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.