Cross-examined by Mr. SERJEANT SHEE--Any irritation of the nerves proceeding to the spinal cord might produce tetanus. I agree with Dr. Watson in his “Lectures on the Principles and Practice of Physic,” that all the symptoms of tetanic convulsions may arise from such slight causes as the sticking of a fish bone, the mere stroke of a whip lash under the eye, from the cutting of a corn, from the bite on the finger by a tame sparrow, from the extraction of a tooth, from the operation of cupping, and simple things of that character. Idiopathic tetanus would not be so likely to bring the patient to the hospital as a sudden wound leading to traumatic tetanus. A syphilitic sore would not be likely to lead to tetanus.
Re-examined by the ATTORNEY-GENERAL--A medical practitioner who saw a case of convulsions would be able at once to know the difference between symptoms of general convulsions and of tetanus. One of the characteristic features of tetanus is that the consciousness is not affected.
Dr. ROBERT TODD, examined by the ATTORNEY-GENERAL--I have been in practice as a doctor for twenty-five years, and have been a physician to King’s College Hospital for many years. I have lectured on the disease called tetanus, and have published the lectures. I have seen two cases of what seemed to be idiopathic tetanus. It is a very rare thing. The term tetanus ought not to be applied to cases of poisoning, for the symptoms are so essentially distinct from the disease. I have had under my own observation cases of traumatic tetanus. When once the disease has begun there are remissions, but not complete; rather a diminution of the severity of the symptoms. There are two classes--an acute class and a chronic class. The acute cases will terminate in the course of three or four days, and the chronic cases will go on from nineteen to twenty-two or twenty-three days, perhaps longer. Sometimes epilepsy will produce convulsions, and sometimes the convulsions from epilepsy assume somewhat of a tetanic character, but they are essentially distinct from tetanus. When the epileptic convulsions assume somewhat of the tetanic form, it is quickly over, not continuous. In epilepsy there is an abolition of consciousness for the time. I have heard the symptoms described which accompanied this gentleman’s seizure and death, and also the appearances after death and the post-mortem examination. I am of opinion there was neither apoplexy nor epilepsy. There are poisons which will produce tetanic convulsions. The chief of these poisons is nux vomica. I have seen animal life destroyed by strychnia, but never human life. The effects of a large dose, such as a grain of strychnia given in a liquid form to a cat or dog, would be apparent in the course of ten minutes. The symptoms would be spasmodic action of the muscles, chiefly of the trunk, the spine, the spinal muscles, producing a very marked opisthotonos, as it is called, where the spine is thrown back, the head thrown back, and the trunk bowed in a very marked manner. The extremities are generally stiffened, jerked out with violent jerks. The muscles are rendered stiff and rigid from the spasms. The stiffness remains, and does not perfectly relax. Fresh paroxysms come in always attended with the peculiar curving back of the head and neck and spine. The extremities of the animals are powerfully stiffened out, distended, every now and then powerfully bent, and jerked out again. Death ensues within half an hour, unless it is a small dose. There is a marked difference between cases where death ensues after taking strychnia and a case of tetanus such as I was describing just now from idiopathic or traumatic causes. The continuity of the symptoms in strychnia poisoning is very characteristic: as long as the poisonous influence lasts, the symptoms last, but the poisonous symptoms will subside after a time. The shortness of the duration of the symptoms is decidedly in favour of strychnine poisoning. There are no other poisons that I know of that produce convulsions of a tetanic character. The symptoms described which attended this gentleman’s death are not referable to idiopathic or traumatic tetanus. I have never seen a person die from the administration of strychnia, but I have seen a person suffer from the consequences of an overdose. There was the opisthotonos and there was the consciousness perfectly retained. There was also dilation of the pupils, a peculiar convulsion of the muscles of the trunk, and the limbs were stiffened out. Difficulty of breathing is common to both tetanus and to tetanic convulsions from strychnia. In the case of Mr.