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THE HONGKONG WEEKLY PRESS AND
felt so well that I need not visit him again unless he sent for me." I next may him on the 27th about 2 p.m. He was then com- pletely unconscious and Dr. Hartigan was with him. My impression was that he was suffering from morphine poisoning. Dr. Hartigan and I relieved each other until he died. We applied antipyrine, strychnine, and strong | coffee, and as his temperature went up very high we used iced cloths to keep down the fever. We were trying to keep him alive until the effects of the morphine could be counteracted. | Morphine tends to paralyse the nerve centres, more especially the respiratory entres. The general treatment is to stimulate the breathing, He was not heard snoring unconsciously till between 12 and o'clock, so we supposed be had taken the morphins between 10 and 11 o'slook. At 1 o'clook, Dr. Hartigan found him almost dying. One point of interest I might | mention. The point where he inserted the needla was plainly visible. I saw him while he was nuder the influence of the morphia Wə looked to see where he had injected the morphia We had his clothes thrown back to give him | plenty of air and to apply the battery. The puncture of the needle was on the upper part of the abdominal wall.
His Worship—Do you wish to make any re- marks about the case i I think you said you considered it irregular for the Dispensary to supply the morphia in this way.
Dr. Stedman-I did not make any such re, mark, sir; I asked him, I said, bow he came to be supplied.
His Worship-Do you consider it, as a medical practitioner, wrong to supply the drug in these circumstances?
Dr. Stedman-No; I do not think I do in the oircumstances. The man was in urgent pain.
His Worship-You do not think blame is attaching to the Dispensary for supplying the
Dr. Stedman-No; I do not think so under the oircumstances. It was very late at night and
His Worship-Not even in the quantity con. tained in that bottle. Do you consider there is any blame attaching to the Dispensary from your point of view as a medical practitioner P
Dr. Stedman-I really can't say. I am unable to answer the question.
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His Worship-1 am asking your opinion. Dr. Stedman—Well, I should say he got the `usual amount.
His Worship-Are the instructions contained on the bottle P
Dr. Stedman-The bottle has the label Hypodermic Solution of Morphia, B.P." No instructions appear on the bottle except as they are naderstood by a medioal man.
His Worship-In serving it out to a medical man, ought the instructions to be on the bottle? Dr. Stedman-I do not think so. I think
· Poison-Hypodermic Solution of Morphis” carries suficient instruction.
His Worship-Nobody would understand that except a medical man ?
Dr. Stedman-Except people who were in the habit of taking morphia.
His Worship-But he was a Frenchman. He would not understand what B.P." meant. Ought not the quantity to be used to be shown on the bottle ?
Dr. Stedman-I would not say ought not to be, but it is not usual.
His Worship-The amount that might be taken with safety depends on the length of time it has been taken ?
Dr. Stedman-Yes.
His Worship-Would you consider the dose yon prescribed for him a considerable dose for an ordinary person P
Dr. Stedman-It was the ordinary dose for anybody.
Hi Worship Supposing a man was used to it, how much might be extend the dose to ?
Dr. Stedman-I think almost without limit, if he gradually increases it.
Dr. Hartigan stated-I was called in to see the deceased about 12 20 p.m. on the 27th inst. I had not seen him before. I found him lying in bed with his pyjamas open. His trousers and hair brush were lying on the bed near. He was breathing very heavily; completely unconscious. his f、ce livid, his mouth covered with froth and some vomited matter. His pulse could not be felt, and his heart could just be heard. He was on the point of death. I found the pupils of
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his eyes were contrapted to A pin-point. From his general symptoms I came to the conclusion that he was suffering from opium poisoning. On looking about the room I found the bottle of solution of morphis and a hypodermic needle case. It contained a spare needle. · On the small table near the bed was the hypodermic syringe with the needle on it. It appeared to bave been used, as the piston was drawn out and the barrel moist.
Later on, Dr. Stedman and I found a puncture of an injec- tion which might have been made within an hour or two. There was an older pndoture. I think | the more recent puncture must have been made within six hours from the tins I saw him. I ør- amined the bottle and should say about 30 drops had been taken from it. I was with him when he died at 5.20 yesterday morning. I would say that death might have been caused by su overdoso of | morphis, bat it might have been accelerated (or that the effect of the morphia was intensified) by | the kidney disease from which, the deceased was suffering. When I first saw the deceased his temperature was subnormal; five hours later it had risen to 107. It remained at that for half- an hour, and then dropped to 104. It remained at 104 to 105 until about au hour before his death, when it went up to 106. It was at that when he died. The infereños I draw is that death might have been due to urinie „poisoning. | The effects of the morphia, were complicated by that. Both act in the same way. I do not think there is any necessity to hold an autopsy.
His Worship-There is evidence to show that the morphia was obtained from the Dispensary Have you any remarks to make? Is there any blame attaching to the Dispensary for selling The morphia to decoased ?
Dr. Hartigan-I think it is not desirable that anybody going in should be able to get morphia. His Worship-Having got it was there any objection to leaving it with him?
* Dr. Hadigan-We cannot say. He said he was in the habit of using it. I could not have taken it upon myself to remove it The risk lies with the man himself.
His Worship-It is not uncommon for private individuals to have supplies of morphia—people in the habit of taking it ?
Dr. Hartigan-I should think it is uncom mon. It is a very bad j practice Of course, I understand this man was sent abroad and that he was in the habit
it of taking morphia, and the doctor might have allowed him to have morphia as he was going where he might not be able to get medical attendance.. It is not a good thing, as a general rule, for people to have a hypodermie syringe.
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H. G. Stevens stated I am a chemist at the Hongkong Dispensary, Messrs A. S. Watson & Co. I remember the deceased coming to the Dispensary on the night of Christmas eve He came about midnight. He came with Mr. Potts. The droessed was in great pain. They wanted to know if I could do anything for him. He appeared to me to be suffering from colio-he used a French term which I did not understand. He asked me to let him have some morphis as it had been used when he had similar attacks. I refused at the time, and told Mr. Potts it was against the Morphin Ordinance.
His Worship-It is only right to tell you that in giving evidence you are at liberty to refuse to give evidence which you are of opinion might incriminate you.
Witness-Thank you. I could ses he was in great pain, and supplied him with the morphia on the condition that it was used by a medical man. Otherwise I would not have given it to him. I supplied him with half-an-onnce and a syringe. The strength was 1 in 10. I gave him no instructions how to use it.
His Worship--What, was your reason for giving the syringe.
Witness--Because I thought it would save time, as the doctor might not have brought his own one. Looking at the bottle, I would say about 30 minims had been used. I put on the bottle "Hypodermie Solution of Morphia, B.P;" that is to let the doctor know the strength. An ordinary person would not understand what B. P." meant.
The evidence of the Chinese servant of the deceased was then taken.
W. M. Wood, Chartered Mercantile Bank, stated that the deceased told him he was going to take a sleeping draught.
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[January 3, 1895.
At the Magistracy on Monday Mr. H. E. Wode- house resumed the inquiry into the circumstances connooted with the death of the Baron de Grand- maison at the Hongkong Hotel on the 27th December.
Mr. Bourgeois, the French Vice Consal, wa again present.
Dr. Stedman (recalled) stated—I did not know the deceased bought the syringe at the Dispenáry. I thought he bad brought it with him. The syringe is capable of holding 20 drop.. - It is marked down the piston rod. A Continental syringe would be marked in the same way, but probably with different measurements. I have never seen one myself. ` I do not think he would have made a mistake because of the markings on the syringe. ́Assuming he, made a mistake I think I could explain how it may have occurred. The French hypodermic solution of morphis is weaker than the English B.P. ia the rẻ- lation of 5 to 12, and therefore you would need to administer a larger quantity of fluid to administer an equivalent dose of morphine. If therefore the deceased thought the solution was the same strength as the French, he would give himself the larger quantity of fluid, bat would get more morphis than he intended in the proportion of 12 to 5. I explained to him the difference in the strength. He must either have forgotten what I said to him or taken the over- dose intentionally. I imagine he may have taken about 13 grains of morphine or 12 minims. That was sufficient to produce death, We found in the post-mortem examination of the body that one kiduey was almost entirely disorganised, that is to say, it was incapable of discharging ite proper functions. Morphine aots more energe- tically and continuously when the kidneys are not performing their proper functions. .
His Worship-Is there any means of moor taining whether the kidneys are performing their ordinary functions?
Dr. Stedman--In some cases, yes; in this case, no.
His Worship Why not in this case ?
Dr. Stedman-Because there was no arine in the bladder from the diseased kidney. The chief indications of kidney during life are obtained from analysis of the urine, but it is possible that one kidney is discharging its proper functions and no true indication would be obtained. I did not make any analysis, Disease of the kidney in the secondary formation of gravel. The existence of gravel does not necessarily indicate kidney disease. If I knew a patient was suffering from kisney disease, I would administer morphia with greater caution,
His Worship Asa medical practitioner, would you leave morphia in a patient's possession ?
Dr. Stedman-Yes, I should. For the rea- son that it is the patient's property, and I have no more right to take away morphia than a man's revolver.
His Worship-I am not talking about taking away property. It was never suggested, was it ?
Dr. Stedman-No, never.
His Worship-Yon say that if you had the knowledge that the kidneys were disassed you would administer morphis with greater caution; would you still leave it with him to administer himself P
Dr. Stedman-It never occurred to me that: he had been in the habit of using it himself. He sent for me at midnight to administer it for him. Personally, I never order morphia for a patient; I carry it about with me and give it to the patient. But if the patient carries it about him- self--and in this case the deceased informed me that he was in the habit of carrying it about with him, that he left the bottle at Saigon, and I gathered from his conversation that he was not in the habit of administering it himself but merely carried it with him to save time. It never occurred to me to think of taking his morphia away, Even if I had known
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kidneys were diseased ́it would not have occurred to me to take the morphis away.
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The deceased being in urgent pain on the morning he took his fatal dose and believing he was using the same solution he had been in the habit of using he might have given himself a stronger dose, which he might have done with safety in the French solution. Even if he had given himself half a grain of the English solution it might not have injured him.
His Worship-How did you diagnoss the
Dr. Stedman-As one of gravel in the kidneys,
His Worship adjourned the inquiry for fur-case ?^ ther medical evidence till Monday at 11 a.m.
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