Dr. George Robinson, examined by Mr. Kenealy: I am a licentiate of the Royal College of Physicians, and Physician to the Newcastle-on-Tyne Dispensary and Fever Hospital. I have devoted considerable attention to the subject of pathology. I have practised as a physician for ten years. I have heard the whole of the medical evidence in this case. From the symptoms described, I should say that Cook died of tetanic convulsions, by which I mean, not the convulsions of tetanus, but convulsions similar to those witnessed in that disease. The convulsions of epilepsy sometimes assume a tetanic appearance. I know no department of pathology more obscure than that of convulsive diseases. I have witnessed post-mortem examinations after death from convulsive diseases, and have sometimes seen no morbid appearances whatever; and in other cases the symptoms were applicable to a great variety of diseases. Convulsive diseases are always connected with the condition of the nerves. The brain has a good deal to do with the production of convulsive diseases, but the spinal cord has more. I believe that gritty granules in the region of the spinal cord would be very likely to produce convulsions, and I think they would be likely to be very similar to those described in the present case. I think that from what I have heard described of the mode of life of the deceased, it would have predisposed him to epilepsy. I have witnessed some experiments with strychnia, and have performed a few. I have also prescribed it in cases of paralysis.
By the Attorney-General: I have seen twenty cases where epilepsy has been attended by convulsions of a tetanic character. I have never seen the symptoms of epilepsy proceed to anything like the extent of the symptoms in Cook’s case. I never saw a body in a case of epilepsy so stiff as to rest upon the head and the heels. I never knew such symptoms to arise in any case except tetanus. When epilepsy presents any of these extreme forms it is always accompanied by unconsciousness. In almost every case of epilepsy the patient is unconscious at the time of the attack. In cases of epilepsy I have found gritty granules on the brain; and any disturbing cause in the system, I think, would be likely to produce convulsions. I believe that the granules in this case were very likely to have irritated the spinal cord, and yet that no indication of that irritation would have remained after death. I think that these granules might have produced the death of Mr. Cook.
The Attorney-General: Do you think that they did so?
Witness: Putting aside the assumption of death by strychnia, I should say so.
The Attorney-General: Are not all the symptoms spoken to by Mr. Jones indicative of death by strychnia?
Witness: They certainly are.
The Attorney-General: Then it comes to this—that if there were no other cause of death suggested, you would say that the death in this case arose from epilepsy?
Witness: Yes.
By Serjeant Shee: Epilepsy is a well-known form of disease which includes many others.
Dr. Richardson said: I am a physician, practising in London. I have never seen a case of tetanus, properly so called, but I have seen many cases of death by convulsions. In many instances they have presented tetanic appearances without being strictly tetanous. I have seen the muscles fixed, especially those of the upper part of the body. I have observed the arms stiffened out, and the hands closely and firmly clinched until death. I have also observed a sense of suffocation in the patient. In some forms of convulsions I have seen contortions both of the legs and the feet, and the patient generally expresses a wish to sit up. I have known persons die of a disease called angina pectoris. The symptoms of that disease, I consider, resemble closely those of Mr. Cook. Angina pectoris comes under the denomination of spasmodic diseases. In some cases the disease is detectable upon post-mortem examination; in others it is not. I attended one case. A girl ten years old was under my care in 1850. I supposed she had suffered from scarlet fever. She recovered so far that my visits ceased. I left her amused and merry in the morning; at half-past ten in the evening I was called in to see her, and I found her dying. She was supported upright, at her own request; her face was pale, the muscles of the face rigid, the arms rigid, the fingers clinched, the respiratory muscles completely fixed and rigid, and with all this there was combined intense agony and restlessness, such as I have never witnessed. There was perfect consciousness. The child knew me, described her agony, and eagerly took some brandy-and-water from a spoon. I left for the purpose of obtaining some chloroform from my own house, which was thirty yards distant. When I returned her head was drawn back, and I could detect no respiration; the eyes were then fixed open, and the body just resembled a statue; she was dead. On the following day I made a post-mortem examination. The brain was slightly congested, the upper part of the spinal cord seemed healthy, the lungs were collapsed, the heart was in such a state of firm spasm and solidity, and so emptied of blood, that I remarked that it might have been rinsed out. I could not discover any appearance of disease that would account for the death, except a slight effusion of serum in one pleural cavity. I never could ascertain any cause for the death. The child went to bed well and merry, and immediately afterwards jumped up, screamed, and exclaimed, “I am going to die!”