Part 12

Mr. SAMUEL SOLLY, surgeon of St. Thomas’s Hospital, examined by Mr. WELSBY: I have been connected with St. Thomas’s Hospital, as lecturer and surgeon, for 28 years, and during that time I have seen many cases of tetanus. I have had six or seven under my own care, and I may have seen ten or fifteen more. Of those cases it was doubtful in one whether the disease was idiopathic or traumatic--the wound was so slight and the symptoms so obscure, that it was difficult to decide which it was. The others were all decidedly traumatic cases. The shortest period that I recollect during which the disease lasted before it terminated in death, was 30 hours. The disease was always progressive in its character. I have heard the description given by the witnesses of Mr. Cook’s attacks, and they differ essentially from those cases which I have seen. In my experience of tetanus there has always been a marked expression of the countenance as the first symptom. It is a sort of grin, and so peculiar, that having once seen it you can never mistake it. In the symptoms that I heard detailed with regard to Mr. Cook, there were violent convulsions on Monday night, and on Tuesday the individual was entirely free from any discomfort about the face or jaw; whereas, in the cases under my notice, the disease was always continuous, and the fixedness of the jaw was the last symptom to disappear. In my judgment, the symptoms detailed in Mr. Cook’s case are referable neither to apoplexy, epilepsy, nor to any disease that I have ever witnessed.

Cross-examined by Mr. Serjeant SHEE: The sort of grin which I have described is known as _risus sardonicus_. It is not common to all convulsions. Epilepsy is a disease of a convulsive character. I heard the account given by Mr. Jones of the last few minutes of Mr. Cook’s death--that he uttered a piercing shriek, and died after five or six minutes quietly. That last shriek and the paroxysm which accompanied it bear in some respects a resemblance to epilepsy. All convulsions which may be designated as of an epileptic character are not attended with an utter want of consciousness. Death from tetanus accompanied with convulsions seldom leaves any trace behind it; but death from convulsions arising from epilepsy does leave its trace in the shape of a slight effusion of blood on the brain, and a congestion of the vessels.

Re-examined by the ATTORNEY-GENERAL: The convulsions of epilepsy are accompanied by a variety of symptoms. When a patient dies of epilepsy he dies perfectly unconscious and comatose. I never saw any case of convulsive disease at all like this. There are cases of convulsive disease which are similar to tetanus in their onset, but not in their progress. For example, laceration of the brain, a sudden injury to the spinal cord, and the irritation from teething in infants, will produce convulsions resulting in death; but there would be wanting the marked expression of the face which I have described, which I have never missed in cases of tetanus.

Mr. HENRY LEE, surgeon to King’s College, and to the Lock Hospital, examined by Mr. BODKIN: The Lock Hospital is exclusively devoted to cases of a syphilitic character, and at present I see probably as many as 3,000 of those cases in the course of a year. I have never known an instance of that disease terminating in tetanus.

By the COURT: I have never seen or read of a case either of primary or secondary symptoms resulting in tetanus.

This witness was not cross-examined.

Dr. HENRY CORBETT, physician of Glasgow, examined by Mr. JAMES, Q.C.: In September, 1845, I was medical clerk at the Glasgow Infirmary, and I remember a patient, named Agnes Sennett, _alias_ Agnes French, who died there on the 27th of September, 1845. It was stated that she had taken strychnine pills, which had been prepared for another patient in the ward, and the symptoms which accompanied her death were those of strychnine. The pills were for a paralytic patient. I saw her when she was under the influence of the poison, and I had seen her the day before that perfectly well. She had been admitted for a skin disease of the head. When I saw her after she had taken the poison she was in bed. The symptoms were these: There was a strong retraction of the mouth; the face was much suffused and red; the pupils of the eye were dilated; the head was bent back; the spine was curved; and the muscles were rigid and hard like a board; the arms were stretched out; the hands were clinched; and there were severe paroxysms recurring every few seconds. She died in about an hour and a-quarter after taking the pills. When I was called first the paroxysms did not last so long; but they increased in severity. According to the prescription there should have been a quarter of a grain of strychnine in each pill, and this woman had taken three. The paralytic patient was to have taken a pill each night, or one each night and morning, I forget which.

Cross-examined by Mr. Serjeant SHEE: The retraction of the mouth was continuous, but it was worse at times. I do not think that I observed it after death. The hands were not clinched after death--they were “semi-bent.” She died an hour-and-a-quarter after taking the medicine. The symptoms appeared about twenty minutes after. I tried to make her vomit with a feather, but failed. She only vomited partially after I had given her an emetic.

Re-examined by the ATTORNEY-GENERAL: There was spasmodic action and grinding of the teeth. She could open her mouth and swallow. There was no lock-jaw or ordinary tetanus.

By Mr. Serjeant SHEE: I do not recollect that touching her sent her into paroxysms.

Dr. WATSON, examined by the ATTORNEY-GENERAL: I am a surgeon at the Glasgow Infirmary. I remember the case of Agnes Sennett. I was called in about a quarter of an hour after she was taken ill. She was in violent convulsions, and her arms were stretched out and rigid. The muscles of the body were also rigid; they were kept quiet by rigidity. She did not breathe, the muscles being kept still by tetanic rigidity. That paroxysm subsided, and fresh paroxysms came on after a short interval. She died in about half an hour. She seemed perfectly conscious. I don’t recollect the state of her hands. Her body was opened. The heart was found distended and stiff. The cavities of the heart were empty. My father published an account of the case.

Cross-examined by Mr. GROVE: The spinal cord was quite healthy.

Dr. J. PATTERSON, examined by Mr. WELSBY: In 1845 I was engaged in the laboratory of the Infirmary at Glasgow. I dispensed the prescriptions. I made up a prescription for a paralytic patient named M’Intyre. It consisted of pills which contained strychnine. There were four pills, and one grain of strychnine in the four.

Baron ALDERSON: Was there any noise made about their being taken by a wrong person?--Yes.

MARY KELLY, examined by Mr. BODKIN: In September, 1845, I was a patient in the Glasgow Infirmary; a paralytic patient was in the same ward, and I attended to her. There was also a patient named French or Sennett who was suffering from a sore head. She died. I was turning a wheel near the paralytic patient on the afternoon of the day Sennett died, for the purpose of applying something to her skin. There were some pills which she was to take near her. The paralytic woman took one and swallowed it according to the orders that had been given, and then handed the box to the girl with a sore head. The girl swallowed two of the pills, and then went and sat by the ward fire. She was taken ill in about three-quarters of an hour. She fell back on the floor, and I went for the nurse. We took her to bed and sent for the doctor. We were obliged to cut her clothes off, because she never moved. She was like a poker. I was by her side when she died. She never spoke after she fell down.

Cross-examined by Mr. Serjeant SHEE: It was three quarters of an hour from the time she took the pills till she was taken to the bed.

CAROLINE HICKSON, examined by Mr. E. JAMES: In October, 1848, I was nurse and lady’s maid in the family of Mr. Sarjantson Smyth. The family were then residing about two miles from Romsey. On the 30th of October Mrs. Smyth was unwell. We dealt with Mr. Jones, a druggist in Romsey. A prescription had been sent to him to be made up for Mrs Smyth. The medicine was brought back about six o’clock in the afternoon. It was a mixture in a bottle. My mistress took about half a wineglass of it the following morning, at five or ten minutes past seven o’clock. I left the room when I had given it her. Five or ten minutes afterwards I was alarmed by the ringing of her bell. I went into her room, and found her out of bed leaning upon a chair, in her night-dress. I thought she had fainted. She appeared to suffer from what I thought were spasms. I ran and sent the coachman for Mr. Taylor, the surgeon, and returned to her. Some of the other servants were there assisting her. She was lying on the floor. She screamed loudly, and her teeth were clinched. She asked to have her arms and legs held straight. I took hold of her arms and legs, which were very much drawn up. She still screamed, and was in great agony. She requested that water should be thrown over her, and I threw some. Her feet were turned inwards. I put a bottle of hot water to her feet, but that did not relax them. Shortly before she died she said she felt easier. The last words she uttered were--“Turn me over.” We did turn her over on the floor. She died a very few minutes after she had spoken those words. She died very quietly. She was quite conscious, and knew me during the whole time. About an hour and a quarter elapsed from the time I gave her the medicine till she died.

Cross-examined by Mr. GROVE: She could not sit up from the time I went up to her till she died. It was when she was in a paroxysm that I endeavoured to straighten her limbs. The effect of cold water was to throw her into a paroxysm. It was a continually recurring attack, lasting about an hour or an hour and a quarter. Her teeth were clinched during the whole time.

Re-examined by the ATTORNEY-GENERAL: The fit came on five or ten minutes after I gave her the medicine. She was stiff all the time till within a few minutes after death. She was conscious all the while.

Mr. FRANCIS TAYLOR, examined by Mr. WELSBY: I am a surgeon and apothecary at Romsey. I attended Mrs. Sarjantson Smyth in 1848. I was summoned to her house one morning soon after eight, and when I arrived I found her dead. The body was on the floor, near the bed. The hands were very much bent. The feet were contracted, and turned inwards. The soles of the feet were hollowed up, and the toes contracted, apparently from recent spasmodic action. The inner edge of each foot was turned up. There was a remarkable rigidity about the limbs.

By Lord CAMPBELL: The body was warm.

Examination continued: The eyelids were almost adherent to the eyeballs. The druggist who made up the prescription was named Jones. I made a _post-mortem_ examination three days after the death. The contraction of the feet continued, but it had gone off somewhat from the rest of the body. I found no trace of disease in the body. The heart was contracted and perfectly empty, as were all the large arteries leading from it. I analysed the medicine she had taken with another medical man. It contained a large quantity of strychnine. It originally contained nine grains, and she had taken one-third--three grains. I made a very casual examination of the stomach and bowels, as we had plenty of proof that poison had been taken without making use of tests.

Cross-examined by Mr. Serjeant SHEE: In cases of death from ordinary causes the body is much distorted. It does not generally, I should think, remain in the same position after death.

If the body is not laid out immediately, is it not stiffened by the _rigor mortis_?--Probably it is. The ancles were tied by a bandage to keep them together. I commenced to open the body at the thorax and abdomen. The head was also opened.

CHARLES BLOCKSOME, examined by Mr. HUDDLESTON: I was apprentice to Mr. Jones, the chymist, at Romsey, in 1848. My master made a mistake in preparing a prescription for Mrs. Smyth. The mistake was the substitution of strychnine for salacite (bark of willow). He destroyed himself afterwards.

JANE WITHAM, examined by Mr. E. JAMES: In March last I was in attendance upon a lady who died. (The learned counsel told the witness she had better not mention the lady’s name.) She took some medicine. After she took it she became ill. She complained first of her back. Her head was thrown back, her body stretched out, and I observed twichings. Her eyes were drawn aside and staring. I put my hand upon her limbs, which did not at all relax. She first complained of being ill in that way on Monday, the 25th of February, and died on Saturday, the 1st of March. She had attacks on the Monday, on the Wednesday, on the Thursday, on the Friday (a very slight one), and at a quarter-past eight o’clock on the Saturday morning. She died about twenty minutes to eleven that night. Between the attacks she was composed. She principally complained of prickings in the legs and twichings in the muscles and in the hands, which she said she could compare to nothing else than a galvanic shock. She wished her husband to rub her legs and arms. She was dead when Dr. Morley came.

Cross-examined by Mr. Serjeant SHEE: On the Saturday night she could not bear to have her legs touched when the spasms were strong upon her. Her limbs were rigidly extended when she asked to be rubbed. That was in the interval between the spasms. Touching her then brought on the spasms. Her body was stiff immediately after death, but I did not stay long in the house. On the Saturday she was sensible from half-an-hour to an hour, from a quarter past eight till after nine. I suppose she was insensible the remainder of the time. She did not speak.

Re-examined by Mr. E. JAMES: On the Saturday before she died the symptoms were the same as on the other days--not more violent.

Mr. MORLEY, examined by Mr. WELSBY: I am a surgeon. I attended on the lady to whom the last witness has alluded for about two months before her death. On the Monday before she died she was in bed apparently comfortable, when I observed (as I stood by her side) several slight convulsive twitchings of her arms. I supposed they arose from hysteria, and ordered medicine in consequence. The same symptoms were repeated on the following Wednesday or Thursday. I saw her on Saturday, the day she died. She was apparently better, and quite composed in the middle of the day. She complained of an attack she had had in the night. She spoke of pain and spasms in the back and neck, and of shocks. I and another medical man were sent for hastily on the Saturday night. We were met by the announcement that the lady was dead. On the Monday I accompanied another medical gentleman to the _post-mortem_ examination. We found no disease in any part of the body which would account for death. There was no emaciation, wound, or sore. There was a peculiar expression of anxiety about the countenance. The hands were bent and the fingers curved. The feet were strongly arched. We carefully examined the stomach and its contents to see if we could find poison. We applied several tests--nitric acid, chloride of sulphuric acid, bi-chloride of potash in a liquid state, and also in a solid state. They are the best tests to detect the presence of strychnine. In each case we found appearances characteristic of strychnine. We administered the strychnine taken from the stomach to animals by inoculation. We gave it to a few mice, a few rabbits, and a guinea pig, having first separated it by chemical analysis. We observed in each of the animals more or less of the effects produced by strychnine--namely, general uneasiness, difficult breathing, convulsions of a tetanic kind, muscular rigidity, arching backwards of the head and neck, violent stretching out of the legs. These symptoms appeared in some of the animals in four or five minutes; in others in less than an hour. The guinea-pig suffered but slightly at first and was left, and found dead the next day. The symptoms were strongly marked in the rabbits. After death there was an interval of flaccidity, after which rigidity commenced, more than if it had been occasioned by the usual _rigor mortis_. I afterwards made numerous experiments on animals with exactly similar results, the poison being administered in a fluid form.

Cross-examined by Mr. GROVE: I did not see the patient during a severe attack. I have observed in animals that spasms are brought on by touch. That is a very marked symptom. The spasm is like a galvanic shock. The patient was not at all insensible during the time I saw her, and she was able to swallow, but I did not see her during a severe attack. After death we found the lungs very much congested. There was a small quantity of bloody serum in the pericardium. The muscles of the whole body were dark and soft. There was a decided quantity of effusion in the brain. There was also a quantity of serum tinged with blood in the membranes of the spinal cord. The membranes of the spinal marrow were congested to a considerable extent. We opened the head first, and there was a good deal of blood flowing out. Part of the blood may have flowed from the heart. That might partially empty the heart, and would make it uncertain whether the heart was full or empty at the time of death. I have often examined the hearts of animals poisoned by strychnine. The right side of the heart is generally full. In some cases I think that the symptoms did not appear for an hour after the administration of the poison. I have made the experiments in conjunction with Mr. Nunneley. We have made experiments upon frogs, but they are different in many respects from warm-blooded animals. I have in almost all cases found the strychnine where it was known to have been administered. In one case it was doubtful. We were sure the strychnine had been administered in that case, but we doubted whether it had reached the stomach. There were appearances which might lead one to infer the presence of strychnine, but they were not satisfactory. I have detected strychnine in the stomach nearly two months after death, when decomposition has proceeded to a considerable extent.

Re-examined by the ATTORNEY-GENERAL: From half a grain to a grain has been administered to cats, rabbits, and dogs. From one to two grains is quite sufficient to kill a dog.

How does the strychnine act? Is it taken up by the absorbents and carried into the system?--I think it acts upon the nerves, but a part may be taken into the blood and act through the blood. We generally examined the stomach of the animals when the poison had been administered internally. Sometimes we examined the skin. The poison found in the stomach would be in excess of that absorbed into the system.

Are you, then, of opinion that, a portion of the poison being taken into the system and a portion being left in the stomach, the portion taken into the system would produce tetanic symptoms and death?

Mr. Serjeant SHEE objected to a question which suggested a theory.

The ATTORNEY-GENERAL: What would be the operation of that portion of the poison which is taken into the system?--It would destroy life.

Mr. Baron ALDERSON: And yet leave an excess in the stomach?--That is my opinion.

The ATTORNEY-GENERAL: Would the excess remaining in the stomach produce no effect?--I am not sure that strychnine could lie in the stomach without acting prejudicially.

Suppose that a _minimum_ quantity is administered, which, being absorbed into the system, destroys life, should you expect to find any in the stomach?--I should expect sometimes to fail in discovering it.

If death resulted from a series of _minimum_ doses spread over several days, would the appearance of the body be different from that of one whose death had been caused by one dose?--I should connect the appearance of the body with the final struggle of the last day.

Would you expect a different set of phenomena in cases where death had taken place after a brief struggle, and in cases where the struggle had been protracted?--Certainly. At the _post-mortem_ examination of which I have spoken we found fluid blood in the veins.

Mr. Serjeant SHEE: Is it your theory that in the action of poisoning the poison becomes absorbed, and ceases to exist as poison?--I have thought much upon that question, and have not formed a decided opinion, but I am inclined to think that it is so. A part may be absorbed and a part remain in the stomach unchanged.

Mr. Serjeant SHEE: What chemical reason can you give for your opinion that strychnine, after having effected the operation of poisoning, ceases to be strychnine in the blood?--My opinion rests upon the general principle that, in acting upon living bodies, organic substances--such as food and medicine--are generally changed in their composition.

Mr. Serjeant SHEE: What are the component parts of strychnine?

Mr. Baron ALDERSON: You will find that in any cyclopœdia, Brother SHEE.

Mr. Serjeant SHEE: Have you any reason to believe that strychnine can be decomposed by any sort of putrefying or fermenting process?

Witness: I doubt whether it can.

Mr. EDWARD D. MOORE, examined by Mr. HUDDLESTON: About fifteen years ago I was in practice as a surgeon, and I attended, with Dr. Chambers, a gentleman named Clutterbuck, who was suffering from paralysis. We had been giving him small doses of strychnine when he went to Brighton. On his return he told us that he had been taking larger doses of strychnine, and we, in consequence, gave him a stronger dose. I made up three draughts, confining a quarter of a grain each. He took one in my presence. I remained with him a little time, and left him, as he said he felt quite comfortable. About three-quarters of an hour afterwards I was summoned to him. I found him stiffened in every limb, and the head drawn back. He was desirous that we should move and turn him, and rub him. We tried to give him ammonia, in a spoon, and he snapped at the spoon. He was suffering, I should say, more than three hours. Sedatives were given him. He survived the attack. He was conscious all the time.

Cross-examined by Mr. Serjeant SHEE: The spasms ceased in about three hours, but the rigidity of the muscles remained till the next day. His hands and feet were at first drawn back, and he was much easier when we clinched them forwards. His paralysis was better after the attack.

Re-examined by the ATTORNEY-GENERAL: Strychnine stimulates the nerves which act upon the voluntary muscles, and therefore acts beneficially in cases of paralysis.

The ATTORNEY-GENERAL intimated that the next witness to be called was Dr. Taylor, and, as it was a quarter after five, the trial was adjourned until Monday, at nine o’clock.

Lord CAMPBELL, before the jury left the box, exhorted them not to form any opinion upon the case until they had heard both sides. They should even abstain from conversing about it among themselves.

Mr. Serjeant SHEE said that medical witnesses would be called for the defence.

His LORDSHIP also expressed a hope that, if the jury were taken out upon the following day (Sunday), they would not be allowed to go to any place of public resort, and mentioned an instance in which a jury, under similar circumstances, had been conducted to Epping Forest.

The Court then rose, and the jury were conveyed to the London Coffee-house.

FIFTH DAY, MAY 19.

The Court was again crowded long before the commencement of the proceedings this morning. The Earl of Denbigh and Lord Lyttleton were among the gentlemen who occupied seats upon the bench.