Medical evidence – did Cook die from strychnine?

It is important to realise this was the first ever trial in Britain where someone was accused of murder by strychnine. For anyone who is not from a medical background it can be difficult to follow all the medical evidence so surely it must have been equally difficult for the jury to fully comprehend the disagreements between the numerous so-called medical experts brought in by each side.

Both the Prosecution and the Defence agreed that Cook died from tetanic convulsions (tetanus), with Cook suffering an horrific form that racked his body and, at times, left his body so agonizingly bowed that he rested on the back of his head and the heels of his feet. However the Prosecution and the Defence could not agree upon what caused the tetanus. Basically tetanus is a disorder of the nervous system, which manifests itself by painful and lengthened spasm of the voluntary muscles throughout the body. The direct causes of tetanus were not known until a Japanese man called Kitasato discovered the bacillus Chostridium tetani in 1889 more than thirty years after Palmer’s trial.

At the time of the trial there were considered to be three main types of tetanus, the first type being idiopathic tetanus. The term “idiopathic” is applied to indicate that the cause of a disease is not known. Idiopathic tetanus could be caused by a chill or by a stomach disorder but fortunately this is a very rare form of tetanus. The second tetanus type is traumatic tetanus, which is also referred to in England as “lockjaw”. A wound such as a deep cut or a gunshot wound usually causes this type of tetanus. The tetanus can start as quickly as three days after the wound or as long as four weeks afterwards when the original wound has healed.

Thirdly there is the type described in the trial as tetanus due to strychnine. This is now known not to be a form of tetanus. The symptoms of strychnine poisoning bear a strong resemblance to tetanus but are more acute and less prolonged than in a case of tetanus.

The Prosecution set out to prove, through the testimony of their expert medical witnesses, that Cook had not died from idiopathic or traumatic tetanus or in fact from any known disease that the Defence might suggest.

Expert medical witnesses for the Prosecution

Firstly Thomas Blizard Curling, member of the College of Surgeons, gave a general description of idiopathic tetanus and traumatic tetanus and denied that Cook’s symptoms were consistent traumatic tetanus. He reasoned that the sudden onset of Cook’s disease contrasted with the normal mild symptoms of tetanus gradually proceeding to the complete development of tetanus.

Dr.Todd from the Times Report of the Trial of William Palmer pub 1856
Dr.Todd from the Times Report of the Trial of William Palmer pub 1856

Dr. Todd, for 20 years a physician at Kings College Hospital who had lectured on physiology, anatomy and on tetanus and diseases of the nervous system, gave his opinion that the term tetanus ought not to be applied to disease produced by poison. He stated traumatic tetanus begins with stiffness about the jaw, gradually developing to extend to muscles of the trunk and although there are periods of remission, these are not complete but merely a lessening of the severity of the symptoms. He ruled out apoplexy and epilepsy as possible causes of death in Cook’s case.

Dr. Todd, physician at Kings College Hospital: Stated that granuals found on the spinal cord of the deceased were unlikely to have caused Cook’s tetanus. He stated that the state of a person suffering from tetanus is identical to that induced by strychnine. This however was contradicted by other witnesses for the Prosecution. Suggested that death was due to strychnine.

At this stage the Attorney General revealed that Dr. Bamford was so unwell that the (octogenarian) Rugeley doctor was unlikely to be able to give evidence and asked that Bamford’s deposition be read to the court. After hearing from two doctors, who stated that Dr. Bamford was in fact suffering from English cholera, Dr. Bamford’s evidence was read out by the Clerk of the Court.

In the deposition, Dr. Bamford mentioned making his first visit to Cook, at Palmer’s request, at 3 o’clock on the Saturday when Cook was suffering from violent vomiting. He detailed his visits and the medicine he prescribed but stated that he had not given Cook antimony. He stated that, “I consider death to have been the result of congestion of the brain when the post mortem examination was made, and I do not see any reason to alter that opinion.” (The death certificate signed by Dr. Bamford gave the reason as apoplexy, which is a malady arresting powers of sense and motion caused by effusion of blood in the brain) He also stated “I attended Mrs. Palmer some days before her decease; also two children, and a gentleman from London, who was on a visit at Palmer’s house, and who did not live many hours after I was called in. The whole of these patients died.” His statement also said, “Mr. Palmer said he was of the same opinion as myself with respect to the death of the deceased. I never knew apoplexy produce rigidity of the limbs. Drowsiness is a prelude to apoplexy. I attributed the sickness on the first two days to a disordered stomach.”

The questioning returned to Dr. Todd who declared that, “Having heard the deposition of Dr. Bamford read, I do not believe that the deceased died from apoplexy or from epilepsy. I never knew tetanus arise either from syphilitic sores or from sore throat. There are poisons which will produce tetanic convulsions. The principal of these poisons are nux vomica and those which contain as their active ingredients strychnine and bruccia. I have never seen life destroyed by strychnine, but I have seen animals destroyed by it frequently.” He talked of differences between Cook’s symptoms and those of tetanus finding it “remarkable” that the deceased was able to swallow, and that there was no fixing of the jaw, which would have been the case with tetanus proper, resulting either from a wound or from disease. Before cross-examination he concluded, “From all the evidence I have heard, I think that the symptoms which presented themselves in the case of Mr. Cook arose from tetanus produced by strychnine.”

Under questioning from the Defence he replied, “There is nothing in the post mortem examination which leads me to think that the deceased died from tetanus proper. I think that granules upon the spinal chord, such as I have heard described, would not be likely to cause tetanus.” He did know that morphia (Cook had been given this) sometimes produces convulsions but thought that they would be of an epileptic nature.

Sir Benjamin Brodie from the Times Report of the Trial of William Palmer pub 1856
Sir Benjamin Brodie from the Times Report of the Trial of William Palmer pub 1856

Sir Benjamin Brodie, a senior surgeon to St. George’s Hospital, also President of the Royal College of Surgeons, gave his evidence with great clearness, slowly, audibly and distinctly. He stated that death from idiopathic tetanus was rare in this country and that ordinary tetanus in this country was traumatic tetanus. He agreed that the general contraction of muscles resembled traumatic tetanus but the course of Cook’s illness was different entirely. He said, “I do not believe that death in the case of Mr. Cook arose from what we ordinarily call tetanus – either idiopathic or traumatic. I never knew tetanus result from sore throat or from a chancre, or of any other form of syphilitic disease. The symptoms were not as a result either of apoplexy or of epilepsy.”

The Times Report of the Trial from 1856 quoted Brodie as saying, “Perhaps I had better say at once that I never saw a case in which the symptoms that I have heard described here arose from any disease.” Following this quote they wrote “(Sensation)” presumably to mark the reaction, of the spectators within the courtroom, to the implication of these words. Brodie continued, “When I say that, of course I refer not to particular symptoms, but to the general course which the symptoms took.”

Dr. Daniel, by then out of practice but for many years a surgeon to the Bristol Hospital, agreed with Sir Benjamin Brodie with respect to the difference between ordinary tetanus and tetanus caused by strychnine. He said that Cook’s symptoms were not those usually associated with ordinary tetanus where symptoms developed from firstly a stiffness of the lower jaw with the contraction of the muscles always a later symptom. He suggested that the clenching of the fist and the twisting of the foot were unusual symptoms not normally associated with tetanus. He did not know of a case of tetanus where death had come so quickly, ruled out apoplexy and epilepsy as possible causes of death and stated that he knew of no cases where syphilitic sores caused tetanus

Mr. Samuel Solly, for twenty-eight years a lecturer and surgeon of St. Thomas’s Hospital, stated that, in his experience of tetanus, there had always been, “a marked expression of countenance” as a first symptom and that once you saw this “sort of grin”, peculiar to tetanus, you could never mistake it. In his judgment Cook’s death could not be attributed to apoplexy, epilepsy or any disease he had ever witnessed.

Mr. Henry Lee was a surgeon to King’s College and Lock Hospitals, which were devoted to treating up to three thousand cases a year of a syphilitic character but had never known an instance of that disease terminating in tetanus. He was not cross-examined.

After the evidence relating to what might or might not have been the cause of Cook’s death the prosecution brought evidence from four cases of accidental strychnine poisoning. In three of the cases the patient died but in the other case the patient recovered. Witnesses were as follows:
Dr. Henry Corbett, physician of Glasgow:
Dr. Watson, surgeon at Glasgow Infirmary:
Dr. J. Patterson, also of the Glasgow Infirmary:
Mary Kelley, patient of the Glasgow Infirmary:
Caroline Hickson, nurse and lady’s maid in the family of Mr. Sarjantson Smyth:
Mr. Francis Taylor, a surgeon from Romsey,
Jane Witham, a lady’s attendant,
Mr. Morley a surgeon from Leeds,
Mr. Edward D Moore, a former surgeon,

Professor Alfred Swaine Taylor, Fellow of the College of Physicians and a lecturer at Guy’s hospital, who had made a study of strychnia but had never witnessed its action on a human subject. He gave evidence for nearly a whole day. He stated that strychnia is first absorbed into the blood, then circulates through the body, and especially acts on the spinal cord, from which proceed the nerves acting on the voluntary muscles. He answered several leading questions put to him by the Attorney-General as follows:

“You have heard the descriptions given by the witnesses of the symptoms and appearances which accompanied Cook’s attacks?”
“I have.”
“Were the symptoms and appearances the same as those you have observed in the animals to which you administered strychnine?”
“They were.”
And later: “How do you account for the absence of any indication of strychnia in cases where you know it was administered?”
“It is absorbed into the blood, and is no longer in the stomach. It is in a great part changed in the blood.”

He was asked if the “parts” sent to him for analysis were in a “favourable condition”? He replied, “The most unfavourable that could possibly be,” and added that, “the stomach had been completely cut from end to end, all the contents were gone, and the fine mucous surface, on which any poison, if present, would have been found, was lying in contact with the outside of the intestines – all thrown together.”

He said that he had heard the four cases mentioned by earlier witnesses and agreed that the deaths in those cases were caused by strychnine and that Cook’s symptoms appeared to be of a similar character. To the question, “As a professor of medical science, do you know any cause in the range of human disease except strychnine, to which the symptoms in Cook’s case can be referred?” he answered, “I do not.”

Professor Taylor had been chosen by Cook’s stepfather to examine the samples taken at Cook’s post-mortem prior to the inquest. Before Cook’s inquest he had originally diagnosed that antimony (a poison which can be used in small quantities as a medicine) had caused the death of Cook.

When questioned by Serjeant Shee for the Defence, in spite of agreeing that the quantity of antimony found in the body was not sufficient to account for death, Taylor claimed that, before the inquest, he had been justified in suggesting that antimony (not strychnine as was later suggested) caused death, reasoning, “We could infer nothing else.”

He continued, “I was told that the deceased was in good health seven or eight days before his death, and that he had been taken very sick and ill, and had died in convulsions. No further particulars being given us we were left to suppose that he had not died a natural death. There was no natural cause to account for death, and finding antimony existing throughout the body we thought it might have been caused by antimony.” Referring to the statement that Cook had been in good health Shee asked if Taylor, “allowed his judgment to be influenced by the statement of a person (Cook’s stepfather) who knows nothing of his own knowledge?”

Taylor stated that he had been present for part of the inquest and heard some of the witnesses and had had some evidence read to him. He had experimented upon five rabbits some twenty-three years previously and on some more rabbits since the inquest stating that this was, “the only knowledge of my own that I had of the effect of strychnia upon animal life.” He claimed to have, “a great objection to sacrifice of life.” When the Defence Council suggested that he might have been better choosing to experiment upon dogs rather than rabbits, his answer of “Dogs are very dangerous to handle”, caused some laughter in the court. The Defence quipped, did he not mean to answer that, “Dogs and cats bear a greater analogy to man because they vomit, while rabbits do not, but rabbits are much more manageable?”

He was asked, “Do you think it your duty to abstain from all public discussion of the question which might influence the public mind?” and, “Did you write a letter to the Lancet?”

He answered “Yes” to both questions but claimed in justification that he had written to the Lancet so as to, “contradict several misstatements of my evidence which had been made.” He also wished to correct the impression, “circulated in every newspaper that a person could not be killed by tartar emetic.” (Tartar emetic is a purgative medicine containing antimony).

He was also questioned upon the following quote from his letter, “During the quarter of a century which I have now specially devoted to toxicological inquiries I have never met with any cases like these suspected cases of poisoning at Rugeley. The mode in which they will affect the person accused is of minor importance compared with their probable influence on society. I have no hesitation in saying that the future security of life in this country will mainly depend on the judge, the jury, and the counsel who may have to dispose of the charges of murder which have arisen out of these investigations.”

When Serjeant Shee for the Defence asked “Do you adhere to your opinion that ‘the mode in which they will affect the person accused,’ that is, lead him to the scaffold, ‘is of minor importance compared with their probable influence on society’?”

Taylor replied “I have never suggested that they should lead him to the scaffold. I hope that, if innocent, he will be acquitted.” Asked what he meant by – “The mode in which they will affect the person accused is of minor importance”? Taylor replied “The lives of 16,000,000 of people are, in my opinion, of greater importance than that of one man.”

Taylor continued, “As you appear to put that as an objection to my evidence, allow me to state that in two dead bodies I find antimony. In one case death occurred suddenly, and in the other the body was saturated with antimony, which I never found before in the examination of 300 bodies. I say these were circumstances which demanded explanation.”

Shee asked, “You adhere to the opinion that, as a medical man and a member of an honorable profession, you were right in publishing this letter before the trial of the person accused?”

To which Taylor responded, “I think I had a right to state that opinion in answer to the comments which had been made upon my evidence.” He agreed that no comments had been made by the prisoner, Palmer, but claimed, “Mr. Smith, solicitor for the Defence, circulated in every paper statements of ‘Dr. Taylor’s inaccuracy’. I had no wish or motive to charge the prisoner with this crime. My duty concerns the lives of all.”

Shee switched his attack to ask Taylor if he had given permission to Mr. Angustus, Mayhew the editor of the Illustrated Times to publish the caricature of himself.

Professor Taylor claimed that he had been tricked by Mr. Mayhew and had not given his permission for the caricature. He claimed that he had given an interview on the subject of poisons without thinking about the links to the Rugeley cases. In fact he claimed he had not realised that Mayhew was the editor of the Illustrated Times. Taylor responded, “On my oath. It was the greatest deception that was ever practiced on a scientific man. It was disgraceful. He called on me in company with another gentleman, with a letter from Professor Faraday. I received him as I should Professor Faraday, and entered into conversation with him about these cases. He represented, as I understood, that he was connected with an insurance company, and wished for information about a number of cases of poisoning which had occurred during many years. ” (It should be noted that, after the trial, Mr. Mayhew entirely denied Dr. Taylor’s statements.)

Taylor denied claims made by a Mr. Johnson, in a letter to Sir George Gray (a member of the Defence team), that Taylor had once said about Cook, “He will have strychnia enough before I have done with him.”

There was some further discussion about Cook’s symptoms with Taylor stating that, “Cook’s symptoms were quite in accordance with an ordinary case of poisoning by strychnia.” Asked if he knew of a case where a patient, seized by tetanic symptoms, sat up in bed and talked, he pointed out that it was after he sat up that he was affected by the symptoms. He was also asked if he knew of any cases in which the symptoms of poisoning by strychnia commenced with the patient beating the bedclothes. He replied that this was a symptom which might be exhibited by a person suffering from a sense of suffocation whether caused by strychnia or other causes.

Questioned about why he had suggested questions for the coroner to ask at the inquest, he replied that the coroner, “did not put questions which enabled me to form an opinion” and commented that, “There was an omission to take down the answers”. He said that, at the time of the inquest he wrote to Mr. Gardner (the solicitor for Cook’s stepfather) “I had not learnt the symptoms which attended the attack and death of Cook. I had only the information that he was well seven days before he died, and had died in convulsions. I had no information which could lead me to suppose that strychnia had been the cause of death, except that Palmer had purchased strychnia. Failing to find opium, prussic acid, or strychnia, I referred to antimony as the only substance found in the body.”

In spite of their finding only small traces of the poison antimony and absolutely no traces of strychnine in the deceased’s body, Professor Taylor stated that, “Cook’s symptoms were quite in accordance with an ordinary case of poisoning by strychnia.”

In his book, They Hanged My Saintly Billy, Robert Graves quotes a “wag” from the time of the trial:
In antimony, great though his faith,
The quantity found being small,
Taylor’s faith in strychnine was yet greater,
For of that he found nothing at all.

Dr. G. O. Rees, lecturer at Guy’s Hospital: Suggested that death was due to strychnine.
Professor Brande, professor of chemistry at the Royal Institution present at the analysis on Cook.
Professor Christianson, professor of Materia Medica to the University of Edinburgh: Suggested that death was due to strychnine.

Expert medical witnesses for the Defence

The Defence’s case rested upon them proving that Cook’s symptoms, although similar in some respects to the effects brought about by strychnine, were not necessarily those produced as a result strychnine. Their medical witnesses did not agree about what had caused Cook’s death but offered eight different possibilities. They also brought witnesses who felt that Dr. Taylor should have been able to trace evidence of strychnia in Cook body had he in fact been poisoned using strychnine.

Mr. Thomas Nunneley from the Times Report of the Trial of William Palmer pub 1856
Mr. Thomas Nunneley from the Times Report of the Trial of William Palmer pub 1856

First to give evidence for the Defence was Mr. Thomas Nunneley, Professor of Surgery at Leeds School of Medicine, called as a man who had a large practice and had seen cases of both traumatic and idiopathic tetanus. He was, “of the opinion that death was caused by some convulsive disease”. From the evidence he had heard he continued, “I assume that Cook was a man of very delicate constitution – that for a long period he had felt himself to be ailing, for which indisposition he had been under medical treatment; that he had suffered from syphilis; that he had disease of the lungs; and that he had old standing disease of the throat; that he lived an irregular life; that he was subject to mental excitement and depression; and that after death appearances were found in his body which show this to have been the case. There was an unusual appearance in the stomach. The throat was in an unnatural condition. The back of the tongue showed similar indications. The air vessels of the lung were dilated. In the lining of the aorta there was an unnatural deposit, and there was a very unusual appearance in the membranes of the spinal marrow. One of the witnesses also said that there was a loss of substance from the penis. That scar on the penis could only have resulted from an ulcer. A chancre is an ulcer, but an ulcer is not necessarily a chancre. The symptoms at the root of the tongue and the throat I should ascribe to syphilitic inflammation of the throat. Supposing these symptoms to be correct, I should infer that Cook’s health had for a long time not been good, and that his constitution was delicate. His father and mother died young. Supposing that to have been his state of health, it would make him liable to nervous irritation

That might be excited by moral causes. Any excitement or depression might produce that effect. A person of such health and constitution would be more susceptible of injurious influence from wet and cold than would one of stronger constitution. Upon such a constitution as that which I have assumed Cook’s to have been convulsive disease is more likely to supervene. I understand that Cook had three attacks on succeeding nights, occurring about the same hour. As a medical man, I should infer from this that the attacks were of a convulsive character. I infer that in the absence of other causes to account for them. According to my personal experience and knowledge from the study of my profession, convulsive attacks are as various as possible in their forms and degrees of violence. It is not possible to give a definite name to every convulsive symptom. There are some forms of convulsion in which the patient retains consciousness. Those are forms of hysteria, sometimes found in the male sex. It is also stated that there are forms of epilepsy in which the patient retains consciousness.”

He had seen cases where convulsions recurred with the time of recovery from a violent attack of convulsions varying from a few minutes to many hours. He stated that with convulsions death comes from asphyxia, a spasm of the heart. He was familiar with idiopathic tetanus, as his own child had suffered from the disease. He had also, within the previous twelve months, made post mortem examinations on two people who had died from strychnia and in each case, using chemical analysis, he had been able to find strychnine.

Mr. Nunneley thought that the Cook’s symptoms on the Saturday night did not resemble those that, from experience, he would expect following the administration of strychnia. Cook had more power of voluntary movement. Cook had, “sat up in bed, and moved his hands about freely, swallowed, talked, and asked to be rubbed and moved, none of which, if poisoned by strychnia, could he have done”. He also believed that the convulsions were not caused by strychnia because of the length of time that had elapsed between Cook taking the pills, which were alleged to have contained strychnine and the commencement of the screaming and vomiting. He felt that strychnine ought to have been detected if it had actually been given to Cook and he had found strychnia in a patient forty days after death. When he experimented on animals he had worked jointly with Dr. Morley who had been a medical witness for the Prosecution and disagreed with the doctor’s evidence. He did not know of any cases of strychnine where rigidity after death was any greater than with the usual rigor mortis.

He concluded that, “I judge that he died from convulsions, by the combination of symptoms.” He supposed that Cook was, “liable to excitement and depression of spirit,” giving as justification the reason that, “The fact that after winning the race he could not speak for three minutes.” And, “Mr. Jones stated that he was subject to mental depression. Excitement will produce a state of brain which will be followed, at some distance, by convulsions. I think that Dr. Bamford made a mistake when he said the brain was perfectly healthy.” He went on to add, “With the brain and the system in the condition in which Cook’s were I believe it is quite possible for convulsions to come on and destroy a person. I do not believe that he died from apoplexy. He was under the influence of morphia. I don’t ascribe his death to morphia, except that it might assist in producing a convulsive attack. I should think morphia was not very good treatment, considering the state of excitement he was in.”

Mr. William Herapeth, professor of Chemistry and Toxicology at the Bristol Medical School had performed experiments on animals and in all cases had been able to detect poison. He was asked, “Are you of the opinion that where strychnia has been taken in a sufficient dose to poison it can and ought to be discovered?”

To which Herapeth answered, “Yes; unless the body has been completely decomposed; that is unless decomposition has reduced it to a dry powder. I am of opinion, from the accounts given by Dr. Taylor and other witnesses, that if it had existed in the body of Cook it ought to have been discovered.”

There is no doubt that he was a great scientist and chemist but the Attorney General tried to undermine the value of Herapeth’s evidence of by asking, “Have you not said that you had no doubt that strychnia had been taken, but that Dr. Taylor had not gone the right way to find it?” Herapeth’s comments had been made at a private function in Bristol. He replied that he might have made some initial comments based upon the impression given in various newspaper articles that strychnine had been given to Cook. There seems to be little doubt that there was professional rivalry between Professor Herapeth and Professor Taylor and that he wished to publicly prove Taylor to be wrong. Herapeth maintained that he could detect as small a quantity of strychnine as one fifty-thousandth part of a grain if unmixed with organic matter or one-tenth part of a grain if in water. However the suggestion of rivalry had been made and there is no doubt that this weakened the credibility afforded to Herapeth’s evidence.

Mr. Rogers, Professor of Chemistry at St. George’s School of Medicine, had made experiments upon a dog poisoned by strychnia and said of Cook’s case, “Strychnia must unquestionably have been discovered in this case if it had been present and the proper tests had been used.” Adding, “If the contents of the stomach were lost it would make a difference, but not if they were only shaken up.” Finally adding that, “If strychnia were in the stomach a portion would probably be smeared over the mucous membrane, and then I should expect to find it on the surface.”

Dr. Henry Letheby, a Medical Officer of Health to the City of London, had been engaged for a considerable time in the study of poisons and concluded that the symptoms described in Cook’s case “did not accord” with the symptoms he had witnessed. He stated that he, “had no hesitation in saying that strychnine is of all poisons, either mineral or vegetable, the most easy of detection.” He claimed that, “When it is pure the 20,000th part of a grain can be detected. I can detect the tenth part of a grain most easily in a pint of any liquid, whether pure or putrid.” Adding, “I never failed to detect strychnine where it had been administered.”

When asked his opinion of the cause of Cook’s death he replied, “We are learning new facts every day, and I do not at present conceive it to be impossible that some peculiarity of the spinal cord, unrecognizable at the examination after death, may have produced symptoms like those which have been described. I, of course, include strychnia in my answer; but it is irreconcilable with everything I have seen or heard of. It is as irreconcilable with strychnia as with everything else; it is irreconcilable with every disease that I am acquainted with, natural or artificial.”

Mr. R. E. Guy, member of the Royal College of Surgeons, described the symptoms of a Mr. Foster whom he attended and who undoubtedly died of idiopathic tetanus with symptoms that were, in his opinion, the same as those of Cook.

Mr. J. B. Ross, a house-surgeon to the London Hospital spoke of a case he had seen where, after death, no poison was found but where old ulcers had left sores on the arm. He stated that these sores had led to death from tetanus. He had also seen old chronic syphilitic wounds in patients, which could account for tetanus.

Mr. Rymers Mantell also a house-surgeon to the London Hospital appeared briefly to agree with the evidence of Dr. Ross that, in the case he mentioned, the patient died from tetanus produced by the sores on the arms.

Dr. Wrightson had been a pupil of Leibig’s at Giessen and was then a teacher of chemistry in a school in Birmingham. He had been involved in another case where poison was detected. He stated that, “I have found no extraordinary difficulties in the detection of strychnia. It is certainly to be detected by the usual tests.”

Professor Partridge a Professor of Anatomy in King’s College lectured at the same college as the Prosecution witness Dr. Todd but disagreed with Todd’s assertion that granules on the spine couldn’t cause tetanus. He stated, “I have heard the statements as to the granules that were found on his spine. They would be likely to cause inflammation, and no doubt that inflammation would have been discovered if the spinal cord or its membranes had been examined shortly after death. It would not be likely to be discovered if the spinal cord was not examined until nine weeks after death. I have not seen cases in which this inflammation has produced tetanic form of convulsions, but such cases are on record. It sometimes does, and sometimes does not produce convulsions and death.”

When asked if he could form any judgement as to the death in Cook’s case he replied, “I cannot. No conclusion or inference can be drawn from the degree or kind of contractions of the body after death. – Hypothetically, I should infer that he died of tetanus which convulses the muscles. Great varieties of rigidity arise after death from natural causes. The half-bent hands and fingers are not uncommon after natural death. The arching of the feet in this case seemed rather greater than usual.”

Asked, “You heard Mr. Jones state that if he had turned the body upon the back it would have rested on the head and the heels. Have you any doubt that that is an indication of death from tetanus?”

He replied, “No; it is a form of tetanic spasm. I am only acquainted with tetanus resulting from strychnine by reading. Some symptoms in Cook’s case are consistent, some are inconsistent with strychnine tetanus. The first inconsistent symptom is the intervals that occurred between the taking of the supposed poison and the attacks.” He also added other inconsistent symptoms namely, “sickness, beating the bed-clothes, want of sensitiveness to external impressions, and sudden cessation of the convulsions and apparent complete recovery”.

Mr. John Gay, a Fellow of the Royal College of Surgeons and surgeon to the Royal Free Hospital, recalled a case he had been involved in 1843. A boy had suffered an accident when a large stone had fallen upon the middle toe resulting in him having to have his toe amputated. A week later he suffered from a stiff neck and could not open his mouth and this was followed by intermittent convulsions. The injury to the toe had given rise to affection of his spinal cord and this irritation of the spinal cord ended in tetanic convulsions.

Dr. W. Macdonald a licentiate of the Royal College of Surgeons, Edinburgh, stated that epileptic convulsions sometimes have the same appearance as tetanic convulsions. He disagreed with all his colleagues by stating lock-jaw is generally a late symptom. He doubted if a patient who had been given strychnine could pull a bell violently as Cook had done and stated, “I think that death was in this case caused by epileptic convulsions, with tetanic complications.” Adding, “I form that opinion from the post mortem appearances being so different from those that I have described as attending poisoning with strychnia, and from the supposition that a dose of strychnia sufficient to destroy life in one paroxysm could not, so far as I am aware, have required even an hour for its absorption before the commencement of the attack. If the attack were of an epileptic character the interval between the attacks of Monday and Tuesday would be natural, as epileptic seizures very often recur at about the same hours of successive days.” Asked by the Defence, “Assuming that a man was in so excited a state of mind that he was silent for two or three minutes after his horse had won a race, that he exposed himself to cold and damp, excited his brain by drink, and was attacked by violent vomiting, and that after his death deposits of gritty granules were found in the neighbourhood of the spinal cord, would these causes be likely to produce a death as that of Cook’s?” He replied, “Any one of these causes would assist in the production of such a death.”

Dr. Bainbridge, a medical officer to St. Martin’s Workhouse who had much experience of convulsive disorders, suggested that, “In both males and females hysteria is frequently attended by tetanic convulsions.” And, “Hysteric convulsions very rarely end in death. I have known one case in which they have done so.”

Mr. Edward Austin Steddy, a Member of the Royal College of Surgeons and of Chatham, told the court of a patient called Sarah Ann Taylor who had convulsions brought on by depression, brought about by a quarrel with her husband. Sarah had had convulsions that lasted for a week before recovering and she had had another attack lasting a week a year later.

Dr. George Robinson was a physician to the Newcastle-on-Tyne Dispensary, who having heard the medical evidence, had come to the conclusion that Cook died of tetanic convulsions by which he meant, not the convulsions of tetanus, but convulsions similar to those witnessed in that disease. He believed that gritty granules in the region of the spinal cord would be very likely to produce convulsions similar to the ones Cook experienced. He also stated that Cook’s “mode of life” would have predisposed him to epilepsy but he had never seen a case of epilepsy where the body was so stiff as to rest upon head and heels. He agreed that the symptoms spoken of by Cook’s friend Mr. Jones could indicate death from strychnine but if there were no other cause of death suggested he would have said that death in Cook’s case arose from epilepsy.

Dr. Richardson, a physician practicing in London, knew of many cases of death by convulsion often tetanic in appearance without being strictly tetanus. There are cases of angina pectoris in which the patient has recovered and appeared perfectly well for a period of twenty-four hours, and then the attack returned. Dr. Richardson was of the opinion that the fact that Cook had a second fit was more likely to be the symptom of angina pectoris than of strychnia poison.

Dr. Wrightson was recalled and said, that although strychnia poison is absorbed into the system, he would have still expected to find it in the spleen and liver and blood. Catherine Watson from Garnkirk gave evidence that, in the previous October, she had been attacked by a fit but had not suffered from a wound or taken poison.

Oliver Pemberton a lecturer on anatomy at Queen’s College, Birmingham and a surgeon at the city’s General Hospital, stated that he had been present at the examination of Cook’s body after its exhumation in the January. He could not form any opinion as to the state of the body immediately after death. After this witness Mr. Serjeant Shee intimated that this concluded the medical evidence on behalf of the prisoner.

The Defence Team’s own experts had given their opinions upon what caused Cook’s death; however, they could not agree suggesting eight different possibilities other than strychnine. The jury had to decide upon an issue that divided the medical experts, though the decisive factor was undoubtedly the masterly way in which the Attorney-General summed up the evidence for the Prosecution.