His Royal Highness the Duke of Cambridge was among the distinguished
persons who were accommodated with seats upon the bench.
The learned Judges, Lord Campbell, Mr. Baron Alderson, and Mr. Justice
Cresswell, took their seats at ten o’clock. The prisoner was at once
placed at the bar. His demeanour was, as on the previous days of his
trial, calm and attentive, but betrayed no additional anxiety.
Immediately after the learned Judges took their seats,
Lord CAMPBELL said: Before the proceedings commence I must express a
most earnest hope that until this trial is concluded the public journals
will continue to abstain from any comments upon the merits of the case,
or upon any part of the evidence. The propriety of this course is so
obvious as to need no explanation. This warning ought to extend to the
insertion of letters as much as to that of editorial articles.
THOMAS NUNNELEY, examined by Mr. GROVE: I am Fellow of the College of
Surgeons, and Professor of Surgery at the Leeds School of Medicine. I am
also a member of several medical and learned societies, foreign and
English, and have been in practice between twenty and thirty years. I
have a large practice, and have seen cases of both traumatic and
idiopathic tetanus. Of the latter disease I have seen four cases. They
did not all commence with lockjaw. One did not commence so, nor did
lockjaw become so marked in it as to prevent swallowing once during the
course of the disease. I have heard the evidence as to the symptoms of
Cook, and had previously read the depositions as to that part of the
case. Judging from those symptoms, I am of opinion that death was caused
by some convulsive disease. I found that opinion upon the symptoms
described in the depositions and the evidence before the Court.
Lord CAMPBELL said that the witness could only be examined as to his
opinion founded upon the _vivâ voce_ evidence before the Court.
Mr. GROVE said that his object was to distinguish between the opinion
founded on the _vivâ voce_ evidence and that founded on the depositions.
Examination continued: From the symptoms described by the witnesses in
court, I am of opinion that death was caused by some convulsive disease.
Looking at Cook’s general state of health--
Mr. Baron ALDERSON: You have nothing to do with that. You must only give
an opinion upon the symptoms described in evidence.
Examination continued by Mr. Serjeant Shee: I have been in court during
the whole of the trial. I have heard the evidence as to the symptoms of
Mr. Cook’s health previous to his final attack at Rugeley, the
description of the actual symptoms during the paroxysms, and the
appearance of the body on the _post-mortem_ examination. Do you remember
the account of the syphilitic sores?
The ATTORNEY-GENERAL objected to this mode of putting the question,
because it was an assumption that these sores existed. A medical man
ought to be asked his opinion on the supposition only that certain
symptoms existed.
Mr. Justice CRESSWELL: Let the witness describe what he assumes to have
been the state of Cook’s health, and you will then see whether he is
justified in his assumption.
Examination continued: I assumed that Cook was a man of very delicate
constitution--that for a long period he had felt himself to be ailing,
for which indisposition he had been under medical treatment; that he had
suffered from syphilis; that he had disease of the lungs; and that he
had old standing disease of the throat; that he led an irregular life;
that he was subject to mental excitement and depression; and that after
death appearances were found in his body which show this to have been
the case. There was an unusual appearance in the stomach. The throat was
in an unnatural condition. The back of the tongue showed similar
indications. The air vessels of the lungs were dilated. In the lining of
the aorta there was an unnatural deposit, and there was a very unusual
appearance in the membranes of the spinal marrow. One of the witnesses
also said that there was a loss of substance from the penis. That scar
on the penis could only have resulted from an ulcer. A chancre is an
ulcer, but an ulcer is not necessarily a chancre. The symptoms at the
root of the tongue and the throat I should ascribe to syphilitic
inflammation of the throat. Supposing these symptoms to be correct, I
should infer that Cook’s health had for a long time not been good, and
that his constitution was delicate. His father and mother died young.
Supposing that to have been his state of health, it would make him
liable to nervous irritation. That might be excited by moral causes. Any
excitement or depression might produce that effect. A person of such
health and constitution would be more susceptible of injurious influence
from wet and cold than would one of stronger constitution. Upon such a
constitution as that which I have assumed Cook’s to have been convulsive
disease is more likely to supervene. I understand that Cook had three
attacks on succeeding nights, occurring about the same hour. As a
medical man, I should infer from this that the attacks were of a
convulsive character. I infer that in the absence of other causes to
account for them. According to my personal experience and knowledge from
the study of my profession, convulsive attacks are as various as
possible in their forms and degrees of violence. It is not possible to
give a definite name to every convulsive symptom. There are some forms
of convulsion in which the patient retains his consciousness. Those are
forms of hysteria, sometimes found in the male sex. It is also stated
that there are forms of epilepsy in which the patient retains
consciousness.
By Lord CAMPBELL: I cannot mention a case in which consciousness has
been retained during the fit. No such case has come under my notice.
Examination continued: I know by reading that that, although rarely,
does sometimes occur. The degree of consciousness in epilepsy varies
very much. In some attacks the consciousness is wholly lost for a long
time. Convulsive attacks are sometimes accompanied by violent spasms and
rigidity of the limbs. Convulsions, properly so called, sometimes assume
a tetanic complexion. I heard the passage from the works of Dr. Copland
read to the Court yesterday. I agree with what he states. Convulsions
arise from almost any cause--from worms in children, affections of the
brain in adults, hysteria, and in some persons the taking of chloroform.
Adults are sometimes attacked by such convulsions. Affections of the
spinal cord or eating indigestible food will produce them. I know no
instance in which convulsions have arisen from retching and vomiting. I
agree with Dr. Copland that these convulsions sometimes end immediately
in death. The immediate proximate cause of death is frequently asphyxia.
By Lord CAMPBELL: Death from a spasm of the heart is often described as
death by asphyxia.
Examination continued: I have seen convulsions recurring. I have seen
that in very various cases. The time at which a patient recovers his
ease after a violent attack of convulsions varies very much. It may be a
few minutes, or it may be hours. From an interval between one convulsion
and another I should infer that the convulsions arise from some slight
irritation in the brain or the spinal cord. When death takes place in
such paroxysms there is sometimes no trace of organic disease to be
found by a _post-mortem_ examination. Granules between the dura mater
and the arachnoid are not common at any age. I should not draw any
particular inference from their appearance. They might or might not lead
to a conjecture as to their cause and effect. I do not form any opinion
upon these points. They might produce an effect upon the spinal cord.
There are three preparations in museums where granules are exhibited in
the spinal cord, in which the patients are said to have died from
tetanus. Those are at St. Thomas’s Hospital. To ascertain the nature and
effect of such granules the spinal cord ought to be examined immediately
after death. Not the most remote opinion could be formed upon an
examination made two months after death, more especially if the brain
had been previously opened. Independently of the appearance of granules,
it would not after that period be possible to form a satisfactory
opinion upon the general condition of the spinal cord.
If there were a large tumour, or some similar change, it might be
exhibited; but neither softening nor induration of the structure could
be perceived. The nervous structure changes within two days of death. To
ascertain minutely its condition, it is necessary to use a lens or
microscope. That is required in an examination made immediately after
death. I have attended cases of traumatic tetanus. That disease commonly
begins with an attack upon the jaw. One of the four cases of idiopathic
tetanus that I have seen was my own child. In three of those cases the
disease began with lockjaw. The fourth case commenced in the body, the
facility of swallowing remaining. I have, within the last twelve months,
made _post-mortem_ examinations of two persons who had died from
strychnia. I did not see the patients before death. In both cases I
ascertained, by chemical analysis, that death had been caused by
strychnia. In both I found the strychnia. In one case--that of a lady
aged 28 years--I made my examination forty-two hours after death, and in
the other thirty hours. In the former case, the body had not been opened
before I commenced my examination. [The witness read a report of this
examination, in which it was stated that the eyelids were partially
open, and the globes flaccid, and the pupils dilated. The muscles of the
trunk were not in the least rigid; indeed, they were so soft, that the
body might be bent in any direction. The muscles at the hip and shoulder
joints were not quite so flaccid, but they allowed these joints to be
easily moved, while those of the head and neck, fore-arms, &c. were
rigid. The fingers were curved, and the feet somewhat arched. All the
muscles, when cut into, were found soft and dark in colour. The
membranes of the liver were exceedingly vascular. The membrane of the
spinal cord was much congested. There was bloody serum in the
pericardium; the lungs were distended, and some of the air-cells were
ruptured. The lining membrane of the trachea and bronchial tubes were
covered with a layer of dark bloody mucus of a dark chocolate colour.
The thoracic vessels and membranes were much congested, and the blood
was everywhere dark and fluid.] After reading this report the witness
continued:--In the second case I made my examination thirty hours after
death. I first saw the body about twelve hours after death. It was a
woman somewhere near twenty years of age. [The witness also read the
report of the examination in this case. The appearances of the body were
substantially similar to those presented in the previous case.] In two
other cases I have seen a patient suffering from over doses of
strychnia. Neither of those cases was fatal. In one case I had
prescribed the twelfth of a grain, and the patient took one-sixth. That
was for a man of middle age. Strychnia had been given in solution. In a
few minutes the symptoms appeared. They were a want of power to control
the muscles, manifested by twitchings, rigidity, and cramp, more violent
in the legs than in any other part of the body. The spasms were not very
violent. They continued six hours before they entirely disappeared.
During that time they were intermittent at various intervals. As the
attack passed off the length of the intervals increased. At first their
length was but a few seconds. The spasms were not combatted by medical
treatment. The other case was a very similar one. The quantity taken was
the same--double what I had prescribed. I have experimented upon upwards
of sixty animals with strychnia. Those animals were dogs, cats, rats,
mice, guinea-pigs, frogs, and toads. The symptoms of the attack in all
animals present great resemblances. Some animals are, however, much more
susceptible of its influence than others are. The period elapsing
between the injection of the poison and the commencement of the symptoms
has been from two minutes to thirty--more generally five or six. I
administered the poison occasionally in solution, but more generally in
its solid state. It was sometimes placed dry upon the back of the
tongue, and some fluid poured down the throat; sometimes it was enclosed
between two portions of meat; sometimes mixed up with butter or suet,
and sometimes rolled up in a small piece of gut. To frogs and toads it
was administered by putting them into a solution of strychnia. I have
also applied it direct to the spinal cord, and in other cases to the
brain. The first symptom has been a desire to be quite still; then
hurried breathing; then slavering at the mouth (when the poison had been
given through that organ); then twitching of the ears, trembling of the
muscles, inability to walk, convulsions of all the muscles of the body,
the jaws being generally firmly closed; the convulsions attended by a
total want of power in the muscles, which, on the least touch, were
thrown into violent spasms, with a galvanic-like shock. Spasms also come
on if the animal voluntarily attempts to move; that is usually the case,
but occasionally the animal is able to move without inducing a
recurrence of the spasms. These spasms recur at various periods, but do
not always increase in violence. The animals die after periods varying
from three hours to three hours and a half. In the cases where the
animals live longest the paroxysms occur at the longest intervals. In
all cases, in the interval before death, the rigidity ceases (I know no
exception to this), and the muscles become quite soft, powerless, and
flaccid. The limbs may be put in any position whatever. There is but
little difference from ordinary cases of convulsive death in the time at
which the _rigor mortis_ comes on.
I have destroyed animals with other poisons, and there is very little
difference between the rigidity in their cases and that in the cases of
death from strychnia. In the two women I have mentioned the _rigor
mortis_ was much less than is usual in cases of death from natural
disease. I have known fatal cases of poisoning animals by strychnia in
which there has between the first and the second paroxysm been an
interval of about half an hour, but that is not common. I have examined
the bodies of upwards of forty animals killed by strychnia. I have
invariably found the heart full on the right side; very generally the
left ventricle firmly contracted, and the blood usually dark, and often
fluid. There is no particular appearance about the spine. I have
experimented with other poison upon upwards of two thousand animals, and
have written upon this subject. It very often happens that in the case
of animals dying suddenly from poisoning the blood is fluid after death.
That also happens in cases of sudden death from other causes. I have
attended to the evidence as to the symptoms exhibited by Cook on the
Sunday, Monday, and Tuesday night. The symptoms on Sunday night I assume
to have been great excitement. Cook described himself as having been
very ill, and in such a state that he considered himself mad for a few
minutes. He stated that the cause of this was a noise in the street.
These symptoms, in the three nights I have mentioned, do not resemble
those which I have seen follow the administration of strychnia. Cook had
more power of voluntary motion than I have observed in animals under the
influence of this poison. He sat up in bed, and moved his hands about
freely, swallowed, talked, and asked to be rubbed and moved, none of
which, if poisoned by strychnia, could he have done. The sudden
accession of the convulsions is another reason for believing that they
were not produced by strychnia. Other reasons for believing that the
convulsions were not produced by strychnia are their sudden accession
without the usual premonitory symptoms, the length of time which had
elapsed between their commencement and the taking of the pills which are
supposed to have contained poison, and the screaming and vomiting. I
never knew an animal which had been poisoned with strychnia to vomit or
scream voluntarily. I apprehend that where there is so much spasm of the
heart there must be inability to vomit. In the cases related in which
attempts were made to produce vomiting they did not succeed. There is
such a case in the 10th volume of the _Journal de Pharmacie_, in which
an emetic was given without success. The symptoms exhibited after death
by animals poisoned by strychnia differ materially from those presented
by the body of Cook. In his case the heart is stated to have been empty
and uncontracted.
Lord CAMPBELL: I do not remember that. I think it was said that it was
contracted.
Mr. Baron ALDERSON: According to my note, Dr. Harland said that the
heart was contracted, and contained no blood.
Examination continued: The lungs were not congested, nor was the brain.
In the case of animals which have recovered, the paroxysms have subsided
gradually. I never knew a severe paroxysm followed by a long interval of
repose. I have experimented upon the discovery of strychnia in the
bodies of animals in various stages of decomposition, from a few hours
after death up to the forty-third day, in which latter case the body was
quite putrid. It has never happened to me to fail to discover the
poison. I have experimented in about fifteen cases.
Supposing a person to have died under the influence of strychnia poison
in the first paroxysm, and his stomach to have been taken out and put
into a jar on the sixth day after death, must strychnia have, by a
proper analysis, been found in the body?--Yes. If the strychnia be pure,
such as is almost invariably found among medical men and druggists, the
test is nitric acid, which gives a red colour, which in a great measure
disappears on the addition of protochloride of tin. If the strychnia be
pure, it does not undergo any change on the addition of sulphuric acid,
but on an addition of a mixture of bichromate of potash, with several
other substances, it produces a beautiful purple, which changes to
varying shades until it gets to be a dirty red. There are several other
tests. In this case the stomach was not, in my opinion, in an
unfavourable condition for examination. The circumstances attending its
position in the jar, and its removal to London, would give a little more
trouble, but would not otherwise effect the result. If the deceased had
died from strychnia poison, it ought to have been found in the liver,
spleen, and kidneys. I have seen this poison found in similar portions
of animals which had been killed by it. I have also seen it found in the
blood; that was by Mr. Herepath, of Bristol.
Could the analyses be defeated or confused by the existence in the
stomach of any other substance which would produce the same
colours?--No. Supposing that pyrozantine and salicine were in the parts
examined, their existence would not defeat the analysis. Pyrozantine is
very unlikely to be found in the stomach. It is one of the rarest and
most difficult to be obtained. The distinction between pyrozantine and
strychnia is quite evident; pyrozantine changes to a deep purple on the
addition of sulphuric acid alone, and the bichromate of potash spoils
the colour. In strychnia no change is produced by sulphuric acid. It
requires the addition of the bichromate to produce the colour.
Supposing the death to have been caused by a dose of strychnia, not more
than sufficient to destroy the animal, would it be so diffused by the
process of absorption that you would not be able by these tests to
detect it in any portion of the system?--No; I believe it would not.
Had that question occupied your attention before you were called upon to
give evidence upon this trial?--It had.
What is your reason for stating that strychnine, when it has done its
work, continues as strychnine in the system?--Those who say that some
change takes place argue that as food undergoes a change when taken into
the body, so does the poison; it becomes decomposed. But the change in
food takes place during digestion; consequently its traces are not found
in the blood. Substances like strychnine are absorbed without digestion,
and may be obtained unchanged from the blood. They may be administered
in various ways.
In your judgment will any amount of putrefaction prevent the discovery
of strychnine?--To say that it is absolutely indestructible would be
absurd, but within ordinary limits, no. I have found it at the end of
forty days.
What is the probable relative rapidity of the action of strychnine in an
empty and a full stomach?--The emptier the stomach the quicker the
action.
Cross-examined by the ATTORNEY-GENERAL.--I am a lecturer on surgery. Mr.
Morley, who was called for the prosecution, is a lecturer on chemistry.
Part (perhaps half) of the experiments on the 60 animals were made by me
and Mr. Morley jointly. There was nothing to distinguish the experiments
which I made alone from those which I made jointly with him. I state the
apparent results of the whole. My experiments were spread over a period
of thirty years. Many of them have been made since the Leeds case. Some
of them were made in reference to this case. I can’t say how many.
Now, don’t put yourself in a state of antagonism to me, but tell me how
many of your experiments were made in reference to this particular
case?--I cannot answer that question. The great bulk certainly were not.
I was first concerned in this case about the time of the death of the
person at Leeds. I was applied to. I was in correspondence with the
attorney for the defence. The details of the Leeds case were forwarded
to him by me, and I called his attention to them. The general dose in
these experiments was from half a grain to two grains. Half a grain is
sufficient to destroy life in the larger animals. I have seen both a dog
and cat die from that dose, but not always. Some animals as a species
are more susceptible than those of a different species, and among
animals of the same species some are more susceptible than others. The
symptoms in the experiments I have mentioned did not appear after so
long a period as an hour. We have had to repeat the dose of poison in
some instances when half a grain has been given. That happened in the
case of a cat. Symptoms of spasm were produced, but the animal did not
die. She had not, however, swallowed the doses. I think I have known
animals of the cat species killed with half a grain.
Have you any doubt about it?--Yes.
Half a grain, then, is the _minimum_ dose which will kill a cat?--I
think it would be the _minimum_ dose in the case of an old strong cat.
If administered in a fluid state I think a smaller dose would suffice.
Harried breathing is one of the first symptoms, afterwards there are
twitching and tremblings of the muscles, then convulsions.
Is there any diversity, as in the intervals and the order of the
symptoms, in animals of the same species?--They certainly don’t occur
after the same intervals of time, but I should say they generally occur
in the order I have described. There is some difference in the periods
at which the convulsions take place. Some animals will die after less
convulsion than others, but an animal generally dies after four or five.
In one or two instances an animal has died after one convulsion. In
those instances a dose has been given equal in amount to another dose
which has not produced the same effect. The order in which the muscles
are convulsed varies to some extent. The muscles of the limbs are
generally affected first. The convulsions generally occur
simultaneously.
Do you know any case of strychnine in which the rigidity after death was
greater than the usual _rigor mortis_?--I think not. I don’t think there
is any peculiar rigidity produced by strychnine.
Have you never found undue rigidity in a human subject after death from
strychnine?--Considerably less.
In the anonymous case to which we have referred were not the hands
curved and the feet arched by muscular contraction?--Not more than is
usual in cases of death from ordinary causes. The limbs were rigid, but
not more than usual.
In face of the medical profession, I ask you whether you signed a report
stating that “the hands were curved and the feet decidedly arched by
muscular contraction,” and whether you meant by those words that there
was no more than the ordinary rigidity of death?--Certainly; I stated so
at the time.
Where? In the report?--No; in conversation. Allow me to explain that a
distinction was drawn between the muscles of the different parts of the
body. I heard Mr. Morley’s evidence with regard to experiments on
animals, and his statement that “after death there was an interval of
flacidity, after which rigidity commenced more than if it had been
occasioned by the usual _rigor mortis_.”
You don’t agree with that statement?--I do not. I generally found the
right side of the heart full.
Does the fact of the heart in Cook’s case having been found empty lead
you to the conclusion that death was not caused by strychnine?--Among
other things it does. I heard the evidence of Dr. Watson as to the case
of Agnes Sennet, in which the heart was found distended and empty; also,
that of Mr. Taylor as to the _post-mortem_ examination of Mrs. Smyth. No
doubt he stated that the heart in that case also was empty.
And do those facts exercise no influence on your judgment?--They would
not unless I knew how the _post-mortem_ examination had been made. If it
was commenced at the head, the blood being fluid, the large drains would
be opened, and the blood, from natural causes, would drain away.
Do you know how the _post-mortem_ examination was made in this
case?--No. Excuse me, I do. The chest and the abdomen, not the head,
were first opened.
The heart, then, was not emptied in the first instance?--No.
Then what occasioned the contraction of the heart?--When the heart is
emptied it is usually contracted.
But how do you account for its contraction and emptiness?--I cannot say
that I am able to account for it.
Lord CAMPBELL: Would the heart contract if there were blood in it?--No.
Lord CAMPBELL: When you find the heart contracted you know, then, that
it was contracted at the moment of death?--It is necessary to draw a
distinction between the two cavities. It is very common to find the left
ventricle contracted and hard, while the right is uncontracted.
Lord CAMPBELL: That is death by asphyxia?--Precisely.
By the ATTORNEY-GENERAL: In Cook’s case the lungs were described as not
congested. Entosthema is of two kinds; one of them consists of dilation
of the cells, the other of a rupture of the cells. When animals die from
strychnine entosthema occurs. I do not know the character of the
entosthema in Cook’s case. It did not occur to me to have the question
put to the witnesses who described the _post-mortem_ examination.
To what constitutional symptoms about Cook do you ascribe the
convulsions from which he died?--Not to any.
Was not the fact of his having syphilis an important ingredient in your
judgment upon his case?--It was. I judge that he died from convulsions
by the combination of symptoms.
What evidence have you to suppose that he was liable to excitement and
depression of spirits?--The fact that after winning the race he could
not speak for three minutes.
Anything else?--Mr. Jones stated that he was subject to mental
depression. Excitement will produce a state of brain which will be
followed, at some distance, by convulsions. I think Dr. Bamford made a
mistake when he said the brain was perfectly healthy.
Do you mean to set up that opinion against that of Dr. Devonshire and
Dr. Harland, who were present at the _post-mortem_?--My opinion is
founded in part upon the evidence taken at the inquest, in part on the
depositions. With the brain and the system in the condition in which
Cook’s were I believe it quite possible for convulsions to come on and
destroy a person. I do not believe that he died from apoplexy. He was
under the influence of morphia. I don’t ascribe his death to morphia,
except that it might assist in producing a convulsive attack. I should
think morphia not very good treatment, considering the state of
excitement he was in.
Do you mean to say, on your oath, that you think he was in a state of
excitement at Rugeley?--I wish to give my evidence honestly. Morphia,
when given in an injured state of the brain, often disagrees with the
patient.
But what evidence have you as to the injured state of the
brain?--Sickness often indicates it. I can’t say whether the attack of
Sunday night was an attack of convulsions. I think that the Sunday
attack was one of a similar character, but not so intense, as the attack
of Tuesday, in which he died. I don’t think he had convulsions on the
Sunday, but he was in that condition which often precedes convulsions. I
think he was mistaken when he stated that he was awoke by a noise. I
believe he was delirious. That is one of the symptoms on which I found
my opinion. Any intestinal irritation will produce convulsions in a
tetanic form. I have known instances in children. I have not seen an
instance in an animal. Medical writers state that such cases do occur. I
know no name for convulsions of that kind.
Have you ever known a case of convulsions of that kind, terminating in
death, in which the patient remained conscious to the last?--I have not.
Where epilepsy terminates in death, consciousness is gone. I have known
four cases of traumatic, and five or six of idiopathic tetanus.
You heard Mr. Jones make this statement of the symptoms of Cook after
the commencement of the paroxysms:--After he swallowed the pills he
uttered loud screams, threw himself back in the bed, and was dreadfully
convulsed. He said, “Raise me up! I shall be suffocated.” The
convulsions affected every muscle of the body, and were accompanied by
stiffening of the limbs. I endeavoured to raise Cook with the assistance
of Palmer, but found it quite impossible, owing to the rigidity of the
limbs. When Cook found we could not raise him up, he asked me to turn
him over. He was then quite sensible. I turned him on to his side. I
listened to the action of his heart. I found that it gradually weakened,
and asked Palmer to fetch some spirits of ammonia to be used as a
stimulant. When he returned the pulsations of the heart were gradually
ceasing, and life was almost extinct. Cook died very quietly a very
short time afterwards. When he threw himself back in bed he clinched his
hands, and they remained clinched after death. When I was rubbing his
neck, his head and neck were unnaturally bent back by the spasmodic
action of the muscles. After death his body was so twisted or bowed,
that if I had placed it upon its back it would have rested upon the head
and the feet.--Now, I ask you to distinguish in any one particular
between those symptoms and the symptoms of tetanic convulsions?--It is
not tetanus at all; not idiopathic tetanus.
I quite agree with you that it is not idiopathic tetanus, but point out
any distinction that you can see between these symptoms and those of
real tetanus?--I do not know that there is any distinction, except that
in a case of tetanus I never saw rigidity continue till death and
afterwards.
Can you tell me of any case of death from convulsions in which the
patient was conscious to the last?--I do not know of any; convulsions
occurring after poison has been taken are properly called tetanic.
We were told by Sir B. Brodie that while the paroxysms of tetanic
convulsion last there is no difference between those which arise from
strychnine and those which arise from tetanus properly so called, but
the difference was in the course the symptoms took. Now, what do you say
is the difference between tetanus arising from strychnine and ordinary
tetanus?--The hands are less violently contracted; the effect of the
spasm is less in ordinary tetanus. The convulsion, too, never entirely
passes away. I have stated that tetanus is a disease of days, strychnine
of hours and minutes; that convulsive twitchings are in strychnine the
first symptoms, the last in tetanus; that in tetanus the hands, feet,
and legs are usually the last affected, while in strychnine they are the
first. I gave that opinion after the symptoms in the case of the lady at
Leeds, which were described by the witness Witham, and I still adhere to
it. I never said that Cook’s case was one of idiopathic tetanus. I do
not think it was a case of tetanus in any sense of the word. It differed
from the course of tetanus from strychnine in the particulars I have
already mentioned.
Repeat them: There was the sudden accession of the convulsions.
Sudden--after what?--After the rousing by Jones. There was also the
power of talking.
Don’t you know that Mrs. Smyth talked and retained her consciousness to
the end; that her last words were “turn me over?”--She did say something
of that kind. No doubt those were the words she used. I believe that in
poison from tetanus the symptoms are first observed in the legs and
feet. In the animals upon which I have experimented twitchings in the
ears and difficulty of breathing having been the premonitory symptoms.
When Cook felt a stiffness and a difficulty of breathing, and said that
he should be suffocated on the first night, what were those but
premonitory symptoms?--Well, he asked to be rubbed; but, as far as my
experience goes with regard to animals--
The ATTORNEY-GENERAL: They can’t ask to have their ears rubbed, of
course. (A laugh.)
Mr. Serjeant SHEE said the witness was about to explain the effect of
being rubbed upon the animals.
Cross-examined continued: In no single instance could the animals bear
to be touched.
Did not Mrs. Smyth ask to have her legs and arms rubbed?--In the Leeds
case the lady asked to be rubbed before the convulsions came on, but
afterwards she could not bear it, and begged that she might not be
touched.
Can you point out any one point, after the premonitory symptoms, in
which the symptoms in this case differ from those of strychnine
tetanus?--There is the power of swallowing, which is taken away by
inability to move the jaw.
But have you not stated that lockjaw is the last symptom that occurs in
strychnine tetanus?--I have. I don’t deny that it may be. I am speaking
of the general rule. In the Leeds case it came on very early, more than
two hours before death, the paroxysms having continued about two hours
and a half. In that case we believed that the dose was four times
repeated. Poison might probably be extracted by chemical process from
the tissues, but I never tried it, except in one case of an animal. I am
not sure whether poison was in that case given through the mouth. We
killed four animals in reference to the Leeds case, and in every
instance we found strychnine in the contents of the stomach. In one case
we administered it by two processes, and one failed and the other
succeeded.
Re-examined: In making reports upon cases such as that which has been
referred to, we state ordinary appearances; we state the facts without
anything more.
Mr. WILLIAM HERAPATH, examined by Mr. GROVE, Q.C.: I am a Professor of
Chemistry and Toxicology at the Bristol Medical School. I have studied
chemistry for more than forty years, and toxicology for thirty. I have
experimented on the poison of strychnine. I have seen no case of a human
subject during life, but I have examined a human body after death. In
one case I examined the contents of the stomach and I found strychnine
about three days after death. There are several tests--sulphuric acid
and bichromate of potash, sulphuric acid and puce-coloured oxide of
lead, sulphuric acid and peroxide of lead, sulphuric acid and peroxide
of manganese, &c. The lower oxides of lead would not succeed. These are
all colour tests, and produce a purple colour, passing to red. Another
class of tests give a different colour with impure, but not with pure,
strychnia. The process used previous to these tests is for the purpose
of producing strychnia. I obtained evidence of strychnia by the colour
tests in the case I have mentioned. I have experimented upon animals
with regard to strychnine in eight or nine cases. I have analysed the
bodies in two cases in which I destroyed the animals myself. Both of
them were cats. I gave the first one grain of strychnia in a solid form.
The animal took the poison at night, and I found it dead in the morning.
It was dreadfully contorted and rigid, the limbs extended, the head
turned round--not to the back, but to the side--the eyes protruding and
staring, the iris expanded so as to be almost invisible. I found
strychnine in the urine which had been ejected, and also in the stomach,
by the tests I have mentioned. I administered the same quantity of
strychnine in a solid form to another cat. It remained very quiet for 15
or 16 minutes, but seemed a little restless in its eyes and in
breathing. In 35 minutes it had a terrible spasm, the extremities and
the head being drawn together, and the feet extended. I watched it for
three hours. The first spasm lasted a minute or two. The saliva dripped
from its mouth, and it forcibly ejected its urine. It had a second spasm
a few minutes afterwards. It soon recovered and remained still, with the
exception of a trembling all over. It continued in that state for three
hours. During nearly two hours and a half it was in a very peculiar
state; it appeared to be electrified all through; blowing upon it or
touching the basket in which it was placed produced a kind of electric
jump like a galvanic shock. I left it in three hours, thinking it would
recover, but in the morning I found it dead, in the same indurated and
contorted condition as the former animal. I examined the body 36 hours
after death, and found strychnia in the urine, in the stomach and upper
intestine, in the liver, and in the blood of the heart. I have
discovered strychnia in all other cases by the same tests, but I took
extraordinary means to get rid of organic matter. In all cases in which
strychnia has been given I have been able to find it, and not only
strychnia, but also the nux vomica from which it is taken. I have found
nux vomica in a fox and in other animals. The detection of nux vomica is
more complicated than that of strychnia. In one case the animal had been
buried two months. I have experimented with strychnia not in a body, but
mixed purposely with organic putrefying matter. I have found it in all
cases, whatever was the state of decomposition of the matter.
Are you of opinion that where strychnia has been taken in a sufficient
dose to poison it can and ought to be discovered?--Yes; unless the body
has been completely decomposed; that is, unless decomposition has
reduced it to a dry powder. I am of opinion from the accounts given by
Dr. Taylor and the other witnesses, that if it had existed in the body
of Cook it ought to have been discovered. I am aware of no cause for
error in the analyses, if the organic matter had been properly got rid
of. The experiments I have mentioned were made in Bristol. I have made
experiments in London, and found strychnia in the stomach, liver, and
blood of an animal.
Cross-examined by the ATTORNEY-GENERAL: I don’t profess to be a
physiologist. I have principally experimented on the stomach until
lately. I tried my chemical process on the 8th of this month with a view
to the present case. The experiment here was on a dog. I experimented on
the tissues of a cat at Bristol, and of a dog in London. I found
strychnia in the blood, the heart, and the urine of the cat, besides the
stomach. One grain was given to the dog. It was a large dog. I have seen
a cat killed with a quarter of a grain. I have said that Dr. Taylor
ought to have found strychnia.
Have you not said that you had no doubt strychnia had been taken, but
that Dr. Taylor had not gone the right way to find it?--I may have said
so. I had a strong opinion from reading various newspaper reports--among
others the _Illustrated Times_,--that strychnia had been given. I have
expressed that opinion, no doubt, freely. People have talked a great
deal to me about the matter, and I can’t recollect every word I have
said, but that was my general opinion.
Re-examined by Mr. GROVE: What is the smallest quantity of strychnia
that your process is capable of detecting?--I am perfectly sure I could
detect the 50,000th part of a grain if it was unmixed with organic
matter. If I put 10 grains in a gallon or 70,000 grains of water I could
discover its presence in the 10th part of a grain of that water. It is
more difficult to detect when mixed with organic matter. If a person had
taken a grain a very small quantity would be found in the heart, but no
doubt it could be found. I made four experiments with a large dog to
which I had given the eighth part of a grain. I have discovered it by
change of colour in the 32d part of the liver of a dog.
Mr. GROVE said he believed his Lordship was of opinion that experiments
could not be shown.
Lord CAMPBELL: We have intimated that that is our clear opinion.
Mr. ROGERS, examined by Mr. GRAY: I am Professor of Chemistry at St.
George’s School of Medicine, in London. I have made experiments upon one
animal (a dog) poisoned by strychnia. The experiments commenced at the
close of last December, and ended about ten days since. I gave it two
grains of pure strychnia in meat. Three days after death I removed the
stomach and contents, and some of the blood. The blood became putrid in
about 10 days, and I then analysed it with a view to find strychnine. I
separated the strychnine by colour tests. I cannot say how much it was
by weight. In a month or five weeks, when the matter had putrefied, I
analysed the stomach and its contents. I treated it with acidulated
distilled water, and succeeded in discovering strychnia in large
quantities about 10 days ago. I never analysed a human subject with a
view to find strychnia, but I have many times done so to find other
poisons. Strychnia must unquestionably have been discovered in this case
if it had been present and the proper tests had been used.
Cross-examined by the ATTORNEY-GENERAL: I have only made one experiment.
If the contents of the stomach were lost it would make a difference, but
not if they were only shaken up. The operation would then be more
difficult. I am a medical man. I did not analyse the tissues of the body
of the dog. If I had tried the tissues of Cook’s body it might have been
found if it was there, notwithstanding the time that had elapsed since
he died. I don’t say that the time would prevent its discovery if there.
Re-examined by Mr. GRAY: If strychnia were in the stomach a portion
would probably be smeared over the mucous membrane, and then I should
expect to find it on the surface.
Dr. HENRY LETHEBY, examined by Mr. KENEALY: I am a Bachelor of Medicine,
Professor of Chemistry and Toxicology in the London Hospital of
Medicine, and Medical Officer of Health to the City of London. I have
been engaged for a considerable time in the study of poisons and their
action on the living animal economy. I have also been frequently engaged
on behalf of the Crown in prosecutions in cases of this nature during
the last 14 years. I have been present during the examination of the
medical witnesses, and have attended to the evidence as to the symptoms
which have been described as attending the death of Cook. I have
witnessed many cases of animals poisoned by strychnine, and many cases
of poisoning by nux vomica in the human body, one of which was fatal.
The symptoms described in this case do not accord with the symptoms I
have witnessed in the case of those animals. They differ in this
respect:--In the first place I never witnessed the long interval between
the administration of the poison and the commencement of the symptoms
which is said to have elapsed in this case. The longest interval I have
known has been three-quarters of an hour, and then the poison was
administered under most disadvantageous circumstances. It was given on a
very full stomach and in a form uneasy of solution. I have seen the
symptoms begin in five minutes. The average time in which they begin is
a quarter of an hour. In all cases I have seen the system has been in
that irritable state that the very lightest excitement, such as an
effort to move, a touch, a noise, a breath of air, would send the
patient off in convulsions. It is not at all probable that a person,
after taking strychnia, could pull a bell violently. Any movement would
excite the nervous system, and bring on spasms. It is not likely that a
person in that state could bear to have his neck rubbed. When a case of
strychnia does not end fatally, the first paroxysm is succeeded by
others, gradually shaded off, the paroxysms becoming less violent every
time, and I agree with Dr. Christison that they would subside in 12 or
16 hours. I have no hesitation in saying that strychnine is of all
poisons, either mineral or vegetable, the most easy of detection. I have
detected it in the stomach of animals in numerous instances, also in the
blood and in the tissues. The longest period after death in which I have
detected it is about a month. The animal was then in a state of
decomposition. I have detected very minute portions of strychnia. When
it is pure the 20,000th part of a grain can be detected. I can detect
the tenth part of a grain, most easily in a pint of any liquid, whether
pure or putrid. I gave one animal half a grain, and I have the strychnia
here now within a very small trifle. I never failed to detect strychnine
where it had been administered. I have made _post-mortem_ examinations
on various animals killed by it. I have always found the right side of
the heart full. The reason is that the death takes place from the fixing
of the muscles of the chest by spasms, so that the blood is unable to
pass through the lungs, and the heart cannot relieve itself from the
blood flowing to it, but therefore becomes gorged. The lungs are
congested and filled with blood. I have administered strychnia in a
liquid and a solid form; I agree with Dr. Taylor that it may kill in 6
or 11 minutes when taken in a solid state in the form of a pill or
bolus. I also agree with him that the first symptom is that the animal
falls on its side, the jaws are spasmodically closed, and the slightest
touch produces another paroxysm. But I do not agree with him that the
colouring tests are fallacious. I do not agree that it is changed when
it is absorbed into the blood, but I agree with its absorption. I think
it is not changed when the body is decomposed. The shaking about of the
contents of the stomach with the intestines in a jar would not prevent
the discovery of strychnia if it had been administered. Even if the
contents of the stomach were lost the mucous membrane would, in the
ordinary course of things, exhibit traces of strychnia. I have studied
the poison of antimony. If a quantity had been introduced into brandy
and water, and swallowed at a gulp, the effect would not be to burn the
throat. Antimony does not possess any such quality as that of immediate
burning. I have turned my attention to the subject of poison for 17 or
18 years.
Cross-examined by the ATTORNEY-GENERAL: I am not a member of the College
of Physicians or of Surgeons. I do not now practise. I have been in
general practice for two or three years. I gave evidence in the last
case of this sort, tried in this court in 1851. I gave evidence of the
presence of arsenic. The woman was convicted. I stated that it had been
administered within four hours of death. I was the cause of her being
respited, and the sentence was not carried into effect, in consequence
of a letter I wrote to the Home Office. Other scientific gentlemen
interfered, and challenged the soundness of my conclusions before I
wrote that letter. I have not since been employed by the Crown.
By Mr. Justice CRESSWELL: I was present at the trial. I perfectly
remember it.
Cross-examination continued: I detected the poison. I said in my letter
that I could not speak as to possibilities, but merely as to
probabilities. I have experimented on animals for a great number of
years: on five recently. I have never given more than a grain, and it
has always been in a solid form--in pills or bread. In the case where
poison was administered under disadvantageous circumstances, it was
kneaded up into a hard mass of bread.
Mr. Baron ALDERSON: Did the animal bolt it or bite it?
Witness: I opened the mouth and put it into the throat. About half an
hour elapsed before the symptoms appeared in one case in which half a
grain had been given. In another case death took place within 13
minutes. I have noticed twitching of the ears, difficulty of breathing,
and other premonitory symptoms. There are little variations in the order
in which the symptoms occur. I have known frequent instances in which an
animal has died in the first paroxysm. I heard the evidence of Mrs.
Smyth’s death, and I was surprised at her having got out of bed when the
servant answered the bell. It is not consistent with the cases I have
seen. That fact does not shake my opinion. I have no doubt that Mrs.
Smyth died from strychnine. Cook’s sitting up in the bed and asking
Jones to ring the bell is inconsistent with what I have observed in
strychnine cases.
If a man’s breath is hurried, is it not natural for him to sit up?--It
is. I have seen cases of recovery of human subjects after taking
strychnine. There is a great uniformity in its effects; that is, in
their main features, but there is a small variation as to the time in
which they are produced.
What do you attribute Cook’s death to?--It is irreconcilable with
everything with which I am acquainted.
Is it reconcileable with any known disease you have ever seen or heard
of?--No.
Re-examined by Mr. Serjeant SHEE: We are learning new facts every day,
and I do not at present conceive it to be impossible that some
peculiarity of the spinal cord, unrecognizable at the examination after
death, may have produced symptoms like those which have been described.
I, of course, include strychnia in my answer, but it is irreconcileable
with everything I have seen or heard of. It is as irreconcileable with
strychnia as with everything else; it is irreconcileable with every
disease that I am acquainted with, natural or artificial. Touching an
animal during the premonitory symptoms will bring on a paroxysm.
Vomiting is inconsistent with strychnia. The Romsey case was an
exceptional one, from the quantity of the dose. The ringing of the bell
would have produced a paroxysm. I am still of opinion that the evidence
I gave on the trial in 1851 is correct. I am not aware that there is any
ground for an imputation upon me in respect of that evidence. I have no
reason to think Government was dissatisfied with me. I have since been
employed in Crown prosecutions. After that case Dr. Pereira came to my
laboratory and asked me, as an act of mercy, to write a letter to him to
show to the Home-office, admitting the possibility of the poison which I
found in the stomach having been administered longer than four hours
before death. I wrote the letter, drawing a distinction between what was
possible and probable, and the woman was transported for life.
Mr. R. E. GAY, examined by Mr. Serjeant SHEE: I am a member of the Royal
College of Surgeons. I attended a person named Forster for tetanus in
October, 1855. He had sore throat, muscular pains in the neck, and in
the upper portion of the cervical vertebræ. He was feverish, and had
symptoms ordinarily attending catarrh. I put him under the usual
treatment for catarrh, and used embrocations externally to the muscles
of the neck and throat, and also gargles. About the fourth day of my
attendance the muscular pains extended to the face, difficulty of
swallowing came on, the pains in the cervical vertebræ increased, also
those of the muscles of the face, particularly the lower jaw. In the
evening of the same day the jaw became completely locked, the pains came
on in the muscles of the bowels, the legs, and the arms. He became very
much convulsed throughout the entire muscular system, had frequent
involuntary contractions of the arms, and hands, and legs, his
difficulty of swallowing increased, and not a particle of food, solid or
liquid, could be introduced into the mouth. Attempting to swallow the
smallest portions brought on violent convulsions; so strong were they
throughout the system that I could compare him to nothing but a piece of
warped board. The head was thrown back, the abdomen thrust forward, and
the legs frequently drawn up and contracted; the attempt to feed with a
spoon, the opening of a window, or placing the fingers on the pulse
brought on violent convulsions. While the patient was suffering in this
manner he continually complained of great hunger, and repeatedly
exclaimed that he was hungry, and could not eat. He was kept alive to
the fourteenth day entirely by injections of a milky and farinaceous
character. He screamed repeatedly, and the noises that he made were more
like those of a wild man than anything else. On the twelfth day he
became insensible, and continued in that state until he died, which was
in the fourteenth day from the commencement of the attack of lockjaw.
The man was an omnibus driver, and when I first attended him he had been
suffering from sore throat for several days. There was no hurt or injury
of any kind about his person that would account for the symptoms I have
mentioned. His body was not opened after death, because it was
considered unnecessary. I consider his disease was inflammatory sore
throat from cold and exposure to the weather, and that the disease
assumed a tetanic form on account of the patient being a very nervous,
excited, and anxious person. His condition in life was that of an
omnibus conductor. He was a hardworking man, and had a large family
dependent upon him, and this, no doubt, acting upon his peculiar
temperament, tended to produce tetanic symptoms. The witness, in
conclusion, said he had not heard all the evidence in this case, but he
thought it right to communicate to the prisoner’s solicitor the
particulars of the case to which he had now referred, as he considered
it had an important bearing upon the charge against the prisoner.
Cross-examined by the ATTORNEY-GENERAL: The case I have mentioned was
undoubtedly one of idiopathic tetanus. It is the only one of the kind I
ever had to deal with. It arose from exposure to cold acting upon a
nervous and irritable temperament. I have a good many patients who are
nervous and irritable, but I never met with such another case. The
disease was altogether progressive from the first onset, and, although
for a short time there was a remission of the symptoms, they invariably
recurred. The locking of the jaw was one of the very first symptoms that
made their appearance.
Serjeant SHEE then addressed the Court, and said that the next witness
he proposed to call would occupy some time in examination, and, as it
was now nearly 6 o’clock, he suggested that it would be better to
adjourn the examination to the next day.
The LORD CHIEF JUSTICE said he had no objection to the course proposed
by the learned Serjeant, and he then inquired of him how much time the
case for the defence was likely to occupy.
Serjeant SHEE said he hoped to conclude the defence to-morrow; and he
should endeavour to do so if he possibly could.
The LORD CHIEF JUSTICE said there was no desire to hurry him. It was
most essential in so important an inquiry that the most ample
opportunity should be allowed for a full and satisfactory investigation.
The Court then adjourned till the following morning, at 10 o’clock.