The Northern Daily Times.
Liverpool, Merseyside, England, 1856-05-24 00:00:00

I am not

The Attorney-General : In the interval between the
convulsions, what would you expect to find his state ?
The Witness : Suffering pain and uneasiness, according
to the power with which the muscle's were convulsed.
Pain in the back—that is usual.

The Attorney-General! You would not expect complete
repose and freedom, both from convulsions and pain for

24 hours ? The Witness : No.
The Attorney-General : You have heard the symptoms
stated, I presume, of his state from midnight on Monday
to Tuesday night. Now, I ask you, as a medical man,
whether you believe under the circumstance.; that he died
from tetanus ? Witness : I should think not, my lord.
The Attorney General There are one or two symptoms
in Cooke's case which might be common to other forms of
death,. such as clenching of the hands. Did you ever
know, in a case of tetanus, of the hands being completely
closed after death ? Witness No.

The Attorney-General Have you ever known it even
of a case of idiopathic or traumatic tetanus; have you
ever known the hands and feet to be clenched, so that the
fingers are pressed down into the hollow of the hand ?
Witness ; I have seen the hand clenched—completely
clenched in the case of traumatic tetanus.
KiThe Attorney-General (tightly clenching his hand) As
mine is now ? Witness : Not so much as that'; but they
(the fingers) often require a good deal of force to open
them. _ .

V Yl-)e Attorney-General: You say the arching of the feet
invariably takes place, in death; did you ever see them so
distorted as to appear like a club foot ? Witness :

Never

1. The Attorney-General : You have heard the description
given by Mr. Jones that, when this man died, the bo:ly
was so bowed that, if it had been turned over on the back,
it would have rested on its head and feet ; have you any
doubt that that indicates death by tetanus? Witness : No,
I have not, and I should , not expect it in ordinary
tetanus.

The Attorney-General: Nowyou acknowledge to having
heard and attended to the description given by Mr. Jones
from the moment the paroxysms set in up to the time that
Cook died; is it clear to you that those symptoms are not
those of death bystrychnii. ? Witness : Some are consis-
tent, others are inconsistent with ordinary tetanus.
The Attorney-General : The question I ask you is this,
whether the symptoms—describing them—whether these
symptoms are not in accordance with what you know of
death by strychnia. ? Witness : Decidedly. (Sensation.)
The Attorney-General : You have known, of your own
experience, cases of traumatic tetanus ? Do you not know
that the symptoms are progressive and gradual, and never
wholly terminate until death ? Witness : I do. Traumatic
tetanns•doei not produce death for three or 'four days. If
death resulted in two hours, I should consider it probable
that there hasrbeen premonitory symptoms. I have never
witnessed a'cleith from strychnine, - In all my experience
I have never known such symptoms, as Cook's are described
to have been; arise from natural causes.
The Attorney-General : 'Before I sit down I will ask you
whether. you have ever known such a disease as that.
described (in Cook's case) to have proceeded from natural
causes ? Witness : Never.

Re examined by Mr. Grove : Several of those symptoms,
such as sitting up in bed, and beating the bed, are, in my
opinion, inconsistent with death by strychnia, as are also
the sudden cessation of the convulsions and apparent sudden
recovery

In the mole in which the attack come in, there
was apparently an absence of the usual nervous and.muscular
agitation as premonitory symptoms. The curving of the
foot might indicate tetanic convulsions, caused either by
poison or arising without poison. I only know by reading
iptoms of tetanic convulsions arising from injury to

vtry in their character—in their degrees of
violence, in the periods of their intermission, and in
the muscles attacked. Intermission of the convulsions I
knosi occurs in traumatic tetanus, but it is not frequent.
I cannot recollect whether death after forty eight hours is' a
common occurrence. Granules in the Tine are more un—
usual in young people than in old, 'but I don't know
that they are more indicative of disease. Ido not
know that the spine would preserve its integuity so long as
nine weeks after death, so as to afford means for a proper
examination. I would not feel myself justified in interring
that there was no disease by examining it after that space of
time and finding no traces of disease. Decomposition sets
in at various periods, from two hours to two days, accord-
ing to the temperature. Ido not think it in the least
probable that the spine could remain for nine weeks unde-

Composed.
At the suggestion of the Attorney-General, Lord Camp-
bell asked the witness : Supposing the stomach were not
acted on by other causes, would sickness be inconsistent
with tetanus ?

Witness

I think not

Mr. John Gay, examined by Mr. Gray : I am a fellow of
the Royal. College of Surgeons. I have been for 17 or 18
years hospital surgeon to the 'Royal Free Hospital; had a
case of traumatic tetanus in a boy under my observation in
1843. He was brought in to the hospital during the time
of his illness—on the 29th July, and died on the 2nd of
August, The accident from which it arose occurred about
a week before he was brought in. During the first three
days after I saw him, he had the usual paroxysms with un-
usual severity. He could not open his month when he was
brought in, and had great pain and stiffness about the
neck. During the first night, he started up and was
convulsed. During the following night he appeared con-
vulsed at times. The abdominal muscles, as well as those
of the neck and back, had become rigid cluing the night. The
muscles of the face were also in a state of great contraction.
On the following morning—the third—the muscles remained
in the same state. At two o'clock I found there was much
less rigidity of the muscles, especially those of the abdo-
men and the back. The following morning the muscular
rigidity had gone. He opened his mouth as wide as usual,
and talked and appeared thoroughly relieved. He asked
his nurse to change his linen, and while she was about to
do so, violent convulsions of the arms and face came on,
and he died in a few minutes. About thirty hours had
elapsed between the convulsions, of which be immediately
died, and the convulsions that had preceded them. The
rigidity bad been completely relaxed before that, but con-
vulsion came on. I had given the patient a small dose of
tartar emetic on the second day, in order to produce
vomiting.. It produced no effect, and on the following tlay
I gave him a larger dose, but did not again repeat it.
Cross-examined by the Attorney-General : The accident
which caused the tetanus in this case was the falling of a
large stone on the little toe of the left foot, which com-
pletely smashed it. The wound had become very
unhealthy. I amputated the toe. When I saw him the
mouth was almost closed up. His jaw was closed when I
administered the tartar emetic to him, but I managed
to get the emetic in. The convulsions appears to
have ceased during the day, with the exception of
rigidity of the muscle§. The muscles of the abdomen,
chest, back, and neck, were all rigid, and continued so
during the two days on which I administered the tartar
emetic. The rigidity of the muscles of the chest and
stomach would, I believe, go far to- prevent vomiting. I
suppose the 'tartar emetic would have produced its ordi-
nary result bat for the rigidity of these muscles. The
rigidity began to subside on the Ist August, and bad en-
tirely gone off by the time the last convulsion occurred.
The nurse set him up in bed in order to change his linen.
I do not think that in that operation the injured toe was
brought into contact with anything to cause the recarrence
of the convulsions. It might be so ; but I think there

must be some action set spin the spinal cord from the
nerves of the original seat of the injury, which action con-
tinues and causes the recurrence of the convulsions. I have
no doubt that the laceration of the toe was the first cause of
the disease.

Re-examined by Mr. Gray : The cause of that irritation
of the spinal cord. of which I have spoken mar, I. think, be
very various. I think it would be extremely difficult, if not
impossible, without some other evidence than the appearance'
of the symptoms, to decide the cause of tetanic convulsions,
fuither than they arise from some irritation of the spinal
cord.
;Dr. Wanald was next called, and examined by Mr.
Seneally : I am a licentiate 'of the Royal College of Sur-
geons of Edinburgh. I have been in practice for a number
of years, and have bad cases of trumatic and idiopathic
tetanus. I have seen two cases of idiopathic. I have also
Made experiments. Tetanus will proceed from slight causes.
Any internal alterations of the secretions will produce it.
Exposure to cold would produce it. Mental excitement will
also cause tetanic convulsions. Sensual excitement will
produce tetanus.: Granules in any part of the body
con-
nected with the nervous structure might produce it. Tetanic
e produced by means yet undiscoverable by human
science. There' is some obscurity about the disease.
Many post mortem examinations have taken place
in cases of death by tetanus, and no cause of disease
has been discovered. Strychnia is easily discoverable. In
the case of Catherine Watson I was fortunate to cure her,
and she is at present in court. [The witness here read the

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