The Sun.
London, England, 1859-08-26 00:00:00

THE SMETHURST CASE.

TO THE EDITOR OF THE TIMES.
Sir,—My evidence at the Smethurst trial, which
has been very briefly reported, was given not from
any sympathy with the accused, but solely because
I considered that an important element of the case
—namely, the existence of pregnancy, had been
almost, if not entirely overlooked. For the same
reason I ask your permission to remark upon cer-
tain facts to which, as it appears to me, due weight

has not been given.
First, as regards the actual pregnancy of Miss
Bankes. This was first discovered at the postmortem
examination by Mr. Barwell, but so little conse-
quence was attached to it that the matter was
scarcely heard of until the recent trial. It must be
remarked that the duration of the pregnancy corres-
ponded as nearly as possible to the length of the
illness of the patient. Mrs. Robinson deposed that
Miss Bankes was taken ill three weeks before she
left her house. She went from Mrs. Robinson's to
Mrs. Wheatley's on the 3d of April, and on the 3d
of May—seven weeks from the commencement of
her malady—she died. Mr. Bar well gives seven
weeks as the limit which the pregnancy might have
reached at the time of death.
Was the illness of Miss Bankes such as could pos-
6ibly have been caused by pregnancy. Obstinate and
irTepressible vomiting, with violent purging, were
the chief symptoms detailed at the inquest and at
the trial. It is an undoubted fact, recognised by
every obstetric authority, that women are often re-
duced to great peril, and sometimes killed, by the
vomiting .of pregnancy. Constant diarrhoea is also
met with as a disorder of pregnancy, either alone
or in connexion with vomiting. It is in the early
part of pregnancy that vomiting is most severe and
dangerous, and it
often begins at the very com-
mencement of this state. It is most likely to hap-
pen in the case of a woman such as Sliss Bankes is
described to have been, pregnant for the first time
in mature age, of bilious temperament, and the
subject of previous internal disorder. Stress was
laid by some of the witnesses on the burning sen-
sations complained of in the stomach and throat.
Pregnancy is constantly accompanied by heartburn,
end in certain cases there is an enormous amount of
acid secretion and eructation from the stomach.
The sickness of pregnancy is commonly most dis-
tressing in the morning on first taking food, or on
moving the body. This was spoken to as the fact
in the case of Miss Bankes, by one of the witnesses.
In the worst cases the vomiting is wholly intract-
able. The remedies which arrest ordinary sickness
are of no avail. Food and medicine era alike re-
jected, and the patient dies of starvation. For the
last two days of her life Miss Bankes was under the
care of her sister, and a nurse provided by Dr.
Julius. It told very forcibly against the prisoner,
that at this time, although the stomach rejected
medieine, it retained food. In two out of four fatal
cases from this kind of vomiting in which I have
been consulted the patients were able to take food
for a short time before death; the sickness ceased
when fatal exhaustion had set in. The same is re-
lated to have been the case in the history of Char-
lotte Bronte. Her biographer states that towards
the close " she begged constantly for food, and even
for stimulants. She swallowed eagerly now ; but
it was too late." Her illness is described as having
lasted six weeks.
Is it possible that the physician in attendance upon
Miss Bankes made an error of diagnosis in assigning
poison as the cause of her illness and death ? It was
strongly insisted on as a proof of poisoning, that
Dr. Todd, Dr. Julius, and Dr. Bird, should, either
individually or concurrently, have formed the opi-
nion that their potient was suffering from slow
irritant poisoning. Against this it is only fair to
place the fact that they did concurrently overlook
the existence of pregnancy, although it was before
them, and marked by one of its most common and
distinctive symptoms. It cannot but be considered
as remarkable that three medical men should have
been in attendance upon a woman 42 years of age,
living for the first time as a married person, who
had been suddenly seized with an illness of which
vomiting was a prominent symptom, without de-
tecting pregnancy. They appear to have been mis-
led by the inforioation given to them by gi:gethurst
as to the absence of one of the common synintoms
of pregnancy, and they made no examin'aiion.
Smethurst himself appears not to have suspectesd
pregnancy. As regards Dr. Todd, it may be
accounted for by the circumstance that, however
undisputed his great eminence as a pure physician
may be, he is not accustomed to treat the disorders
of pregnancy. However the fact may be, the medi-
cal attendants certainly formed a conclusion while
they were -without the knowledge of a very im-
portant element of the case.
Do the symptoms of a fatal case of vomiting from
pregnancy so far resemble poisoning as to be liable
to be mistaken for them ? There is no limit to the
reflex irritation which the pregnant uterus may
excite in various organs of the body, especially the
stomach. In my " Manual of Obstetrics," published
in 1858, I state that " an almost poisonous influence
seems to be exerted by the gravid uterus in some
constitutions." Several years ago I knew of a case of
this kind in which poison was actually suspected.
Dr. Todd laid considerable emphasis on an extra-
ordinary expression of Miss Bankes's countenance,
such as he had never observed in a case of natural
disease. Dr. Paul Dubois, the present physician-
aceoucher to the Empress of the French, who related
that he saw 20 cases of death from the vomiting of
pregnancy in 13 years, refers to " a marked change
in the features," as one of the signs indicating
a state of danger, and calling for the induction of
abortion to save the patient's life.
I do not offer any opinion on the moral or chemi-
cal evidence in the case, but merely testify to that
which I have seen and known in my own depart-
ment of the profession.—l am, sir, your obedient
servant,

W. TYLER. SMITH, M.D.,
Physician-Accoucheur to St. Mary's
Hospital.
Upper Grosvenor-street, Aug. 25.

• TO THE EDITOR OF THE TIMES. 1
Sir,—Being the brother of Dr. Smethurst, I shall
feel obliged if you will be kind enough to insert a
few facts in reference to him in your journal.
1. Dr. Smethurst was a man of property, render-
ing him independent, with his domesticated frugal
habits, having for years past a clear income of £240
a-year, arising from fixed property, besides a few
hundreds in hand. He always lived within his
income, in addition to which he had many casual
fees from private friends, although retired from
practice for the last six years.
2. Miss Bankes had an income of £240 a-year,
besides a contingent reversionary interest in a sum of
£lO,OOO in the English funds, his and her income
making altogether £4BO a-year.
3. The £1,740 or £l,BOO lent on mortgage has
not been proved to be even half the amount, when
it may be realised ; for there has been a Chancery
suit connected with this property, the conclusion of
which has not yet arrived.
4. Miss Bankes and Dr. Smethurst intended to
live together ; for he told me whenever his wife (in
advanced years) should die he would marry her ;
for she was so amiable, kind, and ladylike. I had
an invitation to visit them at Richmond, but, not
having accepted it, I never saw the lady.
5. I told my brother's wife, who sent for me to
Rifle-terrace, through a letter she had received from
him, intimating that he would never live with her
again, as he intended to move about the country ;
but I refused to satisfy her suspicion that he was
absent with Miss Bankes or any other lady, and
endeavoured to appe4pe her by saying that, as he
had offered to support her in a suitable manner, and
to pay her periodical friendly visits, she had better
reconcile her mind to it, for, as he was determined,
there was no help for it ; and a cousin of mine,
Miss Smethurst, agreed with this view.
6. That he had d appomte to meet me on the 18th
of April at the Auctioni Mart, in order to bid for a
house in Hans- place Sloane-street, which he said
t
they should like
the
in, being retired, and at h
the same time near e.is!Larks and places of amuse-
ment. I waited at the andh spokef to
la gentle-
man living next door to the
I have known many years. Thee salee were ns at
off whomwith-
out my brother's appearance there, and I found a
note on my return stating that Miss Bankes's ill-
ness required his attention.
7. He had the supposed best medical man in
Richmond to attend her, and subsequently Dr.
Todd.
8. Dr. Julius, on the 25th of May, at Richmond,
deposed that he attended deceased from the 3d up
to the 18th of April, when he communicated his
suspicions to his partner, Mr. Bird, who then at-
tended her.
9. Dr. Julius deposed on the 7th of July, at the
Old Bailey, " I requested my partner, Mr. Bird,
to see the deceased. I did not make him acquainted
with the impressions that existed in my own mind."
10. Dr. Bird deposed, on the Bth of July, at the
Old Bailey, that about the 18th of April he attended,
by request, the deceased, and about the 22d he
came to the same conclusions as Dr. Julius, but lie
did not form this opinion until after Dr. Julius had
told him his opinion on the subject.
11. Mr. Caudle, on the 25th of May, at Rich-
mond, deposed flirt, with respect to the mixing of
the medicines prescribed, there was not any mineral
poison therein, either Dr. Julius or Dr. Bird being
present at the dispensing on and after the 29th of
April.
12. On the 16th of August, at the Old Bailey,
•Mr. Caudle suppressed, or kept back, that portion
of the above evidence which says that either Dr.