Chapter IV: Part 4

Cross-examined by SERJEANT SHEE--On the occasion of the first examination you say you observed follicles under the tongue; are those pustules?--Not under the tongue, on the tongue. They are not pustules; they are large mucous follicles, not containing matter.

Is it a sort of thickening, then, of the skin?--Of the mucous follicles at the base of the tongue. They appeared to be of long standing, and were very numerous.

Do they indicate that there had been much soreness there?--I have no doubt they would produce inconvenience. They must have given some slight degree of pain in eating and speaking.

Will you undertake to say they were not enlarged glands, enlarged by the irritation of disease?--I do not believe they were; I have seen them frequently.

Do you adhere to your opinion that the lungs were healthy?--Yes.

Did not Mr. Devonshire, in your presence, express a contrary opinion, and say they were unhealthy?--He said he thought there was emphysema, as well as congestion of the lungs.

Is that not a diseased state of the lungs?--Yes, it is an abnormal state. I examined the white spots on the wider part of the stomach.

How did you examine them?--By removing the mucous that was on the surface of the stomach by the finger or scalpel. I had no lens, no glass. I should have examined them with a lens if I had had one.

Was your examination of these appearances satisfactory to you without a lens?--Yes.

You said that the brain was healthy; what sort of examination did you make of the brain?--The brain was carefully taken out; the external part was first of all examined; the membranes were examined, and slices were taken off from the apex to the base of the brain. These slices were, I should think, a quarter of an inch thick.

Is that as thick as it should be to make a full examination?--I think that would show any disease if there was any. The spinal cord was examined down to the first vertebra, and we found no appearance of disease.

Supposing you had discovered a softness of the spinal cord on that occasion, after a full examination, might not that have been sufficient to account for the death of Mr. Cook?--No, certainly not; softening would not produce tetanus at all; it might produce paralysis.

[Sidenote: J. T. Harland]

Do not you think in the case of a man dying by convulsions, in order to ascertain with any degree of certainty what the cause of his death might be, it was necessary shortly after his death to make a careful examination of the spinal cord?--No, I do not. It was afterwards thought desirable. It was first suggested on 26th December.

It was in January the second examination took place; supposing there had been a softening, do not you think, in order to discover it, it was necessary to examine the spinal cord at an earlier period after death than two months?--If there had been a softening it would have been detected at the second examination; the body remaining unexamined for a long time would not produce hardening of the spine.

That is your opinion; might not any softening at that late period be the result of decomposition?--The spine was very little soft indeed. There were some appearances of decomposition upon it. I examined him to see if there was any disease on him of the venereal kind. I observed there was a loss of substance from past disease. It was cicatrised over, and on the cicatrix there was a small abrasion.

Then it must have been in a sore state?--The excoriation might be a little sore. It was very small. It was a mere excoriation; merely a little of the excoriation rubbed off.

Re-examined--There were no chancres, nothing beyond what I would term an excoriation, except the cicatrix from the old disease. There was no symptom of ulcerated throat, nor any appearance of anything syphilitic there. The follicles in the tongue are often produced by a disordered stomach, and are of no serious consequence to health. The congestion of the lungs, which Mr. Devonshire spoke about, was due, in my opinion, wholly to the gravitation of blood after death. There was nothing whatever in the brain to indicate the presence of any disease. Even if there had been, I have never heard or read of any diseased state of the brain occasioning death by tetanus. There is no disease of the spinal cord with which I am acquainted which produces tetanus and that form of death. Sometimes with inflammation of the membranes of the spinal cord there is tetanus; but there were no appearances of inflammation whatever.

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[Sidenote: C. J. Devonshire]

CHARLES JOHN DEVONSHIRE, examined by Mr. HUDDLESTON--I am an undergraduate of London University. I performed the post-mortem on 25th November at the Talbot Hotel. The body was pale. The fingers were clenched firmly; the thumb of the left hand was thrown into the palm, and the fingers were clenched over. The mouth was a little contracted. The body was stiff, much beyond the usual stiffness of death. I took out the stomach and opened it with a pair of scissors. As I was opening the stomach there was a pressure or push from behind. I did not pay any attention to it, and I do not think any of the contents of the stomach escaped. I punctured the anterior surface of the stomach, and a spoonful of the contents fell out on the chair. I tied up where it was punctured, and it was put into a jar and sealed by Dr. Harland. On the same day I got the jar at Mr. Frere’s, and gave it, on the 28th, to Mr. Boycott, Messrs. Lander & Gardner’s clerk. The body was opened again on the 29th to get the liver and kidneys and spleen. They were taken from the body with some blood, placed in a stone jar, which I sealed and handed to Mr. Boycott on the 30th. In consequence of something Mr. Palmer had said, I examined the body to find if there were any indications of syphilis, but I found none. I also took out the throat, and found there were natural papillæ there; they were larger than usual at the base of the tongue.

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[Sidenote: John Myatt]

JOHN MYATT--I am postboy at the Talbot Arms at Rugeley. On 28th of November last I was engaged to drive Mr. Stevens to Stafford station. Before I started Mr. Palmer asked me if I was going to drive them to Stafford. I told him I was. He asked if I was going to take the jars. I said I believed I was. He said there was a £10 note for me if I would upset them. I told him I should not. I saw him next morning, and he asked me who went with the fly. I said Mr. Stevens, and I believed one of Mr. Gardner’s clerks.

Cross-examined--How did you know what he meant by “going to drive them to Stafford”?--I knew I was going to take some one to Stafford.

Did he use the name “Stevens” before he used these words to you?--He mentioned Mr. Stevens afterwards.

You understood the word “them” to mean Mr. Stevens and his party?--Yes.

Were the words used not to this effect, “I should not mind giving £10 to break Mr. Stevens’ neck”?--I do not remember that.

The “£10 to upset him”?--These were the words to the best of my recollection.

When he said “to upset him” did he say anything about him at the time?--He did say something about it, that it was a humbugging concern, or something to that effect. I do not recollect him saying he was a suspicious, troublesome fellow.

* * * * *

[Sidenote: S. Cheshire]

SAMUEL CHESHIRE--I was for upwards of eight years postmaster at Rugeley. I am now from Newgate suffering punishment for having opened a letter as postmaster. I know the prisoner very well, he and I having been schoolfellows together. I was with him at Shrewsbury Races the day “Polestar” won. I saw Mr. Cook at the Talbot Arms on the Saturday, 17th November. He was in bed at the time. On the Tuesday following Palmer asked me to meet him at his house and bring a receipt stamp with me. I did so. He said he wanted me to write out a cheque, which, he said, was for money Mr. Cook owed him. He produced a copy from which I was to write, and I copied it. He gave me as a reason why he wanted me to write it that Mr. Cook was too ill, and he said Wetherby would know his writing. After I had written it I left it with him, and he said he was going to take it over for Mr. Cook to sign.

The ATTORNEY-GENERAL--We know that it went out of his possession afterwards, and therefore perhaps we ought to follow it.

[Evidence was then given to show that this cheque for £350 was sent to Mr. Wetherby, the secretary to the Jockey Club, that it was returned to Palmer, that notice to produce it was given by the prosecution, and that it was not produced.]

* * * * *

[Sidenote: S. Cheshire]

SAMUEL CHESHIRE, recalled--After Mr. Cook’s death, on the Thursday or Friday, Palmer sent for me again. I went to his house and saw him there. He had a sheet of quarto paper in his hand, which he asked me to sign.

LORD CAMPBELL--Was there anything written upon this quarto sheet of paper?--There was.

Examination resumed--I asked him what it was, and he said, “You know that Cook and I have had some dealings together, and this is a document which he gave me some days ago, and I want you to witness it.” I asked him what it was about, and he replied, “There is some business that I have joined him in, and which was all for Mr. Cook’s benefit, and this is a document stating so,” or something of that kind. The paper was a post quarto paper of a yellow description. I observed the writing on it, and thought it was Mr. Palmer’s. I told him I could not sign it, as I might perhaps be called upon to give evidence in the matter at some future day. I said I had not seen Cook sign it, and that the post office authorities would not like me to be called on to give evidence as to a document which took place while I was absent. Palmer replied that it did not matter my signing it, and he dared say they would not object to Mr. Cook’s signature. I gave the paper back to him and left.

(Notice to produce this paper was given, but it was not produced.)

[Sidenote: S. Cheshire]

Palmer was in the habit of calling for letters addressed to his mother, and which I gave to him. I cannot remember whether during October and November, 1855, I gave him letters addressed to his mother or addressed to Mr. Cook. I remember seeing Palmer while the inquest was going on. He came to me on the Sunday evening previous to 5th December, and asked me to let him know if I had seen or heard anything fresh. I understood that was a temptation for me to open a letter, and I told him I could not do that. He said he did not want me to do anything to injure myself. The letter which I read, and for which I am suffering, was a letter from Dr. Taylor to Mr. Gardner, the solicitor. I did not give nor send that letter to Palmer. I merely told him in few words of its contents. I only read part of the letter, and told Palmer the contents as much as I remembered. That was on the morning of the 5th of December. I told Palmer that I found in Dr. Taylor’s letter that there were no traces of strychnia found. I cannot recollect what else I told him. He said he knew they would not, for he was perfectly innocent.

* * * * *

[Sidenote: J. H. Hatton]

Captain JOHN HAINES HATTON--I am chief constable of the police of Staffordshire.

Did you obtain this letter, which I have just proved to be in Palmer’s handwriting, and envelope from Mr. Ward, the coroner?--I did; I endorsed it.

My dear Sir,--I am sorry to tell you that I am still confined to my
bed. I do not think it was mentioned at the inquest yesterday that
Cook was taken ill on Sunday and Monday night in the same way as he
was on the Tuesday night when he died. The chambermaid at the Crown
Hotel, Masters, can prove this. I also believe that a man by the
name of Fisher is coming down to prove he received some money at
Shrewsbury. Now here he could only pay Smith £10 out of £41 he owed
him. Had you better not call Smith to prove this? And again,
whatever Professor Taylor may say to-morrow, he wrote from London
last Tuesday night to Gardner to say “We have this day finished our
analysis, and find no traces of either strychnia, prussic acid, or
opium.” What can beat this from a man like Taylor, if he says what
he has already said, and Dr. Harland’s evidence? Mind you, I know,
and saw it in black and white, what Taylor said to Gardner, but
this is strictly private and confidential, but it is true. As
regards his betting book, I know nothing of it, and it is of no
good to any one. I hope the verdict to-morrow will be that he died
of natural causes, and thus end it.--Ever yours.

* * * * *

[Sidenote: S. Cheshire]

SAMUEL CHESHIRE, recalled, cross-examined--I knew Cook very well, but I could not speak to his handwriting. I am sure that when Palmer came to me he used the words, “seen or heard anything.” He did not simply ask if I had “heard anything.” On the Saturday before Cook’s death I dined with Palmer and Mr. Smith. Cook was expected to dine also, but he was too ill. Palmer said he must call in Bamford.

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[Sidenote: G. Herring]

GEORGE HERRING--I knew Mr. Cook. I was at Shrewsbury Races last November, staying at the Raven, and saw Cook each day. I saw him with money on the Wednesday. He was counting up a lot of Bank of England and other notes. I could not say how many there were, but there were a considerable number. He showed me his betting book, containing entries of bets made at the races. On Monday, 19th November, I received a letter from Palmer asking me to call upon him at 7 Beaufort Buildings at half-past two that day. I called, and he said he wished to see me about settling Cook’s account, as the physician had advised Cook not to go out that day, it being damp. Palmer had a paper in his hand, and read out from it a number of items which he asked me to take down. I did so, and I have here the list I made. He said--“Receive of Ingham, £350; Barr, £300; Green, £140; Morris, £200; Nelson, £30; pay yourself £6 and Shelley £30.” I said that made it £984, and he said--“That is what Cook makes it; if I give you £16 it will make £1000; out of that pay yourself for my bill.” I said, “I know no difference between the two bills”; he said, “Pay Padwick £550 and Pratt £450, making £1000.” He asked me to send cheque for the last two at once. I refused to do so, as I had not received the money. He wished me particularly to pay Pratt the £450, as he said it was for a bill or joint-bill of sale on the mare. I had an account of £45 against Palmer, while he had one of £40 against me. He settled this £5, along with the £16 to make up the £1000 previously spoken to, by a Bank of England £50 note. I do not know the number of the note. Before he left he pressed me to send the cheques to Pratt and Padwick immediately before the closing of the bank. He said, “When you have settled this account write down word to either me or Cook.” I replied, “I shall certainly write to Mr. Cook,” because I thought I was settling Mr. Cook’s account. He said, “It does not matter which.” I asked him if I addressed the letter, “Mr. Cook, Palmer, Rugeley, would that be correct,” and he said “yes.” I received all the money at Tattersall’s on Cook’s account, except £110 of Mr. Morris, who only paid £90 instead of £200. I sent a cheque for £450 to Pratt from Tattersall’s. I wrote a letter to Cook from Tattersall’s. The next day I received a telegraphic message, which I gave to Captain Hatton on the coroner’s inquest. In consequence of this message I wrote a letter the same day to Cook.

(Evidence was given to show that Herring held three bills of exchange, each for £200, on which Cook and Palmer were jointly responsible to him. He received £200 from Cook on one bill; another £200 bill he deducted, as instructed by Palmer from the £1000. The third bill he paid himself for by not paying Padwick as Palmer instructed him. Besides these bills Herring held a fourth for £500 drawn by Palmer on his mother, and endorsed by him and Cook. It was proved that this acceptance was not in Mrs. Palmer’s handwriting.)

The Court then adjourned.

Fourth Day, Saturday, 17th May, 1856.

The Court met at ten o’clock.

[Sidenote: George Bate]

GEORGE BATE, examined by Mr. JAMES--I am a farmer, and was in the employment of the prisoner during September, October, and November of last year. I was engaged to look after his horses, and received no stated salary, sometimes two sovereigns and sometimes one sovereign a week. I remember in the month of September, 1856, being in the company of Mr. Cook and Mr. Palmer. Something was said by one of them to me about an insurance being proposed on my life.

Mr. SERJEANT SHEE objected to this evidence, and his objection was sustained.

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[Sidenote: T. B. Curling]

Mr. THOMAS BLIZZARD CURLING, examined by the ATTORNEY-GENERAL--I am a Fellow of the College of Surgeons, and surgeon to the London Hospital. I have published a work on the subject of tetanus. Tetanus signifies spasmodic affection of the voluntary muscles of the body. There are two sorts of tetanus, idiopathic and traumatic. Idiopathic tetanus is tetanus originating, as it were, as a primary disease, without any wound. Traumatic is from a wound. During twenty-two years I have been surgeon to the London Hospital. I have never seen a case of idiopathic tetanus. I have seen over fifty cases of traumatic tetanus. Traumatic tetanus first manifests itself by a stiffness about the jaws and the back of the neck; rigidity of the muscles of the abdomen usually sets in; a dragging pain at the pit of the stomach is almost a constant attendant of spasm of the diaphragm, and in many cases the muscles of the back are sensibly affected. Then the spasms, though continuous, are liable to aggravation in paroxysms. As the disease goes on these paroxysms become more frequent and more severe. When they occur, the body is drawn backwards; in some instances, though less frequently, it is bent forwards; then, in an acute case, a difficulty in swallowing is a very common thing; a difficulty in breathing also during the paroxysm, a choking sensation. The disease may end, supposing it be fatal, in two ways; the patient may die somewhat suddenly of suffocation, owing to closure of the opening of the windpipe, or the patient may be worn out by the severe and painful spasms, and the muscles may relax and the patient gradually sink and die. Traumatic tetanus is generally fatal, and the locking of the jaw is an almost invariable symptom. A symptom very characteristic of the disease is a contracted condition of the eyelids, a raising of the angles of the mouth, and a contraction of the brow. The lower extremities are sometimes affected, and sometimes the upper; the muscles affected are chiefly those of the trunk. I have never heard of traumatic tetanus being produced from sore throat or from chancre. A case of traumatic tetanus which ends fatally takes from one day to four days, or longer, before death ensues. I never heard of a case in which a man would be attacked one day and then have twenty-four hours’ respite, and be again attacked the next. The symptoms of the death of Mr. Cook, given by Mr. Jones, the surgeon, were not consistent with any form of traumatic tetanus I ever heard of. There was the sudden onset of the fatal symptoms; in all cases that have fallen under my notice the disease has been preceded by the milder symptoms of tetanus. The symptoms given by the woman Mills as to the Monday night were not those of tetanus. The sudden onset and rapid subsidence are not consistent with what I call the true form of tetanus. The poison, nux vomica, produces tetanic convulsions.

Cross-examined by Mr. SERJEANT SHEE--Any irritation of the nerves proceeding to the spinal cord might produce tetanus. I agree with Dr. Watson in his “Lectures on the Principles and Practice of Physic,” that all the symptoms of tetanic convulsions may arise from such slight causes as the sticking of a fish bone, the mere stroke of a whip lash under the eye, from the cutting of a corn, from the bite on the finger by a tame sparrow, from the extraction of a tooth, from the operation of cupping, and simple things of that character. Idiopathic tetanus would not be so likely to bring the patient to the hospital as a sudden wound leading to traumatic tetanus. A syphilitic sore would not be likely to lead to tetanus.

Re-examined by the ATTORNEY-GENERAL--A medical practitioner who saw a case of convulsions would be able at once to know the difference between symptoms of general convulsions and of tetanus. One of the characteristic features of tetanus is that the consciousness is not affected.

* * * * *

[Sidenote: Robert Todd]

Dr. ROBERT TODD, examined by the ATTORNEY-GENERAL--I have been in practice as a doctor for twenty-five years, and have been a physician to King’s College Hospital for many years. I have lectured on the disease called tetanus, and have published the lectures. I have seen two cases of what seemed to be idiopathic tetanus. It is a very rare thing. The term tetanus ought not to be applied to cases of poisoning, for the symptoms are so essentially distinct from the disease. I have had under my own observation cases of traumatic tetanus. When once the disease has begun there are remissions, but not complete; rather a diminution of the severity of the symptoms. There are two classes--an acute class and a chronic class. The acute cases will terminate in the course of three or four days, and the chronic cases will go on from nineteen to twenty-two or twenty-three days, perhaps longer. Sometimes epilepsy will produce convulsions, and sometimes the convulsions from epilepsy assume somewhat of a tetanic character, but they are essentially distinct from tetanus. When the epileptic convulsions assume somewhat of the tetanic form, it is quickly over, not continuous. In epilepsy there is an abolition of consciousness for the time. I have heard the symptoms described which accompanied this gentleman’s seizure and death, and also the appearances after death and the post-mortem examination. I am of opinion there was neither apoplexy nor epilepsy. There are poisons which will produce tetanic convulsions. The chief of these poisons is nux vomica. I have seen animal life destroyed by strychnia, but never human life. The effects of a large dose, such as a grain of strychnia given in a liquid form to a cat or dog, would be apparent in the course of ten minutes. The symptoms would be spasmodic action of the muscles, chiefly of the trunk, the spine, the spinal muscles, producing a very marked opisthotonos, as it is called, where the spine is thrown back, the head thrown back, and the trunk bowed in a very marked manner. The extremities are generally stiffened, jerked out with violent jerks. The muscles are rendered stiff and rigid from the spasms. The stiffness remains, and does not perfectly relax. Fresh paroxysms come in always attended with the peculiar curving back of the head and neck and spine. The extremities of the animals are powerfully stiffened out, distended, every now and then powerfully bent, and jerked out again. Death ensues within half an hour, unless it is a small dose. There is a marked difference between cases where death ensues after taking strychnia and a case of tetanus such as I was describing just now from idiopathic or traumatic causes. The continuity of the symptoms in strychnia poisoning is very characteristic: as long as the poisonous influence lasts, the symptoms last, but the poisonous symptoms will subside after a time. The shortness of the duration of the symptoms is decidedly in favour of strychnine poisoning. There are no other poisons that I know of that produce convulsions of a tetanic character. The symptoms described which attended this gentleman’s death are not referable to idiopathic or traumatic tetanus. I have never seen a person die from the administration of strychnia, but I have seen a person suffer from the consequences of an overdose. There was the opisthotonos and there was the consciousness perfectly retained. There was also dilation of the pupils, a peculiar convulsion of the muscles of the trunk, and the limbs were stiffened out. Difficulty of breathing is common to both tetanus and to tetanic convulsions from strychnia. In the case of Mr. Cook, I think it is an important distinction that he seems to have been able to swallow sufficiently easy, and there was no rigidity of the muscles of the jaw which is characteristic of tetanus, of disease, or of wound. I think the symptoms in his case, judging from my own experience, were those of tetanus from strychnia.

Cross-examined by Mr. GROVE--The proximate effect of tetanus, whether caused by idiopathic or traumatic tetanus, or strychnia, is probably the same on the nerves leading from the spine. The particular affection of the nerves is unknown. In the disorder of convulsions there are cases of very slight affection, others more serious, and so on. I adhere to the opinion given by me in my lectures on “Diseases of the Brain and Nervous System,” that the results of the administration of strychnine exactly imitate the convulsions of tetanus. It does not produce the exact phenomena of the disease in a clinical sense. I have no doubt the peculiar irritation of the nerves in tetanus is identical with the peculiar irritation of the nerves in strychnine poisoning. In traumatic tetanus I do not recollect any instance of the limbs being affected before the jaw. An examination of the spinal cord in tetanic affections shortly after death is of importance. If it were deferred as late as two months, there would be, to a certain extent, a fallacy. There are morbid appearances produced by wounds after death which sometimes simulate diseased conditions before death.

Supposing the spine to be affected by decomposition, would not what may be called the diseased softening of the spine previous to death be confused or obliterated?--You would not be able to speak with certainty as to simple softening if the examination had been long after death. There is nothing in the post-mortem examination on which any one could positively say that the patient died from the ordinary disease of tetanus. I think granules on the spinal cord, such as I have heard of here, are not likely to cause tetanus. In the cases of the animals to whom strychnia was administered they went off into a second spasm immediately they were touched. They retained that tendency as long as the influence of the poison lasted. I examined the animals that were killed by strychnia anatomically. The right side of the heart was not generally full; it was empty, and the heart contracted. Death where strychnine was administered is partly due to the difficulty of action of the respiratory muscles, but chiefly to a general nervous exhaustion which the violence of the paroxysm produces.

Would not the difficulty of action of the respiratory muscles producing death tend to leave the heart full?--I do not think it was asphyxia.

[Sidenote: Robert Todd]

Then I think I may take you as differing from the great mass of authorities on strychnia poisoning?--I don’t know; I think there are differences of opinion on that subject. Persons sometimes have convulsions after poison by morphia. The time in which convulsive symptoms come on after morphia would depend on the dose entirely. I cannot say whether it would be later than strychnia. It is not a question I have devoted attention to.

Re-examined by the ATTORNEY-GENERAL--In death resulting from tetanus I should not expect to find anything peculiar about the heart. I heard the evidence of the gentlemen who examined the spinal cord after Mr. Cook’s death. From their description it appeared to me that those parts were in such a condition that any indication of disease might have been discovered.

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[Sidenote: Sir B. Brodie]

Sir BENJAMIN BRODIE, examined by Mr. JAMES--I was surgeon at St. James’s Hospital for a great number of years, and have had a considerable practice. I have had many cases of death from tetanus. Death from idiopathic tetanus is very rare in this country. I heard the description of the symptoms attending the death of Mr. Cook. As far as the spasmodic contraction of the muscles is concerned, the symptoms resemble those of traumatic tetanus; as to the course the symptoms took, that was entirely different. I heard about the attack on the Monday night and its ceasing, and the patient being comfortable and composed during the Tuesday, and then the attack again about ten minutes before twelve on the 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; then the contraction of the muscles of the back is always a later symptom; 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 a spasmodic contraction of the muscles of that limb. I do not recollect a case in which in ordinary tetanus there was that contraction of the muscles of the hand which I understand was stated to have existed in this instance. Ordinary tetanus rarely runs its course in less than two or three days, and often is protracted to a much longer period; I know one case only in which the disease was said to have terminated in twelve hours.

LORD CAMPBELL--Probably in that case the early symptoms had been overlooked?--I never knew these symptoms of ordinary tetanus to last for a few minutes, then subside, then come on again after twenty-four hours.

[Sidenote: Sir B. Brodie]

Examination continued--I do not believe that death here arose from what we ordinarily call tetanus, either idiopathic or traumatic. I never knew a death from tetanus to result from a sore throat, or a chancre, or any other form of syphilitic disease. The symptoms of the death of Mr. Cook are not consistent with a fit of apoplexy. I never saw a case in which the symptoms that I heard described arose from any disease.

Cross-examined by Mr. SERJEANT SHEE--I remember one case of idiopathic tetanus in our hospital, but I doubted its deserving the name of tetanus.

Considering how rare tetanus is, would you think that the description of a chambermaid and of a provincial medical man, who had only seen one case of tetanus, could be relied upon by you as to what the disease observed was?--I must say I thought the description very clearly given. I have never seen the syphilitic poison produce convulsions except as a consequence of disease in the bones of the head.

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[Sidenote: Henry Daniel]

Mr. HENRY DANIEL, examined by the ATTORNEY-GENERAL--I was for upwards of twenty-eight years surgeon to the Bristol Hospital. I have seen fully thirty cases of tetanus, of which two were idiopathic. One of these two ended fatally. Idiopathic tetanus is of very rare occurrence. The symptoms are not so severe as those in traumatic tetanus. The symptoms which accompanied the attack of Mr. Cook before his death were quite distinguishable from those cases of tetanus which have come within my experience. In pointing out the differences I would repeat very probably the words of Sir Benjamin Brodie. Tetanus, so far as my experience goes, 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. Lockjaw is almost invariably a symptom of traumatic in particular. It is one of the earliest symptoms. I have seen the clenching of the hands, but I do not think it is an ordinary symptom of common tetanus. I cannot recollect a case the duration of which has been less than from thirty to forty hours. I have never known a syphilitic sore producing tetanus. The symptoms I have heard described in Mr. Cook’s case are not referable to either apoplexy or epilepsy. In both these there is a loss of consciousness, but in cases of tetanus that I have seen consciousness has been retained throughout all the period. In my experience of tetanus the symptoms have been invariably continuous without any interruption. In my judgment the symptoms of Mr. Cook could not be referred to idiopathic or traumatic tetanus.

[Sidenote: Henry Daniel]

Cross-examined by Mr. GROVE--I do not know that cases are mentioned in books where there is a long interval of some hours between the symptoms. I have not read Dr. Todd’s book, nor Mr. Curling’s book, nor Dr. Copland’s book on the subject. I have been out of practice some seventeen or eighteen months, and have not looked into the reported cases of tetanus of late. In my opinion the symptoms of tetanic convulsions do not vary much in different cases. There may be an affection of a muscle in this man that there is not in the other, in a leg or an arm. In tetanic affections death is caused by exhaustion and suffocation.

[Sidenote: Samuel Solly]

Mr. SAMUEL SOLLY, examined by Mr. WELSBY--I have been connected with St. Thomas’s Hospital as lecturer and surgeon for twenty-eight years. I have either seen or had under my care twenty cases of tetanus, all of which were traumatic, except one, in which I was doubtful whether it was traumatic or idiopathic. In the latter case the symptoms were slower in their progress and generally rather milder. The shortest period I can remember before the disease arrived at a point is thirty hours. The difference between Mr. Cook’s attacks and the cases I have seen is that, in my experience, there has been a marked expression of the countenance--that is the first symptom; it is a sort of grin, and the symptoms have always been continuous. The symptoms in Mr. Cook’s case are not referable to either epilepsy or apoplexy, or any disease that I ever witnessed.

Cross-examined by Mr. SERJEANT SHEE--A marked expression of the countenance, a sort of grin, frequently occurs in all violent convulsions, which assume, without being tetanus, a tetanic form and appearance. They are not a numerous class. It is difficult to distinguish between them and idiopathic tetanus in the onset, but not in the progress. I heard the account given by Mr. Jones of the last few moments before Mr. Cook died.

That he uttered a piercing shriek, fell back, and died, did he not?--Yes.

The ATTORNEY-GENERAL--I beg your pardon; there was an interval.

Mr. SERJEANT SHEE--No, no; five or six minutes.

LORD CAMPBELL--He died very quietly.

Cross-examination resumed--I heard the description of the shriek with the convulsion; but it was the shriek that called the medical man into the room. That was at the height of the attack. In some respects that last shriek and the paroxysm that occurred immediately afterwards bear a resemblance to epilepsy. Death from tetanus accompanied with convulsions seldom leaves any trace behind; but death from epilepsy leaves behind it some few effusions of blood on the brain or congestion of the vessels.

[Sidenote: Samuel Solly]

Re-examined by the ATTORNEY-GENERAL--Convulsions that take place in epilepsy are not at all of tetanic character. I say that Mr. Cook did not die from epilepsy, because there were none of the symptoms there. When a patient dies with epilepsy he dies perfectly unconscious. Ulceration of the brain from injury, a sudden injury to the spinal cord, irritation of the teeth in infants, all produce convulsions. But those convulsions in their progress are not similar to the convulsions of tetanus. There is no progressive movement and no appearance about the face or jaw of having tetanus.

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[Sidenote: R. Corbett]

Dr. ROBERT CORBETT, examined by Mr. JAMES--I am a physician in Glasgow. I remember a patient of the name of Agnes Sennet who died in the Glasgow Royal Infirmary on 29th September, 1845, after taking some strychnia pills intended for another patient. I saw her while she was under the influence of the poison. The symptoms I noticed were a retraction of the mouth, face much suffused and red, the pupils dilated, the head bent back, the spine curved, and the muscles rigid and hard like a board. She died about an hour and a quarter after taking the pills. There would be a quarter of a grain in each of the three pills she took.

Cross-examined by Mr. SERJEANT SHEE--The retraction of the angles of the mouth was continuous, but it was worse at times. I did not observe it after death. The hands were not clenched, but semi-bent after death. That semi-bending of the hand is a very common thing in cases of death by violent convulsions. Twenty minutes after taking the medicine she was attacked by the symptoms.

* * * * *

[Sidenote: Dr. Watson]

Dr. WATSON, examined by the ATTORNEY-GENERAL--I am one of the physicians in the Glasgow Royal Infirmary, and attended the case of Agnes Sennet spoken to by the last witness. I saw her about a quarter of an hour after the symptoms first began. She was in violent convulsions; her arms were stretched out and rigid; her feet and legs were also rigid. Just at that moment she did not breathe. That paroxysm subsided almost immediately, and fresh ones came on after a very short interval. They occurred at intervals until they destroyed her. She was about half an hour in dying. She seemed perfectly conscious during the time. At the post-mortem examination the spinal cord was quite healthy. The heart was contracted.

* * * * *

[Sidenote: Mary Kelly]

MARY KELLY, examined by Mr. BODKIN--I was a patient in the Glasgow Royal Infirmary, and saw Agnes Sennet take the pills, which were intended for another patient. I saw her take two pills only. After taking the pills she went and sat down by the fire, and in about three-quarters of an hour she was taken ill. She fell back on the floor, and a nurse and I lifted her into bed. The nurse cut her clothes off, and she never moved after she was put upon the bed; she was just like a poker. She never spoke after she fell.

* * * * *

[Sidenote: C. Hickson]

CAROLINE HICKSON, examined by Mr. JAMES--In October, 1848, I was nurse and lady’s maid in the family of Mrs. Serjeantson Smith, at Romsey, in Hampshire. On the 30th of that month Mrs. Smith was unwell, and some medicine was sent to her in the afternoon, about six o’clock, by a Mr. Jones, a druggist in Romsey. Shortly after seven o’clock next morning I saw her take about half a wineglass of the medicine. About five or ten minutes afterwards I was summoned to her bedroom, and on entering I saw her leaning upon a chair, and I thought she had fainted. She appeared to suffer from what I thought spasms. I went out and sent for Mr. Taylor, surgeon, and on returning to the bedroom I found some of the other servants assisting to support Mrs. Smith. She was then lying on the floor and screaming very much, very loudly, but did not open her teeth. She asked me to have her legs pulled straight, and I found them drawn up very much. She still screamed as if in great agony, and requested some water to be thrown over her, which I did. Her feet were turned inwards. I put a hot-water bottle to them, but this had no effect. Shortly before she died she said she felt easier, and her last words were, “Turn me over.” I did so. A few minutes after this she died. She was conscious, and knew me during the whole time. From the time she took the medicine until she died would be about an hour and a quarter.

Cross-examined by Mr. GROVE--From the time I first saw her in the spasms she could not sit up at all. It was a continuous, recurring fit, and lasted about an hour. She only seemed easy for a very short time before her death. Her teeth were clenched during the whole time.

* * * * *

[Sidenote: F. Taylor]

Mr. FRANCIS TAYLOR, examined by Mr. WELSBY--I am a surgeon at Romsey. I was summoned one morning to the house of Mrs. Serjeantson Smith. I arrived between eight and nine o’clock, shortly after she died. I saw the body then. The hands were clenched; the feet were contracted, turned inwards; and the soles of the feet were hollowed up. This appeared to have been from recent spasmodic action. The limbs were remarkably stiff. The body was still warm. The eyelids were totally adherent, almost to the eyeballs. I made a post-mortem examination three days after death. The contraction of the feet continued, but it was gone off somewhat from the rest of the body. No trace of disease was found. The heart was contracted and perfectly empty, and the blood was fluid. I analysed the medicine Mrs. Smith had taken. It originally contained nine grains of strychnia, and Mrs. Smith had taken one-third. As the truth was so apparent, only a very general examination of the stomach and bowels was made, but still sufficient to find traces of strychnia.

* * * * *

[Sidenote: Jane Witham]

JANE WITHAM, examined by Mr. JAMES--In March last I was in attendance on a lady who died. I remember her taking some medicine, after which she became ill. She first complained of her back, and when I went to her I observed her head was drawn back, and I could not get at her back. She was in bed. I noticed she had twistings of the ankles, and her eyes were drawn aside and staring. She first complained of illness on the 25th of February, and she died on 1st March. She had several attacks, between each of which she got better. She generally complained of a pricking in her legs and twitching of the muscles in the hands, and she compared them to a galvanic shock. During the attacks she requested her husband to rub her legs and arms. The first attack was on the Monday, and she died on the Saturday about ten minutes to eleven at night.

(This case was that of Dr. Dove’s wife.)

Cross-examined by Mr. SERJEANT SHEE--It was on the commencement of the spasms that she requested her legs to be rubbed. On the Saturday night she could not bear them to be touched. On that night the spasms were much stronger than on the other days. On the Saturday she did not speak but once or twice. During the interval of the spasms on the Saturday touching her brought the spasms on. She could swallow on each of the days except the Saturday, when her mouth was quite closed. After death her body was stiff.

* * * * *

[Sidenote: G. Morley]

Mr. GEORGE MORLEY, examined by Mr. WELSBY--I was the medical attendant on the lady referred to by the last witness. I had been attending her for about two months before her death for a functional derangement. I saw her on the Monday before her death lying in her bed. I observed several convulsive twitchings of her arms. I saw her on the Saturday about the middle of the day. She was much better, and in a composed state. She complained of an attack she had had in the night, and spoke of pains and spasms, affections of the back and neck. I and another medical gentleman made a post-mortem examination on the Monday. We found no disease which would account for death. There were no abrasions, nor any wound or sore. The hands were semi-bent, the fingers curved, and the feet were strongly arched. We applied several colour tests to the contents of the stomach for the purpose of detecting the presence of poison. On each occasion we produced the appearance characteristic of strychnia. After the separation of the strychnine by chemical analysis we inoculated two mice, two rabbits, and one guinea pig with the stuff taken from the stomach. We observed in each of the animals more or less the effects usually produced by the poison strychnia--general uneasiness, difficult breathing, convulsions of the tetanic kind, muscular rigidity, bending backwards, especially of the head and neck, a violent stretching of the legs. In the case of the animals where death resulted the muscular rigidity continued without any intermission. There was an interval of relaxation, but immediately after death the muscles became very rigid, more so than at rigor-mortis. We afterwards made a similar series of experiments on some animals with strychnia itself, both in solid and liquid forms. The symptoms and the results generally were exactly the same as those I have described in the case of the other animals.

Cross-examined by Mr. GROVE--I did not see the patient during any severe attack. I observed that when the animals were touched it brought on the symptoms. That is a very marked result. Directly they are touched they give a sudden start, and pass into a severe spasm. At the post-mortem examination the lungs were very much congested. The muscles generally were dark and stiff. There was a decided quantity of bloody serous effusion over the brain. There was a notable quantity, but not a large quantity, of serum slightly tinged with blood in the membranes of the spinal cord. The large spinal veins were very much congested, as were the membranes of the spinal marrow. We opened the head first, and that led to a great deal of blood flowing from the head. That would make it uncertain whether the heart was full or empty. The right sides of the hearts of animals that have been poisoned by strychnia are generally full. From one to two hours is the longest time in animals at which I have perceived the first effect of strychnia come on after it has been taken. I made experiments in conjunction with Mr. Nunneley, and my impression is that the interval has been as long as one hour. I discovered strychnia with all the tests I applied with more or less distinctness. I have detected strychnia in the stomach two months after death, and after decomposition had proceeded to a considerable extent.

[Sidenote: G. Morley]

Re-examined by the ATTORNEY-GENERAL--I have given to the animals which I have killed from half a grain to two grains. The animals experimented on were cats, rabbits, and dogs. The strychnia, I think, acts on the nerves, but a part may be taken into the blood also and act through the blood. The poison is absorbed. We searched the stomach to find the presence of the strychnia. The strychnia which we found in the stomach would be that which was there in excess beyond that which had been absorbed in the system. The strychnia that has been absorbed into the system is sufficient to destroy life. The excess that remains in the stomach is inactive. I should expect to fail sometimes to find strychnia in the stomach if the minimum quantity capable of operating to the destruction of life had been administered. If death resulted from a series of minute doses of this poison, administered for a space of several days, it is my opinion that the appearances would be likely to be different after death from what they would, supposing death was produced rapidly by one dose.

Re-cross-examined by Mr. SERJEANT SHEE--Is it your theory that in the act of poisoning the poison is absorbed and ceases to exist as poison, as strychnia?--I am inclined to think so. I have thought much upon that question. I am not decided in my own mind.

What chemical reason can you give for your opinion?--My opinion rests on the general fact that organic substances acting on the human body, such as food or medicine, are frequently changed in composition. It is possible that strychnia may have been discovered in the blood and liver after effecting the operation of poisoning, but I do not know that it has.

Do you know whether strychnia can be decomposed by any sort of putrefying or fermentative process?--I have no fact to show that it can, and I doubt if it is.

* * * * *

[Sidenote: E. D. Moore]

Mr. EDWARD DUKE MOORE, examined by Mr. HUDDLESTON--I was formerly in practice as a surgeon. About fifteen years ago I was attending a gentleman for paralysis, and had been giving him some very small doses of strychnia. Subsequently I made him up a stronger dose containing a quarter of a grain. In about three-quarters of an hour I was summoned to come back and see him. He was stiffened in every limb. His head was drawn back, and he was screaming, frequently requesting that we should turn him, move him, and rub him. His spine was arched. We tried to give him a mixture of ammonia with a spoon. He snapped at the spoon with a sort of convulsive grasp to take it. He was suffering about three hours altogether. He survived the attack, and was perfectly conscious the whole time.

Cross-examined by SERJEANT SHEE--He recovered from the spasms in about three hours, but the rigidity of the muscles remained for the rest of the day and part of the next day. He was completely recovered the next day after the attack, and the patient himself said he thought his paralysis was better.

The Court then adjourned.

Fifth Day, Monday, 19th May, 1856.

[Sidenote: Alfred Taylor]

Dr. ALFRED TAYLOR, examined by the ATTORNEY-GENERAL--I am a Fellow of the College of Physicians, a lecturer on medical jurisprudence at Guy’s Hospital, and the author of a well-known treatise on poisons and on medical jurisprudence. Among other poisons, I have made strychnia the subject of my attention. It is the produce of the nux vomica. There is also in the nux vomica a poison of an analogous nature called bruchsia, which differs from it only in point of strength. The difference of the two poisons is relatively estimated from one-sixth to one-twelfth, bruchsia being one-sixth to one-twelfth the strength of strychnia. I have never witnessed an instance of the action of strychnia on the human subject. I have tried a variety of experiments, I think about ten or twelve, on animal life with strychnia. Rabbits have always been used for these experiments. The symptoms produced by the poison have been on the whole very uniform. I have given a quantity varying from one-half to two or three grains. I have found half a grain sufficient to destroy the life of a rabbit. I have given it in both solid and liquid form. When given in a fluid state it produced its operation in two or three minutes; when given in a solid state, in the form of pill or bolus, from about six to eleven minutes, I think. The time is influenced by the strength of the dose, and also by the strength of the animal. The poison is first absorbed into the blood; it is then circulated through the body, and the poison especially acts on the spinal cord. That is the part of the body from which the nerves affecting the voluntary muscles proceed. The entire circulation through the whole system is considered to take place about once in four minutes.

LORD CAMPBELL--Are you speaking of the human circulation?--Yes; the circulation in the rabbit is quicker.