On re-examination Dr. Julius stated that “vomiting in early pregnancy had nothing to do with the burning sensation in the mouth and throat; that the sickness of Miss Bankes was decidedly not of the same character as that of pregnancy, nor was the diarrhœa such as pregnant women sometimes suffer from.” Dr. Bird, and not the witness, prescribed bismuth, acetate of lead, and nitrate of silver.
Dr. Bird, who from service in the Crimea in 1855 had had great experience and opportunity of studying bowel complaints, confirmed the evidence of his partner.
“None of the symptoms were in his opinion reconcileable with any known disease, but were such as could be accounted for from the administration of small doses of antimony or arsenic. The prisoner, he said, told him, on one occasion, that the deceased had seen her sister, and that it had very much excited her, and in consequence witness told him that it would be better if she did not come again. On the 30th he told the prisoner that he wished to take away a portion of one of her evacuations, that it might be examined under the microscope to see if any purulent matter was in it, that we might judge if there was any ulceration of the bowels—that the prisoner poured out a portion into a tumbler, which he tied over with an old newspaper, and that the witness took it to his surgery, marked it No. 2, sealed it with his own seal, and preserved it intact until delivered to Dr. Taylor with the bottle No. 1 which Dr. Julius had obtained. A third portion of an evacuation was shown to him by the prisoner, which he put into a white jam-pot, and marked No. 3. He was downstairs at the moment Miss Bankes died, but saw her every minute or two before that. He gave an ample quantity of every ingredient used in his prescriptions so as to afford a sufficient opportunity for analyzation.”
On cross-examination, he described the various remedies he prescribed, none of which would account for the symptoms, and stated that he formed his opinion that it was a case of slow poisoning by an irritant, not only from what Dr. Julius and the prisoner told him, but from the vomitings, the motions, and the lady’s own account of her symptoms.
Mr. Caudle, the assistant of Messrs. Julius and Bird, described the medicines he compounded, and Dr. Buzzard detailed the transmission of the bottles of evacuations to Dr. Taylor.
POST-MORTEM EXAMINATION.
Mr. Barwell, Assistant-Surgeon of the Charing Cross Hospital, who, with Mr. Palmer, of Mortlake, made a post-mortem examination of the body on the 4th of May, said:—
“I found the back part of the body externally of a dark purple, being full of blood from the position in which the body lay: I gathered from that that the blood was more fluid, I should say, than usual. The arms were perfectly flexible; legs very rigid; feet bent downwards and turned in, and the muscles at their bottoms very rigid, indicating cramp or spasm in the lower extremities; the abdomen drawn in and the muscles tense and hard; the tongue rough, and the papillæ more elevated than usual. There were no signs of what I could call aphthœ; the face was much emaciated and of a dull earthy colour; lower lip drawn in under the upper teeth; front of the body generally of this dull earthy colour; brain perfectly healthy; nothing wrong about the lungs—they were healthy. I saw that the liver was firm, full-sized, rather large, but did not then cut into it. I examined the uterus, and found the common signs of pregnancy and a fœtus of somewhere between the fifth and seventh week; the heart and great vessels connected with it were perfectly healthy. I examined the liver subsequently; it was slightly fatty, rather fatty; the remainder hard. The liver when it becomes fatty is usually soft, but in this instance it was hard, and it was coloured in the usual manner—speckled. Gullet healthy, no signs of inflammation on it. The outside of the stomach, the smaller end, that nearer the intestine, was red; the larger end, that where the gullet enters, was of a dark colour; in the centre it was pale. On examining the inside of the stomach, the narrow part or small end was also red; at the larger end was a black patch of effused blood; near the small end the mucous membrane was congested, that is the other end from the black spot and near where the red was. The contents of the stomach were a brown mucus mixed with blood and some bile, I should say. There were no ulcers in the stomach, nor appearance of acute inflammation. On the outside of the intestine I noticed on the 4th of May (the first examination) that its commencement was very red, the small intestines generally were inflated and minutely injected with blood, and in certain spots they were roughened by lymph, the result of inflammation, and glued together at certain turns where this lymph or glutinous inflammation was effused; they were coherent together from that cause; that did not apply to the entire length of the intestines, only to a few parts, and chiefly quite the lower parts. Those are the external symptoms. Internally, the first part of the intestine (the duodenum) was inflamed for about three inches from its commencement, but the mucous membrane was quite firm, and there was no ulceration. From that point the rest of the mucous membrane was only slightly injected, not inflamed. In the next intestine, the jejunum, the mucous membrane was still firm; in places the vessels were injected with its own blood, but this only in spots. In the ilium, or lower intestine, there was much the same appearance at the commencement as in the last, except that approaching the lower part the injections increased very much, and at last, about 3 feet from its end, the mucous membrane was greatly altered; there was a deposit of lymph therein, and a thickening of the membrane; an ill-organized granular lymph; the membrane at the same time was roughened, and the glands, which are in the intestine there, were less visible than usual. This deposit of lymph did not begin in the glands, but went over the whole surface of the intestine, and concealed the glands instead of rendering them more prominent—instead of being deposited in the glands, was rather around them at first. This brings me to the cæcum. On its mucous membrane were many very large spots. The appearances within the cæcum indicated very serious disease indeed—inflammation, sloughing, ulceration, and suppuration. Those appearances diminished as I went lower down the intestines. When I reached the termination, the colon, there was still ulceration, but in a minor degree. In the rectum there were three ulcerations. I should also say that in the cæcum were black spots of effused blood, which were also found along the rest and in the rectum. I have heard the evidence given of the symptoms exhibited during life, and the treatment adopted. Taking those into consideration, and the post-mortem appearances, they are not reconcileable with any natural disease with which I am acquainted.”
By the Court.—“What is the conclusion you have formed?”
Witness.—“That the symptoms and appearances together have resulted from some irritant, administered frequently during life.”