The Sun.
London, England, 1856-05-19 00:00:00

I am a physician at King's College Hospital. I have
lectured upon tetanus, and I agree with the last wit-
ness. I have seen cases of idiopathic tetanus, they come
from no external wound, but from constitutional causes.
I think the term tetanus ought not to apply to poison
cases. The first symptom of tetanus is stiffness of the
jaw. There are no intermissions, but there are diminu-
tious, but no subsidence. Acute cases will terminate
in 3 or 4 days, but chronic ones will continue for 19 to
22 days. The locking of the jaw is the first symptom.
Epilepsy will produce convulsions, and epileptic con-
vulsions are tetanic in form. Epileptic convulsions are
soon over ; they are not persistent. I should say that
apoplexy would not produce tetanus ; but if there was an
effusion of blood upon the brain, that might produce
tetanic symptoms. The spasm extends to the heart in
cases of strychnine. A medical practitioner would not,
I think, have any difficulty in distinguishing tetanic
from other convulsions. I have heard the examination
about the spinal cord, and think that if disease had been
in existence it would easily have been detected.
Sir Benjamin Brodie, examined by Mr. E. James—l
am surgeon of Guy's, and have had many cases
of tetanus during the years I have been there.
I have heard the symptoms of death described. This
idiopathic tetanus generally commences with a stiffness
of the lower jaw. The contraction of the back and
muscles is an after symptom generally much later—
affects the extremities in a less degree than the back and
trunk. In ordinary cases it generally lasts for three or
four days. I have heard of one case terminating in
twelve hours ; but then I think the early symptoms had
been overlooked. I never knew that'the ordinary symp-
toms lasted a few minutes, then subside and then return
after a lapse of 24 hours. I have never seen the effects
of strychnia in human life. In my opinion Cook's
death did not arise from either descriptions of tetanus.
I never heard that sore throats caused tetanus, or from
any syphilitic affection at all. I never knew of either
epilepsy or apoplexy producing tetanus it is always
continuous. I may as well state that, from what I have
heard of the description of Cook's death, I do not
think that the symptoms arose from any disease at all.
(Great sensation.) I refer not to the particular symp-
toms, but to the course symptoms took. '
Cross-examined by Sergeant Shee—l recollect being
shown one case of idiopathic tetanus, but doubted if it

was one.

By Mr. Sergeant Shee—Considering the rarity of the
case, would you form an opinion from the statements
which you beard from a country practitioner to a chain
bermaid ?

Lord Campbell interfered, and said he did not think
such a question should be put.
Sergeant Shea—Which would you prefer, the cham-
bermaid or the practitioner

The Court ruled that such a question should not be
put.

Sergeant Shee—Have you heard of cases where
syphilitic poison has caused convulsions ?

'itness—Only when it has reached the bones of the
head and caused disease.

The Court then adjourned for a few minutes.
Oa the re a9semblin:-; of the Court,

Application was here made that the depositions of
Dr. Bamford mi,zht be put in, as he was too ill at pre-
sent to attend. The learned gentleman read an autho-
rity as a precedent for such a proceeding.
Sergeant Shee had not the slightest objection to such
a proceeding.

Lord Campbell said if the Attorney-General wished
the depositions of Dr. Blunford to be read, and Sergeant
Shee did not object, the depositions might be read,
but he would not give any opinion on the point.
The Attorney-General mked the witness, Dr. Todd, ii
ha bad seen Dr. Bamford lately ?
Dr. Todd—Yes, yesterday; he was then too unwell to
attend.

Another medical gentlansan attending on Dr. Blrn-
ford, having been sworn, stated that he had seen Dr.
Bamford that morning, and he was to) unwell to at-
tend.

The depositions were then read and the cause of Cook's
death was attributed to apoplexy, a certificate being
given to that effect by Dr. Bamford.
Dr. Todd then said --I have heard the depositions of
Dr. Bamford read, and I cannot agree that the de•
ceased died from apoplexy. Thera were poisons which
will producs tetanus. Those poisons which contain
strychnine and brucia. The smallest quantity of these
poisons that would kill would perhaps be half a
grain, but I should not like to give a quarter
of a grain. Half of a grain might produce death,
but a grain certainly would. Half a grain would
kill a cat. I have given it to animals in solution. A
large dose would act in about half an hour. The syrup.
toms would consist in strong convuhnonp. Then
would be violent jerking arising from the spasms.
Death would be over in a quarter of an hour, or half an
hour, if a dose sufficient to destroy life was given. There
would be a marked distindtion between that caused by
strychnine and tetanus. I have heard the description
given by Dr. Bamford of Cook's death, and I don't
think he died from traumatic tetanus. 1 have seen a
case of a person suffering from an overdose of
strychnine. There would be a stiffness of the limh4,
and the other symptoms that have been described.
I am of opinion from what I have heard that Mr. Cook's
death resulted from tetanus produced by strychnine.
Cross-examined by Mr. Grove—There are cases of
every degree of convulsions—running from the mild
form into the tetanic form imperceptibly—but then there
would be a difference in the muscles affected. Tito wit-
ness was then examined on the scientific effect of ‘trych
nine on the human body, and also with reference to a
work he has published bearing on the point, but which
was devoid of interest to the general reader. He was
also examined with reference to the evidence of other
medical men on the effeet of this poison.
Witness continued—A speedy examination of the
spinal cord immediately after death was important in
a pathological point of view. Morbid appearances af-
ter death are, produced, similating the appearance of
disease before death. The signs of decomposition would
be easily recognised. Granules upon the spinal
cord as described, I think, were not likely to pro-
duce tetanus. I am not aware of any cases
where small granules on the arachnoid have produced
tetanus. I think the cause of death from strychnine to
arise partly from a difficulty of action in the respiratory
organs, and partly from general nervous excitement. I
think there is a difference of opinion with reference
to that, or whether the animals experimented on
died from asphyxia. I think the word " suffocated" is
used loosely in the medical works. If an animal dies of
asphyxia the heart is full of blood. I can't remember
whether in my experiments on animals with strychnine
it did not take effect for an hour or so after adminis-
tration.

Re-examined by the Attorney-General—l should ex-
pect to find the heart rather empty of blood, and rather
contracted after the use of strychnine.

Dr. Daniels, of Bristol, was called, and said—l have
retired from practice, and have seen a great many cases
of tetanus. I agree with the medical gentlemen who
have been examined. I have seen two cases
of idiopathic tetanus, and one of which terminated
fatally. The symptoms were not so severe as in the
case of traumatic tetanus. I could not trace those
causes. I agree with the statement of the prisoner's
witnesses as to the causes of ordinary tetanus. I have
heard a description of Cook's symptoms. They
were distinct from the symptoms of the cases of tetanus
I have seen. I agree with Sir Benjamin Brodie as to
the points of distinction. Tetanus begins with uneasi-
ness in the lower jaw, followed by spasms of the muscles.
I don't think the clenching of the hands is the
effect of ordinary tetanus. I have seen a great many
cases of syphilis. I never remember a sore from such
a cause produce tetanus. I do not consider Cook's
symptoms were either apoplexy or epilepsy. In my
judgment Cook's symptoms could not be referred to
idiopathic or traumatic tetanus.
Cross-examines by Mr. Grove—l am not aware of
excitement or irritation proceeding from vomiting or
tetanic convulsions. I have seen the bodies of persons
who hail died from suffocation. I cannot say whether
the heart generally was full. The diseases producing,
tetanus bear a very small proportion to those which do
nct.

Mr. Silly—l am surgeon in St. Thomas's Hospital. I
have been 23 years connected with that hospital, and I
have witnessed a number of cases of tetanus.. I cannot
say how many, but I have had six or seven under my
own care, and I might have seen nine or ten others.
They were traumatic cases. Death in no ca'e
occurred under thirty hours. The symptoms
were always progressive. Cook's case differs essen-
tially from the cases I have seen. In all
cases I have seen there is an alteration of the counte-
nance in the first symptoms. It is a sort of grin FO
peculiar that, having once been it
mistaken. In the symptoms I have here detailed there
was stiffness about the face or jaw. Cook's case was
not attributable to apoplexy or any other disease I have
ever witnessed.

Cross-examined by Sergeant Shee—The grin called
risus sardonicus is not common ; it may, perhaps, occur
in idiopathic tetanus. The paroxyms of Cook
have some resemblance to epilepsy. All convul-
sions are not attended with loss of consciousness.
Death from epilepsy, with convulsions, generally
leaves a trace behind -- a slight effusion of blood