Have you known at all or frequently in persons, not further advanced in years than the age of twenty-eight, granules between the dura mater and the arachnoid?--They are not common to any age that I am aware of.
Do you know whether granules have been part of the symptoms of tetaniform convulsions?--I have seen three preparations in St. Thomas’s Hospital museum where granules are found in the membranes of the spinal cord, in which patients are said to have died of tetanus. In order to ascertain with satisfaction the nature and probable extent of the injury of such granules the spinal cord should be examined immediately after death. Not the most remote medical judgment could be formed if the examination was made two or three months after death. If an examination of the spinal cord is made so long after death, if there had been a large tumour or some similar change, it might have been discovered; but neither softening nor induration of the minute structure of the cord could be detected. The minute nervous structures change within two hours after death.
I have in the course of my experience had cases of traumatic tetanus. It generally begins by an attack of the jaw. I have had under my personal observation four cases of idiopathic tetanus. One of them was my own child. In three cases the symptoms commenced with lockjaw. In the fourth case the symptoms commenced in the body; the power of swallowing easily was retained to the last. Within the last twelve months I have made a post-mortem examination of two women who have died from the poison of strychnia. In both cases it was by chemical analysis that I ascertained the deaths had been caused by strychnia. In one case the post-mortem took place forty-two hours after death, in the other case thirty hours.
(The witness produced his report to the coroner on these two cases.)
I have not seen a fatal case, but several of taking too large a dose. One, a middle-aged man, took one-sixth of a grain of strychnia, given in solution. In a very few minutes the symptoms manifested themselves by the want of power of controlling the muscles, by twitching and rigidity, with some cramp, more violent in the legs than any part of the body. He was up and walking about. It was not a severe case. In six hours the spasms entirely disappeared. They were intermittent in character, every two or three seconds at first. The other case was similar with one-twelfth of a grain.