52  Detecting  Cases  of  Poisoning. 
science  in  itself,  and  skill  in  it  is  acquired  only  by  long  individual 
practice.  My  object  is  to  call  attention  to  some  simple  tests  which 
are  available  as  means  of  diagnosis ;  to  some  wide-spread  errors  as 
to  possible  causes  of  disease  and  poisoning,  and  to  some  serious 
mistakes  that  are  too  often  made  by  those  who  have  to  do  with 
collecting  or  forwarding  materials  for  toxicologic  examination. 
I  have  just  alluded  to  the  difficulty  of  determining  precisely 
the  boundary  between  poisoning  and  disease,  and  this  applies  as 
much  to  the  legal  as  to  the  purely  medical  phase  of  the  question. 
In  truth,  under  our  present  scientific  light,  we  must  classify  a 
very  large  number  of  so-called  diseases  as  poisoning.  Most  of  the 
sudden  choleraic  seizures,  so  common  in  the  warmer  season — the 
picnic  illnesses,  from  ice-cream  and  cream-puffs,  for  instance — are 
true  irritant  poisonings,  due  to  materials  produced  by  excessive 
microbic  growth.  Just  here  I  must  warn  against  a  much  over- 
worked word.  A  remark  by  Hobbes,  the  English  philosopher, 
should  be  always  in  the  mind  of  every  scientific  thinker :  ".Words 
are  wise  men's  counters ;  they  do  but  reckon  by  them,  but  they  are 
the  money  of  fools."  I  refer  now  to  the  word  "  ptomain."  This 
word  has  a  legitimate  use,  but  it  has  been  made  to  do  heavy  duty 
for  concealing  ignorance  and  for  ornamenting  the  sensational  articles 
of  newspapers. 
In  large  cities  of  this  country,  intimate  relations  are  often  estab- 
lished between  doctors  and  druggists,  the  latter  performing  some  of 
the  clinical  tests  so  useful  in  diagnosis.  For  such  work  numerous 
valuable  manuals  are  available,  so  that  in  addition  to  the  recollec- 
tion of  the  instruction  that  the  druggist  has  received  in  his  college 
course,  he  can  easily  find  a  guide  to  the  methods  of  these  tests.  I 
find,  however,  that  toxicologic  tests  are  usually  overlooked.  Some 
of  them  are  as  simple  and  as  certain  as  the  usual  tests  for  albumin 
and  sugar.  Reinsch's  test  is  one  of  these.  It  takes  but  a  few  min- 
utes, requires  only  common  materials,  and  is  a  very  satisfactory 
indication  of  the  characteristic  elements  of  three  common  poisons — 
arsenous  oxid,  tartar  emetic  and  corrosive  sublimate.  I  think,  how- 
ever, it  is  as  much  in  its  negative  as  in  its  positive  results  that  it 
should  be  considered. 
When  poisoning  is  accompanied  by  marked  corrosive  action,  as  is 
produced  by  sulphuric  acid,  or  when  the  poison  has  a  distinct  and 
well-known  odor,  as  is  the  case  with  phenol  or  chloroform,  the 
