The Silent Killer

Abstract

Heating and lighting your home in the 19th Century was a daily hazard because of the coal gas we burned for heat and light. Many people probably suffered from undiagnosed low-level chronic carbon monoxide (CO) poisoning during this period, as coal gas contained 8–16% CO and many appliances leaked. This may explain the strange behaviour of the residents in Edgar Allan Poe’s Fall of the House of Usher, written in 1839. In this case study we will learn about the symptoms and treatment for chronic CO inhalation, and the more serious acute poisonings CO can cause. Carbon monoxide is a stealthy poison, leaving no clues to see, taste, smell or feel. It works by chemically suffocating its victims, stopping their blood from taking in and using oxygen. Thankfully today our gas supply is free of CO, but other sources are still around, such as fires, car exhausts, faulty gas boilers and burning charcoal. These crop up in accidental deaths, suicides and occasionally homicides, the most common cause forensic toxicologists see being house fires.