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

“Morphine went into teething medicines for infants; opium into routinely prescribed sedatives; arsenic was an ingredient in everything from pesticides to cosmetics.”

Blum describes how advancements in industrial techniques led to the creation of numerous new products that contained potentially hazardous substances. Along with the increase of such commercially available chemical solutions came a number of deaths. This was due to both accidental deaths caused by mishandling of these products and killers exploiting the easily purchased chemicals to formulate poisons.

“Meanwhile the autopsy result turned out to be a catalog of contradictions […]. The doctors couldn’t agree on how decomposition affected chloroform chemistry in the body. They couldn’t agree on how embalming had changed the chemistry either.”

Prosecutors suspected that millionaire William Rice had been poisoned with chloroform by family members seeking to procure his sizable fortune. However, the science of how chloroform affected a human body was poorly understood, and the defense team hired experts who exploited this uncertainty to argue that it was impossible to know whether Rice had been poisoned. The publicity surrounding the case led to misinformation about chloroform, affecting murder investigations for years to come. 

“The city required no medical background or training for coroners, even though they were charged with determining cause of death.”

In New York City, politically elected coroners were in charge of conducting autopsies for murder investigations. These coroners were typically chosen by the corrupt party machine Tammany Hall and could serve without any proof of medical knowledge. Such a lack of regulation meant that New York’s coroners were often ineffective at their jobs, misidentifying causes of death and thus allowing murderers to evade arrest.

“‘This work, which I may term ‘organization,’ has apparently not been tried before,’ Norris wrote to Hylan, displaying his contempt for the previous system. The relaxed environment of the old coroner’s office, he promised the mayor, was now a thing of the past.”

When Norris took over as New York’s first chief medical examiner, he immediately began instituting a series of reforms that aimed to fix the situation of corrupt and inefficient coroners that preceded him. These reforms centered around creating an organized system by which the police would collaborate with the medical examiners. Norris’s insistence on the necessity of forensic analysis of dead bodies helped to establish the medical examiner’s office core role in investigating homicides. 

“If a test didn’t exist, [Gettler] would invent it. If research methods didn’t exist, he would develop them himself.”

When Alexander Gettler took charge of Norris’s forensic chemistry laboratory, it was the first of its kind in the country, meaning that Gettler essentially had to invent much of the protocols for forensic toxicology as a discipline. Often, Gettler’s work called on him to identify newly produced chemicals in a cadaver, and Gettler would then create a multitude of tests for identifying the poison. 

“Gettler, Norris, and their comrades unanimously predicted that Prohibition, rather than making alcohol disappear, would instead create ‘numerous harmful substitutes for whiskey.’”

In the months before Prohibition was set to take effect, Gettler and Norris noticed more and more cases of methyl alcohol poisoning arriving in their office. They realized that New York’s drinkers were turning to illegal substitutes for alcohol that often contained deadly and toxic industrial alcohol instead of the safe ethyl alcohol found in liquors. Concerned by this, Norris and Gettler held a press conference to warn the country that Prohibition might only worsen the country’s problems with alcohol. 

“The defense argument focused elsewhere: the science was no good; the Jackson’s deaths were still a mystery; the medical examiner’s office had failed to prove that cyanide was responsible.”

One of Gettler’s first significant cases concerned the deaths of Fremont M. and Annie Jackson, who Gettler believed had died from accidental exposure to cyanide in fumigation gases. Though Gettler said that he had found evidence of cyanide in the couple’s lungs, the defense team argued that there was no scientific evidence that could conclusively identify cyanide in a corpse. As forensic science was a new field, and thus poorly understood, the jury was susceptible to the defense’s arguments. 

“A few months [after the Jackson trial], Norris started a crusade to ‘improve the medico-legal situation,’ not only in New York but across the country. He was determined that the profession would gain the credibility and respect it deserved—in court and out of it.”

After the defense team successfully attacked Gettler’s forensic analysis of the Jacksons’ bodies, Norris became convinced of the necessity of publicly advocating for forensic chemistry as a valid form of science. Norris believed that a lack of understanding of the field by a wider public was preventing his office from successfully aiding in homicidal investigations. Norris decided to meet with other early advocates of forensic science to create a set of “national standards” with the goal of eliminating any uncertainty surrounding the scientific discipline. 

“A primary reason for arsenic’s popularity was that when mixed into food and drink, it is extremely difficult to taste […] when the poison was added to soup, liquor, or a cup of hot coffee, the other flavorings easily masked it.”

Though arsenic typically has a strong and bitter taste, it is easily masked if placed in small amounts in food substances. Such undetectability meant that arsenic was a popular poison throughout history, and one that could be easily used to commit mass murders. Blum discusses the unsolved poisonings at New York’s Shelbourne Restaurant, in which 60 people were poisoned after consuming pie dough laced with arsenic. 

“Prohibition had cranked up the level of violence in the city; gunfights rattling the streets were becoming relatively routine. The business of illegal alcohol had quickly become a lucrative gift to the city’s gangs, who’d build newly efficient organizations to manage the multimillion-dollar bootlegging industry.”

Though one of Prohibition’s aims was to diminish the unruliness caused by alcohol, Blum notes that the law had the opposite effect by giving newfound power to New York’s mafia. These gangs earned fortunes through the massive illegal distilleries, serving toxic industrial alcohol to the legions of New Yorkers who still sought to drink. Gun violence became a standard occurrence throughout New York City, as rival gangs would fight each other in bids to claim each other’s territories or fortunes. 

“As medical accounts of the 1920s noted, mercury bichloride was so corrosive, so irritating, that it could destroy tissue to the point that teeth loosened in the mouth, and the stomach eroded into a mass of bleeding ulcers. Physicians knew that because mercury salts, despite the risks, were available in an astonishing variety of commercial products.”

Throughout The Poisoner’s Handbook, Blum charts how the 1920s were rife with readily available products that included substances that could seriously harm or kill an individual if ingested in the wrong way. One such substance was mercury bichloride, which was commonly found in medicines and led to accidental deaths. One such death was of the well-known actress Olive Thomas, who poisoned herself after accidentally drinking her husband’s syphilis medication. 

“Gettler had been able to estimate the amount of bichloride of mercury in Gertie Webb’s body by comparing the Reinsch’s test readings with other data that he’d compiled. Mercury was there, but in such miniscule amounts it was barely detectable, far below a lethal dose.”

After Gertie Webb mysteriously fell ill and died, her family suspected that her husband, Charles, had poisoned her with bichloride of mercury in an attempt to gain control of her family wealth. When Gettler conducted an analysis of Webb’s body, however, he discovered only a slight amount of mercury, stemming from a medication she was taking before her death. Gettler’s analysis helped to prove Charles’s innocence, becoming a sign to the public of the importance of forensic analysis. 

“Thanks to the streets overflowing with automobiles, the increasing reliance on gas appliances, and the sprouting of industrial factories along urban corridors, every living creature, especially in the big cities, now inhaled a constant dose of carbon monoxide.”

Though carbon monoxide could be a harmful gas that suffocated individuals, it was also a ubiquitous part of life in the cities, due to its presence as both a part of illuminating gas and a by-product of car engines. When Gettler aimed to produce studies of carbon monoxide poisonings, he first had to calculate what amount of carbon monoxide a body ingested merely by living in an urban environment like New York. After calculating this amount, Gettler could then gain insight into what level of increased carbon monoxide killed individuals.

“[Anna Fredericksen’s] blood was saturated with carboxyhemoglobin. And as corpses didn’t absorb the gas, and as the saturation level was lethal, Anna Fredericksen had been dead, Gettler reported, before Travia had picked up his knife.”

One of Gettler’s studies on carbon monoxide revealed that the gas remained in the body’s blood by latching onto blood cells, producing the chemical carboxyhemoglobin. Further, Gettler determined that corpses cease absorbing carbon monoxide in the blood after death, meaning that one can study a corpse’s carbon monoxide levels at the moment of death. Such studies played a crucial role in freeing Francesco Travia, who had been accused of murdering Anna Fredericksen. As Fredericksen’s corpse had displayed a lethal amount of carbon monoxide, it was impossible for Travia to have killed her. 

“The government knows it is not stopping drinking by putting poison in alcohol […] Knowing this to be true, 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.”

This quote comes from a statement by Charles Norris in response to the US government’s policy of putting toxic chemicals in industrial alcohol. The government hoped to deter drinking by making illegal alcohol deadly for those who imbibed it. Norris felt that such a policy amounted to the government murdering citizens, as the government was knowingly poisoning drinkers without properly warning them. 

“As always, Gettler said, money bought greater safety. The well-heeled clubbers, the wealthy lovers of jazz-flavored cocktails, could afford the pricey higher-quality alcohol on the market.”

One of Gettler’s chief criticisms of Prohibition was that it affected poorer residents far more than it did the rich. Those with money could find ways of purchasing bootlegged alcohol that had been cleared of any possibly toxic substances. However, New York’s poorer drinkers often had to settle for the cheapest forms of liquor, meaning that they risked alcoholic poisoning far more than the wealthy. 

“People poisoned by methyl alcohol would often seem to recover from that first bout of dizzy sickness, feel better while the alcohol was being metabolized, and then ten to thirty hours later be poisoned again by the breakdown products.”

Blum argues that methyl alcohol is particularly dangerous due to its slow nature as a poison. When drinkers consumed liquor containing methyl alcohol, the poison would have little immediate effect on their bodies, leading them to possibly ingest more of the toxic substance. Death only came many hours later, when the body metabolized methyl alcohol and produced the even more toxic formaldehyde and formic acid.

“Physicians reported [that radium had] healing effects that seemed miraculous, especially compared to the therapies of old. The newspapers compared radium’s magic to the golden healthful rays of the sun.”

When radium was discovered by Marie Curie, scientists and doctors initially believed that the new, glowing element might be a magical cure-all substance. Companies capitalized on these medical beliefs, creating a wide variety of skincare and food products that boasted radium as one of their ingredients. Mistaken beliefs about the benefits of radium led to lax regulations around the substance, and many individuals consumed so much of the substance that it caused their deaths. 

“As a result, when a person swallows radium, the body channels it in a way similar to calcium—some is metabolized away, some goes toward nerve and muscle function, and most is deposited into the bones.”

Blum describes how radium’s chemical structure—particularly its similarity to calcium—makes it especially deadly for the human body. Though radium’s radiation is nearly harmless once outside the human body, the alpha particles it emits can cause severe damage to the body’s interior. As the body stores most radium inside of bones, the element’s alpha particles continually corrode the bones for years until the bones finally break or crumble.

“[Ethyl alcohol] offered an illuminating case study in the peculiar, paradoxical nature of the planet’s chemistry: what sustained life could also kill it.”

Blum notes that the same three elements—carbon, oxygen, and hydrogen—form the basis of a multitude of the planet’s natural substances. While many of these chemicals are necessary for life on earth (such as water and oxygen), they also makeup the chemical structure of methyl alcohol and ethyl alcohol. While methyl alcohol is highly toxic for the human body, ethyl alcohol can be safely consumed in reasonable doses. 

“Many Americans believed that the alcohol restrictions had contributed to the economy’s collapse, closing breweries, coasting jobs, increasing crime, and—as all now admitted—increasing drunkenness.”

By the early 1930s, the attitude of most Americans towards Prohibition had shifted, with many perceiving Prohibition as an outright failure. Though temperance advocates had promised that Prohibition would clean America up and bring peace to its cities, most residents instead felt that Prohibition had driven numerous Americans to partake in illegal behavior and decimated a large portion of the country’s economy. In 1932, Franklin D. Roosevelt successfully ran for president with the repeal of Prohibition as a central part of his presidential platform—signifying how widespread anti-Prohibition sentiments were in America by the early 1930s. 

“There were times, and they came frequently enough, when one could believe that modern society, machine-age America, was addicted to poisons. Every day retold the story of that dependency: poisons floated in the exhaust-smudged air of the morning commute and swam in the evening martini [...].”

A recurring theme in The Poisoner’s Handbook is how toxic substances became a fact of life in 1920s America. Often, the ubiquity of such poisons was due to a lack of science examining how these chemicals affected American’s bodies. However, Blum also suggests that Americans also had an “addiction” to poisons, suggesting that society had a tendency toward self-harm that Americans could do little to combat.

“Yet while the first trial [of Mary Frances Creighton] served as a plaguing reminder of science’s fallibility, the second trial was testament to the great progress Gettler and his colleagues had made in earning forensic toxicology a place of respect in the courtroom.”

Gettler served as an expert witness on two trials of Mary Frances Creighton, with 12 years between them. While in the first trial Gettler provided evidence that exonerated Creighton from charges of arsenic poisoning, in the second trial Gettler provided decisive evidence that helped prove Creighton’s involvement in a different murder. Though Gettler was haunted by his involvement in initially proving Creighton’s innocence, Blum argues that the two trials could be seen as signs of how far the discipline of forensic toxicology had grown in a 12-year span.