The Poisoner's Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York

by Deborah Blum

An invalid would slide away into chloroform-induced unconsciousness and just keep sliding. The breathing would sputter to bare gasps; the heartbeats would decrease in an ever-slowing rhythm. Alarmed doctors began tallying the deaths. On average, it seemed, chloroform anesthesia killed at least one in every three thousand patients. And no one knew how to fix that because no one was sure why it happened.

Coroners had other sources of income as well. They sold fake death certificates and thereby covered up murders, criminal abortions, and suicides. One of Wallstein’s favorite examples involved a man who had been found dead in his bed, with a bullet wound in his mouth and a revolver in his right hand. The gun contained three loaded cartridges and one exploded one. The coroner gave the cause of death as “rupture of thoracic aneurism.”

The list of New York City coroners, from 1898 to 1915, included eight undertakers, seven politicians, six real estate dealers, two saloonkeepers, two plumbers, a lawyer, a printer, an auctioneer, a wood carver, a carpenter, a painter, a butcher, a marble cutter, a milkman, an insurance agent, a labor leader, and a musician. It also included seventeen physicians, but these, Wallstein pointed out, were men like Patrick Riordan, doctors who had lost their practice and turned to a political position.

As a result, Wallstein found, death certificates were filled out with no effort at determining cause. Among the entries were “could be suicide or murder,” and “either assault or diabetes.” In one instance a coroner had attributed a death to “diabetes, tuberculosis or nervous indigestion.” A few death certificates simply read “act of God.”

IT WOULD be imprecise to say that Dr. Charles Norris loved the job of chief medical examiner. He lived it and breathed it. He spent his own money on it. He gave it power and prominence and wore himself into exhaustion and illness over it. Under his direction, the New York City medical examiner’s office would become a department that set forensic standards for the rest of the country. And Norris himself would become something of a celebrity, described by Time magazine as the “famed, sardonic, goat-bearded, public spirited” medical examiner who “battled for pure food laws, fought against quack doctors, Prohibition, unsanitary restaurants, pronounced on many a suicide and murder that perplexed police, made his name and detective work known in medico-legal circles the world over.”

And that mattered, because getting it right had to be the everyday standard of the medical examiner’s office.

Although traditional weapons killed far more people in the Great War, poison gas gave a new nightmare edge to the fighting. “The chemists’ war,” some people nicknamed it, as Germany experimented with other gases, releasing lethal greenish clouds of chlorine; the French introduced phosgene, which combined chlorine and carbon monoxide; and the Americans developed Lewisite—an ugly combination of chlorine and arsenic.

CYANIDES POSSESS a uniquely long, dark history, probably because they grow so bountifully around us. They flavor the leaves of the yew tree, the flowers of the cherry laurel, the kernels of peach and apricot pits, and the fat pale crunch of bitter almonds. They ooze in secretions of arthropods like millipedes, weave a toxic thread through cyanobacteria, massed in the floating blue-green algae along the edges of the murkier ponds and lakes, and live in plants threaded through forests and fields.

Cyanide’s action is murderously precise. It attaches with stunning speed to protein molecules in the blood—called hemoglobins—that carry oxygen throughout the body. Thus the poison is rapidly circulated by the bloodstream and delivered to cells through the body. There it shreds cellular energy mechanisms, breaks down cellular respiration, and causes rapid cell death due to oxygen starvation.

White arsenic, the poison used at the Shelbourne, was a favorite of some of history’s most feared poisoners, ones who made Jean Crones look like the amateur he was. At the top of the list were Lucretia and Cesare Borgia, feared in fifteenth-century Italy for their ruthless mixture of politics and poison. The Borgias used white arsenic preferentially but experimented with different ways to make it more deadly.

Victims of acute arsenic poisoning tended to become so violently sick that their bodies had the slightly shrunken, emaciated look of severe dehydration. Often their hands and feet looked slightly blue due to lack of circulating oxygen. If, on the other hand, the poison had been administered gradually, the victims’ skin tended to turn yellow, even occasionally a kind of parchment brown, and scaly patches appeared on the hands and feet.

On June 1 Smith officially put an end to New York’s Prohibition legislation, trying to portray his action as a reasonable response to unreasonable pressures. He wasn’t legalizing drink or neutralizing the Eighteenth Amendment, he insisted. He was just returning the responsibility for enforcing an unpopular law to the federal government, which was, after all, responsible for the whole debacle.

That final haze provided the real answer. Mercury, for instance, glimmered silvery bright on the glass. Arsenic formed a fine frost, glittering faintly with the octahedral crystals so familiar to chemists who worked with poisons.

In chemistry, though, simplicity doesn’t necessarily mean safety.

Mercury salts work faster and cause more immediate injury, largely because living tissues tend to soak up salty liquids. And mercury bichloride is basically just another chlorine-based salt, a mean-tempered cousin of the familiar sodium chloride (NaCl) that we use as table salt.

He assured reporters that handled properly there was nothing dangerous about his prize discovery. To prove it, he washed his hands in a bowl filled with TEL. “I’m taking no chances whatever,” he said. “Nor would I take any chances by doing that every day.” The management at Dupont and Standard Oil blamed the workers for failing to protect themselves. Gloves and masks had been available at the refinery. It was the workers’ responsibility to wear them.

Just wait...

Gettler discovered that the TEL and its lead by-products form a recognizable distribution pattern, concentrating in the lungs, the brain, and the bones. The highest amounts were spread through the lungs, indicating that most of the poison had been somehow inhaled; later tests showed that the masks used by Dupont and Standard Oil did not filter out the lead in TEL vapors. Rubber gloves did protect the hands, but if TEL splattered and made any direct contact with the skin, it was absorbed extremely quickly. A few months after his press conference, Thomas Midgley Jr. left for an extended European vacation, seeking treatment for the effects of lead poisoning. As the press speculated, the inventor was either a liar or a daredevil—or perhaps he’d just inhaled too much “looney gas.”

...and there it is

Perhaps at a later point, the scientists suggested, the research should be taken up again. It was always possible that leaded gasoline might “constitute a menace to the general public after prolonged use or other conditions not foreseen at this time.” But that was the future’s problem.

The attraction between hemoglobin and carbon monoxide is some two hundred times stronger than that between hemoglobin and oxygen.

When Prohibition went into effect, backed by a Constitutional amendment no less, its supporters had assumed citizens would, however reluctantly, obey the law. The succeeding years had proved them wrong. Many now drank more than ever, more recklessly, more adventurously.

When Norris called methanol pure poison, he wasn’t exaggerating. The lethal undiluted dose was as little as two teaspoons for a child, perhaps a quarter cup for an adult man. That modest amount, far too often, was a direct path to blindness, followed by coma, followed by death.

Structurally, the element radium can be considered a close if crazed cousin of the element calcium. Both are alkaline earth metals, silvery white in color. Both are built in cubic crystalline structures. As a result, when a person swallows radium, the body channels it in a way similar to calcium—some is metabolized away, some goes toward nerve and muscle function, and most is deposited into the bones. But where calcium strengthens the mineral content of the skeleton, radium does the opposite.

“The chief kept his peace publicly, but he had quite a lot to say privately, and his language was picturesque and to the point,”

its technical name was tri-o-cresyl phosphate. The name explains the structure: carbon, hydrogen, and oxygen bond into a ring-shaped structure called a cresol (also found in creosote), and phosphorus hangs on to the ring like an exhausted swimmer gripping a life preserver. In the new Jamaican Gingers the plasticizer combined with denatured alcohol to form a compound called an organophosphate. That potent combination was responsible for Jake’s newly powerful buzz. The dizzying sensation derived from the fact that the compound was also an efficient neurotoxin—as became almost immediately and horrifyingly evident.

In high doses, nicotine is a terrible poison—it blisters its way through tissues, burns a path from mouth to stomach, and induces intense vomiting, rapidly followed by convulsions and then a complete shutdown of the nervous system.

Mayors, he’d learned, had to be trained to appreciate the science of forensic medicine. Repeatedly.

THERE WERE TIMES, AND they came frequently enough, when one could believe that modern society, machine-age America, was addicted to poisons. Every day retold the story of that dependency: poisons floated in the exhaust-smudged air of the morning commute and swam in the evening martini, in the gas-fed blue flames of the stove, in the soft smoke of the after-dinner cigarette, in the barbiturates that so many now swallowed at the end of a stressful day.

The proposed legislation would require safety testing before a product was introduced on the market. It would establish corporate liability for marketing hazardous products. One of the proposals—fought by an unholy alliance of industrial manufacturers and patent medicine companies—simply required that consumers be provided with basic information, for instance that ingredients be listed on containers of medicine, household cleaners, and cosmetics.

After all, these ubiquitous poisons worked as advertised. Tetraeythyl lead did solve engine knocks; carbon monoxide did provide an inexpensive and reliable fuel; cyanide did help neatly fix clear photographic images on film. And thallium, as promised, did cause hair to painlessly fall out, did make it disappear like snow on an unexpectedly warm morning.

In the early twentieth century it had been used to remove the hair of children with scalp infections, such as ringworm, so that doctors could see and treat the fungus. But that practice had been abandoned when too many of the toddlers died.

Too many? As in MORE THAN NONE?

Later studies would find that one reason thallium caused such accelerated damage was that it possesses an atomic structure very like another soft metal, potassium. In the same way that radium takes advantage of the body’s natural affinity for calcium, thallium tends to move rapidly along potassium-uptake channels into the nuclei of cells. But where potassium helps maintain a proper fluid balance in cell walls and feeds the nerve cells that control muscle movement, thallium disrupts cell metabolism and splinters apart chemical bonds.

Even such a brief foray into chemistry teaches that anything, in a large enough amount, can kill. Life-giving water itself is lethal if you gulp down too many gallons. As toxicologists say, the dose makes the poison. But poison by water doesn’t unnerve us. The real scare comes from those elements and compounds whose toxicity is measured in drips and drops. Luckily for us, and other life on Earth, such materials are rare. But somehow we’ve managed to find or create many of them. We use them pragmatically, and for good—our medicine relies on countless toxic compounds—and in deliberate evil.