1912 The Lancet  
SIR,-Your leading article in THE LANCET of April 20th is most admirable and ought to lead to an amendment of the Registration Act of 1874 and of the Coroners Act, 1887. The Death Certification Committee of the House of Commons in 1893 made an exhaustive inquiry into the whole subject of the registration of deaths on certificates given by medical attendants on deceased persons and also on coroners' inquests. The inquiry followed very shortly after the trial of Neill Cream, who was convicted and
more » ... was convicted and executed for the murder of four prostitutes by strychnine given in capsules, or, as they were called by the unfortunate victims, "long pills." In the case of the first victim the cause of death was promptly diagnosed by the surgeon who was called in, but too late to save her life. It was reported to the police who were in search of the murderer. A week later Matilda Clover, another "unfortunate," was poisoned by strychnine. Neill Cream had been with her and was heard saying good-bye to her. Some time after she was heard screaming and was found by the brothel keeper and her servant to be in strong convulsions. She died soon after, and a doctor who had attended her for intemperance called, saw her body, and gave a certificate of death from chronic alcoholism. If he had refused to give a certificate and informed the police or coroner he would have gained credit, and might, humanly speaking, have saved two lives. For after going to America Neill Cream returned to London, and soon after added two more women, Shrivell and Clarke, to his victims, besides attempting to poison another woman named Harvey, who, however, thwarted him, and informed a magistrate. Sir Walter B. Foster, now Lord Ilkeston, was the chairman of the committee, and full details of these cases were given. I gave evidence of the cases of Flannigan and Higgens. We proved four cases of arsenic poisoning against them, and there was reason to believe that the total number of their victims was 11. Well might the judge who tried them suggest that there might be in our local cemeteries other victims. It is known that arsenic poisoning still continues. Next month the summer sessions will begin and many students will be attending for the first time lectures on medical jurisprudence. It is a grave question whether so important a subject ought not to be a winter course. It must be remembered that it is the general practitioner and not the I medical jurist who is called to what turns out to be a case of ' , attempted poisoning by arsenic, strychnine, antimony, or other poisons. Hence the importance of knowing their symptoms and the tests for them. These cases are not welcome to a busy practitioner, giving him much inconvenience and a most inadequate remuneration. But it is the glorious privilege of our profession to save and prolong life under any circumstances, and learned judges have paid the highest compliments to those medical witnesses who have done their duty as medical attendants, and also in the witness-box. Poisoners, though artful and cunning, commit blunders which form what is called circumstantial evidence. Learned counsel for the defence do not like it, but it is the evidence which a guilty man furnishes against himself. I sincerely hope that your leading article and the recent cases of murder by poison will lead to an amendment of the present Deaths Registration Act, 1874, and of the
doi:10.1016/s0140-6736(01)67737-7 fatcat:63oek3slvbd6jlbjn242a4l7vi