Mr. Serjeant Shee: We shall be able to show that there have been such cases.
Cross-examination continued: Do you not know that very lately there was a case in the London Hospital, a case in which tetanus came on so rapidly and so unaccountably, that it was referred to strychnine, and it was thought necessary to examine the stomach of the patient?—I know that such an opinion was entertained before the history of the case was investigated. I have heard that no strychnine was found. In that case old syphilitic sores were discovered.
By Lord Campbell: I did not see the patient, who was under the care of the house-surgeons, who are now in court.
Cross-examination continued: Might not the irritation of a syphilitic sore, by wet, cold, drink, mercury, and mental excitement, lead to tetanic symptoms?—I do not think that that is very likely. The irritation which is likely to produce tetanus is the sore being exposed to friction, to which syphilitic sores in the throat are not exposed. I should class tetanus arising from the irritation of a sore as “traumatic.” Cases very rarely occur which it is difficult to class as either “traumatic” or “idiopathic.” I should class tetanus arising from irritation of the intestines as “idiopathic.” The character of the spasms of epilepsy is not tetanic.
Not of the spasms; but are not the contractions of epilepsy sometimes continuous, so that the body may be twisted into various forms, and remain rigidly in them?—Not continuously.
For five or ten minutes together?—I think not.
Does it not frequently happen that general convulsions, no cause or trace of which in the form of disease or lesion is to be found in the body after death, occur in the most violent and spastic way, so as to exhibit appearances of tetanic convulsions?—No instance of the kind has come under my observation.
Do you agree with this opinion of Dr. Copeland, expressed in his Dictionary of Practical Medicine, under the head “General Convulsions.” “The abnormal contraction of the muscles is in some cases of the most violent and spastic nature, and frequently of some continuance, the relaxations being of brief duration, or scarcely observable, and in others nearly or altogether approaching to tetanic?”—I would rather speak from my own observation. I have not observed anything of the kind.
Does it not happen that a patient dies of convulsions, spastic in the sense of their being tumultuous and alternating, and chronic in the sense of exhibiting continuous rigidity, yet after death no disease is found?—It does not often happen to adults.
Does it sometimes?—I do not know, nor have I read of such a case. I have no hesitation in saying that people may die from tetanus and other diseases without the appearance of morbid symptoms after death.