The Sun.
London, England, 1856-07-07 00:00:00

&c., CONDUIT-STREET.

There cannot, I presume, be a reasonable doubt that
Wm. Palmer murdered John Parsons Cook with poison;
that Cook died with tetanic symptoms, induced by what
Palmer had administered ; nor that antimony had beea
so administered. Several circumstances render it highly
probable that strychnine also was given by Palmer to
Cook; such as the perfect coincidence of the tetanic
symptoms with the known effects of strychnine, the pur-
cbase of strychnine by Palmer during Cook's illness jus t
before each of the two attacks of tetanic symptoms ; the
purchase of double the quantity before the sec,nd and
tatal attack 'hat he had purchased before the first attack
which had passed away ; the absence of explanation by
Palmer of what had become of the strychnine which he
had purchased ; and, with the world at large, the belief
general in the profession that antimony never occasions the
tetanic symptoms witnessed." On the.ocher hand no trace
of strychnine was detected after Cook's death; and Pal-
mer, though not denying that he had poisoned Cook,
firmly denied to the last that strychnine had been the means
of death. These two circumstances, however, may be in-
sufficient to justify a doubt that he had administered
strychnine.

I will now communicate from my own practice two
cases whir h prove that tetanic symptoms may arise from
antimony.
On the 31 of April, 1850, I was requested by a medi-
cal gentleman, re-iding in Saville-row, to see the child,
14 months old, of a mistress needlewoman in Princes-
street, Haymarket, labouring under a first attack of in-
flammatory croup, which he had been treating for 3 days
with solely the potassio.tartrate of antimony. He had
edven 27 grains. 11,e first dose was half a grain, an
he stayed two hours repeating this and watching ifs
effects till two grans had been swallowed, full vomit-
ing excited, and relief obtained. He then left the
house, directing that a tea-spoonful of antimonial
wine—a quarter of a grain of the tartarate—should be
given every four hours till his next visit, as long as
the difficulty of breathing and croupy sounds were
noticed. These returned repeatedly, but never so
alerniingly as they hart been previously, and next a dose
of half a grain was administered continually, both be•
day and night. By the fourth day, April 3, when 21
grins had been taken, the disease was very much alle-
d ; Irut the vomiting had been profuse, there had
been t tanic symptom, and the depression was extreme ,-:
inasmuch that the gentleman, who had made long and
repeated visits every day, became very anxious, and de-
sired my opinion. The arms and legs had been rigid,
the f eerier half bent ; the hands and feet turned in-
wards ; the thumbs drawn upon the palms ; the head
drawn backwards, and to one side ; the jaw closed so
that fluids could be introduced at the sides only, and the
for,.iible use of a spoon ; and, though this condition was
permtnent for three days and nights, and alter all vomit-
ing had ceased, there were catchings of the whole
frame, and every attempt to move the child had ag-
gravated the spasms. Consciousness was never lest.
When I first visited the patient all those symptoms
h-td subsided, the disease was greatly reduced, and
debility was the chief point in the case. I said that
such activity of treatment was new to me ; that I had
never give antimony to children under croup except in
doses just sufficient to excite nausea and frequent vomit-
ing ; but that I had always been very unsuccessful iu
my treatment of such eases of strongly inflammatory
croup, even with the addition of loss of blood and large
quantities of mercury, which acted too slowly to have
great power over the disease, though cases of a purely
or chiefly ima•modic nature yielded for the most part
readily ; that I made it a rule never to interfere with
treatment which was proving successful, notwithstanding
it was new to me, an. perhaps not in perfect accordance
with my notions. The gentletn -n inform, me that I
gave a very decided opinion that the child would recover,
that the treatment had saved its life, and that if the
symptoms of croup returned, they should be combated
agaio with the free but careful exhibition of antimony.
I well rec,dlect he to'd ins at the time that he had feared
I should oppl44e the further use of the medicine in any
circumstances. The child recovered with no further
treattn, nt.., and is now a fine boy, nearly seven years
and a half old.
This gentleman was led to treat the case so freely witk
art mony, he said, by having once been euccessfui in such
a cae with similar treatment put in practice ui-iinten-
tionally. He had lost three children in one family by
croup, and one of these I attended with him, after Dr. R.
Lee hat seen, it, and I know that loss of blood, mer-
cury, and atitimone• were carried es far as prudee oe
jesefied. -A fourth child, the youngest of all, was seized
with inflammatory symptoms in this throat, chile tihe
eldest was being treat,d with antimony f,r its fatal
croup. By mistake the youngest had the medicine in-
tended for the eldest, and quickiy recovered, after great
vomiting and depression ; symptoms of croup showed
themselses ultimately, but very mildly. He remarked
to his assistant that, when be had another case of croup,
he would treat it with such doses of antimony as had
proved successful in this instance. A year afterwards
the same child bad croup again, and, through the
negligence of the friends in not giving the antimony as
directed was nit so treated, and it died.
On Feb. 15, 1852, I was summoned by the same gentle. eeeneS
neailtaropettltweith him upon the case of a baby 8 eennthe
old, affected with inittrnmatory croup for the first
time—the chi!d of a Welsh member of Parliament.
Another child had already died of croup in Wales. Be
had been called up in the night, and had begun with half-
grain doses of the tartrate, giving one dose every hour,
and visiting the patient every two or three hours. He
grew anxious, and we met in the afternoon. From my
knowledge of his farmer case, I at once concurred in
what be was doing, and advised a continuance of the
treatment, carefully watched by him, as I knew it would
he both dly and night. Seven grains were given in. 16
hours ; copious vomiting was produced ; and tetanic
symptoms excited as in the first case, but not so strongly.
I did not witness them. Recovery was rapid and pa r-
feet. No other medicine was given ; two or three leecha
had been applied at the first, and a dose of calomeil
ordered, hut without advantage.
The assistant of this gentleman is now in practice in
Warwicketreet, and three years ago called me in to see
the child of a tradesman, iu Regent-street, affected with
croup, and being treated by him with the large adminis-
tration of the potassio-tartrate of antimony that he had
seen successful in the first case which I have described.
He began by applying three leeches, and with the anti•
mony, gave 12 minins of wine of ipecacuanha and calo-
mel. I first saw the child late at night, after the treat-
ment had been going on for twelve hours. He had
given at first a quarter of a grain of the tartrate every
ten minutes, and, as vomiting was not induced, be soon
gave half a grain. This speedily had the effect, and it
was repeated as often as the vomiting had eesused for a
time. The plan was persisted in for four days, and
about 32 grains of the tartrate was taken ; no tetania
symptoms nor convulsions ware produced, and the child,
though distressed, perfectly recovered. The ;little girl
was six years old. He says I was delighted, that we
both regarded the cure as splendid. and that he after-
wards effected exactly such another cure in a child 13
years of age, at Tornham-green, where he was then
staying, and no spasms occurred.
I have no doubt that I have generally failed with tar-
trate of antimony in violent inflammatory croup, and so nee
other inflammatory diseases of children, by not carry-
ing the remedy far enough. Children have been _re-
ported to have sunk under it, and I had always feared to
do mischief with it. Of the uncertainty of the antimonial
powder, 136 years ago gave ample proofs to the prom
fession,t and from that time have not used it. The
tartrate is all that can be desired ; by regulation of the
dose, it may, like the steam-engine or elephant's trunk,
be employed for the most delicate or the most powerful
work.
In the two examples of tetanic symptoms from anti-
mony the patients were ,infants : one 14, the other 8
months' old. Those in whom no tetanic symptoms took
place were, the one 6, the other 13, years old. Yet an
enormous dose will induce tetanic symptom in children
not babies, and in adults. Dr. Alfred Taylor quotes
from the Lancet two cases of children, a girl three years
old, and a boy five, who each swallowed a powder con-
taining 10 grains of the tartrate mixed with sugar. In
twenty minutes they were seized with vomiting, purg-
ing, prostration, convulsions, and tetanic spasms. The
boy died in eight hours, and the girl in thirteen. He
quotes also from the Lancet the case of a man, 28 years
of age, who swallowed two drachms of the tartrate in
mistake for Epsom salts, and recovered ; and, besides
agony, prostration, some vomiting, and great purging,
had constant spasmodic contractions of all the muscles,
especially those of the abdomen and upper extremities.
The fingers were firmly contracted, and the muscles quite
rigid.
During the whole of Cook's attacks of vomiting, diarr-
beets, and depression, tetanic symptoms occurred till
the Monday night before his death on the Tuesday night.
There is no reason to suppose that strychnine had up to
that time been given—to suppose that Palmer had not
trusted to antimony alone in order to kill Cook. It wall
cunning in him to select antimony. A soporific
would
have suggested foul play by the stupefaction ; Prussro
acid might have given odour perceptible to those around ;
arsenic would have been too common a poison not to
have been easily detected. Antimony was the least
to
likely to excite suspicion or be thought of. He seems
have trusted to it till he was out of patience,and pro-
bably expected to find Coo,nk dtheead Mwohnednaybenriegthut. He
rned to
didß ug e eeyt fromgive q
Londonuenti on
sufficient to excite tetanic
symptoms ; probably he feared to use larger quantities,
lest each administration should produce burning pain at
the stomach, be instantly followed by vomiting, and
lead to certain detection of crime. There is no reason to
suppose that he had any deep views of preparing the sys-
tem for the action of strychnine, which is potent enough
without preparation, or of rendering the detection of
strychnine by the chemist more difficult, which is nob
known to be a fact. His course appears to have been
simple enough—to attempt to murder Cook byantimony,
as he probably had murdered his other vietims, and, not
succeeding so soon as he anxiously desired, to resort, at
the last moment, to strychnine, with which also he
failed, till, on the Tuesday night, he gave it again.

" I employ the expression " tetanie symptoms," because
some may be unwilling to allow the term " tetanus" to 160Y-
thing but the two divisions of the regularly-formed disease --
idiopathic and symptomatic—and their subdivisions. l'rau-
matic tetanus is only one of the subdivisions of the 531ap.
tomatie. ,
" Numerous Cases, illustrative of the Efficacy of the
Hydrocyanic or Pruspic Acid in Affectioee •f tho Stoma ch,
"
.