MEDICAL EVIDENCE

New Zealand Herald, Volume LXXIII, Issue 22352, 25 February 1936, Page 11

MEDICAL EVIDENCE

MUBDEB CHARGE

TWO DOCTORS HEARD CAUSE OF WOMAN'S DEATH QUESTIONS ABOUT VERONAL Before the police evidence in the Mareo case was commenced yesterday the medical testimony was completed. Cross-examined by Mr. O'Leary, Dr. E. B. Gunson said he specialised in general medicine. Heart work was his particular branch. Mr. O'Learv: What is the extent of your practical experience of veronal poisoning?—l have seen in the last three years four cases of veronal poisoning. Fatal cases?—l have not seen a fatal case. I have seen two cases where there have been big doses giving symptoms comparable to those of Mrs. Mareo on the Saturday before her death. They were misadventure cases. A third case was one in which, after it passed out of my observation, the patient died with aggravated symptoms three weeks later. That was a misadventure case. Of course, you have no direct knowledge of this case, no clinical knowledge?—l never saw this case. From what you have heard, you are giving your expert opinion?— Yes. Witness said he had given evidence prior to Mareo's committal. He had been brought into the case some weeks prior to that. Mr. O'Leary: I suppose information was placed before you to enable you to give at least a preliminary opinion on the matter? —Yes, the information consisted of statements by Mr. Griffin, Dr. Gilmour, Graham Mareo and Miss Stark. Those statements contained no expression of opinion by Dr. Gilmour. Dr. Gilmour and witness conferred upon written opinions which they had independently submitted and discussed certain aspects of it. His view was entirely independent of that of any other doctor. Mr. O'Leary: Do you accept the statement from Sir William Wilcox that some persons have a natural increased susceptibility to all drugs?— Yes. What might be a medicinal dose to an ordinary person would be a poisonous dos« to a susceptible person?— Yes. And Mrs. Mareo may have been a susceptible person ?—Yes. Mr. O'Leary: You think this lady had 100 grains?— Yes. Is that the total for the three administrations you think she had, or for the last?— Tha- is the total. Mr. O'Leary: How many doses do you think she had from your knowledge of the case? —I have knowledge of three doses Do you think she had a further dose after the Saturday night?—l have no opinion. 1 don't know.

Accepting the evidence of her condition after the Saturday night could she have had another dose?— No. Witness said that on the Saturday morning he considered she had had more thnn a therapeutic dose and less than a lethal. Mr. O'Lenry; A poisonous dose? —A poisonous dose. Then at least 50 grains?—Up to 50 grains. Did you not say 50 grains was the minimal poisonous dose ? —Less than that. A toxic or poisonous dose is not a lethal dose. Witness still thought Mrs. Mareo took a poisonous dose on Friday night and that she had another dose on Saturday morning just prior to being assisted back to bed and going off to sleep. Mr. O'Leary: Have you overlooked the fact that for 1} hours to two hours she was alone in the house on Saturday morning?—l have considered that. Witness agreed that a fatal dose varied very considerably. He could not speak as to the form in which Mrs. Mareo got the dose. Milk was the handiest thing. It would be reasonable to suppose that digestion would be at a standstill from Saturday morning onward, but that did not mean that the absorption of the veronal would be slower. His estimate of 100 grains was an estimate based on the findings of the analyst, particularly on veronal recovered from specimens taken. Use of Drug In Practice You think that a toxic doso was' taken on Friday?— Yes. Another dose just prior to her getting into bed on Saturday morning ?-4Yes. Another that evening?— Yes. And I put it to you that you cannot see any evidence of any other dose ?—Definitely. Re-examined by Mr. Johnstone Dr. Gunson said this did not exclude the possibility that there were other doses. Do you give veronal in the course of your practice?— Yes, very commonly. Veronal is a sheet-anchor in the matter of hypnotics in the profession. Dr. Gunson said veronal was commonly put on the tongue and washed down. He personally had never ordered that it be washed down with milk, but. his nurses had so used it. The onset of sleep after taking veronal on the Saturday would be rapid. In your opinion would it have been possible for Mrs. Mareo to have taken veronal before calling out on the Saturday night?—l have no reason to think so. If she had had veronal before calling to Miss Stark, would she have remained awake for two hours?— Not in my opinion. Effects of Veronal Dr. S. L. Ludbrook, a consulting physician, of Auckland, said he had used veronal and its compounds very frequently in the course of his practice. A close larger than a therapeutic dose might produce symptoms of poisoning. There might be symptoms before the onset of sleep, such as nervous upsets. The patient sometimes did not speak clearly. There might be mental disturbances, loss of memory. They staggered and might be excited or in delirium. On waking from sleep the patient would again show symptoms of headache, difficulty in speech and staggering gait.

In the case of a large dose, which would prove fatal if not treated in time, there might be a period of excitability, which would be rapidly followed by coma —a condition of unconsciousness. Breathing in coma from veronal poisoning was usually very deep and noisy, with a rattling in the throat. If a person suffering from the effects of veronal was coming out of the coma he would not relapse into the coma without further dose. When a person could respond to questions and drink and swallow those were signs of recovery from coma, continued witness. Recovery of consciousness was the most important sign. From the evidence he had heard and read he concluded that Mrs. Mareo had died of veronal poisoning. He agreed with the estimates of the other medical men as to the amount of veronal taken. Mrs. Mareo's condition on the Satnrday morning when she was found in front of her dressing table might be indicative of recovery from a dose taken the previous .evening, or might have been the result of a dose tafien shortly before. He thought Mrs. Mareo's condition throughout the Saturday indicated that she had had a dose that morning. The fact that she made requests that evening showed that she was recovering from the effects of the veronal. She would have continued to recover if she had had no more. Symptoms Discussed Witness said Mrs. Mareo might have gone into a sleep as distinguished from a coma. It would have been a natural quiet sleep, but later on the Saturday night she was showing symptoms typical of deep coma caused by veronal. He thought she probably had at least three doses —one on Friday night, one on Saturday morning and 0110 on Saturday night. It was quite impossible that Mrs. Mareo should have taken a dose on Saturday night about the time she called out to Miss Stark. Mr. O'Leary: Even doctors might differ as to whether or not this woman was recovering from coma on Saturday night?—l don't think so. Witness said he was basing his opinion largely on the evidence of Miss Stark. Mr. O'Leary: If there are exceptions to your statement that a person who once shows signs of recovering does not relapse the basis of your theory goes? —Not in this caso. What do you mean by that?—l mean that a woman partially wakes and then goes into a deep coma in which she had not been before She could not have gone into that without a drug. Assuming she had been in a coma that day?— But she was not. Where do you get that? —From the evidence, Miss Stark's, and I think Graham Mareo's. She was in a natural sleep. A Case Quoted Miss Stark got stuff to wake her up. How could she have thought she was in a natural sleep?— She was talking to Mrs. Mareo. Mr. O'Leary read the history of a case in which a man had made what was apparently a partial recovery, but afterwards died of the results of veronal poisoning. In th&t case witness said the patient was under active treatment to stimulate the brain and bring back consciousness. Mr. O'Leary: You don't speak with any positiveness of a third dose? I think she had three. The hearing was adjourned until 10 a.m. to-day.