of idiopathic tetanus and traumatic, or what I may call natural tetanus,
are marked by clear and distinct characteristics, distinguishing them
from the tetanus produced by strychnia; and I say that the tetanus which
accompanied Mr. Cook’s death is not referable to either of those forms
of tetanus. You have upon that point the evidence of witnesses of the
highest competency and of the most unquestionable integrity; and upon
their evidence I am quite satisfied you can come to no other conclusion
but that this was not a case either of idiopathic or of traumatic
tetanus. But, then, they say it may have been something else; and
various attempts have been made to set up different causes as capable of
producing this tetanic disease. And, first, we have the theory of
general convulsions; and Mr. Nunneley, having gone through the bead-roll
of the supposed infirmities of Mr. Cook, says, “Oh, this may have been a
case of general convulsions. I have known general convulsions to assume
a tetanic character.” “Well, but pause a moment, Mr. Nunneley, have you
ever seen one single case in which death arising from general
convulsions, accompanied with tetanic symptoms, has not ended in the
unconsciousness of the patient before death!--No, I never knew such a
case--not one. But in some book or other, I am told that there is some
such case reported”; and he cites, not for that purpose, I think, but he
cites, with reference to general convulsions being sometimes accompanied
with tetanic symptoms, and ending in death, a very eminent author of the
present day. I mean Dr. Copland. Dr. Copland is living, and Dr. Copland
might have been called. The author of the book, I apprehend, would stand
before you as a higher authority than a man who merely quotes the book
as the foundation of his knowledge. Dr. Copland might have been called.
Dr. Copland was not called, notwithstanding the challenge which I threw
out. Why? Because it is infinitely better in such a case to call
together from the east and from the west practitioners of more or less
obscurity, instead of bringing to bear upon the subject the light of
science which is treasured up in the breasts of the eminent
practitioners with whom this great city abounds. Dr. Copland is not
called; but I say, as regards general convulsions, the distinction is
plain, that where they destroy the patient they destroy consciousness;
and here it is unquestionably the fact, that to the last moment of Mr.
Cook’s existence, until his burst heart ceased to beat, his
consciousness remained.
[Sidenote: Attorney-General]
But then comes another supposed condition from which death in this form
may be said to have resulted, and that is the case which was intended to
be set up by a very eminent practitioner, I mean Mr. Partridge. It seems
that in the post-mortem examination of Mr. Cook, when the spinal marrow
was investigated, certain granules were found, and this is seized upon.
It is said, “Oh, those granules may have occasioned tetanic convulsions
similar to those which were found in Mr. Cook’s case,” and a very
eminent gentleman is called to give his opinion upon that subject. I
admit him to be not only a man of great eminence, but a man of the
highest honour and the most perfect veracity. I allude to Mr. Partridge.
I must distinguish between him and other of my learned friend’s
witnesses. Some there were who would not be induced, for any
consideration in the world, to swerve from what they believed to be the
truth. Mr. Partridge is called here to prove that this was a case of
what he called arachnitis--inflammation of the arachnoid in consequence
of the granules, or some other abnormal condition. I asked him the
symptoms which he would find in such a case. I called his attention to
what evidently had not been done before, namely, the symptoms of Mr.
Cook’s case; and I asked him, in simple, straightforward terms,
whether, looking at those symptoms, he would pledge his opinion, in the
face of the medical world and the Court, that this was a case of
arachnitis, and he candidly admitted that he would not assert that this
was in his opinion a case of arachnitis.
Then we have the gentleman who comes all the way from Scotland to inform
us, as the next proposition, that Mr. Cook’s was a case of epileptic
convulsions with tetanic complications. Now, I asked him this question,
“Did you ever know a case of epilepsy, with or without tetanic
convulsions, in which consciousness was not destroyed before the patient
died?” He said, “No; I cannot say that I ever did, but I have read in
some book that such a case has occurred.” “Is there anything to make you
think that this was epilepsy?--Well, it may have been epilepsy, because
I do not know what else to ascribe it to; but I must admit that epilepsy
is characterised generally by a loss of consciousness.” “Well, then,
what difference would tetanic complications make?” That he is unable to
explain. I remind you of that species of evidence in which the witnesses
resorted to the most speculative reasoning, and put forward the barest
possibilities without the shadow of a foundation. But this I undertake
to assert, and I refer to the evidence to prove it, that there is not a
single case either to which they have spoken as coming within their own
experience, or of which they have spoken as the result of reading, in
which there were the formidable and decisive symptoms of marked tetanus
which existed in this case of Mr. Cook.
[Sidenote: Attorney-General]
Having gone through this evidence, I think we have four sets of
diseases--general convulsions, arachnitis, epilepsy proper, and epilepsy
with tetanic complications. I expected that we had pretty well exhausted
the whole of those scientific theories, but we were destined to have
another that assumed the formidable name of angina pectoris. I do not
know whether it struck you as remarkable that when my learned friend
opened this case for the defence he never ventured to assert what would
be the nature of the disease to which he would endeavour to refer the
symptoms of Mr. Cook; and it must, I think, have struck you as a very
remarkable thing that no less than four or five distinct and separate
theories are set up by the witnesses who appear on the part of the
defence--general convulsions, arachnitis, epilepsy with tetanic
complications, and, lastly, angina pectoris. My learned friend had,
however, this advantage in not stating to you what was the theory that
his medical witnesses would endeavour to set up, because, one after
another, I must admit they took me entirely by surprise. The gentleman
who was called yesterday at the last moment, and who talked of angina
pectoris, would not have escaped quite so easily if I had had the books
to which he referred under my hand, and had been able to expose, as I
would have done, the ignorance or the presumption of the assertion which
he dared to make. I say ignorance or presumption, or, what is worse, an
intention to deceive. I assert it in the face of the whole medical
profession, and I am satisfied I shall have their verdict in my favour.
[Sidenote: Attorney-General]
But it is a fact which I am entitled to dwell upon, that all those
medical witnesses, one and all, differed in the views which they take in
this case. There is this remarkable coincidence between the views of
some of them and the views of the witnesses whom I called--Mr. Partridge
and Dr. Robinson, two of the most respectable witnesses they called, ay,
and Dr. Letheby himself, strongly as he was biassed in favour of the
defence, being three of the most eminent of the witnesses whom my
learned friend brought forward, agreed with the statement made by Sir
Benjamin Brodie, and supported by other witnesses whom I brought before
you, that in the whole of their experience, in the whole range of their
learning and information, they knew of no known disease to which the
symptoms of Mr. Cook could possibly be referred. When such men as those
tell us such a fact, I cannot but submit to you that it is impossible to
exaggerate its importance. But, then, if it be the fact that no known
disease can account for such symptoms as those of Mr. Cook, and that
they are referable to poison alone, can any one entertain a doubt that
that poison was the poison of strychnia? The symptoms, at all events
from the time the paroxysm set in, are precisely the same. Distinctions
are sought to be made by the subtlety of the witnesses for the defence
between some of the antecedent symptoms and some of the appearances
after death; but I think I shall show you beyond all possibility of
contradiction, that those distinctions are imaginary, and have no
foundation in fact. I think I may take this, however, along with me as I
go on, that the witnesses called for the defence admit this fact, that
from the time the paroxysm set in, of which Mr. Cook died, until the
time of the death, the symptoms are precisely similar to the symptoms of
tetanus from strychnia. But, then, they say, and this is worthy of your
most attentive consideration, that there are points of difference which
have led them to the conclusion, or some of them at all events, that
those symptoms could not have resulted from strychnia. Let us see what
they are. In the first place, they showed that the period which elapsed
between the supposed administration of the poison and the first
appearance of the symptoms was longer than they have ever observed in
animals upon which they have experimented. Now, the first observation
which arises there is this, that there is a known difference between
animal and human life, in the power with which specific things act upon
its organisation, and it may well be that the poison administered to a
rabbit will produce its effect in a given time; it by no means follows
that it will produce effect in the same time upon an animal of a
different description, and still less does it follow that it will
exercise its baneful influence in the same time upon a human subject.
The whole of the evidence on both sides tends to establish this fact,
that not only in individuals of different species, but between
individuals of the same species, the same poison and the same dose will
produce effects different in degree, different in duration, and
different in power. But, again, it is perfectly notorious that the
rapidity with which the poison begins to work depends materially upon
the mode of its administration. If it is administered as a fluid, it
acts with great rapidity; if it is administered in a solid state, its
effects come on more slowly; and if it is administered in some indurated
substance, it will act with still greater tardiness; and if that
substance is difficult of solution, then the period will be still longer
before the substance, having become dissolved, is acted upon by the
absorbents and taken up into the system.
[Sidenote: Attorney-General]
Now, what was the period at which this poison began to act after its
administration, assuming it to have been poison for the purpose of
argument? It seems, from Mr. Jones’ statement, that the prisoner came
and administered these pills; he saw him administer the pills somewhere
about eleven o’clock, so that they were not administered upon his first
arrival. The patient, as though with an instinctive sense of the peril
which impended, strenuously resisted the attempt to make him take them,
and no doubt those remonstrances and the endeavour to overcome them
occupied some period of time. The pills at last were taken, and,
assuming them to have contained strychnia (which I only do now for the
purpose of argument), how soon did they begin to operate? Mr. Jones says
he went down after this and had his supper, and came back about twelve
o’clock. Upon his return to the room, after a word or two of
conversation with Cook, he proceeded to undress and go to bed; and he
had not been in bed ten minutes before the warning came that another of
these paroxysms was about to take place. The maid-servants put it still
earlier; they say that about ten minutes before twelve the first alarm
was given, which would make the interval little more than three-quarters
of an hour from the taking of the pills and the first manifestation of
the symptoms. When, therefore, my learned friend’s witnesses tell us
that it took an hour and a half or two hours, we have here another of
those exaggerated determinations to see the facts only in the way that
will make most for the view which they think proper to put forward. I
say it certainly was not more than an hour, and I find in some of the
experiments that have been made that the duration of time before which
the poison began to work has been little less, if any less, than an
hour. Mr. Morley, who is as much entitled to your attention as Mr.
Nunneley--indeed, when I contrast the way in which the two men gave
their evidence, I am paying him but a poor compliment when I say that he
is as worthy of attention as Mr. Nunneley--Mr. Morley says in his
evidence that five or six minutes, or something less than an hour, is
the period which he observed the poison required to produce its effects
upon animals, and in every one of the cases which we have got it will be
seen that more than an hour was necessary. In the case of the girl at
Glasgow, though I see the medical gentleman speaks of twenty minutes
when he was called in, he could have only had that information from the
statement of some of the people about. I see the nurse says it was
three-quarters of an hour before the pills began to work upon the girl.
There may have been some cause for the pills not beginning to take
effect within a certain time after their administration; it would be
very easy to mix them with some substance that should render them
difficult of solution; nay, which might retard their action. I cannot
for a single moment bring myself to believe, if in all other respects
you are perfectly satisfied that the symptoms, the consequences, and
effects were analogous and similar to those produced by strychnia, it is
not because those pills may have taken a quarter of an hour or a longer
time to manifest their working, it is not on that account you will
hesitate to come to the conclusion that strychnia was administered in
this case. But then they say, yes, but the premonitory symptoms were
wanting here. They tell us in animals they observed that the animal
manifests first some uneasiness, shrinks, and gathers itself into
itself, as it were, avoids movement, and then certain involuntary
twitchings about the head come, those being the premonitory symptoms
before the paroxysms set in. They say there were no premonitory symptoms
in Cook’s case; I utterly deny that proposition--I say there were
premonitory symptoms of the most marked character, though he did not
describe them in language. He is lying in bed--he suddenly starts up in
an agony of alarm. What made him do that? Was there nothing premonitory,
nothing that warned him that the paroxysm was coming? It is clear there
must have been. He jumps up in his bed, and says, “Fetch me Palmer, I am
going to be ill, as I was last night.” What was it but that he knew the
symptoms that attended him on the previous evening were now warning him
of what he might expect in a short period, unless succour could be
obtained? He sits up, and he prays to have his neck rubbed. What was the
feeling about the neck but a premonitory symptom which was to precede
the paroxysm which presently supervened? He says, “Rub my neck, it gives
me comfort to have it done.”
[Sidenote: Attorney-General]
But here again they take exception, and they say this could not have
been tetanus from strychnia, because animals cannot bear to be touched;
a touch brings on the paroxysm; not only a touch but a breath of air, a
sound, a word, a movement of any one near, will bring on a recurrence of
the paroxysm. True; but that is after the paroxysm has once been set up,
or when it is just about to begin. It is quite clear that those
witnesses who come and say that the fact of Mr. Cook having desired to
have his neck rubbed is a fact to prove that this could not be a death
from tetanus, have either wilfully suppressed the knowledge in their own
minds of the evidence they had heard, or they had paid no attention to
it; because in two cases of death from strychnia we have shown the
patient endured the touching of the limbs, and found satisfaction from
it. In Mrs. Smyth’s case, when her legs were distorted, in the agony of
the convulsion she prayed and entreated to have them straightened; she
found no additional pain from that operation. The lady at Leeds, in the
case which Mr. Nunneley himself attended, implored her husband, between
the spasms, to rub her legs and her arms, in order to overcome and
subdue their rigidity. That case was under his own knowledge, and, in
spite of it, although he detected afterwards strychnia in the body of
that unhappy woman, he dares to come forward here and say that the fact
of Mr. Cook having before the paroxysm tolerated rubbing, and found
comfort in it, proves that this could not have been a death from
strychnia. What think you of the honesty of such a witness? But there is
a third case, which is the case of Mr. Clutterbuck, spoken to by Mr.
Moore. That gentleman had taken an overdose of strychnia, and he
suffered from all the pains of tetanus; his only comfort was having his
limbs rubbed; and therefore, I say, to contend and to endeavour to
persuade a jury that the fact of Cook’s having had his neck rubbed
proved that this was not tetanus from strychnia, proves, I say, nothing
but the dishonesty and insincerity of the witnesses who can dare to put
forward such a pretence.
But, then, they go further, and they say that Mr. Cook was able to
swallow. So he was, before the paroxysm came on. Nobody ever pretended
that he could swallow after the paroxysm came on. He swallowed the
pills, and, what is very curious, and, as they think, bears out and
illustrates a part of their theory, is this. It was the act of
attempting to swallow the pills--the sort of movement that must have
taken place in raising his head and neck for the purpose--that
immediately brings on the violent paroxysm of which he died. So far from
that in the slightest degree militating against the supposition that
this was a case of poisoning by strychnia, it is strongly and decisively
conclusive in its favour.
[Sidenote: Attorney-General]
But then they take us to the appearances after death, and they say that
there are circumstances to be found which militate against this being a
case of strychnia poisoning. Let us see what they are. In the first
place, they say the limbs became rigid either at the time of death or
immediately after, and that ought not to be found in a case of tetanus
from strychnia. Mr. Nunneley says, “In all cases upon which I have
experimented I have found the animals become flaccid before death, and
they do not become again rigid after it.” I can hardly believe that
statement, and I certainly was not a little surprised when the very next
witness who got into the box (Mr. Herapath, of Bristol) told us he had
made two experiments upon cats, and killed them both. He described them
as “indurated and contorted.” Those were his expressions when he found
them some hours after death. The presence of rigidity in the body at or
immediately after death here is put forward on the part of Mr. Nunneley
as one of the grounds upon which he says this was not a death by
strychnia, although Dr. Taylor had told us that in the case of one of
the cats he killed the rigidity after death was such that upon taking
the animal by the hind legs and holding it up in the air, the body
maintained its horizontal natural position, as though the animal had
been upon its four legs upon a plain surface. Notwithstanding that
evidence, Mr. Nunneley had the audacity to say that he did not believe
this was a case of poisoning by strychnia, because there had been
rigidity of the limbs--because the feet were distorted, the hands
clenched, and the muscles rigid as the unhappy man exhibited prior to
his death. The very next witness called upon the other side produced two
instances in which the animals were indurated from one end of their
bodies to the other. As he says they were contorted in all their limbs,
and so they remained, it shows what you are to think of the honesty of
this sort of evidence, in which facts are selected because they make in
favour of the particular hypothesis of the party who brings them
forward.
[Sidenote: Attorney-General]
Then the next thing that is said is that the heart in this case was
empty. In the animals Mr. Nunneley and Dr. Letheby have operated upon I
think the heart has been found full. I do not think that applies to all
the cases; I think they make some exceptions; and, as I said at the
outset, it is a remarkable fact connected with the history of this
particular poison, that you never can rely upon the precise form or
order which the symptoms before death and the appearances after it will
assume. There are only certain great, leading, marked characteristic
features--the collateral incidents are capable of infinite variety. We
have here the main marked characteristic features, and we have, what is
more, collateral incidents similar to the cases in which the
administration of strychnia and the fact that death was caused by it
are beyond the possibility of dispute. In the very evidence which has
been adduced of two cases of poisoning, Mrs. Smyth’s and the Glasgow
girl, in both the heart had been found contracted and emptied; and it is
obvious to any one who reflects for a single moment that the question
whether the heart shall be found congested or the lungs congested must
depend upon the immediate cause of death, and we know that in cases of
tetanus death may result from more than one cause. All the muscles of
the body are subject to the exciting action of this powerful poison, but
no one can tell in what order those muscles will be affected, or where
the poisonous influence will put forth the fulness of its power. If it
act upon the respiratory muscles, and arrest the play of the lungs, and
with it the breathing of atmospheric air, the result will be that the
heart will be left full; but if some spasm seizes on the heart,
contracting it and expelling from it the blood that it contains, and so
produces death, why the result will be that the heart will be found
empty, and the other vessels gorged with blood. So that you have never
perfect certainty as to how those symptoms will manifest themselves
after death; but that is again put forward as if the fact of the heart
having been found empty is a conclusive fact against death having in
this case taken place from strychnia. Yet those men who came here to
make those statements as witnesses under the sanction of scientific
authority must have heard both those cases spoken to by the medical
gentlemen who examined those two unfortunate patients after death, and
who told us that in both cases the heart was found empty. That gets rid
of that matter. And so again with regard to the congestion of the brain
and other vessels the same observation applies. If instead of being
killed by the action of the poison upon the respiratory muscles or by
its action upon the heart, death is the result of a long series of
paroxysms exhausting the vital power of the victim, then you expect to
find the brain and other vessels congested by those series of
convulsions and spasms. As death takes place from one or other of those
causes, so will be the appearance of the heart, the brain, and the body
after death. There is nothing, I say, in this for a single moment to
negative the conclusion which you would otherwise arrive at from the
symptoms which appeared in this man’s body at the time of his death and
immediately afterwards--that those are the symptoms of tetanus of the
strongest and most aggravated kind; that is a proposition about which, I
think, you can entertain no doubt. If so, are they referable to tetanus
of any other description? Certainly not; because, as Sir Benjamin Brodie
told you, the course of the symptoms is marked by characteristics of
unquestionable difference.
[Sidenote: Attorney-General]