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Emergency Medicine News:
doi: 10.1097/01.EEM.0000388464.29948.1d
Toxicology Rounds

Toxicology Rounds: CSI New York, Circa 1918

Gussow, Leon MD

Free Access

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

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Deborah Blum

The Penguin Press

$25.95 (319 pp)

Francesco Travia was caught red-handed.

On a cold December night in 1926, a New York City patrol officer spotted the longshoreman pushing a heavy package into the icy waters of the East River. When apprehended, Travia refused to reveal what the package contained. But the police certainly had cause for alarm: Travia's trousers and socks were soaked with blood.

In her fascinating book, The Poisoner's Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York, Pulitzer Prize-winning science writer Deborah Blum describes what the police found when they searched Travia's Brooklyn apartment:

“On the kitchen floor was a dead woman. Or rather half a dead woman. The upper part of the body — torso, arms, battered head — lay between the table and the stove in a clotted pool of red. A spattered butcher's knife and a chisel sat on a table, smeared and streaked with gore.”

It was, seemingly, an open-and-shut case of murder.

But the city's chief medical examiner, Dr. Charles Norris, was not convinced. According to one — perhaps overdramatic — report, he took a quick look at the gruesome scene, noted that the victim's face was pink and the blood congealed around the mutilated body bright red, and proclaimed: “Boys, you can't hold this man for murder.”

In the medical examiner's forensic laboratory, a facility that did not exist a mere eight years earlier, toxicologist Alexander Gettler was able to demonstrate that the victim's blood contained a fatal level of carbon monoxide. When Travia was brought to trial, the jury accepted Norris's contention that the cause of death was accidental carbon monoxide poisoning, and the defendant was acquitted of murder. (He was, however, convicted of criminal dismemberment for panicking when he discovered the dead body in his apartment, and choosing a messy and illegal way of making the problem disappear.)

Before Norris was appointed medical examiner in 1918, the coroner's office was filled with Tammany Hall political hacks possessing few credentials and little training. Coroners supplemented their incomes by selling falsified death certificates and covering up murders, suicides, and botched abortions. Norris's predecessor was well-known for showing up at crime scenes visibly intoxicated. An investigative report at the time concluded: “New York City is compelled to get along virtually without aid from the science of legal medicine, a situation which exists in no other great city of the world.”

Norris was determined to turn this situation around. Coming from a wealthy family, he had studied at Yale and Columbia, and since 1904 had been the director of laboratories at Bellevue Hospital. Norris realized that poisoners particularly benefited from the chaos in the coroner's office; they were able to kill with near impunity because the city did not have the scientific tools to identify arsenic, chloroform, thallium, and other lethal chemicals in dead bodies.

To head the city's forensic laboratory, Norris chose Alexander Gettler, who had worked his way through City College and Columbia University, and was fond of smoking cigars and betting on horse races. Gettler was a fierce competitor, and Blum notes that Norris warned him his new job would not be easy: “No other city in the United States had a dedicated toxicology laboratory. Gettler would have to design the lab from scratch, and invent a methodology for the New York office. There were no training programs in forensic toxicology; there were astonishingly few books on the subject, most of them based on European research.”

By describing a series of cases involving specific lethal toxins, Blum tells the story of how these two men, working tirelessly and for little pay, succeeded not only in establishing a first-class toxicology lab, but also in convincing judges and juries that their scientific methods were reliable and ready for presentation in the courtroom.

The cases themselves are spectacular. A nursing home attendant admits to killing eight of his patients with chloroform, but is released because no forensic tools exist to confirm his seemingly wild claims. An elderly couple are found on the floor of their hotel room dead; Gettler is able to establish the presence of cyanide in their lungs, and to trace the source back to fumigators working in the hotel's basement. A husband dies of trauma during what his wife claims was a violent home invasion; Gettler finds enough methanol in his brain to demolish the alibis of the wife and her lover.

The time Norris and Gettler served in the Medical Examiner's office overlapped with Prohibition, and Blum's discussion of the toxicologic implications of the 18th amendment and the Volstead Act is the most compelling part of this very interesting book. By the time Prohibition began on Jan. 20, 1920, the federal government had long required that industrial ethanol be poisoned (“denatured”) by the addition of toxins such as methanol. The purpose of denaturing was to prevent the diversion of industrial products to the beverage industry without payment of liquor taxes, which financed a good part of the federal budget. Bootleggers employed chemists to “renature” the alcohol, that is, remove the toxins. Their methods were not always successful.

With Prohibition, the government redoubled efforts to poison industrial alcohol, increasing the concentration of added methanol several-fold and considering use of other toxins such as benzene, kerosene, and mercury bichloride. The results were disastrous. In 1926 alone, 1200 people in New York City were sickened or blinded from ingesting methanol in bootleg booze; 400 died. Over the Christmas holiday that year, the emergency department at Bellevue Hospital saw 65 cases of methanol toxicity in just 48 hours, including eight deaths.

Both the medical examiner and his toxicologist were shocked at this state of affairs. As Gettler pointed out in a news conference, “The figures exceed the number who died from alcoholism in the days of the saloon.” Norris was even blunter, writing that “the United States government must be charged with the moral responsibility for the deaths that poisoned liquor causes, although it cannot be held legally responsible.”

The Poisoner's Handbook has some unfortunate lapses in scientific accuracy. Cyanide does not attach to hemoglobin or impair the ability of blood to transport oxygen. Gamma radiation is not particulate. And syphilis lesions generally are not painful. Nevertheless, Blum tells a great story, and I can't imagine anyone with even a passing interest in toxicology not wanting to read her book.

Comments about this article? Write to EMN at emn@lww.com.

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