Part 22
Mr. WILLIAM HEREPATH, examined by Mr. GROVE--I am Professor of Chemistry and Toxicologist at the Bristol Medical School. I have been occupied in chemistry forty years and in toxicology probably thirty. I have experimented on the poison of strychnia. I have examined the contents of the stomach of a patient who died from strychnia. I discovered the strychnia in the contents of the stomach three days after death. I have experimented upon eight, nine, or ten animals. In the case of a cat, to which I gave one grain of strychnia in solid form, I could not get the animal to take it voluntarily, and I left it in meat at night. I found the animal dead next morning. The body was dreadfully contorted--extremely rigid, the fore limbs extended, the head turned round to the side, the eyes protruding and staring, the iris expanded so as to be almost invisible. I found in the urine which had been ejected strychnia, and also in the stomach. I gave the same quantity of strychnia to another cat. It remained very quiet for fifteen or sixteen minutes, with but few symptoms until thirty-five minutes. It merely seemed a little restless with its eyes, the breathing a little quickened, and at thirty-five minutes it had a terrible spasm, the four extremities and the head being drawn together. I watched it for three hours more. After this it had a second spasm. A frothing saliva was dripping from its mouth, and it forcibly ejected its urine. It had another spasm a few minutes after, when I thought the animal would die. It soon recovered itself, and then remained quiet, with the exception of a trembling all over. The slightest breath of air would affect it. It continued in this state for some time longer. During this three hours and a half, or nearly so, the animal was in a peculiar state. Touching it appeared to electrify it all through, even blowing upon it produced the same effect. Touching the basket, the slightest thing that could affect the animal, produced a sort of electric jump. I left it then, thinking it would recover, but in the morning I found it dead, in the same indurated and contracted condition in which the former animal was found. About thirty-six hours afterwards, by chemical examination, I found strychnia in the urine, the stomach, and upper intestines, in the liver, and in the blood of the heart. In my search for strychnia I took extraordinary means to get rid of the organic matter.
In all cases which you have seen where strychnia has been taken has the examination been successful?--Not only strychnia, but nux vomica, has been extracted. In one case the animal had been buried two months. I have detected strychnia in cases where it has been mixed purposely with putrid remains.
Are you of opinion, as a chemist, that where strychnia has been taken in a sufficient dose to poison, it can be detected, and ought to be detected?--Yes, up to the time the body is decomposed completely. Even where there is putrefaction--where the body has become a dry powder. I am of opinion that strychnia ought to have been detected if it had existed in the jar containing the stomach, even in the state it then was.
Cross-examined by the ATTORNEY-GENERAL--Until lately my experiments for the purpose of finding strychnia have been principally in the stomach. In two cases I found it in the tissues of the animals. One was the second cat, the other a dog to which I gave the large dose of one grain. Judging from reports in newspapers, I have said in conversation that strychnia had been given, and that “If it was there, Professor Taylor ought to have found it.”
[Sidenote: W. Herepath]
Re-examined by Mr. GROVE--What is the smallest quantity you have detected in the tissues of the stomach?--I am satisfied that you could discover the fifty-thousandth part of a grain that is unmixed with organic matter. I dissolved the tenth part of a grain in a gallon of water, that is 1 in 70,000. I can take the tenth part of a drop of the water and demonstrate the presence of strychnia.
What is the smallest portion of strychnia when mixed with organic matter you can detect?--I took about an eighth part of the liver of a dog, and from that I had enough to make four distinct experiments with the four tests.
So that you experimented on a thirty-second part of the liver?--Yes.
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[Sidenote: J. E. D. Rogers]
Mr. JULIAN EDWARD DISBROWE ROGERS, examined by Mr. GRAY--I have been sixteen years Professor of Chemistry at St. George’s School of Medicine, in London. I made an experiment with one dog with a view of extracting strychnia from the body. I gave it two grains of pure strychnia between two pieces of meat. Three days after it was dead I removed the stomach and its contents, and took some of the blood. I analysed the blood ten days after its removal from the body, when it was putrid, and found strychnia by the colour tests. About a month or five weeks afterwards I analysed the stomach and its contents, and strychnia was separated in a large quantity. Having heard the evidence as to the stomach and its contents in this case being put in a jar and sent to London, in my judgment strychnia, if it had been administered, must have been found in the contents of the stomach.
Cross-examined by the ATTORNEY-GENERAL--I have only made one experiment with strychnia on this dog.
Do you think it would make any difference if the contents were lost?--If there were no contents spread over the intestines, then that would make a difference. If they had been spilt and shaken, then it would make no difference.
But, supposing they were not there?--There would be the washings of the stomach. If the stomach was sent me with no contents, I would wash the stomach and proceed with that.
If you had tried on the tissues of the deceased’s body I suppose you would have been able to ascertain whether there had been any strychnia?--That is my opinion.
So that the time that has elapsed since Cook died would not matter. If you had an opportunity to operate on it, you would have found the strychnia?--If it had been there, I feel satisfied I should find it.
LORD CAMPBELL--Do you mean then or now?--I do not see that the time would prevent it.
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[Sidenote: H. Letheby]
Dr. HENRY LETHEBY, examined by Mr. KENEALY--I am a Bachelor of Chemistry and Professor of Medicine in the London Hospital; also a medical officer of health to the city of London. I have for a considerable time studied poisons. I believe in every case of this kind tried in this Court during the last fourteen years I have been engaged on behalf of the Crown. I have been present during the examination of the medical witnesses at this trial and heard them describe certain symptoms attending the death of Mr. Cook. I have seen many deaths by strychnia in the lower animals. I have seen several cases of nux vomica in the human subject, one of which was fatal. The symptoms in the animals do not accord with the symptoms in this case. In the first place, I have never known such a long interval between the administration of the poison and the coming on of the symptoms. The longest interval has been three-quarters of an hour, and then the poison was given in a form not easy of solution, and when the stomach was full. I have seen the symptoms begin in five minutes after the poison was administered. A quarter of an hour would be the average. Another reason is that in all the animals I have seen, and the human subject also, when under strychnia, the system has been so irritable that the very slightest excitement, as an effort to move, a slight touch, a noise, or a breath of air, will set them off in convulsions. I do not think it at all probable that a person to whom a dose of strychnia had been given could rise out of bed and ring a bell violently. Any movement at all would excite the nervous system, and there would be spasms. It is not likely a person in that state of nervous irritation could bear to have his neck rubbed. Where poisoning by strychnia does not end fatally, the paroxysm is succeeded by other paroxysms, which gradually shade themselves off. They generally become less and less, over a period of some hours. My experience agrees with Dr. Christison, that it would last over a period of sixteen or eighteen hours before the man gets better. I do not hesitate to say that strychnia is of all poisons the most easy of detection. I have detected it in the stomach, in the blood, and in the tissues of animals in numerous instances. The longest period after death that I have examined a body has been one month. The animal was then in a state of decomposition, and I succeeded in detecting very minute portions of the strychnia. When the strychnia is pure it can be detected in a very small portion of a part, at least the twentieth part of a grain. When mixed up with other matter it is a little more difficult. I can detect the tenth part of a grain in a pint of any liquid that you put before me, whether the liquid was pure or putrefied.
You have succeeded in detecting it in animals which have been killed a month, and were in a state of decomposition. What is the dose you have given them?--I gave the animal, a rabbit, originally half a grain, which killed it, and I have the strychnia here within a fraction of what I gave. I lost about a tenth part of a grain in the course of the investigation.
[Sidenote: H. Letheby]
Supposing a person had taken strychnia eight or ten days before, and that he died of strychnia poison, should you be able positively to say that you could detect it?--I do say so positively. I have never failed. In the post-mortem examinations I have always found the right side of the heart full of blood. The reason for that is that the death takes place by the fixing of the muscles of the chest in spasm. In my opinion this is invariably so. At that time the blood is unable to pass through the lungs, and the heart cannot relieve itself of the blood that is flowing into it. It therefore becomes gorged. I have also observed that the lungs are congested, filled with blood.
Do you agree in the opinion of Dr. Taylor that where strychnia is administered as a sort of pill or bolus it kills from about six to eleven minutes?--It may do so. I do not say it would always. I agree with him that the jaws are spasmodically closed, and also that the slightest noise reproduces another convulsive paroxysm. I do not agree with Dr. Taylor that the colouring tests for the discovery of strychnia are fallacious. They always succeeded with me.
Dr. Taylor has given as a reason for the non-finding of the strychnia that it is absorbed into the blood and becomes changed?--I agree with its absorption, but I do not agree with its being changed.
Have you turned your attention to the theory that strychnia is decomposed after the poisoning?--I have examined the tissues of the body and I have found it; and my opinion is that it is not changed so as not to be discoverable.
Supposing the contents were put into a jar and jumbled up with the intestines and a portion of the stomach, would that prevent the discovery of strychnia?--It would not.
Supposing that all the contents of the stomach were lost, ought the mucous membrane, in the ordinary course of things, to exhibit traces of strychnia?--I think so.
I have also studied the poison of antimony.
Supposing a quantity of antimony were placed in some brandy and water, and it was drunk off at a sudden gulp, would the immediate effect of that be to burn the throat, or anything of that kind?--No. Not in the form of tartar emetic.
[Sidenote: H. Letheby]
Cross-examined by the ATTORNEY-GENERAL--I am neither a member of the College of Physicians nor of the College of Surgeons. I do not now carry on business in the medical line, but have done so in general practice for not more than two or three years. I have destroyed about fifty animals by strychnia, some within the last two months. I have never given more than a grain. In recent cases I have always administered the poison in a solid form--sometimes made into a pill with bread, and at other times put on the tongue of the animal. In one case I gave it under very disadvantageous circumstances; the dog had had a very hearty meal, and it was kneaded up into a hard mass with some bread, and it took three-quarters of an hour before the action came on. There was one other case which took about half an hour, but the poison, half a grain, was not given in sufficient quantity. We gave it another dose, which acted in about ten minutes.
Dr. Nunneley describes the symptoms--first, a desire to be still, then a difficulty in breathing, a slobbering of the mouth, twitching of the ears, trembling of the muscles, and, after that, convulsions; did you observe all these?--I cannot say all of them in that order. There is an excitement manifested in the animal, an indisposition to touch, and trembling on being touched.
I am speaking of the symptoms before the convulsions. The touching, did that occasion a tremulous action of the muscles?--Yes, I have noticed that.
Have they come on in regular order?--No, I think not. There are some little variations.
After the convulsions have once commenced, is there an interval?--Yes. A breath, a sound, or a touch will cause a recurrence of the convulsive symptoms after they have been seized. This does not apply where the animal dies in the first paroxysm, and I have known many cases where an animal has so died.
You mentioned a distinctive feature in this case of Cook. You were surprised at his manifesting so much power as to be able to sit up in bed and ring the bell. Are you aware that that was at the commencement, before any of the convulsive symptoms had set in?--Yes, I apprehend that was at the onset or beginning of the paroxysm.
Do you know that he sat up in bed and rang the bell, and it was not till Palmer had been and had gone back and brought the pills that the convulsions came on?--Yes, I do; and I have noticed in animals that the mere touch sends them into convulsions, and they show an indisposition to move.
In the case of the lady who died near Romsey, did you hear what the maid said, that she discovered, when her mistress’ bell rang violently, that she had got out of bed and was sitting on the floor?--It struck me as inconsistent with what I have seen. I have no doubt that was a death from strychnia.
If that evidence be true, and it is a fact that she got up and rang her bell, does not that shake your faith?--No, it does not. You must compare it with what I have seen. Both are irreconcilable with what I have seen.
[Sidenote: H. Letheby]
Speaking of the Tuesday night, with the exception of the ringing of the bell, and that in this case it was an hour or an hour and a half after the supposed administration of the poison, can you point to anything to distinguish the symptoms and death of Mr. Cook from death by tetanus of strychnia?--No, I cannot. It is inconsistent with what I have seen, but it is not inconsistent with what I have heard in the case of Mrs. Smyth.
Is not one of the symptoms hard breathing?--It is a panting respiration. It is excitement of the breathing rather than difficulty. It is in the convulsions that there is a difficulty of breathing. If a man were to breathe hardly it is a position naturally assumed for him to sit up. Until the convulsion of the muscles comes on there is nothing to prevent the patient sitting up.
If I understand you, if I except the delay and the fact of his sitting up in bed and crying for help on the Tuesday, is there anything to distinguish the convulsions under which this man suffered and died from the convulsions of tetanus of strychnia?--It is not perfectly consistent with strychnia, because I say that the account which is given of Mrs. Smyth is what I cannot reconcile with what I have before observed.
With regard to the abrupt termination instead of the gradual subsidence?--I have observed the gradual subsidence in man as well as in animals.
In the case of the man--what dose had he taken?--Nearly a grain and a half.
This is a strongish dose?--Yes.
You might expect a recurrence of the paroxysm?--Certainly. The subsidence will not depend on the strength of the dose; it will depend on whether the individual is to recover or not. I have seen four or five instances of recoveries.
Is it not generally known that the effect of strychnia is very varied in different individuals?--No, I do not think so. There would be a little variation in time, but in the main features of the case there is no variation.
Do not you find this difference, that from the same dose in the same species you get no paroxysm, or you get a series of paroxysms ending in death?--Yes, that is true; but the attacks are the same for all that. The symptoms are the same.
What do you say about the Sunday night fit?--I was disposed to think it was a fit. I cannot tell you what it was; I have formed no opinion.
What do you ascribe Mr. Cook’s death to?--It is irreconcilable with everything I am acquainted with.
By LORD CAMPBELL--Is it reconcilable with any known disease which you have ever seen or heard of?--No, my lord.
[Sidenote: H. Letheby]
Re-examined by Mr. SERJEANT SHEE--Do you mean to say it could not be the result of any variety of convulsions, however violent, though not classed under a particular description of convulsion?--We are learning new facts every day, and I do not conceive it to be impossible that some peculiarity of the spinal cord, unrecognisable except the examination be made immediately after death, may produce symptoms like these.
When you say it is irreconcilable with anything you have heard of, do you include anything you have heard of strychnia poison as well as anything else?--Certainly I do.
Is the vomiting of the pills just before death inconsistent with what you have known and observed of strychnia poison?--It is not consistent with anything I have observed.
Have you ascertained whether, if you touch an animal which is beginning those minor premonitory symptoms, but which as yet has had no paroxysms, this brings the paroxysms on?--Yes.
Was not the Romsey case exceptional from the manner in which the strychnia was administered and the quantity of the dose?--Yes, it was. It is quite consistent with all I am saying that the ringing of the bell by the lady the moment she felt anything of uneasiness would produce the paroxysm which ultimately was observed. In my judgment, it is not safe to argue from the symptoms of a case in which the paroxysm took place only a few moments after the ingestion of the poison, and it was in a fluid state, to what may be the probabilities in another case.
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[Sidenote: R. E. Gay]
Mr. ROBERT EDWARD GAY, examined by Mr. SERJEANT SHEE--I am a member of the Royal College of Surgeons. In 1855 I attended a person named Foster suffering under tetanus. He had an inflammatory sore throat, muscular pains in the neck and the upper portion of the spinal vertebræ. He was feverish, and had the usual symptoms attending catarrh. On about the fourth day the muscular pains extended to the face. A difficulty of swallowing came on, the pains in the muscles covering the spinal vertebræ and in those of the lower jaw increased. In the evening of that day the jaw became completely locked; the pain came on in the muscles of the bowels, the same in the legs and the arms. He became very much convulsed throughout the entire muscular system. He had frequent and violent convulsions of the arms and hands, and afterwards of the legs. The difficulty of swallowing increased up to the ninth or tenth day. Not a particle of food, either solid or liquid, could be taken or introduced to the mouth. An attempt to swallow the smallest portion brought on the most violent convulsions. The convulsions were so strong throughout the whole system that I could compare him to nothing more than a piece of warped board in shape. The head was drawn back, the abdomen was forced forward, and the legs were frequently drawn upwards and backwards. The attempt of feeding with the spoon, the opening of the window, or placing the fingers on the pulse frequently brought on violent convulsions. He complained of great hunger. He was able to speak. He repeatedly cried out he was very hungry, what would he do if he could not eat? and he was kept alive till the fourteenth day by injections of a nutritive character. He screamed during these convulsions, and the noises he made were more like those of a dying man. About the twelfth day he became insensible. The convulsions, although very weak, continued till the fourteenth day, when he died. He was by business an omnibus conductor. He had been ill some few days--it might be a week. He had no other hurt or injury to his person of any kind which would account for these symptoms. His body was not examined after death.
By LORD CAMPBELL--What do you call the disease?--I call it inflammatory sore throat from cold and exposure to the weather. The symptoms became tetanic in consequence of an extremely nervous and anxious disposition. He had a very large family, and was a very hard-working man. I did not hear the evidence of the witnesses who described the symptoms of Mr. Cook.
Cross-examined by the ATTORNEY-GENERAL--That is what you call idiopathic tetanus?--Yes, decidedly so. I have had a vast number of cases of inflammatory sore throats and a great many anxious, nervous patients. That is the only case I have ever seen of idiopathic tetanus.
If I rightly apprehend your history of the symptoms, the disease was altogether progressive in its character, and, although there was an occasional cessation of the more painful symptoms, there never was a full cessation of the symptoms?--He was not suffering from tetanic affection. There was a twitching of the muscles going on, but there was not that violent convulsion. The lockjaw was the first of the more aggravated symptoms that presented itself, the muscular spasms about the trunk of the body progressing onwards to the extremities. He was conscious till the tenth day, when insensibility supervened while the convulsions were upon him. I consider the brain had been affected and congestion had taken place, and that produced insensibility.
After that was there some diminution in the severity of the convulsions?--Very great diminution, but they still continued.
Would that be likely to take place from the constant recurrence of the convulsions?--From the constant recurrence of the convulsions the brain would be congested.
You would expect to find a difference in that respect in a case where a man died very early in such a disease, and where it was spread over a longer period?--That would depend greatly on the violence of the convulsions.
By LORD CAMPBELL--And the repetition?--And the repetition.
The Court then adjourned.
Ninth Day, Friday, 23rd May, 1856.
The Court met at ten o’clock.
[Sidenote: J. B. Ross]