excessive gluttony may cause sudden death. Generally indeed the symptoms
and appearances in the dead body show that death is the consequence of
apoplexy; but sometimes not. In order to preserve the continuity of the
succeeding remarks on the diseases of the stomach which imitate
poisoning, it may be useful to consider in the present place all the
varieties of the effects of distension.
Excessive distension of the stomach, then, sometimes causes sudden death
by inducing apoplexy, which is commonly of the congestive kind,—that is,
without rupture of vessels. Mérat has related an instructive case of
this kind. A man in good health, while greedily devouring an excellent
dinner, became suddenly blue and bloated in the face; a clammy sweat
broke out over his body; and he died almost immediately. On dissection
the stomach was found enormously distended with food, and the vessels of
the brain were so gorged, that the brain appeared too large to be
contained within the skull.[141]
There is reason, however, to suppose that death from distension is the
consequence not always of apoplexy,—but sometimes of an impression on
the stomach itself. Sir Everard Home relates the case of a child, who,
being left by its nurse beside an apple-pie, was found dead a few
minutes afterwards, and in whose body no appearance of note could be
discovered, except enormous distension of the stomach with the pie.—A
still more distinct case in point forms the subject of a medico-legal
report by Wildberg. A corpulent gentleman died suddenly fifteen minutes
after dinner; and as he lived on bad terms with his wife, a suspicion
arose that he had been poisoned. His wife said that he fell asleep
immediately after dinner; but had not slept many seconds, when he
suddenly awoke in great anguish, called out for fresh air, exclaimed he
was dying, and actually expired before his physician, who was instantly
sent for, could arrive. Wildberg found the stomach so enormously
distended with ham, pickles, and cabbage-soup, that, when the belly was
laid open, nothing could be seen at first but the stomach and colon.
Some white powder, found on the villous coat of the stomach, was at
first suspected to be arsenic; but it proved on analysis to be merely
magnesia, which the gentleman had been in the habit of taking
frequently. The diaphragm was pushed high into the chest by the
distended stomach. There was not any particular congestion in the brain.
Wildberg very properly ascribed death to simple over-distension of the
stomach.[142]—In all such cases the symptoms may be suspicious; but when
carefully considered they can scarce be said to resemble closely the
effects of irritant poisoning; and at all events the appearances in the
dead body will at once distinguish them.