POISONINGS
Stories by
Berton Roueché
Annotations by
Roger Smith

PREFACE

I do not remember the first time that I read a Berton Roueché "Annals of Medicine" story. It may have been as early as my college years. As an undergraduate at Purdue University, I worked on the campus humor magazine, and we assembled a parody of The New Yorker, the magazine in which the stories were all originally published. That was in 1953, and he had been writing them as a regular feature since the late 1940's. The series was to go on for four decades. I am fond of telling people that they played an important role in my choosing a career as a biomedical scientist, but I can't really be certain of that now. One of my favorites was "Eleven Blue Men". Perhaps it was only a coincidence that I was to spend forty years at Dartmouth Medical School exploring related areas.

The stories are all true, and they have an enduring popularity. They have been published and republished over and again in the form of anthologies, some of which are still in print. He wrote primarily in two areas, communicable diseases and poisonings. In the anthologies there is no organization in terms of any relationship between or among the stories. One about malaria may be followed by another on mushroom poisoning. When the stories about poisonings are pulled out, it is obvious to a pharmacologist and toxicologist that they can be grouped together in logical ways. This allows the drawing of analogies and contrasts within the group.

His usual and highly successful formula was a catchy title, a dramatic and baffling introductory case presentation, the long, patient epidemiological search for the cause and the final denouement. One anthology was appropriately titled The Medical Detectives, and Rouché created this genre single-handedly. They are still great fun to read, but time has taken its toll on the scientific and medical facts. Advances in our understanding of the science now go far beyond the original stories. In order to make them more informative, and update the science and medicine, I used some of them as the basis for various elective courses for graduate and medical students at Dartmouth. The objective was to bring them up to date in terms of current science and medical practice. From our mutual efforts, I have written addenda to each story, so as not to interrupt the flow of the originals. At first I tried to make the addenda no more technical than the story, and understandable to the average readership of The New Yorker. Unfortunately, things are just much more complicted now, so there is an introduction to each of the three topics: Cholinergic Transmission, Oxygen Transport and Heavy Metals, which attempts to give the necessary background.

I once had the experience of writing a textbook for a course for which no suitable text was available. I found, to my chagrin, that I no longer had anything new to talk about in class. If I learned anything from that experience and from my pathetic attempts at golf, it is that sometimes it is better to leave a little something in the bag. For those of you who might find use for this effort as a teaching device, I have included a reference or two to a relatively new and more detailed scientific source at the end of each addendum. The stories themselves are protected by copyright, and they cannot be included here, but the two anthologies still in print, The Medical Detectives and The Man Who Grew Two Breasts contain contain between them most of the stories. The rest can be found in other out-of-print anthologies which are likely to be found in most medical, or even public, libraries. Complete citations are included in the text. As I use them, the students read each story, and the class time is spent discussing the material in the appropriate addendum.

I will never meet Berton Roueché. He died in 1994. I can only hope that this volume will help to extend the tremendous popularity of his stories for a few more years, until the inexorable march of science renders my contributions obsolete. And, there is always the possibility that there are a few people out there who, to their delight, may discover them for the first time. As a fan once said to Mark Twain, "I would give anything not to have read Tom Sawyer, so that I could experience again the pleasure of reading it for the first time."

I am deeply indebted to the staff of Dartmouth's Dana Biomedical Library for their help in developing this web site and their patience in dealing with an electronic media moron, particularly Sheila Gorman, but also Director Bill Garrity, David Izzo, Donald Fitzpatrick and Ann O'Hara.

Roger Smith

Hanover, NH


 

TABLE OF CONTENTS

Cholinergic Transmission

Something a Little Unusual Citation

Addendum

The Dead Mosquitoes and The Fumigation Chamber Citations

Addenda to both

The Hoofbeats of a Zebra Citation

Addendum

Family Reunion Citation

Addendum

A Pinch of Dust and The Case of Mrs. Carter Citations

Addenda to both

Oxygen Transport

A Woman with a Headache Citation

Addendum

Eleven Blue Men Citation

Addendum

Heavy Metals

Cinnabar Citation

Addendum

The Huckleby Hogs Citation

Addendum

Live and Let Live Citation

Addendum