Duty Of Practitioner In Supposed Case Of Poisoning
If called to a case supposed or suspected to be one of poisoning, the
medical man has two duties to perform: To save the patient's life, and
to place himself in a position to give evidence if called on to do so.
If life is extinct, his duty is a simple one. He should make inquiries
as to symptoms, and time at which food or medicine was last taken. He
should take possession of any food, medicine, vomited matter, urine, or
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fæces, in the room, and should seal them up in clean vessels for
examination. He should notice the position and temperature of the body,
the condition of rigor mortis, marks of violence, appearance of lips and
mouth. He should not make a post-mortem examination without an order in
writing from the coroner. In making a post-mortem examination, the
alimentary canal should be removed and preserved for further
investigation. A double ligature should be passed round the oesophagus,
and also round the duodenum a few inches below the pylorus. The gut and
the gullet being cut across between these ligatures, the stomach may be
removed entire without spilling its contents. The intestines may be
removed in a similar way, and the whole or a portion of the liver should
be preserved. These should all be put in separate jars without any
preservative fluid, tied up, sealed, labelled, and initialled. All
observations should be at once committed to writing, or they will not be
admitted by the court for the purpose of refreshing the memory whilst
giving evidence. If the medical practitioner is in doubt on any point,
he should obtain technical assistance from someone who has paid
attention to the subject.
In a case of attempted suicide by poisoning, is it the duty of the
doctor to inform the police? He would be unwise to do so. He had much
better stick to his own business, and not act as an amateur detective.