Lord Campbell: Can you not say, from the symptoms you heard, whether death was produced by tetanus, without saying what was the cause of tetanus?
Witness: Hypothetically I should infer that he died of the form of tetanus which convulses the muscles. Great varieties of rigidity arise after death from natural causes. The half-bent hands and fingers are not uncommon after natural death. The arching of the feet, in this case, seemed to me rather greater than usual.
Cross-examined by the Attorney-General: Granules are sometimes, but not commonly, found about the spine of a healthy subject—not on the cord itself; they may exist consistently with health. No satisfactory cases of the inflammation I have described have come under my notice without producing convulsions. It is a very rare disease. I cannot state from the recorded cases the course of the symptoms of that disease. It varies in duration, sometimes lasting only for days, sometimes much longer. If the patient lives, it is accompanied with paralysis. It produces no effect upon the brain which is recognisable after death. It would not affect the brain prior to death. I do not know whether it is attended with loss of sensibility before death. The size of the granules which will produce it varies. This disease is not a matter of months, unless it terminates in palsy. I never heard of a case in which the patient died after a single convulsion. Between the intervals of the convulsions I don’t believe a man could have twenty-four hours’ repose. Pain and spasms would accompany the convulsions. I cannot form a judgment as to whether the general health would be affected in the intervals between them.
You have heard it stated, that from the midnight of Monday till Tuesday Cook had complete repose. Now, I ask you, in the face of the medical profession, whether you think the symptoms which have been described proceeded from that disease?—I should think not.
Did you ever know the hands completely clinched after death except in case of tetanus?—No.
Have you ever known it even in idiopathic or traumatic tetanus?—I have never seen idiopathic tetanus. I have seen the hands completely clinched in traumatic tetanus. A great deal of force is often required to separate them.
Have you ever known the foot so distorted as to assume the form of a club foot?—No.
You heard Mr. Jones state that if he had turned the body upon the back it would have rested on the head and the heels. Have you any doubt that that is an indication of death from tetanus?—No; it is a form of tetanic spasm. I am only acquainted with tetanus resulting from strychnine by reading. Some of the symptoms in Cook’s case are consistent, some are inconsistent, with strychnine tetanus. The first inconsistent symptom is the intervals that occurred between the taking of the supposed poison and the attacks.
Are not symptoms of bending of the body, difficulty of respiration, convulsions in the throat, legs, and arms, perfectly consistent with what you know of the symptoms of death from strychnine?—Perfectly consistent. I have known cases of traumatic tetanus. The symptoms in those cases had been occasionally remitted, never wholly terminated. I never knew traumatic tetanus run its course to death in less than three or four days. I never knew a complete case of the operation of strychnine upon a human subject.
Bearing in mind the distinction between traumatic and idiopathic tetanus, did you ever know of such a death as that of Cook according to the symptoms you have heard described?—No.