Book Review

Poison, Detection, and the Victorian Imagination

N Engl J Med 2007; 357:1164-1165September 13, 2007

Article

Poison, Detection, and the Victorian Imagination
(Encounters.) By Ian Burney. 193 pp., illustrated. Manchester, England, Manchester University Press, 2006. $59.95. ISBN: 978-0-7190-7376-2

For three days he would water this cabbage with a solution of arsenic. . . . [He] got a rabbit . . . and made the rabbit eat a leaf of the cabbage. The rabbit died. . . . [He] gets his cook to gut the rabbit and throws the intestines on a dungheap. On the dungheap there is a hen, which pecks at the intestines, falls ill in its turn and dies the following day. Just as it is in its final, convulsive agony, a vulture flies past . . . dives at the body and carries it off to a distant crag to eat it. Three days later the poor vulture, having felt constantly ill since its meal, is seized with a fainting fit. . . . It falls out of the sky and plummets into your fishpond. Pikes, eels, and moray eels . . . bite the vulture. Well, suppose that on the following day this eel or this pike is served up at your table, poisoned at four removes, and your guest is poisoned at the fifth and dies after a week or ten days from a pain in the guts, vomiting and an abscess on the duodenum. There will be a post-mortem and the doctors will say: “The patient died of a tumour on the liver, or of typhoid fever.”

— The Count of Monte Cristo (1844–45) by Alexandre Dumas

Like many novelists of his time, Alexandre Dumas both reflected and stimulated the fascination of Victorian society with the art and emerging science of poisoning. In this highly referenced scholarly book, Ian Burney, a historian at the University of Manchester, investigates the origins and consequences of this fascination. What emerges is a rich and vivid description of Victorian life that is focused on its literature, social mores, legal system, journalistic practices, attitudes toward women, criminal infrastructure, and medical institutions.

Physicians will find themselves particularly engaged in this slim volume as Burney explores the intricate interdependence of the doctor and the poisoner. The doctor is supposed to uncover the stealthy poisoner and provide the convincing expert testimony that will ultimately convict him or her (and there were a lot of female poisoners). In the process, he (medicine was essentially a male profession at the time) experiments to find ever more subtle and sophisticated methods of detection and, in turn, methods of poisoning. The public nature of his testimony and the insatiable appetite of the press and the populace for his dramatic findings further fuel the public appetite and the imagination of popular writers. As he testifies, the doctor also inadvertently becomes a teacher, essentially writing instructions for would-be poisoners. The work of these poisoners becomes increasingly refined — delayed, distant, natural-looking, and increasingly difficult to detect.

The ultimate example of the synergistic relationship between doctor and poisoner is when the doctor is the poisoner. We are treated in this book to a detailed presentation of a famous case — that of William Palmer, who perverted his medical knowledge, his privileged position in certifying individuals as fit candidates for life insurance, and his access to the postmortem examinations of his victims to become a highly effective serial killer. Although he eventually was sent to the gallows, his amazing skill with strychnine put him in a classic duel with the leading expert in toxicology, Albert Taylor, who failed to find poison in the victim. The intense psychology, snappy courtroom tactics, and Palmer's cryptic last words — “I am innocent of poisoning Cook by strychnine” — could be right out of a television episode of Law and Order: Criminal Intent.

Laburnum anagyroides (Golden Chain Tree).

This is a book about poison, poisoning, and the detection of poison. It also reveals remarkable insights into the development of clinical chemistry as a discipline, the early attempts to mandate the labeling of potentially toxic medications, the development of medical school curricula, the relationship between prescribers and pharmacists, the responsibility of the medical witness, and the role of the press and the entertainment industry in stimulating criminal behavior.

Orah S. Platt, M.D.
Harvard Medical School, Boston, MA 02115