; and this led to the further inference that he
was almost or completely blind in the right eye.
This conclusion was, indeed, to some extent negatived by a deep
indentation on the bridge of the nose, evidently produced by spectacles,
and by marks which I looked for and found behind the ears, corresponding
to the hooks or "curl sides" of the glasses. For those spectacles which
are fitted with curl sides to hook over the ears are usually intended to
be worn habitually, and this agreed with the indentation on the nose;
which was deeper than would have been accounted for by the merely
occasional use of spectacles for reading. But if only one eye was
useful, a single eye-glass would have answered the purpose; not that
there was any weight in this objection, for a single eye-glass worn
constantly would be much less convenient than a pair of hook-sided
spectacles.
As to the nature of the patient's illness, only one opinion seemed
possible. It was a clear and typical case of opium or morphine
poisoning. To this conclusion all his symptoms seemed to point with
absolute certainty. The coated tongue, which he protruded slowly and
tremulously in response to a command bawled in his ear; his yellow skin
and ghastly expression; his contracted pupils and the stupor from which
he could hardly be roused by the roughest handling and which yet did not
amount to actual insensibility; all these formed a distinct and coherent
group of symptoms, not only pointing plainly to the nature of the drug,
but also suggesting a very formidable dose.
But this conclusion in its turn raised a very awkward and difficult
question. If a large--a poisonous--dose of the drug had been taken, how,
and by whom had that dose been administered? The closest scrutiny of
the patient's arms and legs failed to reveal a single mark such as would
be made by a hypodermic needle. This man was clearly no common
morphinomaniac; and in the absence of the usual sprinkling of
needlemarks, there was nothing to show or suggest whether the drug had
been taken voluntarily by the patient himself or administered by someone
else.
And then there remained the possibility that I might, after all, be
mistaken in my diagnosis. I felt pretty confident. But the wise man
always holds a doubt in reserve. And, in the present case, having regard
to the obviously serious condition of the patient, such a doubt was
eminently disturbing. Indeed, as I pocketed my stethoscope and took a
last l
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