If you imagine you feel yourself justified in saying that the irritation of the spinal cord once set up continues, why should you infer that the irritation of the nerve may not also continue?--There must be some peculiar irritation of the nerve to give rise to the affection of the spinal cord from which tetanus arises. There appear to be some particular circumstances which produce it.
You have no doubt the state of the toe was the original cause of the convulsions?--I have not.
And that death took place by something or other distinct from the first cause?--Yes.
Re-examined by Mr. GRAY--I think you told my friend that, with regard to the convulsions which end in death, you thought they arose from some irritation set up in the spinal cord?--I did, from that and other causes.
May the causes of such irritation be very various in different cases? May the cause of the irritation in the spinal cord which would end in tetaniform be very various?--I think so.
Suppose in one you have a death accompanied with tetaniform symptoms and opisthotonos, and the various symptoms of a tetanic character; in the absence of any knowledge of the case--of the cause you state, probably the irritation of the spinal cord--do you think it is possible to ascribe them to any particular cause?--I think it would be extremely difficult to do so.
Will you give me the proposition you lay down?--In the event of a given set of symptoms, tetanic symptoms I should say, being proposed, it would be extremely difficult, if not impossible, without some other evidence, or collateral evidence, to assign it to any given disease.
Dr. WILLIAM M‘DONNELL, examined by Mr. KENEALY--I am a licentiate of the College of Surgeons of Edinburgh, and have been in practice for about eight years. I have had practical as well as theoretical knowledge of idiopathic and traumatic tetanus. Tetanus will proceed from very slight causes. Almost any internal disorder or alteration of the internal secretions will produce idiopathic tetanus. Exposure to cold or damp would produce it. Mental excitement would be a probable cause.
By LORD CAMPBELL--Mental excitement would be the proximate cause of tetanus. The presence of gritty particles or granules in any part connected with the nervous structure, in either the spine or the brain, might produce tetanic convulsions. I have seen small deposits or tubercles in the brain, the only assignable cause for death terminating in convulsions.