Victorian Medicine – The Dose Makes the Poison
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Sarah Ellen Collyer’s triple entry in the civil registration index for deaths for the March quarter of 1847 aroused Geoff Culshaw’s curiosity. Here he tells of the intriguing circumstances surrounding her early demise, at a time when medical ‘cures’ could be as dangerous as the illnesses they were trying to relieve.
My attention was first drawn to the death of Sarah Ellen Collyer when I came across three entries for her name in the March quarter of 1847, while searching the civil registration death indexes some years ago at St Catherine’s House, London. All three entries were in St Pancras Registration District with the same volume number. Only the page number varied: 250; 251; and 258.
Although not in my direct ancestral line, I knew that Sarah’s name featured in my research, but these entries were a complete surprise to me. Sarah was only aged 22 when she died in 1847. The fact that the event appeared to have been registered three times seemed quite odd, and I had the feeling that Sarah’s death might have been in some way unusual. I obtained all three of the death certificates; these appeared to be identical, but my suspicions were confirmed by the stated cause of death.Sarah had died as a result of chemical poisoning, `Prussic Acid taken in a mixture prepared by a chemist from a prescription ordering the water of Bitter Almonds. Inquest.’ The death was registered some six weeks after the event, by the coroner, and evidently had been the subject of an inquest. The following account of the demise opf Sarah Ellen Collyer is taken from reports in contemporary newspapers, medical periodicals, and court records, but firsy, by way of context, here is a little bit of background about Sarah Ellen and her Collyer kinsfolk.
Sarah Ellen Collyer was born in London on 20 June 1824. At the time of her birth her family was living in Frith Street, Soho, a fashionable address in the early 19th century and one time home to the artist John Constable, and to William Hazlitt, the essayist. Sarah came from a well-educated and, for the most part, prosperous family. Her father was John Collyer, a carver and gilder, a son of Joseph Collyer the Younger (1748-1827). Joseph the Younger was an eminent artist, serving as official engraver to Queen Charlotte, and being a regular exhibitor at the Royal Academy. His father (Sarah’s great-grandfather) was Joseph Collyer the Elder (1714-1776). He was a writer, printer and translator whose wife, Mary (Mitchell) Collyer (c1716-1762), was a pioneer female novelist and a translator. Sarah’s father had died in 1840, aged 57, and at the time of the 1841 Census, Sarah was living in Frith Street, in the household of her widowed mother. However, in 1846, her mother inherited a house at 15 High Street, Camden Town, north of London (mentioned in the will of a relative, Robert Pounds); it was here that the family was living on 15 February 1847, when Sarah met her end.
In early February 1847, Sarah twice consulted Dr Dennis Cronin of Leicester Square in the West End of London. Dr Cronin had obtained his medical degree from Giessen in Germany in 1843, having been licensed to practice medicine by the Society of Apothecaries in 1832. He regularly advertised in The Times newspaper, promulgating his prowess at treating consumption.
Dr Cronin gave Sarah two prescriptions. One of them was made up by a chemist known to him, and was consumed with no ill effect. Dr Cronin had advised that his prescription could be made up by any chemist, so when, on the evening of 15 February 1847, Sarah wanted to obtain the medicine prescribed on the second prescription, it was taken on her behalf to a different chemist – Daniel Corfield of Camden Town. On receiving the medicine, Sarah immediately took a dose, looking for relief from what she had described as ‘a violent pain in her back’. Within a few minutes she was taken ill. In the words of her cousin, John Pounds, a witness at the inquest, she looked unwell, saying ‘Oh! How queer I feel’. She went into the garden and fell to the ground. Medical help was summoned in the form of George Weathers, a local surgeon. He reached the house at 10pm, finding Sarah ‘perfectly insensible and motionless’. He concluded that she had taken prussic acid, and urgently sought to treat her, but to no avail, for she expired within 15 minutes of his arrival. The post mortem was conducted by George Weathers, and his stated opinion at the inquest was that the cause of death was prussic acid poisoning. He said that ‘…he never saw organs in a more healthy state than hers appeared to be in…’.
So, who was to blame for Sarah’s sudden demise?
At the inquest, the chemist who had made up the prescription, Daniel Corfield, expressed surprise at the inclusion of two of the prescription’s ingredients: bitter almond water and compound strychnine. He said that he had never seen these two ingredients in a prescription in all his 12 years in business, adding that they were not listed in any of the pharmacopoeias in use at the time, and so, not having them in stock, he tried to obtain them from other chemists. He managed to obtain some bitter almond water from Jacob Bell of Oxford Street, but had not been able to get the strychnine, so omitted this ingredient from the preparation. Another chemist to whom Corfield had applied to obtain the missing ingredients – Mr Morson of Southampton Row – said that if he had been approached with this prescription he would have declined to make it up, as he was uneasy about its ingredients. Jacob Bell said that if he had been approached with such a prescription he would have wanted to speak with the physician before making it up. The coroner reminded the court that apothecaries refusing to dispense were exposed by law to a penalty. Bell said that he had not seen the prescription itself, just a note written by Corfield, and had not been aware that the bitter almond water he supplied to him was intended for use in a medicine. George Weathers said that in 15 years in his profession he had never seen these two ingredients included in a medical prescription.
In response, Dr Cronin said that bitter almond water was used by confectioners, citing evidence to this effect, but Morson and Bell countered this by saying that the bitter almond water used by confectioners was of a definite strength, whereas that used by chemists was of indefinite strength, and only used externally.
Dr Cronin produced medical writings to show that bitter almond water had, in the past, been used in medicine. He claimed that had all the prescribed ingredients been included in the medicine , the chemical reaction caused by the inclusion of the compound strychnine powder would have neutralised the effect of the prussic acid and thus rendered the prescription safe. Furthermore. he produced several chemists as witnesses, all of whom attested to the fact that they had made tip Dr Cronin’s prescriptions – which had included bitter almond water – with no known ill effects to patients. However.their evidence suggests that they used bitter almond water of a lower strength than that which killed Sarah.
After hearing all the evidence and the summing up by the coroner, Thomas Wakley, who, referring to Dr Cronin’s qualifications, opined that medicine degrees from Giessen were worthless as they could be bought by anyone, the jury recorded a verdict of manslaughter against Dr Cronin, and he was taken into custody by the police.
The trial of Dr Cronin took place at the Old Bailey before Mr Justice Coleridge on Wednesday 7 April 1847, eight weeks after the inquest. The evidence given at the inquest was reprised, but the interpretation placed on it by Coleridge was very different from that of Wakley, the inquest coroner. On hearing Corfield testify that he had omitted the missing compound strychnine powder, Coleridge interjected to say that supplying a medical prescription without including all the ingredients was ‘monstrous’, and tantamount to a fraud on the patient.
Under cross examination, Bell stated that, had he known that the bitter almond water was intended for human consumption, he would have supplied a milder form of the chemical, which would have been harmless. He also said that had he realised that Corfield was not familiar with the qualities of bitter almond water he would have labeled the bottle ‘poison’. However, he was not so aware, and he said that it was not customary to do so.
Further evidence was given by another chemist, Spratt, who said that he was used to making up prescriptions containing bitter almond water. He had five different types of the ingredient, and if the word ‘concentrated’ was not in the prescription then, as a matter of course he used a weaker version, suitable for human consumption. He said that if he had received Sarah’s prescription he would have used the weak compound, and she would not have died.
The judge concluded that any chemist with a working knowledge of his trade should have should have known that the bitter almond water used in a medicine for human consumption must be of a weak strength. Taken with the omission of the compound strychnine powder, he concluded that the cause of Sarah’s death was not Dr Cronin’s prescription but the way in which it was dealt with by the chemist. The jury took only two or three minutes to acquit Dr Cronin, who was discharged. The verdict implied that it was the chemist who had been at fault and had the prescription been made up by Dr Cronin’s usual chemist. Sarah’s death would not have occurred.
Is it possible that the radically different verdicts reached by the juries at the inquest and the trial reflected the different personalities and interests of the people presiding over these proceedings? The coroner, Thomas Wakley, was a noted radical MP, founder of The Lancet and no friend of the status quo. Mr Justice Coleridge, on the other hand, was more of an establishment figure, who later became a member of the Queen’s Privy Council.
In the immediate aftermath of the trial, the medical press carried a number of articles which expressed disquiet at the verdict. The Medical Times, in particular, pointed to a number of unsatisfactory aspects, such as the fact that Dr Cronin had told Sarah that his prescription could be dispensed by any chemist, but the inquest and trial had established that the unusual nature of his use of bitter almond water and compound strychnine powder meant that, to be safe, the prescription needed to be dispensed by a chemist familiar with Dr Cronin’s work. The view was also put forward that Dr Cronin should have been aware that he was including ‘a deadly agent’ in his prescription, and should have defined the strength to be used. There was also dispute about the size of spoon needed both to measure the ingredients and to administer the made-up prescription. Then there was a question about the impartiality of a key witness; Bell, who had supplied the bitter almond water, had been party to its subsequent scientific analysis. The accuracy of the scales used in the analysis was also called into question.
The Medical journal also carried an article from The Pharmaceutical Times, which voiced other misgivings about the trial. It noted that ‘no counsel for the prosecution was employed by the friends of the deceased.’ Thus, many pertinent questions were never asked. This seems odd, because the Collyer family was financially very comfortable. When administration of Sarah’s estate was granted to her mother by the Prerogative Court of Canterbury, it was valued at £16,000 – a huge sum for a lady of her age.
Thus it was that a routine search at St Catherine’s House in London resulted in a trail of research that encompassed the needless death of an affluent young woman, an Old Bailey trial of a London doctor, and a fair amount of controversy. That’s the thing about our hobby. You never know where it will lead you.
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