In cross-examination Dr. Macnamara stated that, to the best of his judgment, Mr. Maybrick died of gastro-enteritis, not connected with arsenical poisoning, and which might have been caused by the wetting at the Wirrall races.
Dr. Paul, professor of medical jurisprudence at University College, Liverpool, and pathologist at the Royal Infirmary, stated he had made and assisted at something like three or four thousand post-mortem examinations, and that the symptoms in the present case agreed with cases of gastro-enteritis pure and simple; that the finding of the arsenic in the body, in the quantity mentioned in the evidence, was quite consistent with the case of a man who had taken arsenic medicinally, but who had left it off for some time, even for several months.
A Toxicological Study
So positive were Dr. Tidy and Dr. Macnamara of their position as to the effect of arsenic on the human system, that they subsequently published “A Toxicological Study of the Maybrick Case,” thus challenging medical critics the world over to refute them. From this study the following, in tabular form, is taken, in order to contrast the symptoms from which Mr. Maybrick suffered with those which, it will be generally admitted, are the usual symptoms of arsenical poisoning:
| Arsenical Poisoning | Mr. Maybrick’s Case |
| Countenance tells of severe suffering. | Not so described. |
| Very great depression an early symptom. | Not present until toward the end. |
| Fire-burning pain in stomach. | Not present. |
| Pain in stomach increased on pressure. | Pressure produced no pain. |
| Violent and uncontrollable vomiting independent of ingesta. | “Hawking rather than vomiting;” irritability of stomach increased by ingesta. |
| Vomiting not relieved by such treatment as was used in Mr. Maybrick’s case. | Vomiting controlled by treatment. |
| During vomiting burning heat and constriction felt in throat. | Not present. |
| Blood frequently present in vomited and purged matter. | Not present. |
| Intensely painful cramps in calves of the legs. | Not present. |
| Pain in urinating. | Not present. |
| Purging and tenesmus an early symptom. | Not present until twelfth day of illness, and then once only. |
| Great intolerance of light. | Not present. |
| Eyes suffused and smarting. | Not present. |
| Eyeballs inflamed and reddened. | Not present. |
| Eyelids intensely itchy. | Not present. |
| Rapid and painful respiration an early symptom. | Not present. |
| Pulse small, frequent, irregular, and imperceptible from the outset. | Not so described until approach of death. |
| Arsenic easily detected in urine and fæces. | Not detected, although looked for. |
| Tongue fiery red in its entirety, or fiery red at tip and margins and foul toward base. | Tongue not red; “simply filthy.” |
| Early and remarkable reduction of temperature generally. | Temperature normal up to day preceding death. |
“Maybrick’s symptoms are as unlike poisoning by arsenic as it is possible for a case of dyspepsia to be. Everything distinctive of arsenic is absent. The urine contained no arsenic. The symptoms are not even consistent with arsenical poisoning.
“Regarding the treatment adopted by the medical men, and more especially Dr. Carter’s action with regard to the meat juice, we are justified in assuming that the doctors themselves, even after a certain suggestion had been made to them, did not come to the conclusion that the illness of Maybrick was the result of arsenic.
“It is noteworthy (1) that none was found in the stomach; (2) that Maybrick was in the habit of taking drugs, and among them arsenic.
“Thus two conclusions are forced upon us: