As a congeries, would they be still more likely to produce it?—Yes.
Cross-examined by the Attorney-General: I am a general practitioner, and am parochial medical officer. I have had personal experience of two cases of idiopathic tetanus. What I have said about mental and sensual excitement, and so on, has not come within my own observation. In the case of Catherine Watson, I saw the patient at about half-past ten at night. She had been ill nearly an hour, and had five or six spasms. She had gone about her usual duties up to evening. She felt a slight lassitude for two days previous to the attack. It was only by close pressing that I ascertained that lock-jaw came on about an hour or two after I was called in. The case of Coupland was that of a young child between three and four years old. I was attending the mother, and saw the child in good health half an hour before it came on. It was seized with spasm, what I conjectured to be of the diaphragm, and died in about half an hour. I had seen the child asleep, but I did not examine it. I don’t know whether I saw the face of the child, but it was in bed; I judged that it was asleep.
Is that the same as seeing it asleep?—Sometimes a medical man can form a better judgment than a lawyer. Mr. Smith applied to me to be a witness in this case. I communicated to him the case of Catherine Watson, as resembling the case of Cook. I furnished my notes to be copied the night before last. I have been here since the commencement of the trial. I have been at all the consultations. I began the experiments for this case in January. I had made experiments before. That was eight or ten years ago. I then found out that strychnia could be discovered by chemical and physiological tests. I killed dogs, cats, rabbits, and fowls. The doses I administered were from three-quarters up to two grains. To dogs, the smallest quantity administered was a grain. In four cases, I killed with one grain, five with a grain and a half, one with a grain and a quarter, and two with two grains. I never killed a dog with half a grain of strychnia, and therefore never experimented to find that quantity after death. I have always found the brain and heart highly congested. The immediate cause of the fulness of the heart is, that the spasm drives the blood from the small capillaries into the large vessels. The spasm of the respiratory muscles prevents the expansion of the lungs. The congestion of the brain is greatest when the animal was young, and in full health. It does not depend upon the frequency of the spasms. I have seen cases of traumatic tetanus. I have had two in my own practice. One lasted five or six days, the other six or seven days, and the patient recovered. I have never seen a case of strychnia in the human subject. So far as I can judge, Cook’s was a case of epileptic convulsions, with tetanic complications. Nobody can say from what epilepsy proceeds. I have not arrived at any opinion on the subject. I have seen one death from epilepsy. The patient was not conscious when he died. I can’t mention a case in which a patient dying from epilepsy has preserved his consciousness to the time of death.
You have been reading up this subject?—I am pretty well up in most branches of medicine. (A laugh.) I know of no case in which a patient dying from epilepsy has been conscious. My opinion is Cook died of epileptic convulsions with tetanic complications.
By Lord Campbell.—That is a disease well known to physicians. It is mentioned in Dr. Copland’s Dictionary.
Examination continued. I believe that all convulsive diseases, including the epileptic forms and the various tetanic complications, arise from the decomposition of the blood acting upon the nerves. Any mental excitement might have caused Cook’s attack. Cook was excited at Shrewsbury, and wherever there is excitement there is consequent depression. I think Cook was afterwards depressed. When a man is lying in bed and vomiting he must be depressed.
This gentleman was much, overjoyed, at his horse winning, and you think he vomited in consequence?—It might predispose him to vomit.
I am not speaking of “mights.” Do you think that the excitement of the three minutes on the course at Shrewsbury on the Tuesday accounts for the vomiting on the Wednesday night?—I do not. I find no symptoms of excitement or depression reported between that time and the time of his death. The white spots found in the stomach of the deceased might, by producing an inflammatory condition of the stomach, have brought on the convulsions which caused death.
The Attorney-General.—But the gentlemen who made the post-mortem examination say that the stomach was not inflamed.
Witness.—There were white spots, which cannot exist without inflammation. There must have been inflammation.