MEDICO-SCIENTIFIC EVIDENCE FOR THE DEFENCE.
The conflict in the testimony given by scientific experts in this case, will be more clearly shown if, instead of deferring it to its original position, after the speech for the defence, the evidence of the eminent medical men and analysts is at once contrasted with that of those called for the prosecution. The two points mainly in contest were, (1.) Were the symptoms in Cook’s case such as could only be produced by strychnia, or could they have arisen from other diseases, and especially from one of the forms of ordinary tetanus? (2.) If strychnia had been given, could it not have been discovered by chemical analysis?[53] Under the first head came the consideration of Cook’s mode of life and general state of health, and his excitement at the victory of his horse at such a critical period of his fortunes, as predisposing causes to one or other of the various diseases to which the witnesses for the defence were prepared to attribute the symptoms and the result. Under the second, the success that uniformly attended such analysts as Mr. Herapath in detecting, even twenty times less than the fiftieth part of a grain of strychnia, and the inference that as it was not discovered by such eminent analysts as Dr. Taylor and Dr. Rees, that none had been given. If this inference was fair, it would follow that, however mysterious the causes of the death of Cook might have been, and the symptoms of his attacks difficult of being referred to any known form of disease, yet it was not proved that he died of strychnia, and that therefore Palmer was entitled to an acquittal. “According to the witnesses for the Crown,” said Serjeant Shee, “the poison of strychnia is of that nature, that when it has done its fatal work, and become absorbed into the system, it ceases to be the thing it was when it was taken into the system; it becomes decomposed, its elements separated from each other, and, therefore, no longer capable of responding to the tests which, according to Taylor, would certainly detect the presence of undecomposed strychnia. They account for the fact that it is not detected, and for their still believing that it destroyed Mr. Cook, by this hypothesis. Now it is only an hypothesis: there is no foundation for it in experiment: it is not supported by the evidence of any eminent toxicologists but themselves; it was the theory of Dr. Taylor, which he propounds in his book—but he propounds it as a theory of his own; he does not vouch, as I remember, any eminent toxicologist in support of it.”
Against this theory, among other eminent men, the defence called Mr. Nunneley, of Leeds, who had assisted Mr. Morley (previously called for the prosecution) in the case of Mrs. Dove, Dr. Letheby, the medical officer of health of the city of London, and Mr. William Herapath. Of these three experts it will be advisable to give the evidence at some length, contenting oneself with summarising that of the other scientific witnesses who agreed with them in rejecting, as a scientific heresy, the hypothesis of Dr. Taylor.
The evidence of Mr. Nunneley covered both points—the character of Cook’s symptoms and the discovery of strychnia. “He had been, he said, in large practice for more than twenty-five years, and had seen four cases of idiopathic tetanus, all of which did not commence with lockjaw; in one of them lockjaw not becoming so marked as to prevent the person from swallowing once during the disease.”
“I assume,” said the witness, “that Cook was a man of very delicate constitution; that for a long time he had felt himself ailing, for which indisposition he had been under medical treatment; that he had suffered from syphilis; that he had disease of the lungs, and an old standing disease of the throat; that he led an irregular life; that he was subject to mental depression and excitement, and that after death appearances were found in his body to show this to have been the case. There was an unusual appearance in the stomach. The throat was in an unnatural condition. The back of the tongue showed similar indications. The air vessels of the lungs were dilated. In the lining of the aorta there was an unnatural deposit, and there was an unusual appearance in the membranes of the spinal marrow. One of the witnesses also said there was a loss of substance from the penis. That scar on it could only have resulted from an ulcer. A chancre is an ulcer, but an ulcer is not necessarily a chancre. The symptoms at the root of the tongue and throat I should ascribe to syphilitic inflammation of the throat. Supposing these symptoms to be correct” (which they were not), “I should infer that Cook’s health had not for a long time been good, and that his constitution was delicate. His father and mother died young. Supposing that to have been his state of health, it would make him liable to nervous irritation. That might be excited by moral causes. Any excitement or depression might produce that effect. A person of such health and constitution would be more susceptible of the injurious influence of wet and cold than one of a stronger one. Upon such a constitution convulsive disease is more likely to supervene. I understand he had three attacks on succeeding nights, occurring about the same hour. As a medical man I should infer from this that they were of a convulsive character—in the absence of other causes to account for them. Convulsive attacks are as various as possible in their forms and degrees of violence: it is not possible to give a definite name to every convulsive symptom. There are some forms of convulsion in which the patient retains consciousness. Those are forms of hysteria, sometimes found in the male sex. It is also stated that there are forms of epilepsy in which the patient retains consciousness.”
To Lord Campbell.—“I cannot mention a case in which consciousness has been retained during the fit. No such case has come under my notice.”
Examination continued.—“I know from reading that, though rarely, it does sometimes occur. The degree of consciousness in epilepsy varies very much. In some attacks it is wholly lost for a long time. Convulsive attacks are sometimes accompanied by violent spasms and rigidity of the limbs—they sometimes assume tetanic complexion. I agree with Dr. Copland that convulsions arise from almost any cause. Affections of the spinal cord, or eating indigestible food, will produce them. I know of no case in which they resulted from retching and vomiting. I agree with Dr. Copland that they sometimes end immediately in death. The immediate proximate cause of death is frequently asphyxia. Death from spasm of the heart is often described as death by asphyxia. I have seen convulsions recurring—in various cases. The time at which a patient recovers his ease after a violent attack of convulsions varies very much. It may be a few minutes, it may be hours. From an interval between one convulsion and another I should infer that the convulsions arose from slight irritation in the brain or the spinal cord. When death takes place in such paroxysms there is sometimes no trace of organic disease to be found by a post-mortem examination. Granules between the DURA MATER and the ARACHNOID are not common at any age. I should not draw any particular inference from their appearance. They might or might not lead to a conjecture as to their cause and effect. I do not form any opinion upon these points. They might produce an effect upon the spinal cord. There are three preparations in museums where granules are exhibited in the spinal cord, in which the patients are said to have died from tetanus. Those are at St. Thomas’s Hospital.[54] To ascertain the nature and effect of such granules the spinal cord ought to be examined immediately after death. Not the most remote opinion could be formed upon an examination made two months after death, more especially if the brain had been previously opened. Independently of the appearance of granules, it would not after that period be possible to form a satisfactory opinion upon the general condition of the spinal cord. If there were a large tumour, or some similar change, it might be exhibited; but neither softening nor induration of the structure could be perceived. The nervous structure changes within two days of death. To ascertain minutely its condition it is necessary to use a lens or microscope. That is required in an examination made immediately after death. I have attended cases of traumatic tetanus. That disease commonly begins with an attack upon the jaw. One of the cases of idiopathic tetanus that I have seen was my own child. In three of those cases the disease began with lockjaw. The fourth case commenced in the body, the facility of swallowing remaining. I have within the last twelve months made post-mortem examinations of two persons who had died from strychnia. I did not see the patients before death. In both cases I ascertained by chemical analysis that death had been caused by strychnia. In both I found the strychnia. In one case—that of a lady aged twenty-eight years—I made my examination forty-two hours after death, and in the other thirty hours. In the former case the body had not been opened before I commenced my examination.” [The witness read a report of this examination, in which it was stated that the eyelids were partially open, the globes flaccid, and the pupils dilated. The muscles of the trunk were not in the least rigid; indeed, they were so soft that the body might be bent in any direction. The muscles at the hip and shoulder joints were not quite so flaccid, but they allowed these joints to be easily moved; while those of the head and neck, forearms, &c., were rigid. The fingers were curved, and the feet somewhat arched. All the muscles, when cut into, were found soft and dark in colour. The membranes of the liver were exceedingly vascular. The membrane of the spinal cord was much congested. There was bloody serum in the pericardium; the lungs were distended, and some of the air cells were ruptured. The lining membrane of the trachea and bronchial tubes was covered with a layer of dark bloody mucus of a dark chocolate colour. The thoracic vessels and membranes were much congested, and the blood was everywhere dark and fluid.] After reading this report the witness continued:—“In the second case I made my examination thirty hours after death. I first saw the body about twelve hours after death. It was a woman somewhere near twenty years of age.” [The witness also read the report of the examination in this case. The appearances of the body were substantially similar to those presented in the previous case.] “In two other cases I have seen a patient suffering from over doses of strychnia. Neither of those cases was fatal. In one case I had prescribed the twelfth of a grain, and the patient took one-sixth. That was for a man of middle age. Strychnia had been given in solution. In a few minutes the symptoms appeared. They were a want of power to control the muscles, manifested by twitchings, rigidity, and cramp, more violent in the legs than in any other part of the body. The spasms were not very violent. They continued six hours before they entirely disappeared. During that time they were intermittent at various intervals. As the attack passed off the length of the intervals increased. At first their length was but a few seconds. The spasms were not combated by medical treatment. The other case was a very similar one. The quantity taken was the same—double what I had prescribed. I have experimented upon upwards of sixty animals with strychnia. Those animals were dogs, cats, rats, mice, guinea pigs, frogs, and toads. The symptoms of the attack in all animals present great resemblances. Some animals are, however, much more susceptible of its influence than others are. The period elapsing between the injection of the poison and the commencement of the symptoms has been from two minutes to thirty,—more generally five or six. I administered the poison occasionally in solution, but more generally in its solid state. It was sometimes placed dry upon the back of the tongue, and some fluid poured down the throat; sometimes it was enclosed between two portions of meat; sometimes mixed up with butter or suet, and sometimes rolled up in a small piece of gut. To frogs and toads it was administered by putting them into a solution of strychnia. I have also applied it direct to the spinal cord, and in other cases to the brain. The first symptom has been a desire to be quite still; then hurried breathing; then slavering at the mouth (when the poison had been given through that organ); then twitching of the ears, trembling of the muscles, inability to walk, convulsions of all the muscles of the body, the jaws being generally firmly closed; the convulsions attended by a total want of power in the muscles, which on the least touch were thrown into violent spasms with a galvanic-like shock. Spasms also come on if the animal voluntarily attempts to move; that is usually the case, but occasionally the animal is able to move without inducing a recurrence of the spasms. These spasms recur at various periods, but do not always increase in violence. The animals die after periods varying from three hours to three hours and a half. In the cases where the animals live longest, the paroxysms occur at the longest intervals. In all cases in the interval before death the rigidity ceases (I know no exception to this) and the muscles become quite soft, powerless, and flaccid. The limbs may be put in any position whatever. There is but little difference from ordinary cases of convulsive death in the time at which the rigor mortis comes on. I have destroyed animals with other poisons, and there is very little difference between the rigidity in their cases and that in the cases of death from strychnia. In the two women I have mentioned the rigor mortis was much less than is usual in cases of death from natural disease. I have known fatal cases of poisoning animals by strychnia in which there has between the first and the second paroxysm been an interval of about half-an-hour, but that is not common. I have examined the bodies of upwards of forty animals killed by strychnia. I have invariably found the heart full on the right side; very generally the left ventricle firmly contracted, and the blood usually dark, and often fluid. There is no particular appearance about the spine. I have experimented with other poisons upon upwards of 3000 animals, and have written upon this subject. It very often happens that in the case of animals dying suddenly from poisoning the blood is fluid after death. That also happens in cases of sudden death from other causes. I have attended to the evidence as to the symptoms exhibited by Cook on the Sunday, Monday, and Tuesday nights. The symptoms on Sunday night I assume to have been from great excitement. Cook described himself as having been very ill, and in such a state that he considered himself mad for a few minutes. He stated that the cause of this was a noise in the street. These symptoms in the three nights I have mentioned, do not resemble those which I have seen follow the administration of strychnia. Cook had more power of voluntary motion than I have observed in animals under the influence of this poison. He sat up in bed, and moved his hands about freely, swallowed, talked, and asked to be rubbed and moved, none of which, if poisoned by strychnia, could he have done. The sudden accession of the convulsions is another reason for believing that they were not produced by strychnia. Other reasons for believing that the convulsions were not produced by strychnia are their sudden accession without the usual premonitory symptoms, the length of time which had elapsed between their commencement and the taking of the pills which are supposed to have contained poison, and the screaming and vomiting. I never knew an animal which had been poisoned with strychnia to vomit or scream voluntarily. I apprehend that where there is so much spasm of the heart there must be inability to vomit. In the cases related in which attempts were made to produce vomiting they did not succeed. There is such a case in the 10th volume of the Journal de Pharmacie, in which an emetic was given without success. The symptoms exhibited after death by animals poisoned by strychnia differ materially from those presented by the body of Cook. In his case the heart is stated to have been empty and uncontracted.”
Lord Campbell.—“I do not remember that. I think it was said that it was contracted.”
Mr. Baron Alderson.-”According to my note, Dr. Harland said that the heart was contracted, and contained no blood.”