The Most Extraordinary Trial of William Palmer, for the Rugeley Poisonings, which lasted Twelve Days

by Anonymous

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.