Part 9

Cross-examination resumed--I heard the description of the shriek with the convulsion; but it was the shriek that called the medical man into the room. That was at the height of the attack. In some respects that last shriek and the paroxysm that occurred immediately afterwards bear a resemblance to epilepsy. Death from tetanus accompanied with convulsions seldom leaves any trace behind; but death from epilepsy leaves behind it some few effusions of blood on the brain or congestion of the vessels.

[Sidenote: Samuel Solly]

Re-examined by the ATTORNEY-GENERAL--Convulsions that take place in epilepsy are not at all of tetanic character. I say that Mr. Cook did not die from epilepsy, because there were none of the symptoms there. When a patient dies with epilepsy he dies perfectly unconscious. Ulceration of the brain from injury, a sudden injury to the spinal cord, irritation of the teeth in infants, all produce convulsions. But those convulsions in their progress are not similar to the convulsions of tetanus. There is no progressive movement and no appearance about the face or jaw of having tetanus.

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[Sidenote: R. Corbett]

Dr. ROBERT CORBETT, examined by Mr. JAMES--I am a physician in Glasgow. I remember a patient of the name of Agnes Sennet who died in the Glasgow Royal Infirmary on 29th September, 1845, after taking some strychnia pills intended for another patient. I saw her while she was under the influence of the poison. The symptoms I noticed were a retraction of the mouth, face much suffused and red, the pupils dilated, the head bent back, the spine curved, and the muscles rigid and hard like a board. She died about an hour and a quarter after taking the pills. There would be a quarter of a grain in each of the three pills she took.

Cross-examined by Mr. SERJEANT SHEE--The retraction of the angles of the mouth was continuous, but it was worse at times. I did not observe it after death. The hands were not clenched, but semi-bent after death. That semi-bending of the hand is a very common thing in cases of death by violent convulsions. Twenty minutes after taking the medicine she was attacked by the symptoms.

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[Sidenote: Dr. Watson]

Dr. WATSON, examined by the ATTORNEY-GENERAL--I am one of the physicians in the Glasgow Royal Infirmary, and attended the case of Agnes Sennet spoken to by the last witness. I saw her about a quarter of an hour after the symptoms first began. She was in violent convulsions; her arms were stretched out and rigid; her feet and legs were also rigid. Just at that moment she did not breathe. That paroxysm subsided almost immediately, and fresh ones came on after a very short interval. They occurred at intervals until they destroyed her. She was about half an hour in dying. She seemed perfectly conscious during the time. At the post-mortem examination the spinal cord was quite healthy. The heart was contracted.

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[Sidenote: Mary Kelly]

MARY KELLY, examined by Mr. BODKIN--I was a patient in the Glasgow Royal Infirmary, and saw Agnes Sennet take the pills, which were intended for another patient. I saw her take two pills only. After taking the pills she went and sat down by the fire, and in about three-quarters of an hour she was taken ill. She fell back on the floor, and a nurse and I lifted her into bed. The nurse cut her clothes off, and she never moved after she was put upon the bed; she was just like a poker. She never spoke after she fell.

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[Sidenote: C. Hickson]

CAROLINE HICKSON, examined by Mr. JAMES--In October, 1848, I was nurse and lady’s maid in the family of Mrs. Serjeantson Smith, at Romsey, in Hampshire. On the 30th of that month Mrs. Smith was unwell, and some medicine was sent to her in the afternoon, about six o’clock, by a Mr. Jones, a druggist in Romsey. Shortly after seven o’clock next morning I saw her take about half a wineglass of the medicine. About five or ten minutes afterwards I was summoned to her bedroom, and on entering I saw her leaning upon a chair, and I thought she had fainted. She appeared to suffer from what I thought spasms. I went out and sent for Mr. Taylor, surgeon, and on returning to the bedroom I found some of the other servants assisting to support Mrs. Smith. She was then lying on the floor and screaming very much, very loudly, but did not open her teeth. She asked me to have her legs pulled straight, and I found them drawn up very much. She still screamed as if in great agony, and requested some water to be thrown over her, which I did. Her feet were turned inwards. I put a hot-water bottle to them, but this had no effect. Shortly before she died she said she felt easier, and her last words were, “Turn me over.” I did so. A few minutes after this she died. She was conscious, and knew me during the whole time. From the time she took the medicine until she died would be about an hour and a quarter.

Cross-examined by Mr. GROVE--From the time I first saw her in the spasms she could not sit up at all. It was a continuous, recurring fit, and lasted about an hour. She only seemed easy for a very short time before her death. Her teeth were clenched during the whole time.

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[Sidenote: F. Taylor]

Mr. FRANCIS TAYLOR, examined by Mr. WELSBY--I am a surgeon at Romsey. I was summoned one morning to the house of Mrs. Serjeantson Smith. I arrived between eight and nine o’clock, shortly after she died. I saw the body then. The hands were clenched; the feet were contracted, turned inwards; and the soles of the feet were hollowed up. This appeared to have been from recent spasmodic action. The limbs were remarkably stiff. The body was still warm. The eyelids were totally adherent, almost to the eyeballs. I made a post-mortem examination three days after death. The contraction of the feet continued, but it was gone off somewhat from the rest of the body. No trace of disease was found. The heart was contracted and perfectly empty, and the blood was fluid. I analysed the medicine Mrs. Smith had taken. It originally contained nine grains of strychnia, and Mrs. Smith had taken one-third. As the truth was so apparent, only a very general examination of the stomach and bowels was made, but still sufficient to find traces of strychnia.

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[Sidenote: Jane Witham]

JANE WITHAM, examined by Mr. JAMES--In March last I was in attendance on a lady who died. I remember her taking some medicine, after which she became ill. She first complained of her back, and when I went to her I observed her head was drawn back, and I could not get at her back. She was in bed. I noticed she had twistings of the ankles, and her eyes were drawn aside and staring. She first complained of illness on the 25th of February, and she died on 1st March. She had several attacks, between each of which she got better. She generally complained of a pricking in her legs and twitching of the muscles in the hands, and she compared them to a galvanic shock. During the attacks she requested her husband to rub her legs and arms. The first attack was on the Monday, and she died on the Saturday about ten minutes to eleven at night.

(This case was that of Dr. Dove’s wife.)

Cross-examined by Mr. SERJEANT SHEE--It was on the commencement of the spasms that she requested her legs to be rubbed. On the Saturday night she could not bear them to be touched. On that night the spasms were much stronger than on the other days. On the Saturday she did not speak but once or twice. During the interval of the spasms on the Saturday touching her brought the spasms on. She could swallow on each of the days except the Saturday, when her mouth was quite closed. After death her body was stiff.

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[Sidenote: G. Morley]

Mr. GEORGE MORLEY, examined by Mr. WELSBY--I was the medical attendant on the lady referred to by the last witness. I had been attending her for about two months before her death for a functional derangement. I saw her on the Monday before her death lying in her bed. I observed several convulsive twitchings of her arms. I saw her on the Saturday about the middle of the day. She was much better, and in a composed state. She complained of an attack she had had in the night, and spoke of pains and spasms, affections of the back and neck. I and another medical gentleman made a post-mortem examination on the Monday. We found no disease which would account for death. There were no abrasions, nor any wound or sore. The hands were semi-bent, the fingers curved, and the feet were strongly arched. We applied several colour tests to the contents of the stomach for the purpose of detecting the presence of poison. On each occasion we produced the appearance characteristic of strychnia. After the separation of the strychnine by chemical analysis we inoculated two mice, two rabbits, and one guinea pig with the stuff taken from the stomach. We observed in each of the animals more or less the effects usually produced by the poison strychnia--general uneasiness, difficult breathing, convulsions of the tetanic kind, muscular rigidity, bending backwards, especially of the head and neck, a violent stretching of the legs. In the case of the animals where death resulted the muscular rigidity continued without any intermission. There was an interval of relaxation, but immediately after death the muscles became very rigid, more so than at rigor-mortis. We afterwards made a similar series of experiments on some animals with strychnia itself, both in solid and liquid forms. The symptoms and the results generally were exactly the same as those I have described in the case of the other animals.

Cross-examined by Mr. GROVE--I did not see the patient during any severe attack. I observed that when the animals were touched it brought on the symptoms. That is a very marked result. Directly they are touched they give a sudden start, and pass into a severe spasm. At the post-mortem examination the lungs were very much congested. The muscles generally were dark and stiff. There was a decided quantity of bloody serous effusion over the brain. There was a notable quantity, but not a large quantity, of serum slightly tinged with blood in the membranes of the spinal cord. The large spinal veins were very much congested, as were the membranes of the spinal marrow. We opened the head first, and that led to a great deal of blood flowing from the head. That would make it uncertain whether the heart was full or empty. The right sides of the hearts of animals that have been poisoned by strychnia are generally full. From one to two hours is the longest time in animals at which I have perceived the first effect of strychnia come on after it has been taken. I made experiments in conjunction with Mr. Nunneley, and my impression is that the interval has been as long as one hour. I discovered strychnia with all the tests I applied with more or less distinctness. I have detected strychnia in the stomach two months after death, and after decomposition had proceeded to a considerable extent.

[Sidenote: G. Morley]

Re-examined by the ATTORNEY-GENERAL--I have given to the animals which I have killed from half a grain to two grains. The animals experimented on were cats, rabbits, and dogs. The strychnia, I think, acts on the nerves, but a part may be taken into the blood also and act through the blood. The poison is absorbed. We searched the stomach to find the presence of the strychnia. The strychnia which we found in the stomach would be that which was there in excess beyond that which had been absorbed in the system. The strychnia that has been absorbed into the system is sufficient to destroy life. The excess that remains in the stomach is inactive. I should expect to fail sometimes to find strychnia in the stomach if the minimum quantity capable of operating to the destruction of life had been administered. If death resulted from a series of minute doses of this poison, administered for a space of several days, it is my opinion that the appearances would be likely to be different after death from what they would, supposing death was produced rapidly by one dose.

Re-cross-examined by Mr. SERJEANT SHEE--Is it your theory that in the act of poisoning the poison is absorbed and ceases to exist as poison, as strychnia?--I am inclined to think so. I have thought much upon that question. I am not decided in my own mind.

What chemical reason can you give for your opinion?--My opinion rests on the general fact that organic substances acting on the human body, such as food or medicine, are frequently changed in composition. It is possible that strychnia may have been discovered in the blood and liver after effecting the operation of poisoning, but I do not know that it has.

Do you know whether strychnia can be decomposed by any sort of putrefying or fermentative process?--I have no fact to show that it can, and I doubt if it is.

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[Sidenote: E. D. Moore]

Mr. EDWARD DUKE MOORE, examined by Mr. HUDDLESTON--I was formerly in practice as a surgeon. About fifteen years ago I was attending a gentleman for paralysis, and had been giving him some very small doses of strychnia. Subsequently I made him up a stronger dose containing a quarter of a grain. In about three-quarters of an hour I was summoned to come back and see him. He was stiffened in every limb. His head was drawn back, and he was screaming, frequently requesting that we should turn him, move him, and rub him. His spine was arched. We tried to give him a mixture of ammonia with a spoon. He snapped at the spoon with a sort of convulsive grasp to take it. He was suffering about three hours altogether. He survived the attack, and was perfectly conscious the whole time.

Cross-examined by SERJEANT SHEE--He recovered from the spasms in about three hours, but the rigidity of the muscles remained for the rest of the day and part of the next day. He was completely recovered the next day after the attack, and the patient himself said he thought his paralysis was better.

The Court then adjourned.

Fifth Day, Monday, 19th May, 1856.

[Sidenote: Alfred Taylor]

Dr. ALFRED TAYLOR, examined by the ATTORNEY-GENERAL--I am a Fellow of the College of Physicians, a lecturer on medical jurisprudence at Guy’s Hospital, and the author of a well-known treatise on poisons and on medical jurisprudence. Among other poisons, I have made strychnia the subject of my attention. It is the produce of the nux vomica. There is also in the nux vomica a poison of an analogous nature called bruchsia, which differs from it only in point of strength. The difference of the two poisons is relatively estimated from one-sixth to one-twelfth, bruchsia being one-sixth to one-twelfth the strength of strychnia. I have never witnessed an instance of the action of strychnia on the human subject. I have tried a variety of experiments, I think about ten or twelve, on animal life with strychnia. Rabbits have always been used for these experiments. The symptoms produced by the poison have been on the whole very uniform. I have given a quantity varying from one-half to two or three grains. I have found half a grain sufficient to destroy the life of a rabbit. I have given it in both solid and liquid form. When given in a fluid state it produced its operation in two or three minutes; when given in a solid state, in the form of pill or bolus, from about six to eleven minutes, I think. The time is influenced by the strength of the dose, and also by the strength of the animal. The poison is first absorbed into the blood; it is then circulated through the body, and the poison especially acts on the spinal cord. That is the part of the body from which the nerves affecting the voluntary muscles proceed. The entire circulation through the whole system is considered to take place about once in four minutes.

LORD CAMPBELL--Are you speaking of the human circulation?--Yes; the circulation in the rabbit is quicker.

Examination resumed--How is it the absorption would be quicker in a rabbit?--I think it is from the effects produced; that will also depend on the state of the stomach, as to whether there be much food in the stomach and whether the poison comes in immediate contact with the inner surface of the stomach. The poison must first, I believe, be absorbed before it acts on the nervous system.

[Sidenote: Alfred Taylor]

Will you describe the series of symptoms from the commencement to the close?--The animal for about five or six minutes does not appear to suffer; it moves about freely and actively. It then, when the poison begins to act, suddenly falls on its side. There is a trembling of the whole muscles of the body, a sort of quivering motion arising from the poison producing those violent and involuntary contractions. There is then a sudden paroxysm of it; the fore legs and the hind legs are stretched out, the head and the tail are drawn back so as to give it the form of a bow. The jaws are spasmodically closed, the eyes are prominent, protruding. After a short time there is a slight remission of the symptoms, and the animal appears to lie quiet, but the slightest noise or touch reproduces convulsive paroxysms. There is sometimes a scream or sort of shriek; the heart beats very violently during the fit, and after a succession of these fits the animal dies quietly.

There is not invariably, immediately prior to death, a remission of the symptoms?--I have only known an animal has died by having the hand over the heart. It has been in a state of spasms at that time. In one or two cases the animal has died quietly, as if there was a remission; sometimes it dies apparently during the spasms itself.

What appearance have you observed after death which would be different from the ordinary appearances--the outward appearances? Are the muscles more than usually rigid?--In some instances the animal has been rigid throughout; that is to say, it has died in a spasm, and the rigidity has continued, the muscles so strongly contracted that for a week afterwards it was possible to hold the animal horizontally extended by the hind legs without the body falling. In an animal killed the other day the body was flexible at the time of death, but it became rigid about five minutes after death. I have opened the bodies of animals that have been thus destroyed. I have found no appearances in the stomach or intestines which would indicate any injury there. I have found in one or two cases congestion of the vessels of the membranes. In other cases I have not found any departure from the ordinary state of blood. The membranes of the spinal cord and brain are a continuation one of the other, so that it is not easy to have congestion of one without congestion of the other. The congestion of those membranes has been due to fits which the animal has had before death. In three out of five cases I failed to discover any abnormal condition of the spinal cord or brain. As to the hearts of animals thus killed, from all that I have seen the heart has been congested with blood, the right side especially. The description given by Elizabeth Mills and Mr. Jones of the symptoms which accompanied the attack on Mr. Cook are similar to those I have seen in animals to which I have administered strychnia.

[Sidenote: Alfred Taylor]

How long does it take in the case of rabbits to which you have administered strychnia from the time the first symptoms manifest themselves to the time of the death?--They have died in various periods--one died in thirteen minutes, one in seventeen minutes; that, I should mention, would be the whole time. The symptoms appear more rapidly when the poison is administered in a fluid state, and death has taken place in five or six minutes after. The experiments which I have particularly noticed and performed lately, and which I am about to detail, have been in reference to solid strychnia. In the first the symptoms began in seven minutes, and the animal died in thirteen minutes from the time the poison was given; in the second the symptoms appeared in nine minutes, the animal died in seventeen minutes; in the third the symptoms appeared in ten minutes, the animal died in eighteen minutes; in the fourth the symptoms appeared in nine minutes, and the death took place in twenty-two minutes; in the fifth the symptoms appeared in twelve minutes, and the death took place in twenty-three minutes. In the human subject, supposing this poison to be administered in the shape of pills, I should expect it would take a longer period before the poison began to act, because it requires that the pill structure should be broken up in order to bring the poison in contact with the mucous membrane of the stomach.

[Sidenote: Alfred Taylor]

Given that the poison is administered in both cases, to the rabbit and the human subject, in the shape of pills, should you expect a longer period before it began to act on the human subject than the rabbit?--I do not think we can fairly draw any inference; the circulation and absorption are very different. It is very probable that there would also be a difference between one human subject and another in the power of taking the thing up with more or less rapidity. The strength of the dose would make a difference; a large dose would be more rapid than a small dose. I have experimented upon the intestines of animals to reproduce the strychnia or to discover it. (Dr. Taylor described the chemical tests.) These colour tests, as they are called, are, I think, very fallacious. There are other vegetable matters to which, if these colour tests are applied, similar results as to colour would be obtained. A mixture of sugar and bile will produce the purple and red tint, for instance. Vegetable poisons are more difficult of detection by chemical processes than the mineral ones, and the tests are more fallacious. In four cases of animals destroyed by strychnia Dr. Rees and I endeavoured to reproduce the strychnia, and then applied to it those colouring tests which I mentioned just now. We also tried the effect of taste. In one case by the colour test we satisfied ourselves of the presence of strychnia; in another there was a bitter taste in the liquid, but no indication of strychnia by the colour test. In other two cases there was no indication at all of the presence of strychnia. In the first case we had given a dose of two grains at intervals; in the second case one grain; in the other two cases one grain and half a grain.

How did you account physiologically for the absence of any indication of strychnia where you know strychnia to have been given and to have caused death?--By absorption into the blood so that it is no longer in the stomach; it is in a great part too changed in the blood. In the case of the larger dose there would be a retention of some not absorbed. That would be in cases beyond what was required for the destruction of life. If the minimum of the quantity required to destroy life was given, I do not think I would find any. It would be removed by absorption, and no longer discoverable in the stomach.

Are there any chemical means you are acquainted with whereby the presence of this poison can be detected in the tissues?--There are not; there is no process I am acquainted with when it is in a small quantity; so far as I know it cannot be detected.

In addition to this distribution of the half grain, which you tell us is known to have destroyed human life, over the whole system, in your opinion does it undergo decomposition as it mixes itself with the animal tissues?--I believe it undergoes some change in the blood. That increases the difficulty in detecting it in the tissues. I have never heard of its being separated in a crystallised state from the tissues.

[Sidenote: Alfred Taylor]