Reports of Trials for Murder by Poisoning; / by Prussic Acid, Strychnia, Antimony, Arsenic, and Aconita. Including the trials of Tawell, W. Palmer, Dove, Madeline Smith, Dr. Pritchard, Smethurst, and Dr. Lamson, with chemical introduction and notes on the poisons used

by G. Lathom Browne; active 19th century C. G. Stewart

Question.—“Supposing that they differed in their description, which would you rely upon—the medical man or the chambermaid?”

Lord Campbell.—“That is hardly a proper question.”

Baron Alderson.—“It may be a very proper observation for you to make.”

Cross-examination continued.—“I never knew syphilitic poison produce tetanic convulsions, except in cases where there was disease of the bones of the head.”

Two other surgeons, Dr. Daniell, late surgeon to the British Hospital, and Mr. Samuel Solly, of St. Thomas’s Hospital, confirmed in every respect the views of the previous medical witnesses, that the circumstances attending Cook’s death were clearly distinguishable from those attendant on ordinary tetanus. They relied on the fact that ordinary tetanus was always progressive, and that it is never intermittent to the extent witnessed in Cook’s case, and seldom endured less than from thirty to forty hours. Mr. Solly alluded to the peculiar grin—“the risus Sardonicus, as the first symptom of true tetanus, which is not common to all convulsions, and which having once seen,” he said, “you cannot forget.” He distinguished between tetanus with convulsions and death from epileptic convulsions by the fact that “the first seldom leaves any trace behind it, whilst the latter does leave its trace in the shape of a slight effusion of blood on the brain, and a congestion of the vessels.” The syphilitic theory was finally overthrown by the testimony of Mr. Henry Lee, surgeon to the Lock Hospital, which is exclusively devoted to syphilitic cases. Though he saw there nearly 3000 cases a year, he had never known one resulting in tetanus, or read of a case of primary or secondary symptoms having that result.

In addition to these experts, on the sixth day important evidence was given by Dr. Jackson, who had had twenty-five years’ experience of tetanus in India, on the difference of the symptoms observed in the idiopathic and traumatic kinds; the former being much more frequent in India than in other climates, affording him in his practice as many as forty cases.

“It is as equally fatal,” said Dr. Jackson, “according to my experience, as traumatic. It is frequently found, in India, in children, both natives and Europeans, and generally takes place the third day after birth. It will also be occasioned by cold in that climate. In infants there is a more marked symptom of lockjaw in idiopathic tetanus. In adults there is no difference in the symptoms from traumatic. I have always seen the idiopathic form preceded by premonitory symptoms, such as a peculiar expression of the countenance, stiffness of the muscles of the throat and of the jaw. The usual period from the attack to death in infants is forty-eight hours; in adults, when arising from cold, it is of longer duration, and may continue for many days, going through the same grades as the traumatic forms.”

Cross-examined by Mr. Serjeant Shee.—“The patient always appears to be very uncomfortable shortly before an attack of idiopathic tetanus. His appetite would not be affected, but he would chiefly complain of the muscles of the neck. He might entertain a desire for food, and take it as usual within twelve hours of the attack. I never heard a patient complain of want of appetite. Within the twelve hours I should say that the patient’s attention would be more directed to the stiffness of his mouth and neck. I have known cases of idiopathic tetanus, where the first paroxysm was in bed. Difficulty of swallowing is another premonitory symptom.”

Re-examined by the Attorney-General.—“In the case of a child not more than six hours would elapse between the premonitory symptoms and the tetanic convulsions; in an adult the period would not be greater than twenty-four hours. The duration of the disease generally varies from three to ten days, but death has occurred as early as two days. The traumatic and idiopathic cases are alike in these respects. Both forms of the disorder are much more common in India than they are in this country. The symptoms are not more severe. In all my experience I never saw a case in which the disease ran its course in twenty minutes.”