“I would like to present my colleagues. D.C.I. Green, D.S. Reed, D.S. Berger and our temporary local guide, W.P.C. Prior.”
Haywood waved a hand and smiled. “All the leading lights together, in fact.”
“You don’t mind an audience, Professor?”
“Not a bit of it. My file’s over here.” He moved to the table-tennis table. “But I don’t think I’ll need it.”
“Shall we sit?”
“Would you like me to take shorthand notes, Chief?” asked Betty Prior.
“Before I say yes or no to that . . . Professor, are we going to use words that will be intelligible to a non-medical shorthand taker?”
“Depends on how closely you question me.”
“He’ll give you the works, Prof,” grunted Green. “Give him a chance to get in among the unmentionables and unpronounceables of medicine and he’ll be here till doomsday.” He turned to Betty. “I tell you what, love, you go and get half a dozen cups of tea and a couple more cakes and we’ll eat those I brought. Don’t worry, we won’t start without you, so you can take that pout off your pretty little physog.”
Betty grinned and got to her feet. Masters said: “But please hurry, Betty. The Professor is a busy man.”
“Meaning you’re not a busy man?” asked Haywood with a grim smile after Betty had slipped out.
“The Chief’s busy enough,” said Reed. “He just gives the impression he isn’t.”
“Better that than those who try to give a false impression t’other way,” said Haywood. “Now, having demonstrated that I don’t fall into that category myself—by being here well before the agreed time, I think I should tell you that this little job has taken me so long because I didn’t use my loaf. By that I mean I tested for a lot of common toxic agents—and failed to find them—before I had the necessary gumption to accept that an uncommon agent could have been used. I tell you that, gentlemen, just in case you’ve been cursing me for having kept you waiting so long for the answer.”
“I knew it,” said Green. “Just our luck. Why is it we never get a job where a nice, easy household substance has been used? As soon as I heard that word thrombocytopenia I guessed we were in for a dog’s dinner of a case. And now the prof’s just confirmed it. It makes you wonder, doesn’t it?”
Haywood said: “Mr Green, would you be surprised to learn that what killed Boyce can be found in practically every household in the country? That if you went out into the High Street at this moment you would find quite a large percentage of people were carrying it about on their persons—particularly the women—and that W.P.C. Prior definitely is at this moment?”
“Definitely is what?”
“In possession of the substance that killed Boyce.”
Green was saved from the necessity of making an immediate reply by the bump at the door which heralded Betty’s arrival with the tray. Berger opened the door and the W.P.C. backed in, both hands fully occupied with her burden.
“Put it down here, love,” said Green, regarding her closely, “and tell me what you’ve got on you that’s poisonous.”
“Poisonous? Nothing.”
“The Prof says you have.”
Betty looked at Haywood. “Did you say that, sir? Or are you pulling his leg?”
“It’s true enough.”
“What, my powder or eye-shadow or something?”
“None of those things. It’s round your wrist.”
She looked with surprise at the tiny watch she was wearing. “I don’t understand.”
“Right,” said Masters. “Shall we all sit down? Betty, we have merely been gassing to fill in the time until you got back because we promised not to start without you. Take your tea, everybody. And, please, Professor, could we now begin in earnest?”
“Sure thing. But I wasn’t fooling, you know.”
“Maybe not, but you have me baffled, nevertheless.”
“What do you think the toxic substance was that killed Boyce?”
“Please tell us.”
“Gold.”
There was a moment of silence.
“Gold?” murmured Masters. “I now see what you meant when you said you had found an uncommon agent.”
“You say gold is poisonous, sir?” asked Berger. “In its normal state? Like Betty’s watch or . . .”
“Or gold earrings or wedding rings? Yes, Sergeant. I can quote you chapter and verse, because I took the trouble to look it up. There are cases of women developing persistent, papular, eczematous lesions on both earlobes following ear-piercing and the subsequent wearing of gold earrings. Many women cannot wear gold wedding rings without getting dermatitis so seriously that they have to take them off permanently and there are cases where jewellers have developed necrotising vasculitis through their work. All these nasties have come about through simple external contact with the metal—among people who are sensitive to gold, that is. Fortunately most of us are unaffected by our jewellery. But think of the effect of gold on sensitive people if internal contact is made.”
“Wait a moment, Prof!” said Green. “Are you saying that young Boyce could have swallowed a lump of solid gold, out of a tooth or something?”
“Nothing like that. I am saying he took or was given a massive dose of sodium aurothiomalate, which is a disodium salt—to give it its chemical name—but which has a gold content of roughly forty-five per cent.”
“A medicine?” asked Masters.
Haywood nodded. “You must all have heard of gold injections for rheumatoid arthritis.”
“I have,” admitted Masters. “However, I know very little about it except that I have the impression that gold has to be administered with great caution.”
“You’re absolutely right. I’m no rheumatologist, but my textbooks tell me that toxic reactions are liable to occur in up to fifty per cent of patients undergoing gold therapy. In about five per cent, these reactions may be severe and, occasionally, even fatal.”
“Excuse me, sir,” said Reed, “but surely no medical man would use a medicine that had so much danger attached to it?”
“There is no clear cut answer to that, Sergeant, except to say, as a generalisation, that it is used as a last resort treatment when everything else has failed. Then, when it is used, the doctor will start with very small injections at very long intervals and monitor the progress and reaction of the patient. Many of them do very well on it and gain tremendous relief, but those who react badly are taken off it immediately.”
“But, sir, you said that up to half of them showed toxic reactions.”
“True enough, but some of those reactions are preferable—in the patient’s view—to the everlasting pain of rheumatoid arthritis. What I mean is, Sergeant, that . . .”
“I think I know, sir. If I had a non-stop headache and I knew aspirin would cure it even though it gave me a pimple on my big toe, I’d choose to have the pimple rather than the headache.”
“Excellently put.”
“But we’re not talking about pimples, are we?” asked Masters. “I imagine the alternatives with gold therapy could be pretty horrific.”
“Nightmarish.”
“Scare us,” said Green. “We can take it.”
“Very well. How’s this? Stomatitis, pruritus, erythema, papular eruptions, urticaria, exfoliative dermatitis, colitis, nephrosis, aplastic anaemia, agranulocytosis, leucopenia, thrombocytopenia and toxic hepatitis—among others. Occasionally—according to the book—there are things like haematuria, encephalitis and a few more like that. Finally, fatal blood dyscrasias may occur suddenly.”
“Like in Boyce’s case.”
“Right. He had a massive blood dyscrasia.”
“What is the average, normal dose of aurothiomalate?” asked Masters.
“It depends a bit on individual patients, but as a yardstick I would suggest an initial dose of fifty milligrams—to start them off. The next week, twenty-five milligrams, and then every week after that only ten milligrams until there was remission of pa
in, or evidence of toxicity.”
“An ever-decreasing dose, virtually?”
“Sort of.”
Masters paused a second to collect his thoughts. “That suggests there is a build-up in the body.”
“Most definitely there is. It can still be traced a couple of years after cessation of treatment. And I’d like you to know that some rheumatologists go the other way about treatment. They start low and build up the amounts. Then when they have reached the top dose, they lengthen the intervals between treatments so that, in essence, the patients get the same amounts by both methods.”
“Fine. I understand that. Am I right, therefore, in assuming that total amounts taken—even over a long period—are critical?”
“You certainly are.”
“What are those total amounts?”
Haywood took a bite at the lemon curd tart he held in his hand before replying. As he munched, he gesticulated after the fashion of a man who wants to indicate that he has something pertinent to say as soon as his mouth is empty.
“Ah!” he said at last. “There is no cut and dried answer. Each patient reacts differently. But I think you should assume—again as a yardstick—that blood dyscrasias might occur when the total dose reaches three hundred to five hundred milligrams. That is why it is stressed that patients should have a full blood count before each injection and even if the patient shows no signs of reaction, the dose should never exceed fifty milligrams. But—and this will make you realise that I can’t be specific—there is, on record, a paper which says that ten patients developed dyscrasias without warning on a total dose of only two hundred milligrams.”
“Fatal dyscrasias?”
“No, they were caught in time and treated, but the same paper records fifteen fatalities during gold therapy with an average dose of about seven hundred milligrams.”
“This stuff is deadly,” said Green sternly. “Surely the Committee on Safety of Medicines is doing something about it?”
Haywood shrugged. “They are doing what they can. And I think you will find that not so much gold is now used and certainly not used without very strict precautions.”
“I should hope not.”
“The next pertinent point,” said Masters, “is the amount Boyce took. Presumably he must have ingested a vast amount?”
“You know how we estimate the amount ingested, don’t you?”
“You measure as accurately as possible in one or two organs and then multiply by some formula or other to arrive at the total.”
“Roughly right. And though it sounds a bit haphazard it is, in fact, extremely accurate. I say this because you are going to be more than a little astounded to hear that my calculation suggests Boyce’s body contained upwards of two thousand milligrams.”
“Two thousand! But that’s . . . that would have killed anybody, I suspect, judging by what you’ve already told us.”
“Certainly it would if it were not spread over several years. And this wasn’t. Boyce took that little lot only a matter of hours before his death. That was easy to establish.”
“In other words he took it all at once.”
“That would be my guess.”
Masters took out his pipe and started to pack it. Berger said: “Two thousand milligrams is what? Two grams?”
“Right. You can judge the amount better, I think, if you remember that there are roughly thirty grams to the ounce. So he took a fifteenth of an ounce.”
“Not much if you say it quickly,” said Green.
Masters completed the lighting of his pipe. When he had an even burn, he sat back from the table and crossed one leg over the other.
“Professor,” he said, “you’ve given us the poison . . .”
“Sorry, Chief Super, may I interrupt for a second? I should have mentioned that Boyce had, in fact, an incipient gastric ulcer. I mention it only because it could conceivably have made absorption of the aurothiomalate that much better and quicker. I suspect that over the last year or two the young man had over-indulged in liquor.”
“Thank you, Professor.”
“That’s all.”
“Right. Now there are lots of things we’ve still got to ask you. First, where could he have got the gold?”
“From a doctor, a pharmacist or a person suffering from rheumatoid arthritis who had the ampoules as a supply for his or her course of injections.”
Green grunted. Masters wasn’t sure whether or not this suggested an idea had leapt into his assistant’s mind, but he realised that almost since the professor had first started talking about gold injections he, himself, had held Miss Foulger in mind. Snell had described her as rheumaticky with misshapen fingers. Furthermore, at some unspecified time on Tuesday, there had been an intruder at her home. Had that intruder taken a supply of gold injections from the house, as well as breaking a few bottles of wine to cover up the theft? If so, it argued a knowledgeable man—or woman. One familiar with the properties of gold. And if—as seemed likely from the report in the Incident Book—Miss Foulger claimed that only her outhouse had been entered, then that fact alone would bring the magistrate even more into the reckoning. She could be the one who—because she had been treated with it—knew the properties of gold; she could be the one who had a supply; and she could be the one who had staged an apparent break-in of her own property in order to do what? Cover up the disappearance of her supply of gold?
Masters got no further with this line, because Haywood was continuing.
“I’ve checked up on how sodium aurothiomalate injection is supplied. There are an incredible number of strengths. One, five, ten, twenty and fifty milligram ampoules. But don’t be led astray by that. They are all the same size, because they are all dissolved in the same tiny amount of water, namely one millilitre. And you can judge how much that is when you recall that the average plastic medicine spoon that chemists supply will hold five millilitres.”
“The fluid will be in tiny ampoules, I take it?”
“Yes. They are packed in tens and the whole pack would be no bigger than a cigarette packet. Remember, too, that gold is light-sensitive, so the ampoules are made of brown glass—actinic glass, it is called—so that sunlight won’t cause chemical change to the contents. The ampoules themselves are of the usual sort—the snap variety with a coloured ceramic snap band round the neck.”
Masters waited a moment or two, and then asked: “Has aurothiomalate no taste? Wouldn’t the lad have known he was taking something strange?”
“I’ve never tasted it myself, but the powder—from which the solution is made—is said to have a slight odour. What of, I don’t know. But I think that when tiny amounts are dissolved in water there would be no more smell than there is, say, to sugar in water. You will remember, no doubt, that sugar also has a slight odour?”
Masters nodded. “And colour?”
“A fine, pale yellow. The sort of shade that would never be noticed in any other drink.”
“Drink? You said that as though you thought he had taken it in some sort of booze.”
Haywood shrugged. “There was alcoholic liquor in the body. I was told he had taken a couple of halves of beer, but there was more than that. He’d also taken white wine. A good amount of it. Plonk, I suspect, but these things, liquors, tend to mingle in the body and take a bit of sorting out.”
“As much as a bottle of plonk, would you say?” asked Green.
“That would be my estimate. A full bottle.”
“So a bottle of wine and two beers . . . that would carry him well on the way to being blotto—which is what the constable said he was.”
“Quite right. His degree of drunkenness, allied to his bodily malfunctions due to the effects of the gold, would make him appear to be absolutely plastered.”
Masters said nothing. Wine! Here it was again. Miss Foulger had lost wine—or so she claimed. Could she have doctored a bottle, given it to Boyce—under the guise of a generous gesture to support her leniency in court—and then smashed the rest of t
he brew to disguise the fact that one bottle had gone?
Haywood drew his file towards him. “I’ve no need to remind you gentlemen that when a medico-legal autopsy is ordered, one of the measures that has to be taken is an examination of the clothing. This I have done.
“The young man was dressed in a T-shirt and jeans—apart from socks, boots and underpants, I mean. His clothes were surprisingly clean. I imagine he had put on clean clobber for his court appearance that morning and later removed whatever sort of jacket he had worn then. Because it has been very hot.”
Masters nodded his ready agreement of Haywood’s supposition and waited for the professor to continue.
“Now, although his shirt was basically clean, it was stained. I examined not only the substance that had caused these stains, but also the shape of the marks. Now I can’t be absolutely certain about this, but the shapes suggested to me that Boyce had been drinking direct from a bottle or one of these ring-pull cans the young seem to accept as suitable vessels from which to take refreshment.”
“You mean he had carelessly thrown his head back with the bottle or tin at his lips and some of the liquid had dribbled down his chin and on to his shirt?”
“That’s it.”
“What had he drunk?”
“Wine. And not red wine, either. The stains were very pale.”
“Are you going to tell us that you found traces of aurothiomalate in those stains?”
“How did you guess?”
“So the gold was in the wine?”
“I think you can bank on that as one solid piece of fact. I know you must already have deduced that, but now you have forensic support for your deduction.”
“Thank you. Anything else?”
“Should there be?”
“Did you examine his boots?”
“Yes. By that I mean I gave them the once over. I paid less attention to them than I did the shirt, because I saw nothing to warrant closer inspection.”
“Thank you.”
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