Chapter VI: Part 6

What is the usual period that elapses between the commencement and the termination of the disease?--The cases may be divided into two classes. Acute cases will terminate in three or four days, chronic cases will go on as long as from nineteen to twenty-two or twenty-three days, and perhaps longer. I do not think that I have known a case in which death occurred within four days. Cases are reported in which it occurred in a shorter period. In tetanus the extremities are affected, but not so much as the trunk. Their affection is a late symptom. The locking of the jaw is an early one. Sometimes the convulsions of epilepsy assume somewhat of a tetanic character, but they are essentially distinct from tetanus. In epilepsy the patient always loses consciousness. Apoplexy never produces tetanic convulsions. Perhaps I might be allowed to say that when there is effusion of blood upon the brain, and a portion of the brain is involved, the muscles may be thrown into short tetanic convulsions. In such case the consciousness would be destroyed. Having heard described the symptoms attending the death of the deceased, and the _post-mortem_ examination, I am of opinion that in this case there was neither apoplexy nor epilepsy.

The ATTORNEY-GENERAL said that, as Dr. Bamford was so unwell that it was doubtful whether he would be able to appear as a witness, he proposed to put in his deposition, in order to found upon it a question to the witness now under examination.

Dr. TODD and Dr. TWEEDIE deposed that they had seen Dr. Bamford on the previous day, and that he was then suffering from a severe attack of English cholera. He was too unwell to be able to attend and give evidence.

The COURT ruled that the depositions taken before the coroner might be read; and they were accordingly read by the Clerk of Arraigns. They were to the following effect:--

“I attended the late Mr. Cook at the request of Mr. William Palmer. I first saw him about three o’clock on Saturday, the 17th of November, when he was suffering from violent vomiting, the stomach being in that irritable state that it would not contain a teaspoonful of milk. There was perfect moisture of the skin, and he was quite sensible. I prescribed medicine for him, and Mr. Palmer went up to my house and waited till I had made it up, and then took it away. I prescribed a saline medicine, to be taken in an effervescing state. Between seven and eight o’clock in the evening Mr. Palmer again requested me to visit Mr. Cook. The sickness still continued, everything being ejected which he took into his stomach. I gave him two pills as a slight opiate. Mr. Palmer took the pills from my house. I did not accompany him, nor do I know what became of the pills. On the following morning (Sunday) Mr. Palmer again called, and asked me to accompany him. Mr. Cook’s sickness still continued. I remained about ten minutes. Everything he took that morning was ejected from his stomach. Everything he threw up was as clear as water, except some coffee which he had taken. Mr Palmer had administered some pills before I saw Mr. Cook on Saturday, which had purged him several times. Between six and seven o’clock in the evening I again visited the deceased, accompanied by Mr. Palmer. The sickness still continued. I went on Monday morning, between eight and nine o’clock, and changed his medicine. I sent him a draught which relieved him from the sickness, and gave him ease. I did not see him again until Tuesday night, when Mr. Palmer called for me. I examined Mr. Cook in the presence of Mr. Jones and Mr. Palmer, and I observed a change in him. He was irritable and troubled in mind. His pulse was firm, but tremulous, and between 80 and 90. He threw himself down on the bed and turned his face away. He said he would have no more pills nor take any more medicine.”

“After they had left the room Mr. Palmer asked me to make two more pills similar to those on the previous night, which I did, and he then asked me to write the directions on a slip of paper; and I gave the pills to Mr. Palmer. The effervescing mixture contained twenty grains of carbonate of potash, two drachms of compound tincture of cardamine, and two drachms of simple syrup, together with fifteen grains of tartaric acid for each powder. I never gave Mr. Cook a grain of antimony. I did not see the preparations after they were taken away by Mr. Palmer. Mr. Cook did not say he had taken the pills which he had prepared, but he expressed a wish on Sunday and Monday nights to have the pills. His skin was moist, and there was not the least fever about him. When I saw the deceased on Monday he did not say that he had been ill on the Sunday night, but Mr. Palmer told me he had been ill. I considered death to have been the result of congestion of the brain when the _post-mortem_ examination was made, and I do not see any reason to alter that opinion. I have attended other patients for Mr. Palmer. I attended Mrs. Palmer some days before her decease; also two children, and a gentleman from London, who was on a visit at Mr. Palmer’s house, and who did not live many hours after I was called in. The whole of those patients died. Mr. Palmer first made an application to me for a certificate of Mr. Cook’s death on the following Sunday morning, when I objected, saying, “He is your patient.” I cannot remember his reply; but he wished me to fill up the certificate, and I did so. We had no conversation at that time as to the cause of death--nothing more than the opinion I have expressed. Mr. Palmer said he was of the same opinion as myself with respect to the death of the deceased. I never knew apoplexy produce rigidity of the limbs. Drowsiness is a prelude to apoplexy. I attributed the sickness of the first two days to a disordered stomach. Mr. Cook never sent for me himself.”

The examination of Dr. TODD by the ATTORNEY-GENERAL was then proceeded with, as follows: Having heard the deposition of Dr. Bamford read, I do not believe that the deceased died from apoplexy, or from epilepsy. I never knew tetanus arise either from syphilitic sores or from sore throat. There are poisons which will produce tetanic convulsions. The principal of those poisons are nux vomica, strychnine, and bruccia. I have never seen human life destroyed by strychnine, but I have seen animals destroyed by it frequently. The poison is usually given in a largish dose in those cases, so as to put an end to the sufferings and destroy life as soon as possible. I should not like to give a human subject a quarter of a grain. I think that it is not unlikely that half a grain might destroy life; and I believe that a grain certainly would. I think that half a grain would kill a cat. The symptoms which would ensue upon the administration of strychnine, when given in solution--and I believe that poisons of that nature act more rapidly in a state of solution than in any other form--would develope themselves in ten minutes after it was taken, if the dose were a large one; if not so large, they might be half an hour, or an hour before they appeared. Those symptoms would be tetanic convulsions of the muscles--more especially those of the spine and neck; the head and back would be bent back, and the trunk would be bowed in a marked manner; the extremities, also, would be stiffened and jerked out. The stiffness, once set in, would never entirely disappear; but fresh paroxysms would set in, and the jerking rigidity would re-appear; and death would probably ensue in a quarter of an hour or so. The difference between tetanus produced by strychnine and other tetanus is very marked. In the former case the duration of the symptoms is very short, and, instead of being continuous in their development, they will subside if the dose has not been strong enough to produce death, and will be renewed in fresh paroxysms; whereas, in other descriptions of tetanus, the symptoms commence in a mild form, and become stronger and more violent as the disease progresses. The difficulty experienced in breathing is common alike to tetanus, properly so called, and to tetanic convulsions occasioned by strychnine, arising from the pressure upon the respiratory muscles. I think it is remarkable that the deceased was able to swallow, and that there was no fixing of the jaw, which would have been the case with tetanus proper, resulting either from a wound, or from disease. From all the evidence I have heard, I think that the symptoms which presented themselves in the case of Mr. Cook arose from tetanus produced by strychnine.

Cross examined by Mr. GROVE, Q.C.--There are cases sloping into each other, as it were, of every grade and degree, from mild convulsions to violent tetantic spasms. I have published some lectures upon diseases of the brain, and I adhere to the opinion there expressed that the state of a person suffering from tetanus is identical with that which strychnine is capable of producing. In a pathological point of view, an examination of the spinal cord shortly after death, in investigating supposed deaths from strychnine, is important. The signs of decomposition, however, could be easily distinguished from the evidences of disease which existed previously to death; but it would be difficult to distinguish in such a case whether mere softening resulted from decomposition or from pre-existing disease. There is nothing in the _post-mortem_ examination which leads me to think that deceased died from tetanus proper. I think that granules upon the spinal cord, such as I have heard described, would not be likely to cause tetanus. I have not heard of cases treated by Mr. Travers. In animals to which strychnine has been administered I cannot say that I have observed what you call an intolerance of touch; but by touching them the spasms are apt to be excited. That sensibility to touch continues as long as the operation of the poison continues. I have examined the interior of animals that have been killed by strychnine; but I have not observed in such cases that the right side of the heart was usually full of blood. It is some years since I made such an examination; but I am able, nevertheless, to speak positively as to the state of the heart. It was usually empty on both sides. I do not agree with Dr. Taylor, or other authorities, in the opinion that in cases of tetanus animals died asphyxiated. If they did, we should invariably have the right side of the heart full of blood, which is not the case. I think that the term asphyxiated, or suffocated, is often very loosely used. I know from my reading that morphia sometimes produces convulsions; but I believe that they would be of an epileptic character. I think that the symptoms from morphia would be longer deferred in making their appearance than from strychnine; but I cannot speak positively on the point. Morphia, like strychnine, is a vegetable poison. I have not observed in animals the jaw fixed after the administration of strychnine.

Re-examined by the ATTORNEY-GENERAL.--Whatever may be the true theory as to the emptiness of the heart after strychnine, I should say that the heart is more ordinarily empty than filled after tetanus. I think that the heart would be more contracted after strychnine than in ordinary tetanus. I do not believe that a medical practitioner would have any difficulty in distinguishing between ordinary convulsions and tetanic convulsions. I have heard the evidence of the gentlemen who made the _post-mortem_ examination, and I apprehend that there was nothing to prevent the discovery of disease in the spinal cord, had any existed previously to death.

Sir BENJAMIN BRODIE, examined by Mr. JAMES, Q.C.: I have been for many years senior surgeon to St. George’s Hospital, and have had considerable experience as a surgeon. In the course of my practice I have had under my care many cases of death from tetanus. Death from idiopathic tetanus is, according to my experience, very rare in this country. The ordinary tetanus in this country is traumatic tetanus. I have heard the symptoms which accompanied the death of Mr. Cook, and I am of opinion that so far as there was a general contraction of the muscles they resembled those of traumatic tetanus; but as to the course those symptoms took, they were entirely different. I have attended to the detailed description of the attack suffered by Mr. Cook on the Monday night, its ceasing on Tuesday, and its renewal on Tuesday night. The symptoms of traumatic tetanus always begin, so far as I have seen, very gradually, the stiffness of the lower jaw being, I believe, invariably, the symptom first complained of--at least, so it has been in my experience. The contraction of the muscles of the back is always a later symptom--generally much later. The muscles of the extremities are affected in a much less degree than those of the neck and trunk, except in some cases where the injury has been in a limb, and an early symptom has been spasmodic contraction of the muscles of that limb. I do not myself recollect a case of ordinary tetanus in which occurred that contraction in the muscles of the hand which I understand was stated to have taken place in this instance. Again, ordinary tetanus rarely runs its course in less than two or three days, and often is protracted to a much longer period. I knew one case only in which the disease was said to have terminated in so short a time as 12 hours; but probably in that case the early symptoms had been overlooked. Again, I never knew the symptoms of ordinary tetanus to last for a few minutes, then subside, and then come on again after 24 hours. I think that these are the principal points of difference which I perceived between the symptoms of ordinary tetanus and those which I have heard described in this case. I have not witnessed tetanic convulsions from strychnine on animal life. I do not believe that death in the case of Mr. Cook arose from what we ordinarily call tetanus--either idiopathic or traumatic. I never knew tetanus result from sore throat, or from a chancre, or from any other form of syphilitic disease. The symptoms were not the result either of apoplexy or of epilepsy. Perhaps I had better say at once that I never saw a case in which the symptoms that I have heard described here arose from any disease. (Sensation.) When I say that, of course I refer not to particular symptoms, but to the general course which the symptoms took.

Cross-examined by Mr. Serjeant SHEE: I believe I remember one case in the physicians’ ward of St. George’s Hospital, which was shown to me as a case of idiopathic tetanus, but I doubted whether it was tetanus at all. It was a slight case, and I do not remember the particulars.

Considering how rare cases of tetanus are, do you think that the description given by a chambermaid and a provincial medical man, who had never seen but one case, is sufficient to enable you to form an opinion as to the nature of the case?--I must say I thought that the description was very clearly given.

Supposing that they differed in their description, which would you rely upon--the medical man or the chambermaid?

Baron ALDERSON: This is hardly a question to put to a medical witness, although it may be a very proper observation for you to make.

Cross-examination continued: I never knew syphilitic poison produce tetanic convulsions, except in cases where there was disease of the bones of the head.

[Sir Benjamin Brodie gave his evidence with great clearness--slowly, audibly, and distinctly,--matters in which other medical witnesses would do well to emulate so distinguished an example.]

Dr. DANIELL, examined by the ATTORNEY-GENERAL: I was for many years surgeon to the Bristol Hospital, but have been out of practice for some time. In the course of a long practice I should think that I have seen at least thirty cases of tetanus. Two of those were certainly cases of idiopathic tetanus: one of them terminated fatally, the other did not. I quite agree with the other medical witnesses, that idiopathic tetanus is of very rare occurrence in this country. The only difference in the symptoms between idiopathic and traumatic tetanus that I perceived was, that the former were more modified--not so severe--in their character. I was not able to trace these two cases of idiopathic tetanus to any particular cause. I have heard the description given of the symptoms which accompanied the attack upon Mr. Cook before his death, and it appears to me that the circumstances of that attack are assuredly distinguishable from those which came under my experience in dealing with cases of tetanus. The evidence of Sir B. Brodie quite expresses my opinion with respect to the difference of the symptoms between ordinary tetanus and tetanic convulsions produced by strychnine. Tetanus begins with uneasiness in the lower jaw, followed by spasms of the muscles of the trunk, and most frequently extending to the muscles of the limbs. Lock-jaw is almost invariably a symptom of those cases of tetanus--of traumatic tetanus especially. I do not recollect that clinching of the hands is a usual symptom of ordinary tetanus, nor do I remember any twisting of the foot. I do not believe that any of the cases which came under my experience endured for a shorter time than from thirty to forty hours. I never knew a case of syphilitic sore producing tetanus. The symptoms, as they have been described, certainly cannot be referable to apoplexy or epilepsy. I never heard of such a thing. In all the cases of tetanus which came under my observation consciousness has been retained to the last, throughout the whole disease. The symptoms have never set in in their full power from the commencement, but have invariably commenced in a milder form, and have then gone on increasing, being continuous in their character, and without intermission. In my judgment the symptoms in the case of Mr. Cook could not be referred either to idiopathic or traumatic tetanus.

Cross-examined by Mr. GROVE, Q.C.: I have not read Dr. Curling’s or Dr. Copeland’s books on the subject of tetanus; nor have I of late studied much the reported cases. I am not aware that excitement or irritation from vomiting has ever been given as the cause of tetanus. The main symptoms of tetanus are, in my opinion, always very similar, although the inferior symptoms may vary simply. I cannot undertake to say that the convulsions of tetanus arise from the spine. I do not like the term “asphyxia;” but I think that death from tetanic convulsions may probably arise from suffocation. It is many years since I saw a _post mortem_ upon a case of tetanus. I cannot say whether, in the case of death from suffocation, the heart would be full of blood or the reverse. An examination of the spinal cord or marrow never, so far as I know, afforded evidence of the cause to which the tetanus was to be attributed.

Mr. SAMUEL SOLLY, surgeon of St. Thomas’s Hospital, examined by Mr. WELSBY: I have been connected with St. Thomas’s Hospital, as lecturer and surgeon, for 28 years, and during that time I have seen many cases of tetanus. I have had six or seven under my own care, and I may have seen ten or fifteen more. Of those cases it was doubtful in one whether the disease was idiopathic or traumatic--the wound was so slight and the symptoms so obscure, that it was difficult to decide which it was. The others were all decidedly traumatic cases. The shortest period that I recollect during which the disease lasted before it terminated in death, was 30 hours. The disease was always progressive in its character. I have heard the description given by the witnesses of Mr. Cook’s attacks, and they differ essentially from those cases which I have seen. In my experience of tetanus there has always been a marked expression of the countenance as the first symptom. It is a sort of grin, and so peculiar, that having once seen it you can never mistake it. In the symptoms that I heard detailed with regard to Mr. Cook, there were violent convulsions on Monday night, and on Tuesday the individual was entirely free from any discomfort about the face or jaw; whereas, in the cases under my notice, the disease was always continuous, and the fixedness of the jaw was the last symptom to disappear. In my judgment, the symptoms detailed in Mr. Cook’s case are referable neither to apoplexy, epilepsy, nor to any disease that I have ever witnessed.

Cross-examined by Mr. Serjeant SHEE: The sort of grin which I have described is known as _risus sardonicus_. It is not common to all convulsions. Epilepsy is a disease of a convulsive character. I heard the account given by Mr. Jones of the last few minutes of Mr. Cook’s death--that he uttered a piercing shriek, and died after five or six minutes quietly. That last shriek and the paroxysm which accompanied it bear in some respects a resemblance to epilepsy. All convulsions which may be designated as of an epileptic character are not attended with an utter want of consciousness. Death from tetanus accompanied with convulsions seldom leaves any trace behind it; but death from convulsions arising from epilepsy does leave its trace in the shape of a slight effusion of blood on the brain, and a congestion of the vessels.

Re-examined by the ATTORNEY-GENERAL: The convulsions of epilepsy are accompanied by a variety of symptoms. When a patient dies of epilepsy he dies perfectly unconscious and comatose. I never saw any case of convulsive disease at all like this. There are cases of convulsive disease which are similar to tetanus in their onset, but not in their progress. For example, laceration of the brain, a sudden injury to the spinal cord, and the irritation from teething in infants, will produce convulsions resulting in death; but there would be wanting the marked expression of the face which I have described, which I have never missed in cases of tetanus.

Mr. HENRY LEE, surgeon to King’s College, and to the Lock Hospital, examined by Mr. BODKIN: The Lock Hospital is exclusively devoted to cases of a syphilitic character, and at present I see probably as many as 3,000 of those cases in the course of a year. I have never known an instance of that disease terminating in tetanus.

By the COURT: I have never seen or read of a case either of primary or secondary symptoms resulting in tetanus.

This witness was not cross-examined.

Dr. HENRY CORBETT, physician of Glasgow, examined by Mr. JAMES, Q.C.: In September, 1845, I was medical clerk at the Glasgow Infirmary, and I remember a patient, named Agnes Sennett, _alias_ Agnes French, who died there on the 27th of September, 1845. It was stated that she had taken strychnine pills, which had been prepared for another patient in the ward, and the symptoms which accompanied her death were those of strychnine. The pills were for a paralytic patient. I saw her when she was under the influence of the poison, and I had seen her the day before that perfectly well. She had been admitted for a skin disease of the head. When I saw her after she had taken the poison she was in bed. The symptoms were these: There was a strong retraction of the mouth; the face was much suffused and red; the pupils of the eye were dilated; the head was bent back; the spine was curved; and the muscles were rigid and hard like a board; the arms were stretched out; the hands were clinched; and there were severe paroxysms recurring every few seconds. She died in about an hour and a-quarter after taking the pills. When I was called first the paroxysms did not last so long; but they increased in severity. According to the prescription there should have been a quarter of a grain of strychnine in each pill, and this woman had taken three. The paralytic patient was to have taken a pill each night, or one each night and morning, I forget which.

Cross-examined by Mr. Serjeant SHEE: The retraction of the mouth was continuous, but it was worse at times. I do not think that I observed it after death. The hands were not clinched after death--they were “semi-bent.” She died an hour-and-a-quarter after taking the medicine. The symptoms appeared about twenty minutes after. I tried to make her vomit with a feather, but failed. She only vomited partially after I had given her an emetic.

Re-examined by the ATTORNEY-GENERAL: There was spasmodic action and grinding of the teeth. She could open her mouth and swallow. There was no lock-jaw or ordinary tetanus.

By Mr. Serjeant SHEE: I do not recollect that touching her sent her into paroxysms.

Dr. WATSON, examined by the ATTORNEY-GENERAL: I am a surgeon at the Glasgow Infirmary. I remember the case of Agnes Sennett. I was called in about a quarter of an hour after she was taken ill. She was in violent convulsions, and her arms were stretched out and rigid. The muscles of the body were also rigid; they were kept quiet by rigidity. She did not breathe, the muscles being kept still by tetanic rigidity. That paroxysm subsided, and fresh paroxysms came on after a short interval. She died in about half an hour. She seemed perfectly conscious. I don’t recollect the state of her hands. Her body was opened. The heart was found distended and stiff. The cavities of the heart were empty. My father published an account of the case.

Cross-examined by Mr. GROVE: The spinal cord was quite healthy.

Dr. J. PATTERSON, examined by Mr. WELSBY: In 1845 I was engaged in the laboratory of the Infirmary at Glasgow. I dispensed the prescriptions. I made up a prescription for a paralytic patient named M’Intyre. It consisted of pills which contained strychnine. There were four pills, and one grain of strychnine in the four.

Baron ALDERSON: Was there any noise made about their being taken by a wrong person?--Yes.

MARY KELLY, examined by Mr. BODKIN: In September, 1845, I was a patient in the Glasgow Infirmary; a paralytic patient was in the same ward, and I attended to her. There was also a patient named French or Sennett who was suffering from a sore head. She died. I was turning a wheel near the paralytic patient on the afternoon of the day Sennett died, for the purpose of applying something to her skin. There were some pills which she was to take near her. The paralytic woman took one and swallowed it according to the orders that had been given, and then handed the box to the girl with a sore head. The girl swallowed two of the pills, and then went and sat by the ward fire. She was taken ill in about three-quarters of an hour. She fell back on the floor, and I went for the nurse. We took her to bed and sent for the doctor. We were obliged to cut her clothes off, because she never moved. She was like a poker. I was by her side when she died. She never spoke after she fell down.

Cross-examined by Mr. Serjeant SHEE: It was three quarters of an hour from the time she took the pills till she was taken to the bed.

CAROLINE HICKSON, examined by Mr. E. JAMES: In October, 1848, I was nurse and lady’s maid in the family of Mr. Sarjantson Smyth. The family were then residing about two miles from Romsey. On the 30th of October Mrs. Smyth was unwell. We dealt with Mr. Jones, a druggist in Romsey. A prescription had been sent to him to be made up for Mrs Smyth. The medicine was brought back about six o’clock in the afternoon. It was a mixture in a bottle. My mistress took about half a wineglass of it the following morning, at five or ten minutes past seven o’clock. I left the room when I had given it her. Five or ten minutes afterwards I was alarmed by the ringing of her bell. I went into her room, and found her out of bed leaning upon a chair, in her night-dress. I thought she had fainted. She appeared to suffer from what I thought were spasms. I ran and sent the coachman for Mr. Taylor, the surgeon, and returned to her. Some of the other servants were there assisting her. She was lying on the floor. She screamed loudly, and her teeth were clinched. She asked to have her arms and legs held straight. I took hold of her arms and legs, which were very much drawn up. She still screamed, and was in great agony. She requested that water should be thrown over her, and I threw some. Her feet were turned inwards. I put a bottle of hot water to her feet, but that did not relax them. Shortly before she died she said she felt easier. The last words she uttered were--“Turn me over.” We did turn her over on the floor. She died a very few minutes after she had spoken those words. She died very quietly. She was quite conscious, and knew me during the whole time. About an hour and a quarter elapsed from the time I gave her the medicine till she died.

Cross-examined by Mr. GROVE: She could not sit up from the time I went up to her till she died. It was when she was in a paroxysm that I endeavoured to straighten her limbs. The effect of cold water was to throw her into a paroxysm. It was a continually recurring attack, lasting about an hour or an hour and a quarter. Her teeth were clinched during the whole time.

Re-examined by the ATTORNEY-GENERAL: The fit came on five or ten minutes after I gave her the medicine. She was stiff all the time till within a few minutes after death. She was conscious all the while.

Mr. FRANCIS TAYLOR, examined by Mr. WELSBY: I am a surgeon and apothecary at Romsey. I attended Mrs. Sarjantson Smyth in 1848. I was summoned to her house one morning soon after eight, and when I arrived I found her dead. The body was on the floor, near the bed. The hands were very much bent. The feet were contracted, and turned inwards. The soles of the feet were hollowed up, and the toes contracted, apparently from recent spasmodic action. The inner edge of each foot was turned up. There was a remarkable rigidity about the limbs.

By Lord CAMPBELL: The body was warm.

Examination continued: The eyelids were almost adherent to the eyeballs. The druggist who made up the prescription was named Jones. I made a _post-mortem_ examination three days after the death. The contraction of the feet continued, but it had gone off somewhat from the rest of the body. I found no trace of disease in the body. The heart was contracted and perfectly empty, as were all the large arteries leading from it. I analysed the medicine she had taken with another medical man. It contained a large quantity of strychnine. It originally contained nine grains, and she had taken one-third--three grains. I made a very casual examination of the stomach and bowels, as we had plenty of proof that poison had been taken without making use of tests.

Cross-examined by Mr. Serjeant SHEE: In cases of death from ordinary causes the body is much distorted. It does not generally, I should think, remain in the same position after death.

If the body is not laid out immediately, is it not stiffened by the _rigor mortis_?--Probably it is. The ancles were tied by a bandage to keep them together. I commenced to open the body at the thorax and abdomen. The head was also opened.

CHARLES BLOCKSOME, examined by Mr. HUDDLESTON: I was apprentice to Mr. Jones, the chymist, at Romsey, in 1848. My master made a mistake in preparing a prescription for Mrs. Smyth. The mistake was the substitution of strychnine for salacite (bark of willow). He destroyed himself afterwards.

JANE WITHAM, examined by Mr. E. JAMES: In March last I was in attendance upon a lady who died. (The learned counsel told the witness she had better not mention the lady’s name.) She took some medicine. After she took it she became ill. She complained first of her back. Her head was thrown back, her body stretched out, and I observed twichings. Her eyes were drawn aside and staring. I put my hand upon her limbs, which did not at all relax. She first complained of being ill in that way on Monday, the 25th of February, and died on Saturday, the 1st of March. She had attacks on the Monday, on the Wednesday, on the Thursday, on the Friday (a very slight one), and at a quarter-past eight o’clock on the Saturday morning. She died about twenty minutes to eleven that night. Between the attacks she was composed. She principally complained of prickings in the legs and twichings in the muscles and in the hands, which she said she could compare to nothing else than a galvanic shock. She wished her husband to rub her legs and arms. She was dead when Dr. Morley came.

Cross-examined by Mr. Serjeant SHEE: On the Saturday night she could not bear to have her legs touched when the spasms were strong upon her. Her limbs were rigidly extended when she asked to be rubbed. That was in the interval between the spasms. Touching her then brought on the spasms. Her body was stiff immediately after death, but I did not stay long in the house. On the Saturday she was sensible from half-an-hour to an hour, from a quarter past eight till after nine. I suppose she was insensible the remainder of the time. She did not speak.

Re-examined by Mr. E. JAMES: On the Saturday before she died the symptoms were the same as on the other days--not more violent.

Mr. MORLEY, examined by Mr. WELSBY: I am a surgeon. I attended on the lady to whom the last witness has alluded for about two months before her death. On the Monday before she died she was in bed apparently comfortable, when I observed (as I stood by her side) several slight convulsive twitchings of her arms. I supposed they arose from hysteria, and ordered medicine in consequence. The same symptoms were repeated on the following Wednesday or Thursday. I saw her on Saturday, the day she died. She was apparently better, and quite composed in the middle of the day. She complained of an attack she had had in the night. She spoke of pain and spasms in the back and neck, and of shocks. I and another medical man were sent for hastily on the Saturday night. We were met by the announcement that the lady was dead. On the Monday I accompanied another medical gentleman to the _post-mortem_ examination. We found no disease in any part of the body which would account for death. There was no emaciation, wound, or sore. There was a peculiar expression of anxiety about the countenance. The hands were bent and the fingers curved. The feet were strongly arched. We carefully examined the stomach and its contents to see if we could find poison. We applied several tests--nitric acid, chloride of sulphuric acid, bi-chloride of potash in a liquid state, and also in a solid state. They are the best tests to detect the presence of strychnine. In each case we found appearances characteristic of strychnine. We administered the strychnine taken from the stomach to animals by inoculation. We gave it to a few mice, a few rabbits, and a guinea pig, having first separated it by chemical analysis. We observed in each of the animals more or less of the effects produced by strychnine--namely, general uneasiness, difficult breathing, convulsions of a tetanic kind, muscular rigidity, arching backwards of the head and neck, violent stretching out of the legs. These symptoms appeared in some of the animals in four or five minutes; in others in less than an hour. The guinea-pig suffered but slightly at first and was left, and found dead the next day. The symptoms were strongly marked in the rabbits. After death there was an interval of flaccidity, after which rigidity commenced, more than if it had been occasioned by the usual _rigor mortis_. I afterwards made numerous experiments on animals with exactly similar results, the poison being administered in a fluid form.

Cross-examined by Mr. GROVE: I did not see the patient during a severe attack. I have observed in animals that spasms are brought on by touch. That is a very marked symptom. The spasm is like a galvanic shock. The patient was not at all insensible during the time I saw her, and she was able to swallow, but I did not see her during a severe attack. After death we found the lungs very much congested. There was a small quantity of bloody serum in the pericardium. The muscles of the whole body were dark and soft. There was a decided quantity of effusion in the brain. There was also a quantity of serum tinged with blood in the membranes of the spinal cord. The membranes of the spinal marrow were congested to a considerable extent. We opened the head first, and there was a good deal of blood flowing out. Part of the blood may have flowed from the heart. That might partially empty the heart, and would make it uncertain whether the heart was full or empty at the time of death. I have often examined the hearts of animals poisoned by strychnine. The right side of the heart is generally full. In some cases I think that the symptoms did not appear for an hour after the administration of the poison. I have made the experiments in conjunction with Mr. Nunneley. We have made experiments upon frogs, but they are different in many respects from warm-blooded animals. I have in almost all cases found the strychnine where it was known to have been administered. In one case it was doubtful. We were sure the strychnine had been administered in that case, but we doubted whether it had reached the stomach. There were appearances which might lead one to infer the presence of strychnine, but they were not satisfactory. I have detected strychnine in the stomach nearly two months after death, when decomposition has proceeded to a considerable extent.

Re-examined by the ATTORNEY-GENERAL: From half a grain to a grain has been administered to cats, rabbits, and dogs. From one to two grains is quite sufficient to kill a dog.

How does the strychnine act? Is it taken up by the absorbents and carried into the system?--I think it acts upon the nerves, but a part may be taken into the blood and act through the blood. We generally examined the stomach of the animals when the poison had been administered internally. Sometimes we examined the skin. The poison found in the stomach would be in excess of that absorbed into the system.

Are you, then, of opinion that, a portion of the poison being taken into the system and a portion being left in the stomach, the portion taken into the system would produce tetanic symptoms and death?

Mr. Serjeant SHEE objected to a question which suggested a theory.

The ATTORNEY-GENERAL: What would be the operation of that portion of the poison which is taken into the system?--It would destroy life.

Mr. Baron ALDERSON: And yet leave an excess in the stomach?--That is my opinion.

The ATTORNEY-GENERAL: Would the excess remaining in the stomach produce no effect?--I am not sure that strychnine could lie in the stomach without acting prejudicially.

Suppose that a _minimum_ quantity is administered, which, being absorbed into the system, destroys life, should you expect to find any in the stomach?--I should expect sometimes to fail in discovering it.

If death resulted from a series of _minimum_ doses spread over several days, would the appearance of the body be different from that of one whose death had been caused by one dose?--I should connect the appearance of the body with the final struggle of the last day.

Would you expect a different set of phenomena in cases where death had taken place after a brief struggle, and in cases where the struggle had been protracted?--Certainly. At the _post-mortem_ examination of which I have spoken we found fluid blood in the veins.

Mr. Serjeant SHEE: Is it your theory that in the action of poisoning the poison becomes absorbed, and ceases to exist as poison?--I have thought much upon that question, and have not formed a decided opinion, but I am inclined to think that it is so. A part may be absorbed and a part remain in the stomach unchanged.

Mr. Serjeant SHEE: What chemical reason can you give for your opinion that strychnine, after having effected the operation of poisoning, ceases to be strychnine in the blood?--My opinion rests upon the general principle that, in acting upon living bodies, organic substances--such as food and medicine--are generally changed in their composition.

Mr. Serjeant SHEE: What are the component parts of strychnine?

Mr. Baron ALDERSON: You will find that in any cyclopœdia, Brother SHEE.

Mr. Serjeant SHEE: Have you any reason to believe that strychnine can be decomposed by any sort of putrefying or fermenting process?

Witness: I doubt whether it can.

Mr. EDWARD D. MOORE, examined by Mr. HUDDLESTON: About fifteen years ago I was in practice as a surgeon, and I attended, with Dr. Chambers, a gentleman named Clutterbuck, who was suffering from paralysis. We had been giving him small doses of strychnine when he went to Brighton. On his return he told us that he had been taking larger doses of strychnine, and we, in consequence, gave him a stronger dose. I made up three draughts, confining a quarter of a grain each. He took one in my presence. I remained with him a little time, and left him, as he said he felt quite comfortable. About three-quarters of an hour afterwards I was summoned to him. I found him stiffened in every limb, and the head drawn back. He was desirous that we should move and turn him, and rub him. We tried to give him ammonia, in a spoon, and he snapped at the spoon. He was suffering, I should say, more than three hours. Sedatives were given him. He survived the attack. He was conscious all the time.

Cross-examined by Mr. Serjeant SHEE: The spasms ceased in about three hours, but the rigidity of the muscles remained till the next day. His hands and feet were at first drawn back, and he was much easier when we clinched them forwards. His paralysis was better after the attack.

Re-examined by the ATTORNEY-GENERAL: Strychnine stimulates the nerves which act upon the voluntary muscles, and therefore acts beneficially in cases of paralysis.

The ATTORNEY-GENERAL intimated that the next witness to be called was Dr. Taylor, and, as it was a quarter after five, the trial was adjourned until Monday, at nine o’clock.

Lord CAMPBELL, before the jury left the box, exhorted them not to form any opinion upon the case until they had heard both sides. They should even abstain from conversing about it among themselves.

Mr. Serjeant SHEE said that medical witnesses would be called for the defence.

His LORDSHIP also expressed a hope that, if the jury were taken out upon the following day (Sunday), they would not be allowed to go to any place of public resort, and mentioned an instance in which a jury, under similar circumstances, had been conducted to Epping Forest.

The Court then rose, and the jury were conveyed to the London Coffee-house.

FIFTH DAY, MAY 19.

The Court was again crowded long before the commencement of the proceedings this morning. The Earl of Denbigh and Lord Lyttleton were among the gentlemen who occupied seats upon the bench.

The jury came into Court shortly before ten o’clock, and were soon followed by Lord Campbell and Mr. Justice Cresswell, accompanied by the Recorder, the Sheriffs and Under-Sheriffs, &c. Mr. Baron Alderson did not take his seat until about two o’clock.

The prisoner was immediately placed at the bar. There was no alteration perceptible in his countenance or demeanour, and he took notes of several parts of Dr. Taylor’s evidence.

The Attorney-General, Mr. E. James, Q.C., Mr. Welsby, Mr. Bodkin, and Mr. Huddleston, appeared for the Crown; Mr. Serjeant Shee, Mr. Grove, Q.C., Mr. Gray, and Mr. Kenealy, for the prisoner.

Dr. ALFRED SWAYNE TAYLOR, examined by the ATTORNEY-GENERAL: I am a fellow of the College of Physicians, lecturer on medical jurisprudence at Guy’s hospital, and the author of the well-known treatise on poisons and on medical jurisprudence. I have made the poison called strychnia the subject of my attention. It is the produce of the nux vomica, which also contains brucia, a poison of an analogous character. Brucia is variously estimated at from one-sixth to one-twelfth the strength of strychnia. Most varieties of impure strychnia that are sold contain more or less brucia. Unless, therefore, you are certain as to the purity of the article, you may be misled as to its strength. I have performed a variety of experiments with strychnia on animal life. I have never witnessed its action on a human subject. I have tried its effects upon animal life--upon rabbits--in ten or twelve instances. The symptoms are, on the whole, very uniform. The quantity I have given has varied from half a grain to two grains. Half a grain is sufficient to destroy a rabbit. I have given it both in a solid and a liquid state. When given in a fluid state, it produces its effects in a very few minutes; when in a solid state, as a sort of pill or bolus, in about six to eleven minutes. The time varies according to the strength of the dose, and also to the strength of the animal.

In what way does it operate, in your opinion?--It is first absorbed into the blood, then circulated through the body, and especially acts on the spinal cord, from which proceed the nerves acting on the voluntary muscles.

Supposing the poison to have been absorbed, what time would you give for the circulating process?--The circulation of the blood through the whole system is considered to take place about once in four minutes. The circulation in animals is quicker. The absorption of the poison by rabbits is therefore quicker. The time would also depend on the stomach,--whether it contained much food or not,--whether the poison came into immediate contact with the inner surface of the stomach.

In your opinion, does the poison act immediately on the nervous system, or must it first be absorbed? It must first be absorbed.

The symptoms, you say, are uniform. Will you describe them?--The animal, for about five or six minutes, does not appear to suffer, but moves about gently; when the poison begins to act it suddenly falls on its side, there is a trembling, a quivering motion, of the whole of the muscles of the body, arising from the poison producing violent and involuntary contraction. There is then a sudden paroxysm or fit, the fore legs and the hind legs are stretched out, the head and the tail are drawn back in the form of a bow, the jaws are spasmodically closed, the eyes are prominent; after a short time there is a slight remission of the symptoms, and the animal appears to lie quiet, but the slightest noise or touch reproduces another convulsive paroxysm; sometimes there is a scream, or a sort of shriek, as if the animal suffered from pain; the heart beats violently during the fit, and after a succession of these fits the animal dies quietly. Sometimes, however, the animal dies during a spasm, and I only know that death has occurred from holding my hand over the heart. The appearances after death differ. In some instances the rigidity continues. In one case, the muscles were so strongly contracted for a week afterwards, that it was possible to hold the body by its hind legs stretched out horizontally. In an animal killed the other day the body was flaccid at the time of death, but became rigid about five minutes afterwards. I have opened the bodies of animals thus destroyed.

Could you detect any injury in the stomach?--No. I have found in some cases congestion of the membranes of the spinal cord to a greater extent than would be accounted for by the gravitation of the blood. In other cases I have found no departure from the ordinary state of the spinal cord and the brain. I ascribe congestion to the succession of fits before death. In a majority of instances, three out of five, I found no change in the abnormal condition of the spine. In all cases the heart has been congested, especially the right side. I saw a case of ordinary tetanus in the human subject years ago, but I have not had much experience of such cases. I saw one case last Thursday week at St. Bartholomew’s Hospital. The patient recovered.

You have heard the descriptions given by the witnesses of the symptoms and appearances which accompanied Cook’s attacks?--I have.

Were those symptoms and appearances the same as those you have observed in the animals to which you administered strychnine?--They were. Death has taken place in the animals more rapidly when the poison has been administered in a fluid than in a solid form. They have died at various periods after the administration of the poison. The experiments I have performed lately have been entirely in reference to solid strychnine. In the first case the symptoms began in seven minutes, and the animal died (including those seven) in thirteen minutes. In the second case the symptoms appeared in nine minutes, and the animal died in seventeen. In the third case the symptoms appeared in ten minutes, and the animal died in eighteen. In the fourth case the symptoms appeared in five minutes, and death took place in twenty-two. In the fifth case the symptoms appeared in twelve minutes, and death occurred in twenty-three. If the poison were taken by the human subject in pills it would take a longer time to act, because the structure of the pill must be broken up in order to bring the poison in contact with the mucous membrane of the stomach. I have administered it to rabbits in pills.

Would poison given in pills take a longer period to operate on a human subject than on a rabbit?--I do not think we can draw any inference from a comparison of the rapidity of death in a human subject and in a rabbit. The circulation and absorption are different in the two cases. There is also a difference between one human subject and another. The strength of the dose, too, would make a difference, as a large dose would produce a more rapid effect than a small one. I have experimented upon the intestines of animals, in order to reproduce the strychnia. The process consists in putting the stomach and its contents in alcohol, with a small quantity of acid, which dissolves the strychnia, and produces sulphate of strychnia in the stomach. The liquid is then filtered, gently evaporated, and an alkali added--carbonate of potash, which, mixed with a small quantity of sulphuric acid, precipitates the strychnia. Tests are applied to the strychnia, or supposed strychnia, when extracted. Strychnia has a peculiar strongly bitter taste. It is not soluble in water, but it is in acids and in alcohol. The colouring tests are applied to the dry residue after evaporation. Change of colour is produced by a mixture of sulphuric acid and bi-chromate of potash. It produces a blue colour, changing to violet and purple, and passing to red; but colouring tests are very fallacious, with this exception--when we have strychnine separated in its crystallised state we can recognise the crystals by their form and their chemical properties, and, above all, by the production of tetanic symptoms and death when administered through a wound in the skin of animals.

Are there other vegetable substances from which, if these colouring tests were applied, similar colours would be obtained?--There are a variety of mixtures which produce similar colours. One of them has also a bitter taste like strychnia. Vegetable poisons are more difficult of detection, by chemical process, than mineral poisons; the tests are far more fallacious. I have endeavoured to discover the presence of strychnine in animals I have poisoned in four cases, assisted by Dr. Rees. I have applied the process which I first described. I have then applied the tests of colouring and of taste.