Post Mortem Specimen of Ruptured Tubal Pregnancy: Symptoms Suggesting Irritant Poisoning

Wm. Alex. Mackay
1914 BJOG: an International Journal of Obstetrics and Gynaecology  
THE interest in this case lies principally in the history of the illness and of how the specimen came into my possession. Ou the evening of March 4th last, I received a telephone request from the secretary of the Grocers' Association to attend, on their behalf, some miles fpom Southport, the post mortem examination of the body of a lady who had died suddenly shortly after eating some bloater paste, supplied by one of their members. The autopsy was to be made at the instance of the coroner, and
more » ... f the coroner, and in addition to the two medical gentlemen who had attended the case during life, I was to meet a distinguished bacteriologist. The cause of death was supposed to be poisoning from the bloater paste. Just before the sectio the following history was obtained : -Mrs. E. O., aet. 40, a healthy woman, made a meal of bloater paste, bread and butter, at 4-30 on March 2nd ; a t 7-30 she took some cold beef; at 10, part of an apple; and went to bed perfectly well. She wakened about 7-50 a.m.-her usual time-apparently well. At 8 a.m. she felt sick, and going to the bathroom, took a dose of Eno'a fruit salt. Shortly after 8 she called over the banisters to the servant to prepare breakfast, mentioning the food she required-ham and eggs. She then complained of faintness, went giddy, and had nausea, followed by vomiting. Immediately thereafter she had diarrhea. The diarrhea continued with occasional vomiting. I cannot say what quantity of faecal matter passed-the motions were liquid; apparently, however, her desire to have the bowels moved was so marked as to cause her anxiety that she could not relieve herself decently. She was then collapsed, pale and bloodless. The pupils were dilated. She was on her right side. The radial pulse was not perceptible, and only a faint impulse was felt in the carotid. Later a certain amount of cyanosis of the lips was noted, but the pallor persisted. She complained of some, but not severe, pain, and was troubled with thirst. I n spite of stimulant treatment, including the administration of 20 ounces of normal saline subcutaneously, she died about 1 p.m. The menstrual history could not be obtained before the body was opened. Later I learned from the husband that she wa0 near a menstrual period, and that the one preceding had been less than usual; indeed he had made some chaffing remark to her of the possibility of pregnancy. She was seen by her doctor from 10-30-11 a.m.
doi:10.1111/j.1471-0528.1914.tb12252.x fatcat:mc5dngeuwjdlbntsvky3xzzey4