VI 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 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 œsophagus, 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.