Examination continued.—“After this interruption the opening of the stomach was pursued. The stomach contained about three ounces of a brownish fluid. There was nothing particular in that. Palmer was looking on, and said, ‘They won’t hang us yet.’ He said that to Mr. Bamford in a loud whisper. That remark was made upon his own observation of the stomach. The stomach after being emptied, was put into the jar. The intestines were then examined, but nothing particular was found in them. They were contracted and very small. The viscera, with their contents, as taken from the body, were placed in the jar, which was then covered over with two bladders, which were tied and sealed. I tied and sealed them. After I had done so I placed the jar upon the table by the body. Palmer was then moving about the room. In a few minutes I missed the jar from where I had placed it. During that time my attention had been withdrawn by the examination. On missing the jar I called out, ‘Where’s the jar?’ and Palmer from the other end of the room, said, ‘It is here; I thought it would be more convenient for you to take away.’ There was a door at the end of the room where he was. He was within a yard or two of that door, and about twenty-four feet from the table on which the body was lying.” (Before making this last statement the witness referred to a plan of the room which was put in by the Attorney-General.) “The other door near which Palmer was standing was not the one by which he entered the room. I called to Palmer, ‘Will you bring it here?’ I went from the table and met Palmer half-way coming with the jar. Since I last saw it it had been cut through both bladders. The cut was hardly an inch long, done with a sharp instrument. I examined the jar. The edges were quite clean; no part of the contents could have passed through it. Finding this cut, I said, ‘Here is a cut! who has done it?’ Palmer, Devonshire, and Newton, all said they had not done it, and nothing more was said. When I was about to remove the jar from the room, the prisoner asked me what I was going to do with it. I said I should take it to Mr. Frere’s (a neighbouring surgeon). He said, ‘I would rather you would take it to Stafford than take it there.’ I made no answer that I remember. On finding the slit, I cut the strings, and altered the bladder, so that the slits were not over the top. I took it to Mr. Frere’s, and left it in his hall, tied and sealed. Afterwards when I went for my carriage, whilst waiting in the yard, the prisoner came and asked me what would be done with it, and I said, ‘Sent either to Birmingham or London for examination.’ When I recovered the jar, I tied each corner separately and resealed it with my own seal. During the first post-mortem examination, there were several Rugeley persons present, but, I believe, no one on behalf of the prisoner. At the second examination there was some one on behalf of Palmer (Mr. Pemberton and Mr. Bolton).”
On cross-examination, after stating that Palmer’s words, “they won’t hang us yet,” were addressed to Bamford in a loud whisper, and afterwards repeated to several persons, and that his original notes in pencil were destroyed, a more formal report being written by him on getting home, Dr. Harland said—
“At the base of the tongue of the deceased I observed some enlarged mucous follicles; they were not pustules containing matter, but enlarged mucous follicles of long standing. There were a good many of them, but I do not suppose that they would occasion much inconvenience. They might cause some degree of pain, but it would be slight. I do not believe they were enlarged glands. I should not say that the deceased’s lungs were diseased, although they were not in their normal state. The lungs were full of blood and the heart empty. I had no lens at the post-mortem examination, but I made an examination which was satisfactory without one. The brain was carefully taken out; the membranes and external parts were first examined, and thin slices about a quarter of an inch in thickness were taken off and subjected to separate examination. I think that by that means we should have discovered disease if any had existed; and if there had been any indication of disease I should have examined it more carefully. I examined the spinal cord as far down as possible, and if there had been any appearance of disease, I should have opened the canal. There was no appearance of disease, however. We opened down to the first vertebra. If we had found a softening of the spinal cord, I do not think that it would have been sufficient to have caused Mr. Cook’s death; certainly not. A softening of the spinal cord would not produce tetanus; it might produce paralysis. I do not think, as a medical man investigating the cause of death, that it was necessary carefully to examine the spinal cord. I do not know who suggested that there should be an examination of the spinal cord two months after death. There were some appearances of decomposition when we examined the spinal cord, but I do not think that there was sufficient to interfere with our examination.[36] I examined the body to ascertain if there was any trace of venereal disease. I did find certain indications of that description, and the marks of an old excoriation, which was cicatrized over.”
Re-examined by the Attorney-General.—“There were no indications of wounds or sores such as could by possibility produce tetanus. There was no disease of the lungs to account for death. The heart was healthy, and its emptiness I attribute to spasmodic action. The heart being empty, of course death ensued. The convulsive spasmodic action of the muscles of the body, which was deposed to yesterday by Mr. Jones, would, in my judgment occasion the emptiness of the heart. There was nothing whatever in the brain to indicate the presence of any disease of any sort; but if there had been, I never heard or read of any disease of the brain ever producing tetanus. There was no relaxation of the spinal cord which would account for the symptoms accompanying Mr. Cook’s death as they have been described. In fact, there was no relaxation of the spinal cord at all, and there is no disease of the spinal cord with which I am acquainted which would produce tetanus.”
Dr. Monckton, a physician at Rugeley, made a separate examination of the spinal marrow of the deceased on the 28th of January, when he said that the body was in such a condition as to enable him to do so satisfactorily, and when had there been any disease of a normal character on the spine he should have had no difficulty in discovering it. All that he found were certain granules, the origin of which it was difficult to account for, though frequently found in persons of an advanced age, but which he never knew to occasion sudden death. He agreed entirely with the evidence of Dr. Harland.[37]
EVIDENCE OF MEDICAL EXPERTS.
We come next to a remarkable body of evidence given by men of such eminence in their profession as Mr. Curling, Dr. Todd, Sir Benjamin Brodie, and others of nearly equal mark, negativing the idea that had been suggested in the previous cross-examinations that the death was due to one of the two forms of true tetanus, and affirming that the symptoms which had been detailed were those of the action of strychnia. Not only were these opinions closely questioned in cross-examination, but as many medical men, several of them of not less eminence than these witnesses, were subsequently called for the defence to contradict them; and thus the most extraordinary conflict of scientific evidence raised that had hitherto been witnessed in a criminal court. Subsequently, as we shall see, a similar dispute between the medical giants of the day was roused in the case of Dr. Smethurst, but with, in the end, a very different result. In reading the following statements for the prosecution, it will help to make them more clear, if it is borne in mind that tetanus is of two kinds—(1), Idiopathic, or self-generated, and the other (2), Traumatic, the result of a wound or a sore; that the former may arise from exposure to cold or damp, or even from the irritation of worms in the alimentary canal, but in temperate climates is by no means a frequent disease; whilst the latter, from the various accidents to which human beings are liable, is of more frequent occurrence. Another point to be remembered is, that it is a moot point in medical practice whether a syphilitic sore, unless of course of a most aggravated character, will produce tetanus, and that the difference between the symptoms and progress of true tetanus and of that due to poison is, in the opinion of these experts, very marked. Dr. James Blizard Curling, surgeon to the London Hospital, was first called, and after describing the two kinds of tetanus and their causes, and speaking of the very numerous cases of the “traumatic” kind which he had seen, he thus detailed the symptoms:—
“The disease first manifests itself about the jaws and neck. Rigidity of the muscles of the abdomen afterwards sets in. A dragging pain at the pit of the stomach is almost a constant attendant. In many instances the muscles of the back are extensively affected. These symptoms, though continuous, are liable to aggravations into paroxysms. As the disease goes on these paroxysms become more frequent and more severe. When they occur the body is drawn backwards; in some instances, though less frequent, it is bent forward. A difficulty in swallowing is a very common symptom, and also a difficulty of breathing during the paroxysms. The disease may, if fatal, end in two ways. The patient may die somewhat suddenly, from suffocation, owing to the closure of the opening of the windpipe; or he may be worn out by the severe and painful spasms, the muscles may relax, and the patient gradually sink. The disease is generally fatal. The locking of the jaw is an almost constant symptom attending ‘traumatic tetanus;’ I may say a constant symptom. It is not always marked, but generally so. It is an early symptom. Another symptom is a peculiar expression of countenance. I believe this is not peculiar to ‘traumatic tetanus,’ but my observation is from such cases. There is a contraction of the eyelids, a raising of the angles of the mouth, and contraction of the brow. In ‘traumatic tetanus’ the lower extremities are sometimes affected, and sometimes, but rarely, the upper ones. When the muscles of the extremities are affected, the time at which that occurs varies. If there is no wound in the arms or legs, the extremities are generally not affected until late in the progress of the disease. I never knew of tetanus being produced by a sore throat or a chancre. In my opinion a syphilitic sore would not produce tetanus. I know of no instance in which one has led to tetanus. I think it a very unlikely cause. The time within which ‘traumatic tetanus’ causes death varies from twenty-four hours to two or three days or longer. The shortest time to my knowledge was eight to ten hours. When once commenced, the disease is continuous.”