Original article 13. 14. 15.
Izawa M. Issues in brain death debate. In: Kenkyukai S, ed. Shinto and bioethics. Tokyo: Kobunsha, 2008:177e203. Tanatsugi M. Shiseigaku to shiseikan. In: Fusegi S, ed. Seimeirinri to Iryorinri. Kyoto: Kinpodo, 2008:119e27. Shochiku Company, Inc Jigyobu. Stone-letter. In: Shochiku Company, Inc, ed. Okuribito pamphlet. Tokyo: Hisae Press, 2008: p27.
16. 17. 18. 19.
Aoki S. Nokanfu Nikki. Tokyo: Bunshun Bunko, 1996. Seijo University Anthropology Society. Saniku. Seijo University Anthropology Investigation Report 1986;9:67e72. Hirafuji K. Okuribito. In: Inoue J, ed. Eiga de manabu gendai Shukyo. Tokyo: Kobunsha, 2009:22e3. Aoki K. Seimei to Rinri. Tokyo: Maruzen Planet Company, Inc., 2004.
Miscellanea ‘Horrible, most horrible’: Hamlet and forensic medicine
speculation is correct, Shakespeare may inadvertently have been one of the first authors, if not the first, to note these classic findings, several centuries before their description in the forensic literature.
In William Shakespeare’s Hamlet, the old King is poisoned by his brother, who instills ‘a juice of cursed hebona’ into the King’s ear.1 According to the testimony of the King’s ghost, the poison rapidly induces fatal systemic coagulation (“it doth posset/And curd . the blood”) and a diffuse dermal reaction, covering the body with a ‘lazar-like . and loathsome crust’.1 Several authors examined medical aspects of the King’s death, discussing the identity of the poison, dosage of herbal poisons, drug administration through the ear and whether the sequelae of chronic otitis media may have led to oral ingestion of the poison via the Eustachian tube, rather than absorption through the skin.2e6 The observation that none of the suspect poisons can actually induce fatal clotting and diffuse skin changes is strangely omitted in these discussions. We wish to contribute to the current literature by suggesting the symptoms described by the King’s ghost were induced by death itself, rather than by a specific poison. Shakespeare may have attended a dissection of an executed criminal, a common practice at the time.7 Postmortem changes such as blood clotting and skin discoloration by lividity would be evident during such a procedure, however these normal findings were not systematically described until the 19th century.8 We believe he mistook these normal postmortem changes for findings related to the cause of death, an error that still occurs today, even among professional coroners.9 If our
Thomas D Ruder, Gary M Hatch, Michael J Thali
J Med Ethics; Medical Humanities June 2010 Vol 36 No 1
Institute of Forensic Medicine, University of Bern, Buehlstrasse, Bern, Switzerland Correspondence to Thomas D Ruder, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland;
[email protected] Competing interests None. Provenance and peer review Not commissioned; not externally peer reviewed. Accepted 11 May 2010 J Med Ethics; Medical Humanities 2010;36:35. doi:10.1136/jmh.2010.004846
REFERENCES 1. 2. 3. 4. 5. 6. 7. 8. 9.
Shakespeare W. Hamlet. Stuttgart: Philipp Reclam jun, 1998. Macht DI. A pharmacological appreciation of Shakespeare’s Hamlet; on instillation of poisons into the ear. Bull Johns Hopkins Hosp 1918;29:165e70. Simpson RR. Shakespeare and medicine. Edinburgh and London: E.&S. Livingstone LTD, 1959. Huizinga E. Murder through the ear. Pract Otorhinolaryngol (Basel) 1971;33:361e5. Kotsias BA. Scopolamine and the murder of King Hamlet. Arch Otolaryngol Head Neck Surg 2002;128:847e9. Eden AR, Opland J. Bartolommeo Eustachio’s De Auditus Organis and the unique murder plot in Shakespeare’s Hamlet. N Engl J Med 1982;307:259e61. Burton JL. A bite into the history of the autopsy; from ancient roots to modern decay. Forensic Sci Med Pathol 2005:4:277. Mallach HJ. Zur Frage der Todeszeitbestimmung. Berl Med 1964;18:577e82. Sauvageau A, Racette S. Postmortem changes mistaken for traumatic lesions: a highly prevalent reason for coroner’s autopsy request. Am J Forensic Med Pathol 2008;29:145e7.
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