Dr. J. E. D. Rodgers, Professor of Chemistry in Knowle College, but for seventeen years at the Grosvenor School, agreed with Dr. Richardson that chlorate of potass would have no effect in eliminating arsenic or antimony from the human system; that the absence of arsenic or antimony from the tissues, and especially from the liver, would cause him to doubt whether the allegation of poisoning was correct, and that he did not think it possible to find it in the blood and not in the liver, “as the blood in the heart must be regarded as a sample of the whole 28 lbs. circulating in the system, and, if you find the poison in one small portion, you must find it wherever the blood flows.” He confirmed the amount of arsenic said to be in bismuth, and had found antimony in grey powder: should expect to find, in a case of slow poisoning, the symptoms spoken to by Dr. Richardson, and, if he did not find any arsenic in a body from which an evacuation containing one-sixth of a grain came, it would lead him to doubt whether the experiment had been correct.
Dr. J. L. W. Thudichum, Lecturer on Chemistry at the Grosvenor School, and a pupil of Liebig’s, attributed the death to what he called diphtheritic dysentery, of which he had seen two cases, and, on opening the body in one case, found the false membrane from which the disease takes its name. The only medical work in which he had seen this form of dysentery described was Rokitansky’s Morbid Anatomy.[177] It was not, however, at all necessary to find the false membrane, as it might be broken up and discharged, and hearing that shreddy matters were found in the evacuations, would confirm his view. He quite concurred with the previous witnesses as to the symptoms they would expect to find in a case of slow arsenical or antimonial poisoning. He had analysed grey powder and bismuth. In the former he found caustic and carbonate of lime, mercury partly oxidised, silica, with phosphate of iron, arsenic and antimony—more arsenic than antimony; in the bismuth he found both arsenic and antimony—more than a trace—enough to answer the test two or three times—an appreciable quantity. “I dare say,” he said, “there was half a grain in 20 grains. It is almost necessary, from the mode of its preparation, that it should contain arsenic.”
On cross-examination, the witness admitted that he had not made any quantitative analysis, because they were so laborious; had used in his experiment about one-sixteenth of 2 ounces of the grey powder, which he dissolved; neither the grey powder nor the bismuth had anything to do with the death of Miss Bankes, but the fact of bismuth containing arsenic might account for the traces in the evacuation, and if antimony was taken in a medicine it might account for the analysis, but this would depend upon the quantity in the medicine.
Dr. Cornelius Webb, Lecturer on Medical Jurisprudence and Toxicology at the Grosvenor School, and Physician to the Great Northern Hospital, said:—
“From all he had heard deposed to in court he was of opinion that the deceased died from natural causes that might be accounted for—that the fact of her being in an early state of pregnancy ought most decidedly to be taken into consideration; though he did not know of a case, he was of opinion, founded on practical experience and general knowledge, that severe vomiting and severe diarrhœa which would not yield to ordinary treatment may arise from an early state of pregnancy—that Miss Bankes died from dysentery, made worse by the condition of early pregnancy, and that a burning sensation in the mouth is consequent upon dysentery, and the diarrhœa and vomiting of pregnancy. All the symptoms in her case might arise from the vomiting and diarrhœa of pregnancy. The ulceration in the stomach, obliteration and partial destruction of the mucous membrane, the effusion of blood under it, and the dark patchy spots and ulcers and injection generally of the membrane might, as Dr. Wilkes said, arise from dysentery. If the deceased at one time had an affection of the womb, for which she used nitrate of silver (a pint bottle of this was found in her room), it would indicate ulceration of the neck of the womb; and if there had been such a condition of the womb an appreciable time before pregnancy, it might add to the irritation of pregnancy. Unless he found other symptoms, the vomiting, diarrhœa, sensation of the throat and the intestinal canal, accompanied by ulcerous appearances in parts of the body, would not, in his judgment, necessarily lead to the conclusion that she must be the subject of irritant poisoning—unless he found other symptoms, it would not enter his head. In a case of antimonial poisoning he should expect to find a clamminess and cold perspiration of the skin. In arsenical poisoning he should expect to find arsenic in the kidneys and the spleen, as well as the liver; should expect to find it in the liver first—it is the great criterion. And from the absence of these symptoms and appearances in this case, he was fortified in his opinion that she died from natural causes.”
The cross-examination of this witness was mainly directed to his assertion that, “in such a case as this, had he been called in at its early stage, notwithstanding he was told that she was not pregnant, and that her courses were in order, he should have examined the patient for pregnancy, especially if he found that the remedies were useless in stopping the vomiting and diarrhœa.”
“Dysentery,” he said, “was a most common disease, and in such a state as Miss Bankes was, the quarter-of-a-grain copper pill might increase the irritation. Diphtheritic dysentery was a form of idiopathic dysentery, that is, occurring without any particular poison—the Eastern form; there is a dysentery that arises from natural poison, just the same as fever. If I had been acquainted with all the symptoms I have heard described in court, I should not have dreamt of poison.”
Dr. G. F. Girdwood, who had delivered upwards of 3,000 women, strongly supported the view of the death being due to the effects of dysentery, combined with pregnancy. “Idiopathic dysentery would be its proper name—a special disease originating in itself, one single malady, one single suffering. He had had several cases of dysentery at early stages of pregnancy, one of them very severe, in fact, contemporaneous with it—he should say symptomatic of pregnancy: this would be much aggravated by a bilious temperament, and any affection of the liver.”
On cross-examination the witness explained that “in this country idiopathic dysentery assumed a less severe form than in warm climates—was what is called subacute or chronic, and that the state of the cæcum indicated a case of subacute, not of severe dysentery, of prolonged dysentery, and that it did not necessarily follow that such a case should commence with febrile symptoms.” On re-examination he stated, that “in early pregnancy the dysenteric motions have become bloody, the sign of dysentery which may come on immediately or not; in a day or two in acute dysentery, the result of neglected diarrhœa. Subacute dysentery is frequently the result of neglected diarrhœa, or chronic dysentery—you have acute, subacute, and chronic.”
Mr. James Edmunds, Surgeon to the Royal Maternity Charity, cited a case in his own practice of a woman of about forty years of age, who had been married ten or twelve years, and who in her pregnancy suffered from vomiting, purging, and severe pain in her abdomen, and who, from the post-mortem examination which he made, he was convinced died of dysentery, complicated by vomiting and irritability of the stomach attributable to pregnancy, and purging attributable to dysentery. “Purging,” he said, “was often a symptom at an early stage of pregnancy, and often of impending labour.”