces, and tears flowed copiously; the 
Schneiderian membrane seemed much stimulated ; there 
was coryxa, and great difficulty of breathing through the 
nose and injection of the vessels of the conjunctivae ; the 
lips and palpebrse began to puff as if stung by a bee, and 
gradually assumed a livid appearance. The power of de- 
glutition was now nearly lost; the voice became feeble ; 
* Lond. Med. Gazette, June 1834. p. 606. 
+ Lond. Med. Gazette, idem. p. 60o. 
t Dublin Hospital Reports. Vol. 5. 
i Ed. Med. Surg. Journ. V. 53, 1840, p, 10. 
J Bo; ton Med. Surg. Jour, V. 10, 1834. 
S Geddings’ North Amcr. Arch V, 2, p. 81,1836. 23 
the jaws were fixed, and with dilHeulty could an answer 
be elicited. Previous to arriving at this point, she com- 
plained of pain in every nerve, and a sensation of empti- 
ness of the head ; carbonate of ammonia was administer- 
ed and frictions resorted to, and as the pulse rose and the 
patient recovered, .there was a general perspiration, the 
matter of which emitted the peculiar fetor of ergot. 
Dr. E. H. Bishop, in a communication to Professor Dun- 
glison regarding the powers of ergot, states that he lias 
“ once seen unpleasant effects, when giving the powder; the 
labor was protracted and narcotism produced.* 
For another case of poisoning by ergot, too interesting 
not to be cited at length, we are indebted to Dr. John 
Beckwith, of Raleigh, North Carolina.f In a letter to Dr. 
McKee, he thus relates the case : 
“ Mrs. , aged 30, enjoying excellent health, was, during her fifth labor, 
induced to take thirty grains of ergot, for the purpose of restraining a real or 
supposed tendency to hemorrhage after the expulsion of the placenta. In 
about an hour she complained of nausea and palpitation, and presently of dim- 
ness and confusion of sight. Vomiting was encouraged, and she threw up 
most of the ergot; the effect, however, continued and increased. The pulse, 
usually about 80, sank to 40, with frequent intermission, double vision soon 
followed, and then entire blindness; in two hours more delirium came on, suc- 
ceeded by heavy sleep and snoring. She could be roused, not to consciousness, 
but to low muttering wonderings; temperature of skin low, with free perspira- 
tion. Next morning, the hands, feet, ears and nose became purple, and much 
of the surface assumed a mottled aspect; then came on strong and general 
convulsions. When they subsided her color slowly returned, and from that 
time all the symptoms of poisoning gradually disappeared and by evening she 
was decidedly out of danger. Through the day she complained much of sore- 
ness and tightness about the throat, and the tongue was swollen. The memo- 
ry was tardily recovered; almost every incident connected with her labor, 
even the birth of her child, was entirely forgotten. There was extraordinary 
secretion of urine.” 
Another interesting case is reported by M. J. Wright, of 
Nottingham: 
“ In attendance upon Mrs. S , the mother of two children, and observing 
the inefficiency of the labor pains, Dr. W administered two drachms in 
infusion in two doses. She was delivered in half an hour from the time of 
taking the first dose. In a few minutes she became sick, and vomited wffiat ap- 
peared to be the medicine recently taken. Presently afterwards she lost all 
voluntary motion, and even the power of utterance. Her heart beat very ra- 
pidly, and her breathing was extremely laborious. The room presented to her 
the impression of water excessively agitated on its surface; she compared it to 
the ‘foaming of a troubled sea.’ She lay motionless during the earlier part of 
the day, and micturated abundantly. She declared that such w'as her helpless- 
ness at one time, that ‘had the child been falling out of bed, or had the 
house been on fire, she could not have made the least muscular effort.’ 
That these are indeed the effects of ergot, and to be refer- 
red with every plausibility to its action, is fully substantiated 
by direct experiments upon animals. These investigations 
*Am. Med. Intelligencer, 1837, p. 330, 
t Dungiison’s Amer. Med. Intel., Oct. 1839, p. 2l3. 
J Edin. Med. Surg. Journal, V. 53, p. 12,1810, 24 
have been made by several physiologists, both upon ani- 
mals, and so far as practicable, upon the human subject; 
but those by far the most complete and satisfactory are by 
Dr. Wright,* and more recently by Bonjean of Chambery.f 
Whether injected into the arterial or venous systems, or 
introduced into the stomach, the effects of ergot, (always 
poisonous.) have varied according to the peculiar tempera- 
ment of the animals. Solutions of ergot injected into the 
vessels prove rapidly destructive, in a concentrated form, 
at once influencing the nervous centres, brain and chord, 
and paralyzing the animal instantly, no resistance to its ef- 
fects being discernible; J and even in a weak solution, pro- 
gressively impairing the energies of the system, and ex- 
hausting the vital force. When eAibited through the 
stomach, local irritation of that organ is always produced, 
evinced by nausea, hiccup and vomiting. The fatal re- 
sults are much less rapid in these latter experiments, as 
gradual marasmus, gangrene and suppurations are most 
frequently developed, but where a peculiar predisposition 
engenders convulsions, spasms, and as in one instance 
mentioned by Bonjean, where in an entire family the con- 
vulsive form alone manifested itself, then narcosis may fol- 
low, and death is more rapid. Such is the local irritation 
of a solution of ergot, that if injected into the rectum, it 
produces tenesmus, disury and priapism, and in connection 
with this remark, it is worthy of attention, that among Dr. 
Wright’s experiments, the injection of the solution into 
the veins produced congestion of the mucous surface of 
the stomach, which was deeply injected with blood-ves- 
sels, dark spots variegating its pyloric extremity, and the 
whole gastro-intestinal track presenting on some occasions 
a deep claret color, with bloody mucus towards the rectum.|| 
Frequently again the hypnotic effect seems to supervene 
so rapidly as to anticipate completely the convulsive phe- 
nomena ; neither spasms, convulsions, nor any nervous 
symptoms declaring themselves, the body grows cold, the 
heart flutters, the eye is insensible to touch or light, and 
death soon Another remarkable pathological 
condition is the congested state of the trachea and bron- 
chial ramifications, filled as they often are with frothy mu- 
cus. The lungs themselves are sometimes engorged, and 
extravasated blood was also noticed in the gastro-colic- 
and throughout all these experiments, the fre- 
quent discharge of the contents of the bladder and rectum* 
is a circumstance that should attract notice. 
* Vide Ed. Med. Journ. 1839, and two subsequent numbers for 1840. 
f Journal de Pharmacie. 
j Wright, Loo. cit. V. 52. p. 32S. 
[ lx>■■. cit- Exp. vi. p, 3.3. 
$ Vide Exp. VII 
% Exp. IX 25 
The ergot in substance, and even the infusion or decoc- 
tion, as we have seen, are all able to give rise under cir- 
cumstances not always easy of explanation, to a cohort of 
symptoms and changes, which sooner or later usher in 
death. Experiments with the oil of ergot, supposed itself 
to be either the vehicle or the active principle of the grain, 
is poisonous to a high degree. 
If any additional evidence is required of the pernicious 
effects of ergot, this may be found in numerous experi- 
ments instituted upon perfectly healthy individuals ; refe- 
rences may be made to those of J. C. Lorinser,* which are 
quite satisfactory, so far as they go. The distinguished and 
far-famed Professor Dunglisonf caused experiments of 
the kind to be performed by Drs. Cottmann and McKee, 
then resident physicians of the Philadelphia Hospital, 
which clearly establish the narcotic properties of ergot. 
And still more recently, Dr. Germain SeeJ and Dr. Hardy|| 
have justified, by further experiments, these conclusions 
regarding the sedative property of ergot, the latter re- 
marking that even the pulsations of the fcetal heart are 
also diminished. De Gravina,§ another experimenter upon 
this substance, tried the effects upon himself; he only took 
twenty-four grains, which in three quarters of an hour, 
produced vertigo, nausea, and attempts to vomit, excessive 
epigastric pain, great oppression at the head, the pulse fell 
from 65 to 54, and respiration decreased considerably per 
minute. These sedative effects are not to be regarded as 
the primary, but secondary action of ergot—this substance, 
as we have already said, is a narcotico-acrid poison, and 
narcosis is more frequently its secondary and final result. 
What we have now said, furnishes ample and sufficient 
proof of the powerful energies of this agent upon the ani- 
mal economy, and whatever theory of its physiological ac- 
tion we adopt, it will be able, perhaps, to explain them. 
The first point of importance which we take occasion 
to mention, is the rapidity with which the special effects 
of ergot are manifested. Dr. HardyTI examined into this 
question, and the accuracy of the assertion that only a few 
minutes—six or seven, and rarely fifteen—are required 
for the development of its action upon the uterus, will be 
confirmed by the experience of those who have availed 
themselves of it. We cannot stop here to inquire at 
length, whether this immediate supervention of its effects 
is proof sufficient that it acts upon the sentient extremities. 
* Bust’sIieportorium, and Arch. Gen. Med. 182S, V.T.3, p. 440. 
f Amer. Med. Intelligencer, Sept. 2,1839, p. 161. 
j These, Sur les proprietes du Seigle ergote. 
fDublin Journ. May 1-45. 
§ Br. For. Med. Bey. 1830, V. 10, p, 6i5. 
V Loc. cit. 26 
of tlie nerves of the stomach, or those spent upon the in- 
ner tunic of the blood-vessels, which would seem to be the 
ease, as time sufficient for its absorption scarcely inter- 
venes, or whether indeed it must pass into the circulatory 
stream before it can exert its influence. It is very likely, 
if I may express an opinion when such discrepancy of 
sentiment exists, that it acts in both ways. That it enters 
the circulation is probable, for we know that narcotics do. 
Prof. Dunglison* saw a new-born infant completely nar- 
cotized, the mother having taken morphia previous to its 
birth ; Kamsbothamf also witnessed just such a case when 
opium had been taken, and Barbier d’AmiensJ found that 
a child at the breast was similarly influenced, whose 
mother had taken the wine of opium. Wright’s experi- 
ments lead me to believe that the young in utero are some- 
times affected without the ergot having materially influ- 
enced the parent. But ilamsbotham|| has presented us 
with four instances in which the foetus died a few hours 
after birth, by convulsions; and we have seen that Dr. 
Hardy observed its effects upon the foetal heart. It most 
undoubtedly enters the circulation when the general econ- 
omy is so infected as to fall into a state of marasmus and 
gangrene, but the speedy revelation of its power, when it 
sometimes overwhelms the nervous centres, or again in- 
duces a preternatural exacerbation of nervous irritability, 
evinced by convulsions, spasms and aberration of the in- 
tellectual faculties, is equally well explained by its sudden 
agency upon the nerves of the inner coats of the vessels. 
Whatever we assume as the truth, one fact is positive, 
• which is its influence upon the cerebro-spinal axis; this is 
declared by the abnormal feeling in the limbs and rest of 
the frame, by the cephalagia, dilation of the pupils, and 
convulsions. These disturbances are not always present 
when the ergot has passed into the circulation, and when 
they do occur, they are not always in dependence upon the 
perturbations in the circulatory system. 
The ergot, affecting the spinal chord and brain, is in my 
opinion the true expression of its mode of action and sup- 
posed specilic agency upon the uterus, which power ma- 
ny agree that it displays through the medium of the ner- 
vous and not the arterial system, but their explanation of 
the phenomenon differs. Dr. Wright suggests that the er- 
got’s sedative action upon the system, by a general rather 
than a local impression, “ favors the disposition of the 
uterus to expel its contents.” Though it is true that de- 
* Dunglison’a Gen. Therap. and Mat.Med. 4th Ed, 18{0, V, l,p. 341, 
■f Process of Parturition, p. 488. 
1 Dunglis n’s Op. (.'it, 
jj Rams hotham Op ; Cit: Appendix. 27 
pression of the system often solicits the energies of a dis- 
tended or excited organ—such as the stomach or the rec- 
tum—and in this way, perhaps, the uterus ; yet were this 
theory correct, the parturient power of ergot could only be 
adventitiously displayed, would always require to be pre- 
ceded by marked evidence of depression, and could not be 
depended upon as invariable in its effects. I am rather in- 
clined to confess that in its operation upon the spinal mar- 
row, it may resemble strychnine in exciting the reflex ac- 
tion of that centre, which, transmitted to the spinal nerves 
in this manner, produces the apparently special influence 
upon the uterus ; and this, I reluctantly admit, is restricted 
to that organ, but believe it to extend to others under the 
dependance of the chord ; much might be advanced in 
support of such an opinion. In Dr. Wright’s sixth exper- 
iment, he says : “the sphincter ani contracted powerfully, 
and there was every appearance of severe tenesmus.”* 
Barbier d’Amiensf exhibited the advantages of ergot in 
paraplegia, and as regards its efficacy in affections of the 
bladder and rectum, when these organs have been paral- 
yzed, we may mention the following authorities: Stein- 
beck, X Petrequin,|| Houston,§ Hargrave,H Allier,** Guer- 
rant,ft and more especially P. S. Pagan,JJ who in an in- 
teresting memoir has subjected the question to experimen- 
tal tests of a very satisfactory character. In all these in- 
stances, decided effects were produced upon tlm pelvic 
viscera, and calculi were even expelled the bladder during 
micturition, amidst hypogastric pain, formication, and dis- 
turbance of sight. There seems to be unequivocal proof 
of this mode of action upon the spinal chord, and attention 
is directed to the circumstance, that when consorted with 
the rapidity of its effects, and the natural proclivity which 
idiosyncrasy may awaken, either for the development of 
convulsions or narcosis, a more adequate appreciation may 
be entertained of the power of this drug. 
Now the application of all these principles and facts to 
the case before us, exhibits not only the possibility, but the 
probability that ergot, either in infusion, decoction or pow- 
der, poisoned the patient. She was a fit subject for the 
occurrence of such fatal results: previously afflicted in 
two attacks with well-marked opisthotonos and empros- 
thotonos, and nervous depression of the vital energies, it is 
natural to infer that though enjoying good health, in a con- 
•Loc.cit. r. 62, p. 323. 
t Rer. Med., 1839. 
t Lancet, 1843, v. I, p 631. 
il Bulletin de Therapeutique, Mars 1842. 
3 Lancet, 1S44, v. 1, p. 700. 
Idem. 
** Med. Chirur. Rey. July, 1839. 
Jour, de Med. et do Chir., Nov. 1839. 
jj Memoirc sur l’ergot; eon action therap.et son emploi modicale. Aix., 1841, 28 
stitution so readily impressed and so easily overcome, an 
over-dose, as we have seen in the above cases and experi- 
ments, might at once develop strong convulsions, and the 
resiliency of the powers of life be subdued, and a fatal ter- 
mination secured by adscititious symptoms ot narcosis, sus- 
pending and extinguishing existence. The yellowness of 
the integuments and the mottled state of the body—the 
congestion of the capillaries of the head and neck, and to 
a certainty of the brain itself—the great development of 
gas, and the fetor accompanying it, are all particularly 
characteristic of ergot. The gas, by distending the abdo- 
men and driving the diaphragm into the thoracic cavity, 
indirectly compressed the lungs, the bronchial tubes of 
which, with the trachea, were filled with a bloody froth, 
and probably also with the substances regurgitating from 
the stomach, as the frothy mucus revealed the same odor 
and color of the liquid found in the latter organ, and in 
this manner this colored substance was subsequently forced 
through the nostrils and mouth. The particular mode of 
death contributed to increase the congested state of the ab- 
dominal viscera, and although all this may have been the 
effects of a single dose, yet we have reason to suspect 
that it may have resulted from the repeated use of ergot, 
which possesses, 1 believe, a cumulative action, and this 
leads me to a reconsideration of the condition in which we 
found the stomach. It is true that Dr. Hume considered 
this organ as indicating an intense degree of disease, and 
gangrenous in certain parts; that its mucous membrane 
exhibited a most unusual appearance is positive; as we 
have already stated, it was intensely congested in many 
parts, hypertrophied and abraded; I may add, that the 
rugae on its surface was raised in elevations, black and re* 
sembling melanosis, and of a hue somewhat darker than 
that of the contained liquid. At first I also thought that this 
was sufficient to establish the existence of true gangrene, 
but since 1 have experimented, as I have already mention- 
ed to my friend, I must be allowed to dissent from my pre- 
viously expressed opinion. The portion which, upon 
washing the stomach, fell as detritus to the bottom of the 
vessel, was not sphacelus nor gangrene, but a simple dis- 
organization after death, which is in itself equally express- 
ive of the action of ergot—a substance, according to Bon- 
voisin, highly conducive to putrefaction. The actual con- 
dition of the viscera was unquestionably due to the action 
of ergot, the presence ol which in the contained liquid 
was clearly demonstrated,* but I believe it to have been 
* The tests used for its detection were precisely tho6e employed by Christison on a simi- 
lar occasion, in which ergot was detected amidst the presence of several other substances 
—such as saein, contharides, etc-, criminally usod to procure abortion. 29 
the sojourn of the colored and highly irritating poison in 
contact with the mucous surface, which produced all these 
phenomena. We must remember that many writers, hut 
especially Dr. Yelloly, maintain that often a high degree 
of vascular repletion, amounting to a dark color, is noticed 
where perfect health has shown that no disease existed; 
the actual contact of a colored irritant may tinge, and 
even corrode the heart after death, by chemical action ; 
corrosion takes place rapidly, but ulceration, which is a 
vital act, requires time. The only means by which we 
may determine, then, whether violent inflammation exist- 
ed previous to death, which unmistaken symptoms alono 
would settle, is the detection of the indications of inflam- 
matory action, redness, adhesion, production of pus, pseudo- 
membranes or their plastic materials in process of forma- 
tion. But here there was no such evidence. The long 
protracted contact of the liquid in the cul-de-sac of the 
stomach produced the softening, for after death even the 
gastric juice may sometimes act chemically upon part; 
such was the opinion of Hunter, supported by many other 
writers—Carswell, Adams, Allan Burns,* and " ~eger,f 
though the latter believes that diseased action is generally 
necessary to elaborate gastric juice so endowed with acetic 
acid as to become corrosive. 
Putrefactive infiltration, or a blackish extravasation, 
gave rise to this appearance of sphacelus. Of this I con- 
vinced myself, by suspending the stomach for a time in di- 
luted alcohol, and transferring it gradually to the pure li- 
quid. The cleansing which it thus underwent divested it 
of its blackness, leaving a marked blush over one part of 
its surface, and one or more small abrasions. These I term 
abrasions, for they cannot be considered as ulcers, as there 
exists no inflammatory circles around them. The disap- 
pearance, by these means, of such singular traces of dis- 
ease, is a point of great interest to the medical jurist, for it 
shows that in this, like in other tissues of the body, we may 
detect such extravasations as occur before, from those pro- 
duced after death. Simple imbibition in the tissues disap- 
pears, but any change of a vital character becomes incor- 
porated in, and identified with, the texture of the part— 
alcohol having no effect upon it; this I have frequently 
noticed in preparing anatomical specimens. But here, 
though no sphacelus nor gangrene can be admitted, yet 
there certainly exists disease—the lining membrane is hy- 
pertrophied, and there is a well marked blush upon its sur- 
face in some parts. This suggests, that if she had not ta- 
* Vide Carswell’s Rechercbcs sur la dissolution chlmiq.u9 cu digestion des parols ds 
1’estomac apres la mort, etc., etc. 
f Journal d’Hufeland. 18ll—1813- 30 
ken erg i before, some other medicine of an abortive char- 
acter must have been used ; but I incline to the be- 
lief that ergot was given during this time, and that proba- 
bly the attack under which she labored, a few weeks pre- 
vious to her death, was some of the transient symptoms of 
ergotism. The singular burning experienced in the limbs, 
and the extreme-prostration of her are to be no- 
ticed with particular interest in this connection. 
We therefore conclude, that from the powers of ergot 
and from all' the circumstances of this interesting case, 
this unhappy woman was a victim to the poisonous pro- 
perties of a medicine, operating upon a constitution whose 
liabilities guarantied the most fearful consequences. To 
these, indeed, must he referred those many difficulties 
which so often perplex the physician ; for, in the language 
of another, we hold that “ idiosyncrasj', as arising in most 
cases from inappreciable causes, is the most absolute and 
inevitable difficulty in medical evidence, since no accumu- 
lation of instances, such as might suffice for the removal 
of all other doubts, can secure us wholly against this 
source of error.”