5th August, 1889
Dr. Rawdon Macnamara Examined by Sir Charles Russell: I am a Fellow of the Royal College of Surgeons of Ireland. I have been its President, and am its representative on the General Medical Council of the Kingdom. I am also a Doctor of Medicine of the University of London, and the author of a standard work on the action of medicine, which has passed through many editions. I am Professor of Materia Medica at the Royal College. I have been for many years senior surgeon at the Lock Hospital, Dublin, and I am also surgeon at the Meath Hospital.
Sir Charles Russell: Have you, in the course of your experience, had to administer arsenic in a large number of cases?
Dr. Macnamara: Yes, in a very large number of cases.
Sir Russell: And for the purposes of administration it has been necessary to saturate the patient?
Dr. Macnamara: It has been on several occasions.
Sir Russell: And has that not, owing to accident or the idiosyncrasies of the patient, been exceeded?
Dr. Macnamara: Yes, either by accident, or the peculiarities of the patient, or the necessities of the case.
Sir Russell: That point has been reached, and what has been your observation of the effects of arsenic?
Dr. Macnamara: The most strong symptoms in the case of saturation is the redness of the eyelid, where the lashes come out upon the eye.
Sir Russell: If it has been beyond that, are there marked peculiarities in the pit of the stomach?
Dr. Macnamara: Yes, about the size of a shilling, and that shilling burning hot, and thus spreading gradually down until the arsenic is eliminated.
Sir Russell: Have you observed any marked symptom in the matter of vomiting and purging?
Dr. Macnamara: In cases of arsenic poisoning there is a group of symptoms, but in any one case some one or other of these may be absent.
Sir Russell: You spoke of the purging and vomiting; describe what you mean by that in the case of these symptoms?
Dr. Macnamara: Vomiting is at first copious, violent, and persistent; the purging is of a severe character at first, but, of course, it passes into ineffectual effort eventually.
Sir Russell: You have heard the description of the case of Dr. Humphreys, where he first describes the sickness when the deceased could not retain anything on the stomach, and then he went on to describe it as “hawking," rather than vomiting?
Dr. Macnamara: That points rather to inflammation of the stomach or bowels than to arsenical poisoning.
Sir Russell: Now, you have noticed in Dr. Humphreys’ evidence where he describes the application of a blister to the stomach with the view to stopping the retching and vomiting, and where he describes that it seemed to be effective for a time—is it your experience that an application of that kind would stop arsenical vomiting?
Dr. Macnamara: It would not stop arsenical poisoning, but it would be very judicious in the case of gastro-enteritis, and would stop it.
Sir Russell: You have used the words arsenical poisoning?
Dr. Macnamara: I meant the vomiting attending upon arsenical poisoning.
Sir Russell: Now, some reference has been made to dryness in the throat and a sensation as if a hair were present. Can you say whether these are distinctive symptoms of arsenical poisoning?
Dr. Macnamara: In the vast number of cases I have had under treatment in which I have been administering arsenic, I have never heard one of them complain of a hair in the throat; but I have had repeatedly very many patients to whom arsenic had never been administered but who continually complained of this sensation—a reflex action of the throat.
Sir Russell: In that case what was the patient suffering from?
Dr. Macnamara: Oh, scarcely anything. There is one lady I know now frequently complains of it, and is in perfect health.
Sir Russell: You don’t attach much importance to the symptom?
Dr. Macnamara: Not any.
Sir Russell: As regards tenesmus, I must ask you, whenever there is tenesmus, does it follow or precede violent purging?
Dr. Macnamara: It follows in arsenical poisoning. If follows violent purging.
Sir Russell: Have you ever known cases where it preceded it?
Dr. Macnamara: Never. I don’t remember ever having read of such a case.
Sir Russell: Now, you have spoken of cramps as a symptom—cramps, I understand you to say, in the calves of the leg?
Dr. Macnamara: Yes.
Sir Russell: You have heard the description of Dr. Humphreys of pains in the thighs. Have you in your experience known of that in connection with cases of saturation or over-saturation with arsenic?
Dr. Macnamara: Never.
Sir Russell: I would like to ask you this question. Have you ever in your experience diagnosed patients living, and then had the opportunity of examining the remains post-mortem?
Dr. Macnamara: I have.
Sir Russell: And have you found that, on your post-mortem, diagnosis was not borne out?
Dr. Macnamara: Unfortunately, I have.
Sir Russell: Are there cases that you have not, from the post-mortem, been able to satisfy yourself as to the cause of death at all?
Dr. Macnamara: There are repeated cases of that kind.
Sir Russell: Now, bringing your best judgment to bear upon the matter, you have been present at the whole of this trial, and heard the evidence, in your opinion was this a death from arsenical poisoning?
Dr. Macnamara: Certainly not.
Mr. Addison cross-examining: As you have listened to the case, and formed your own opinion, will you tell me what he died of?
Dr. Macnamara: To the best of my judgment and belief, he died of gastro-enteritis, not connected with arsenical poisoning.
Mr. Addison: Are you agreed, then, with the gentlemen called fro the Crown, and with Dr. Tidy, that he died of gastro-enteritis, which is an inflammation of the stomach and bowels?
Dr. Macnamara: I am.
Mr. Addison: And the gastro-enteritis is due also, I believe, to some foreign substance—I do not want to use the word poison, because Dr. Tidy guarded himself?
Dr. Macnamara: No, I do not agree with Dr. Tidy in that. I think foreign substances, in the manner in which he guarded himself, may give rise to gastro-enteritis; but I believe there are outside circumstances which, in a patient, would certainly result in gastro-enteritis.
Mr. Addison: But do outside circumstances mean, taking something that produces it in the system?
Dr. Macnamara: No, dear, no. Shall I explain? The case of a person affected or troubled with a weak stomach—suppose dyspepsia—exposed to wet for some time, and not taking proper care and precaution against getting wet; the result is that the blood from the surface of the body is driven to the internal organs—amongst others, the stomach—and there produces that which you explain as congestion; and if, by any accident, such a patient committed any trifling error of diet, the result would be gastro-enteritis—a gastritis that would extend down to the bowels, constituting the congestion of the stomach and of the bowels.
Mr. Addison: Then, in other words, you disagree with Dr. Tidy, and you think that gastro-enteritis may be produced idiopathically?
Dr. Macnamara: I do not say idiopathically. I agree with Dr. Tidy, but I do go beyond Dr. Tidy in my experience, in my belief.
Mr. Addison: The like to take him a little further, and you suggested foreign substances or fruit may have disagree with Mr. Maybrick?
Dr. Macnamara: I have known very serious--
Mr. Addison: Don't speak like that, doctor, please. Without going into normal cases, do you suggest that in this particular case it was any particular food that caused this?
Dr. Macnamara: Unless I was told that he was, I could not particularize it.
Mr. Addison: Then does it require some to act as an irritant or poison upon that particular person?
Dr. Macnamara: Oh, no.
Mr. Addison: Then will harmless food do it?
Dr. Macnamara: I have seen pips of grapes produce very great gastric disturbances. I have seen skins of gooseberries and other equally harmless substances act in that way.
Mr. Addison: Does it require some sort of substance taken from the outside to produce it?
Dr. Macnamara: I do not think all the evidence goes in that direction.
Mr. Addison: You have spoken of a wetting. Will a wetting do it without taking pips of grapes or sausages?
Dr. Macnamara: I can perfectly believe the wetting, coupled with neglect of precautions in a weak stomach and circulation, may produce these consequences.
Mr. Addison: Then, do you mean to say that by getting wet elements of gastro-enteritis-- this acute inflammation--may be produced in the stomach and bowels?
Dr. Macnamara: That, I think, is the evidence I have given.
Mr. Addison: In saying that gastro-enteritis would be produced by a man with a weak stomach getting wet, do you understand that to be the opinion of Dr. Tidy as well?
Dr. Macnamara: I do not; Dr. Tidy can speak for himself.
Mr. Addison: Did you hear him give his evidence?
Dr. Macnamara: I did.
Mr. Addison: Do you agree or disagree with him?
Dr. Macnamara: Will you kindly tell me what Dr. Tidy said?
Mr. Addison: Did you hear him?
Dr. Macnamara: I have heard so much in this Court that it would be very hard to tax my memory.
Mr. Addison: Dr. Tidy said gastro-enteritis was produced by the introduction of some foreign substance into the stomach, producing the effect of an irritant?
Dr. Macnamara: I got to Dr. Tidy is a toxicologist, but not as a general practitioner.
Justice Stephen: Please answer the question. Do you agree with him or not?
Dr. Macnamara: I do not.
Mr. Addison: Do you agree that there is any diagnostics symptom in lifetime of arsenic. In other words, if you saw a case of arsenic in lifetime, is there anything to enable you to say this is arsenic rather than any other irritant?
Dr. Macnamara: Well, that is a very difficult question.
Mr. Addison: Well, pass on then. Probably it is a difficult question. All the symptoms--vomiting, purging, cramp, intense pulse--all these are symptoms of arsenical poisoning and other poisons?
Dr. McNamara: Yes, and the other irritant poisons.
Mr. Addison: You have told us of a lady who was quite well in health, and Who Feels the Sensation of a Hair in Her Throat. Then did you find intense thirst in that case?
Dr. Macnamara: No.
Mr. Addison: Do you find the throat to dry, glazed?
Dr. Macnamara: No.
Mr. Addison: What is that the effect of?
Dr. Macnamara: Generally febrile disturbance; but, of course, it may arise in different ways.
Mr. Addison: But if you find that accompanied by tenesmus, what does that arise from?
Dr. Macnamara: In that case, it may be a case of gastritis or gastro-enteritis.
Mr. Addison: Supposing you leave out the dysentery?
Dr. Macnamara: It may be due to inflammation of the mucous membranes.
Mr. Addison: Suppose you find the temperature nearly normal, and no fever whatever?
Dr. Macnamara: Well, I should have to take into consideration the other symptoms.
Mr. Addison: Quite so. Do you believe that tenesmus is generally the result of the vomiting?
Dr. Macnamara: I do not understand your question.
Mr. Addison: What is tenesmus, ineffectual straining, due to; to what is it due?
Dr. Macnamara: It may be due to a great number of causes.
Mr. Addison: But take this case?
Dr. Macnamara: I should say it is one of the phenomena of gastro-enteritis. I have heard none of the witnesses in this case speak of cramp.
Mr. Addison: You are quite right. Is it a fact that in cases of this kind the symptoms vary very much, both in degree, in order, and in the absence of some of them?
Dr. Macnamara: Certainly.
Sir Russell: I should like to ask you now, is dryness of the throat, according to your experience, it anyway peculiar to particular form of disease?
Dr. Macnamara: It is not.
Sir Russell: As regards the temperature, we know it was only taken wants, and that it was found to be one degree above what it is supposed to be a normal temperature.
Mr. Addison: If my learned friends will allow me, the nurses' notes were put in, and they show that the temperature was taken at different times.
Sir Russell: I was referring to Dr. Humphreys' evidence.
Sir Russell (to witness): I wish to ask you this, doctor. Assume a case where there is a chronic weakness or derangement of the stomach, in the case of a man who had been taking various drugs, and who in that condition gets a wetting, such as that described, is a man in that condition the more liable from a slight cause to have set up in his system this gastro-enteritis?
Dr. Macnamara: Yes.
Sir Russell: The weaker, from whatever cause, the patient is, the more likely is disease to be set up?
Dr. Macnamara: Yes, the weakest spot invariably suffers.
Sir Russell: For instance, when you speak of cold or wet driving the blood to the parts and congesting, would it drive it to the weakest part?
Dr. Macnamara: Yes, to the lungs if they were, and the stomach if it was.
Sir Russell: I think, doctor, you know nothing about the parties concerned in this case?
Dr. Macnamara: Neither directly nor indirectly.
Frank Thomas Paul, F.R.C.S., (as examined by Sir Russell): I am Professor of Medical Jurisprudence at University College, Liverpool, and Examiner in Forensic Medicine and Toxicology to the Victoria University.
Sir Russell: There are one or two smaller matters I must ask you about. In the first instance, you recollect the glazed pan produced by Mr. Davies?
Dr. Paul: I do.
Sir Russell: Have you seen a pan made in the same way—glazed in the same way?
Dr. Paul: I believe so.
Sir Russell: Did you yourself examine some of these pans?
Dr. Paul: I did.
Sir Russell: Are you satisfied yourself whether arsenic enters into the glazing of these pans?
Dr. Paul: I found arsenic in all the pans that I have examined of this class, in the glazing.
Sir Russell: I want to ask you how the arsenic in glazing is set free?
Dr. Paul: Anything that will tend to corrode the pan at all.
Sir Russell: Does that need any acid?
Dr. Paul: Yes.
Sir Russell: According to degree of the strength of the acid, the arsenic will be set free in a greater or less degree?
Dr. Paul: It will.
Sir Russell: Would this show in any marked way on the glazing?
Dr. Paul: No, not unless it was carried to a great extent.
Sir Russell: Well, will you just tell us what experiment you tried to show whether there was arsenic or not?
Dr. Paul: I added a little acid to some boiling water in the pan, and applied Reinsch's test to the result, and found the copper was noted with a film of arsenic. I tried to four times over, with the different pans.
[A pan was then handed to the witness, which, he stated, was exactly similar to the ones he had tested, and apparently of the same manufacturer.]
Sir Russell: Now, have you also tried to the experiment of what quantity— what minute quantity— of arsenic in urine will reveal itself upon Reinsch's test?
Dr. Paul: Yes.
Sir Russell: Just tell us what was the experiment?
Dr. Paul: I experimented with various quantities, and found 1-200th of a grain to one ounce, which would be readily detected by a person, scientific or otherwise, who saw the test; 1-1000th of a grain would be readily detected in this way.
Sir Russell: Now, I wish just to follow that to thousandths of a grain. What I want to ask you is this. You can reduce that to proportion between the arsenic and the urine in which it is placed?
Dr. Paul: I can.
Sir Russell: And how many times was there the quantity of urine that there was of arsenic?
Dr. Paul: About 55 thousand.
Sir Russell: That would be 1 to 55 thousand?
Dr. Paul: Yes.
Sir Russell: Then you boiled it for how long did you say?
Dr. Paul: I heated it for nearly one minute on the lamp, but not boiled all the time.
Sir Russell: And you introduced the copper foil?
Dr. Paul: We introduced the copper foil, and it showed the presence of arsenic.
Sir Russell: Now, I wish to ask you this question. We have heard Dr. Humphreys' statements of his experiments, and also, it is proper to say, his expression of belief that it was perfectly carried out. Taking his account of what he did, viz., putting the urine and fćces upon the lamp about a minute and heating it—
Justice Stephen: He said over the flame for two minutes till he had got it to a boiling point.
Sir Russell: I want to ask, if a serious or fatal dose had been administered within a fortnight of that time, must there have been, in your judgment, a deposit on the copper?
Dr. Paul: Yes, in my judgment.
Sir Russell: Have you taken the test exactly as he described it?
Dr. Paul: Yes.
Sir Russell: In your judgment, how long after the taking the administration of arsenic in a series of over-medicinal doses —how long after that may its presence be revealed in the system?
Dr. Paul: Do you mean if it has been continuous, or administered on one or two occasions?
Sir Russell: First of all on one or two occasions?
Dr. Paul: I think it would be eliminated in a fortnight on one or two occasions.
Sir Russell: And taken over several occasions?
Dr. Paul: Then the elimination would not be complete probably for months.
Sir Russell: Just explain that?
Dr. Paul: I take it, from my reading, that in cases of arsenical poisoning elimination appears to take place very rapidly over only one or two doses. But when people take arsenic for a long time— they may have given it up for months before death—still arsenic will be found after incorporated in some of the tissues.
Sir Russell: The liver particularly?
Dr. Paul: Yes.
Sir Russell: Let me as soon the case of this being taken medicinally over considerable period, in medicinal doses, would you, long after its administration had been stopped, expect to find traces in the liver?
Dr. Paul: I should.
Sir Russell: Now, as regards the symptoms of this case—the symptoms during life, what do you say of the common symptoms?
Dr. Paul: The common symptoms of those of an intense irritant in the stomach, producing violent vomiting, excessive purging, severe cramps, accompanied by pain over the stomach.
Sir Russell: Would you expect to find tenesmus or straining to precede or to follow violent purging?
Dr. Paul: To follow violent purging.
Sir Russell: Now, you agree that one of the other of these symptoms may be wanting in cases of arsenical poisoning?
Dr. Paul: They may.
Sir Russell: Is it the result of your study and reading the several of that several of the most marked should be absent in any marked degree?
Dr. Paul: No, certainly not.
Sir Russell: I think you have, as pathologist and the Royal Infirmary, assisted at a great many post-mortem examinations?
Dr. Paul: I have made between two and three thousand.
Sir Russell: Have you assisted, amongst others, at post-mortems where the patient is supposed to have died from gastro-enteritis?
Dr. Paul: I have.
Sir Russell: And where there was no suggestion of arsenical poisoning?
Dr. Paul: I have.
Sir Russell: You know the symptoms described in this case?
Dr. Paul: I do.
Sir Russell: Did they, or did they not, accord with your experience of what you have found in cases of gastro-enteritis?
Dr. Paul: They agree with cases of gastro-enteritis pure and simple.
Sir Russell: Was there anything in the post-mortems appearances which were wanting if you had expected to find a case of arsenical poisoning?
Dr. Paul: Yes. I would expect to find the stomach more affected, and showed the characteristics of the petechić spots.
Sir Russell: You are aware that the petechić are not mentioned in the post-mortems notes?
Dr. Paul: I am.
Sir Russell: You are aware that Dr. Humphreys, as he candidly told us, was looking the subject up; that he did mentioned the word petechić, and then proceeded to define what he thought was petechić. Were they petechić at all?
Dr. Paul: Certainly not, nothing like it.
Sir Russell: I should ask you this. What, in your judgment, in the case of a man like the late Mr. Maybrick, described of such an age and so on, what would you described as a fatal dose of arsenic?
Dr. Paul: Certainly Not less than three grains.
Sir Russell: You are aware there is one recorded case of two grains; that was the case of a woman, was it not?
Dr. Paul: Yes, it was.
Sir Russell: Now, I ask you this. You have heard the account given by Dr. Stevenson and Mr. Davies as to the quantities actually found?
Dr. Paul: I have.
Sir Russell: First of all, I should like to ask you, do you agree that it is proper or safe to argue upon the quantities actually found in certain parts as to the possible quantity that may have been embodied?
Dr. Paul: Certainly not.
Sir Russell: And why not?
Dr. Paul: Because it varies very much.
Sir Russell: Unequally distributed?
Dr. Paul: Yes.
Sir Russell: And is the liver a part in which you would especially expect it?
Dr. Paul: Of course, the analysis shows that it was very unequally distributed.
Sir Russell: Looking at the fact that there was no trace in the bile, the spleen, in the stomach, and the heart, do you think that the calculation of Dr. Stevenson as to what might be assumed to be there is likely to be not very precise? His language was that there was possibly and approximately a fatal dose?
Dr. Paul: I do not think it was a justifiable assumption.
Sir Russell: Taking altogether what was found by hand and by Mr. Davies quantitatively, 88-1000ths or 92-1000ths, would you explained to the jury what that quantity would represent?
Dr. Paul: It is so very small that I hardly can. I don't know anything quite small enough to indicate it.
Sir Russell: It would be a very minute quantity?
Dr. Paul: Very minute. A thousandth of a grain would be, I suppose, barely visible.
Justice Stephen: Can you give us what to the eye a grain of arsenic would represent?
Dr. Paul: A good big pin's head.
Justice Stephen: That would be a grain?
Dr. Paul: Yes, of solid arsenic.
Sir Russell: What do you say would be visible to the naked eye, thousandth part of a grain? Divide a pin's head to one thousand parts, it would only be very small—very, very minute?
Dr. Paul: Yes.
Sir Russell: According to the figures given by Mr. Davies and Dr. Stevenson, the first of Jones said 88-1000ths, and the second 92-1000ths, would that be visible?
Dr. Paul: Yes.
Justice Stephen: Can you compare them with anything?
Dr. Paul: I cannot think of anything I can suggest.
Sir Russell: It would be altogether a little less than a tenth of a grain?
Dr. Paul: I can imagine in my own mind what it would be to cut up a grain into ten parts.
Sir Russell: It would be extremely small?
Dr. Paul: Yes, a small dot would represent it.
Sir Russell: You have heard of the minute quantities found in the places where there was arsenic in the body?
Dr. Paul: Yes.
Sir Russell: Is and that consistent with the case of a man who has been taking it medicinally?
Dr. Paul: Yes, quite consistent.
Sir Russell: And who had left it off?
Dr. Paul: Yes, for a considerable time.
Justice Stephen: When you say a considerable time, what do you mean—weeks, months, or what?
Dr. Paul: I should say several months.
Sir Russell: You have heard that the greatest eliminating agents the kidneys?
Dr. Paul: Yes.
Sir Russell: What is the action of repeating small or medicinal doses upon the kidneys?
Dr. Paul: It tends to check the amount of water, and checks elimination.
Sir Russell: Where do you expect to find in such cases the strongest evidence of the presence of the uneliminated arsenic?
Dr. Paul: In the liver.
Sir Russell: You told us you have assisted a very large number of post-mortem examinations; does your experience enable you to say whether you are always able to verify on the post-mortem the diagnosis that has been arrived at during life?
Dr. Paul: No, frequently not.
Sir Russell: And does it not frequently happen, though not, I presume, nearly so frequently, that on a post-mortem you are not able to satisfy yourself clearly as to the cause of death?
Dr. Paul: It does sometimes, but not frequently in the hands of a skilled practitioner.
Sir Russell: In your judgment, do you say this is a case of arsenical poisoning?
Dr. Paul: I think it is a case of gastro-enteritis. The post-mortem appearances do not show that it was set up by arsenic.
Sir Russell: If, in the case of a man who had been complaining for a considerable number of years of what do you would call chronic dyspepsia, who had been drugging himself, or had been drugged, following the occurrences we heard of on the day of Wirral races—take the case of such a man, would a slighter cause be sufficient on such a man to set up gastro-enteritis than in a man perfectly well?
Dr. Paul: Certainly; such a case in such a man would be more likely to be fatal.
Mr. Addison: Did you hear from his going to Wirral races—his sickness—would such sickness be any indication of poisoning?
Dr. Paul: Oh, certainly.
Mr. Addison: I would just ask you about his sickness occurring and reoccurring twice before he went to the Wirral races. Sickness is the first indication of an irritant poisoning?
Dr. Paul: Violent vomiting is generally the first indication, not mere sickness.
Mr. Addison: As regards gastro-enteritis, all the gentleman seem to be agreed that was what immediately followed—acute inflammation of the stomach and bowels, which set up exhaustion, which caused death in this case?
Dr. Paul: Yes.
Mr. Addison: Do you agree with Dr. Tidy and the gentleman from Ireland—Dr. Mcnamara—that it was gastro-enteritis that caused such inflammation to be set up without foreign agency?
Dr. Paul: Yes, I think it could. I have seen a great deal more redness in cases of death from natural causes.
Mr. Addison: What natural cause?
Dr. Paul: Scirrhosis of the liver particularly.
Mr. Addison: That is hardness of the liver?
Dr. Paul: Yes. Any condition which may produce congestion of the stomach and intestines is liable to run into inflammation.
Mr. Addison: Can you suggest any other cause than scirrhosis to produce such an acute inflammation of the stomach?
Dr. Paul: There is disease of the heart.
Justice Stephen: I think every medical witness who has been examined has said that he would put special diseases tending to produce inflammation on the same footing as the introduction from without of a tainted body. The instances which they gave were in particular ulcers and cancers. And this gentleman seems to think that this scirrhosis of the liver is a case of the same kind.
Mr. Addison: It is a very fatal and terrible disease?
Dr. Paul: It slowly tends to a fatal end.
Mr. Addison: That is that all these diseases, such as heart disease and scirrhosis of the liver, produce such a state of the stomach or the intestines as would be readily ascertainable on a post-mortem without your skill?
Dr. Paul: I should think so.
Mr. Addison: You have told us that where arsenic was taken medicinally, the presence in the liver of those quantities may be attributable to the medicines which have been taken up to seven months before?
Dr. Paul: That is the longest case in my reading. I took an extreme case.
Mr. Addison: In your practice, how long? Have you ever started with a case in which there were traces in the liver of arsenic, and in which you could trace in the post-mortem how long before it had been taken?
Dr. Paul: I have never analysed the liver in such a case. I cannot answer from my own experience, I can only answer from my reading.
Mr. Addison: May I take it you have no experience of arsenic found in the liver as the remains of the administration some months or weeks before?
Dr. Paul: You can hardly find in the man in England except a specialist who could answer that.
Mr. Addison: I don't suggest. It might have been that you had some practical knowledge of it. You have often found in post-mortem examinations arsenic in the liver?
Dr. Paul: Often; no.
Mr. Addison: Have you never had a case at all where you detected arsenic in the liver?
Dr. Paul: I have never analysed and found arsenic in such cases, having had no large experience.
Mr. Addison: Can you remember a case in which you have had arsenic in the liver?
Dr. Paul: I have not been engaged in an arsenical case before this.
Mr. Addison: Well, that does not detract from your general knowledge, but you cannot recollect any case in your own mind that you have found arsenic in the liver?
Dr. Paul: I have never had such a case.
Mr. Addison: Then, I think, I cannot ask you how long before finding it there, from the history of the case, it was administered?
Dr. Paul: Not from my own experience.
Justice Stephen: Have you carefully considered the question how long arsenic administered either medicinally or of some motive of his own by the person who took it, how long it remains in the liver?
Dr. Paul: Not personally, my lord. It is very clear to my mind what the conclusion is. When arsenic is taken for a line of time it becomes very closely incorporated in the tissues of the body, and is very difficult to eliminate.
Mr. Addison: We have hated from Dr. Tidy in Dr. Stevenson, both men of great experience, and I was seeing whether you had the same advantages of noticing the arsenic in the liver and are able to trace in back?
Dr. Paul: I have nothing like the experience of those gentleman.
Mr. Addison: In your reading, you have read as an outside case of seven months?
Dr. Paul: Yes, as an outside case.
Mr. Addison: Then you have told us of those spots—which I find so difficult to pronounce—these petechić spots. Were you then speaking from your general skill and knowledge?
Dr. Paul: I was.
Mr. Addison: Now, with the matters of vomiting and purging, these are common symptoms of arsenical poisoning, but is not tenesmus the result of purging?
Dr. Paul: In might experience tenesmus results from severe purging.
Mr. Addison: But in the case of an irritant, assuming there was some irritant in this man's system, would not the purging lead to tenesmus?
Dr. Paul: I think it is far more common then you seem to assume.
Mr. Addison: In this case do you think it was from purging?
Dr. Paul: I cannot say positively. It is from some irritant in the blood.
Mr. Addison: Well, then, in the pains in the stomach. We are told that abdominal pains were first complained of, and these are produced, I think, that acute inflammation of the stomach?
Dr. Paul: We had rather to judge between one of the nurses and the doctors, and the doctors said nothing about pain. I always go by the doctors in these cases.
Mr. Addison: One of the nurses did speak of the pains on Friday?
Dr. Paul: I paid very little attention to this, because the nurses could tell the doctor, and if the pain was severe I can hardly imagine the nurse would pass over it.
Mr. Addison: Have you any doubt that inflammation of the stomach was there?
Dr. Paul: Surely he would have complained of it.
Mr. Addison: Have you any doubt after hearing the statement as to the condition of the stomach?
Dr. Paul: I don't think the condition of the stomach was at all unusual.
Mr. Addison: Do you mean that he did not die from it?
Dr. Paul: I presume that he died from exhaustion, produced by gastro-enteritis. I do not call this a severe case.
Mr. Addison: Don't you call a case which kills a man an indication of severe inflammation?
Dr. Paul: Some people are more easily killed than others. He merely had to get into a condition of exhaustion. I don't think there was pain in this case; I feel morally certain there was not.
Mr. Addison: Now, in the same way about the experiment you made, I suppose you used the same size of copper that Dr. Humphreys says he used?
Dr. Paul: I tried to get it the same size.
Mr. Addison: And did you perform the experiment lately?
Dr. Paul: I performed a number of the experiments on which Dr. Humphreys gave his evidence in order to prove them.
Mr. Addison: You are a skilled chemist?
Dr. Paul: Yes.
Mr. Addison: And the results on the copper required a skilled eye to detect?
Dr. Paul: Would you like to look at them?
Mr. Addison: No; probably the jury would like to see them. It would take a skilled eye to detect them on the copper?
Dr. Paul: Certainly not; if you only ask an unskilled person to look at it.
Mr. Addison: I will take your answer, but it is true that very often when the arsenic is there it is not traced to the urine?
Dr. Paul: I think it is there sometimes when not in the urine.
Mr. Addison: That arsenic when in the body sometimes cannot be traced in the urine?
Dr. Paul: I think that depends very much upon how recent the administration was. A single dose or two is rapidly eliminated, and certainly would be found in the urine; but it locked up in the liver for some time, the elimination would be extraordinarily slow.
Mr. Addison: May are ask you whether you have had any patience suffering from excessive doses of arsenic do you have examined professionally?
Dr. Paul: I do not know that I have.
Mr. Addison: Then the result of your skill is from reading? None of your patients had been suffering from excessive doses, and you examined none to ascertain this point?
Dr. Paul: No.
Mr. Addison: The arsenic was found by Mr. Davies after the ordinary preparation in the food?
Dr. Paul: Yes.
Mr. Addison: I think he said he detected none after boiling water. The pan was one such as you have here. What did you use?
Dr. Paul: Hydrochloric acid.
Mr. Addison: What quantity?
Dr. Paul: About one in ten. I have tried it with soda, and found this enamel on the pan contained arsenic.
Mr. Addison: Did you try the experiment with warm water?
Dr. Paul: I did.
Mr. Addison: Could you detect arsenic in the pan?
Dr. Paul: Not simply with warm water. I examined it by Reinsch's test.
Mr. Addison: Did you find arsenic in the liver?
Dr. Paul: Yes.
Mr. Addison: To what extent?
Dr. Paul: I cannot say. I had only a small piece.
Sir Russell (re-examining): You tried it by Reinsch's test to see whether it indicated the presence of arsenic?
Dr. Paul: That is so.
Sir Russell: And you have no doubt that there was?
Dr. Paul: I have no doubt that there was.
Sir Russell: As regards the detectability of arsenic, if a man has been taking it for a considerable time, you say it would be less quickly eliminated?
Dr. Paul: After the dosing is stopped, yes.
Sir Russell: And in such cases as that, it may be in the system without necessarily revealing itself in the urine?
Dr. Paul: Yes.
Sir Russell: As regards the pain in the pit of the stomach, does that increase on pressure? That is the pain you refer to?
Dr. Paul: Yes.
Sir Russell: Let me remind you of what Dr. Humphreys said about the Wirral races. He said that Mr. Maybrick had told him that he had taken a double dose of his medicine, and he repeated the same thing to Mr. Thompson. Would that be sufficient to account for his sickness before he went to the Wirral races?
Dr. Paul: Yes.
Sir Russell: Would it also probably have the effect of making his stomach more sensitive—increasing any normal derangement?
Dr. Paul: It would.
Hugh Lloyd Jones (examined by Mr. Pickford): I am a chemist and druggist, carrying on a business at Bangor. I was for some time assistant to Mr. Lathbury, a chemist, of Liverpool.
Mr. Pickford: Can you speak, when you were there, as to the use of arsenic as a cosmetic?
Mr. Jones: I can speak to the fact that ladies came to buy fly-papers when no flies were about.
Mr. Pickford: Apart from that, do you know from the usual experience of your business that arsenic is used as a cosmetic?
Mr. Jones: I do not know of my own experience; but I know there is an impression in the trade that it is used for that purpose.
James Bioletti (examined by Sir Charles Russell): I am a hairdresser and perfumer, carrying on business on Dale Street, Liverpool. I have been in business for about thirty years. Arsenic is used a good deal in the hair for some purposes, and I have used it as a wash for the face on being asked for it by ladies. There is an impression among ladies that it is good for the complexion. I have used it on a few occasions, and only when I have been asked for it.
Sir Russell: Was Mrs. Maybrick ever a customer of yours?
Mr. Bioletti: Not to my knowledge.
Mr. Addison (cross-examining): You say that you use it for the hair. Tell me how you use it?
Mr. Bioletti: Very largely for removing here. It is used principally by ladies for removing here from the arms. I mix it with lime—one-quarter of arsenic to three-quarters of lime, in powder. I generally use yellow arsenic, but I have used white arsenic. I put the lime and arsenic up together and label it "Depilatory," along with the directions.
Mr. Addison: There is nothing to show that there is arsenic in it?
Mr. Bioletti: No. I generally put it up in a two-ounce bottle. I produce one of my bottles. The label is as follows:--"Depilatory, to remove superfluous hair; mix with a quantity of water to the consistency of a thick cream, and then spread one-eighth of an inch on skin, and all over it, to remain three minutes; if the skin is sensitive, five minutes. Then remove it with a paper knife. Wash with cold water, and apply a little cold cream. Do not touch a sore or it will be painful." I have never tasted it, and I cannot say whether the lime would make the yellow arsenic very nasty to the taste.
Mr. Addison: Do you know whether it is used as a cosmetic?
Mr. Bioletti: Not as a rule. I have been asked for it a very few times in my life. I have been spoken to on the subject by ladies, asking as to its value as a cosmetic. It is supposed to be a good thing for improving the complexion. I only prepared it just for the occasion, and only in small quantity. I only remember distinctly one occasion.
Sir Russell (re-examining): The depilatory is in common use.
Sir Russell: Although you do not have it for sale, are you sometimes asked for it for the purpose of cosmetics?
Mr. Bioletti: Yes.
Sir Russell: In that case you would prepared it in that form, I suppose, in solution?
Mr. Bioletti: I would just put a little into milk of almonds. I have seen it in the country papers recommended for making the hair grow.
Edwin Maybrick (recalled, examined by Mr. Addison): Shown box labelled "Taylor Brothers, Pharmaceutical Chemist's, Norfolk, Virginia. Iron, Quinine, and Arsenic, one capsule every three or four hours; to be taken after food. Mr. Maybrick." I found that pill box in the drawer of the wash-hand stand in my brother's bedroom. The last time my brother was in Norfolk, Virginia, was in 1884. Edwin Maybrick (cross-examined by Sir Russell): I found the pill box a week or two after my brother died—before the furniture was removed. I was aware that Mr. Cleaver was acting for Mrs. Maybrick. I did not communicated with him.
Sir James Poole (examined by Sir Russell): I am a merchant, and have lived practically my whole business life here. I at one time served the office of Mayor. I knew the late Mr. James Maybrick. I belong to the Palatine Club, of which he was a member. I remember one day in the month of April of this year coming out of the underwriters' room and meeting him and one or two other friends. Some one made the remark that it was becoming a common custom to take poisonous medicines. Mr. Maybrick, who had an impetuous way, blurted out, "I take poisonous medicines." I said, "How horrid. Don't you know, my dear friend, that the more you take of these things the more you require, and you will go on till they carry you off." I think he made some expression and shrugged his shoulders, and I went on.
Sir Russell: That is the evidence I place before you, my lord. I don't know what the desire of the lady may be now as to making any statement.
Mr. Addison: It appears to me that Sir Charles might very well make them himself if they are to be received.
Sir Russell: I will ask the lady what is now her wish.
Sir Russell held a short whispered conversation with Mrs. Maybrick—Then he said, addressing his Lordship: My Lord, I wish to tell you what has taken place. I asked if it was her wish to make any statement, and she said "Yes." I asked her if it was written, and she said "No."
Our thanks to Stephanie Thompson for transcribing this page.