Science

AMONG certain tribes of Australia and South Africa, every death is attributed to witchcraft, and among our own European ancestors, until comparatively recent times, every sudden death, not explicable by contemporary medical knowledge or medical ignorance, was supposed to have been occasioned by poison. If our memory serves us, we have already referred, in the course of these notes, to the interesting and instructive case of Henrietta, sister-inlaw of Louis XIV., as it has been acutely analyzed and brilliantly elucidated by Littré, in his lately published volume of Essays on medical topics. At the distance of two centuries, not only does the great physiologist demonstrate that the sudden death of this lady was not caused by poison, but he determines with precision the character of the disease which killed her.

If the jurors who were called upon three years ago to decide whether Dr. Paul Schoeppe was guilty of murder had possessed sufficient enlightenment to read and comprehend such an essay as that of the illustrious Littré, it is probable that an innocent man would have been spared three years of unjust confinement with the loss of reputation and social position. The case is so important, as illustrating both the dangers of jury-trial and the false views current respecting the worth of the testimony of experts, that we may be excused for recalling its main incidents.

In 1868 Dr. Paul Schoeppe, a highly educated physician and graduate of the University of Berlin, about thirty years of age, established himself in practice at Carlisle, Pennsylvania. He soon became engaged to a wealthy maiden lady, Miss Steinecke, old enough to be his mother She made a will, bequeathing him all her property, amounting to some fifty thousand dollars. Shortly before the time set for the wedding, Miss Steinecke died very suddenly, Dr. Schoeppe and one Dr. Herman being in attendance upon her. No one suspected any foul play until Dr. Schoeppe demanded the property under the will, when the lady’s relatives, unwilling to be thus set aside in favor of the gallant newcomer who had captivated her fancy, at once raised the cry of poison, just as the same cry used to be raised in the Middle Ages whenever a sudden death occurred. The scene which followed would have done credit to the darkest of the dark ages. The community of gossips instantly inferred murder from the circumstances ; the newspapers began at once to deal with the case with as much assurance as if their respective editors had actually seen the doctor mixing and administering the fatal dose; an “expert” — Professor W. E. Aiken of the Baltimore Infirmary—was summoned and told to look for poison, and seeing some blue spots which might conceivably have been due to prussic acid, he incontinently declared that he had found prussic acid in the stomach of the deceased. Dr. J. S. Conrad, another “ expert,” gave some concurring testimony, and accordingly Dr. Schoeppe was found guilty and sentenced to be hanged.

Now the evidence upon which this conviction was procured was so ridiculously flimsy, when viewed by any one sufficiently conversant with scientific methods to estimate it at its due weight, that a protest against the unjust sentence was speedily called forth from scientific students in all parts of the country. Numerous letters from eminent experts were addressed to Governor Geary, exhibiting the worthlessness of Dr. Aiken’s testimony, and praying for the reprieve of the prisoner. At last, only two days before the time appointed for the execution, a writ of error was granted, with an order for a new trial. With the proverbial procrastination of the law, the doctor was allowed to lie three years in jail, when upon the second trial, just concluded, he was triumphantly acquitted.

The result of this second trial has been to make it plain, even to the average juror, — what no competent person ever doubted from the beginning, — that Drs. Conrad and Aiken, far from being “ experts ” in such matters as these, are no more capable of conducting a scientific inquiry into the presence of poisons in the stomach than a couple of college freshmen would be capable of concocting a treatise on the Sankhya philosophy. For example, in examining the body of the deceased, two points were to be determined : first, whether there were any signs of disease not caused by poison, of which she might have died ; secondly, whether there were any traces of poison in the system. Even though the indubitable presence of poison might render the determination of the first point unessential, it could not render it superfluous for a thorough understanding of the case. Now Dr. Conrad, among other crude statements, pronounced the heart perfectly sound, while admitting that he had not used a microscope in examining it; although the merest tyro in the study of pathology knows that it is quite impossible to detect sundry forms of heart-disease without microscopic scrutiny. But still worse, when he came to “ examine ” the brain, not only was the microscope disregarded as an idle toy, but no attempt was made to ascertain the quantity of blood emitted by the cerebral bloodvessels, though this would have been a point of the first importance as bearing on the hypothesis of death from apoplexy or congestion of the brain ! Still more atrocious was the bungling of Dr. Aiken in his search for traces of poison. His positive statement at first was that he had actually found prussic acid existing in the stomach. But on further examination it appeared that he had found no such thing. What he did was to mix some of the juices of the stomach with a solution of sulphate of iron and potash in muriatic acid, and to obtain therefrom a blue color. Prussic acid mixed with such a solution will give it a blue color, ergo this particular blue color was caused by prussic acid ; and this is what the doctor called “finding” prussic acid! He was apparently ignorant of the fact that the same result would follow from the presence of healthy saliva ! And his confidence in this non-sequitur was so great that he dispensed altogether with the nitrate of silver test, which is by far the surest index of the presence or absence of prussic acid. To crown all, his management of his materials was so careless and slovenly that it became at last quite impossible to say what substances he had under inspection.

Upon these evidences of gross incompetence the case for the prosecution rvas entirely shattered, and when it was further proved by the most careful medical reasoning, that the symptoms of Miss Steinecke’s illness were those of serous apoplexy consequent upon uræmia or blood-poisoning from inaction of the kidneys, it became evident to all that an innocent man had narrowly escaped hanging at the hands of an ignorant jury adapting its inferences to the statements of a pair of “experts ” who knew not the veriest rudiments of their subject.

We characterize thus severely the sciolism of Drs. Aiken and Conrad, both because ignorance in such matters and on such occasions becomes in itself a crime of the first magnitude, and because the daily press, in its comments on this trial and the similar case of Mrs. Wharton, has by no means perceived the true relations of the facts, “ Why boast of the precision of science,”asks the “New York Tribune,” “when the blunders of its professors can thus doom a wretch to strangulation ? ” And so again the old thrust is made which ignorance loves to make at knowledge. Yet again it is asked, who shall decide when doctors disagree ? And from other quarters may be heard Similar mistaken criticisms.

To this we reply that the “ precision of science ” would not be disturbed, in a case of astronomy, if some sciolist were to swear that the radius vector of a planet does not describe equal areas in equal times. No more is the precision of science disturbed in a case of pathology when some sciolist asserts that a certain color is the infallible index of the presence of a certain substance, though it is well known that it is not an infallible or even a valuable index. Nor can that be called a “ disagreeing of doctors,” which consists in the detection of the ignorance of one side by the cross-questioning of the other.

Toward the close of the last century a “ disagreement” of this sort resulted in the hanging of a gentleman who is now almost universally regarded as an innocent victim of crudeness aping the mien of science. In the celebrated trial of Captain Donellan for the alleged murder of his brotherin-law, Sir Theodosius Boughton, the testimony of three common country doctors, alleging the presence of poison, was allowed to prevail over that of the great John Hunter, on the ground that three are Less likely to be wrong than one.

The true criticism to be made upon such cases, as it seems to us, is that they show very forcibly some of the inconveniences and dangers attendant upon that system of jury-trial which we have inherited from earlier and less civilized ages. As the judge who presided at the trial of Captain Donellan could not be expected to know that in mere matter of authority the single testimony of John Hunter might fairly be allowed to outweigh that of three fourths of the physicians in Europe, so the average juryman of our time is utterly incompetent to decide whether such men as Drs. Aiken and Conrad understand their business or not. That which saved Dr. Schoeppe in the present case was not any device of legislation, but the vehement and indignant protest of the scientific world.

The blundering of Dr. Aiken is further interesting as showing how hypothesis warps perception and inference. Because the circumstantial evidence suggested foul play on the part of Dr. Schoeppe, because he had engaged himself to an old lady whose property he was now endeavoring to secure for himself, our “ expert ” hastened to the inference that the spots which he saw were traces of prussic acid rather than of saliva; and it was because his perceptions were so entirely under the sway of the hypothesis of Dr. Schoeppe’s guilt, that he did not go on to test their soundness by the use of nitrate of silver, supposing him to have known of this test. But when a physiological chemist allows his conclusions to be governed by an analysis of motives rather than by the application of reagents, the blunders which he will inevitably make, however disgraceful to himself and dangerous to others, are not to be set down to the discredit of the scientific world in general.

In his monograph on “Autumnal Catarrh,”¹ Dr. Wyman gives from observations of a long series of years a very exhaustive account of the symptoms, causes, diagnosis, prognosis, and treatment of that exceedingly unpleasant disorder commonly known as “ hay fever.” The latter appellation Dr. Wyman very properly rejects, since that can hardly be termed “ hay fever ” which is neither dependent on the haying season nor attended by feverish symptoms. The absence of fever is one of the differential marks by which the disease in question is distinguished from bronchitis ; and newly cut hay, which often causes paroxysms in persons affected with the socalled “ June cold,” or “rose cold,” rarely or never produces such effects in the case of autumnal catarrh. Dr. Wyman calls attention to the fact that the most prominent symptoms of the latter disease — the suddenness with which it begins, the redness of the conjunctiva, or lining of the eyelids, the profuse shedding of tears, the itching of the skin, the frequent and spasmodic asthma, the sudden coughing, and “ the speedy disappearance of all these symptoms, without the usual signs of inflammation”— point to the nervous system, and more specifically to the sympathetic nerves, as the probable seat of the disease. An instructive parallel is drawn between the symptoms of autumnal catarrh and the effects of Claude Bernard’s experiments on the great sympathetic nerve. When the molecular continuity of the great sympathetic is interfered with by cutting or tying, there ensues congestion of the blood-vessels of the head, the membrane lining the eyelids and nostrils is reddened, and there is copious secretion, with a short cough. Itching also follows, and the changes of heat are sudden. Similar results have been obtained by arresting the action of the fifth pair of nerves. To these facts we may add that it seems to be well established that the sympathetic system exerts an inhibitive or restrictive action upon the blood-vessels throughout the body, so that to heighten the activity of the sympathetic (by bromide of potassium, for example) is to diminish the sectional area of the blood-vessels and vice versa. If this be regarded as established, we may well understand that interference with the sympathetic, especially with its cervical branch, will enlarge the blood-vessels in the head and cause the phenomena of congestion, though the ill-understood affection of the blood-corpuscles, which constitutes inflammation, need not ensue. That the trouble is with the sympathetic system we may thus admit to be quite probable ; but when it comes to assigning the external causes which affect these nerve-centres so as to produce the disease, the inquiry fails entirely. Yearly the disease begins about the 20th of August, and no experiment has yet succeeded in preventing its appearance at this period, by excluding any of its supposed causes. Whatever theory, then, we may be able to frame concerning the physiology of this interesting disease,—and no one will pretend that even here we have yet obtained anything that amounts to an item of positive knowledge,—we are at present quite in the dark as to its origin. But, as Dr. Wyman well observes, though our ignorance is matter of regret, we must still remember that even if we did understand perfectly the cause of the disease, “ it would by no means follow that our success in its prevention or treatment would exceed that we now have with our present knowledge of the character of its symptoms.”

For, although we are so ignorant of the manner of origination of autumnal catarrh, we are nevertheless tolerably well informed as to its geographical relations. There are certain places which it does not visit ; and if a person suffering from the disease will but consult one of our author’s maps and betake himself to some one of the exempt localities, the chances are that he will recover within a day or two. This fact seems well established by a multitude of careful observations; though Dr. Wyman is far from asserting that a journey to one of the favored spots will necessarily or in all cases bring relief. In particular, we may expect to find that places near the boundaries of the exempt region will afford relief in some seasons but not in others, owing to the normal variations in physical circumstances from year to year. Still it is undeniable that the autumnal catarrh is, on the whole, quite strictly confined to certain geographical areas. It does not exist in Europe; and the same persons who suffer from it yearly in New England may escape it by crossing the Atlantic. Less expensive and laborious relief is, however, at hand. The White Mountain region is exempt, and surely there can be no pleasanter prescription for a disease which recurs each August than a sojourn of five or six weeks among the pine woods of New Hampshire. But when we come to inquire into the local characteristics of the places where immunity may be expected, we are as far as ever from finding the materials for a generalization. Neither with respect to elevation, nor to temperature, nor to moisture, nor to soil, nor to vegetation, does there appear to be any common characteristic which is the peculiar property of the exempt regions.

But while Dr. Wyman’s essay thus leaves us in the dark as to many interesting points, — as every scientific essay must until that millennium comes in which we shall know as we are known, — it is, for that very reason, all the more a scientific essay. It does not pretend to be the final solution of a problem (the sure mark of sciolism), but it brings together, with praiseworthy scientific acumen, all the facts thus far obtainable with reference to the subject of which it treats.