Chalfant: Cause of death in question

When Samuel Lipscomb died on Feb. 16, 1902, The Sedalia Democrat reported the details of the death and of the autopsy before the coroner’s jury had met. Democrat reporters aggressively sought out the doctors who had attended Lipscomb during his final days, interviewed attorneys and spoke to insurance agents. Their premature printing of the details on Feb. 18 caused questions as to whether the coroner’s jury could render an impartial verdict.

When the coroner’s jury did meet on Feb. 18, John Dow, John McFadden, W.D. Ilgenfritz, H.H. Vogts, E.E. Johnson and Sol Kingsbaker had already read the accounts printed by The Democrat. The evidence they heard at the inquest provided details not already printed. Those details involved the nature of Lipscomb’s injuries, the treatment he received and information about a previous illness. The information presented also raised questions about the diagnosis provided by Drs. Wood and Cowan.

Lipscomb had been at his brother-in-law’s home arguing with him over wages he was to be paid for his labor. John Baldwin, Lipscomb’s brother-in-law, testified that Lipscomb had claimed to be ill, suffering from a sore throat and unable to work prior to the argument. When Baldwin called Lipscomb a “deadbeat,” Lipscomb put his hand into his jacket pocket. Baldwin testified that he feared Lipscomb was reaching for the gun he frequently carried. Baldwin picked up a chair, hit Lipscomb and knocked him into a window. The glass broke, cutting his temple.

Baldwin summoned Dr. W.G. Cowan, who cleaned the wound and stitched the laceration. Cowan noted that he returned later that day and gave Lipscomb “something to ease the considerable pain.” Cowan saw Lipscomb twice more. The first time he found Lipscomb up and about. The third day, Cowan testified that he found “considerable fluttering about his (Lipscomb’s) face” and Lipscomb complaining of an ache in his jaw that he attributed to a toothache.

Cowan saw Lipscomb next on Feb. 14 at Lipscomb’s home. Dr. E.A. Wood was also there. Cowan said he found Lipscomb “in a stupor.” He had no fever, but his pulse was very low. The next evening, Cowan attended Lipscomb as he was dying.

Coroner McCluney and Dr. Wood performed the autopsy, which Cowan viewed. Cowan testified that Lipscomb had suffered a fracture of the cheekbone, which would account for the intense pain Lipscomb suffered. Cowan said the skull was not depressed and the brain was not inflamed. He did, however, notice pus draining from Lipscomb’s ear. Cowan identified the case of death as uraemic poisoning, and when questioned by a member of the coroner’s jury, said that the head wound did not cause Lipscomb’s death.

Wood testified that he had treated Lipscomb several times for colds during the months prior to his death. Wood also testified that Lipscomb had asked him to treat the head wound, but that he refused because Cowan was the physician on the case. Later, Wood said, he did dress Lipscomb’s wound and administer pain medication. Wood consulted with Cowan, then treated Lipscomb again, noting a “severely swollen” face, a temperature of 102, and delirium.

Wood said that for three days prior to his death, Lipscomb’s pulse and temperature were normal, but that Lipscomb was in a “stupor” and complained of pain in his head and jaw.

Wood’s testimony about the autopsy gave more detail than Cowan’s testimony, but the two agreed on the cause of death. Lipscomb had died of “Bright’s disease of the kidneys.” Wood, however, was less certain about the relation of the head injury to the death, noting that “the effect of the wound, the intense pain and fever, may have contributed to hasten his death.”

The jury deliberated only 50 minutes before giving their verdict. They determined that Lispcomb “came to his death from uaremic poisoning as a result of Bright’s disease.” Baldwin, though guilty of assault, was exonerated from any guilt in the death.

The patient’s symptoms and his behavior prior to the altercation with Baldwin raise questions, as does the autopsy report. Bright’s disease was a term used in the past to describe what today are recognized as a number of different kidney problems that result in blood or protein in the urine. Today, the acute form of the disease is recognized as being caused by a streptococcal infection occurring elsewhere in the body that causes inflammation of and damage to the kidneys. Symptoms include water retention causing puffiness and facial twitching.

Wood did not testify to ever having treated Lipscomb for Bright’s disease. Wood, while using the best medical technology of the time, could not have known whether the colds that he had treated Lipscomb for earlier in the winter and the sore throat he complained of were actually strep infections that might have led to kidney problems.

Coroner McCluney’s testimony also raised questions. He said that he had not seen Lipscomb prior to his death, and that “it would be difficult for him to say what caused Lipscomb’s death.” However, the autopsy did not, according to his testimony, involve an examination of the kidneys; it only explored the head wound.