Welcome to The Quack Doctor, a weekly publication that unearths stories from medicine’s past. Subscribe for free to receive new posts and support my work.
This article contains details that some readers might find distressing.
A woman walking down a Dorset country lane saw an old boot lying on the ground. Might there be another one nearby? It would be fortunate to find a sturdy pair of boots during these hard times. Yet something wasn't right. The summer air held an oppressive tension; the birds had deserted the hedgerows. Danger swooped down in their place.
She picked up the boot and at once dropped it in horror. Within was the ragged surface of a severed foot, blood still dripping from its veins. Looking over the wall, she saw two men; one standing, one motionless on the ground. She had become a witness to ‘one of the most horrible murders that has ever been committed in the county of Dorset’.
Adam Stapleton Puckett had been a Medical Officer for the Poor Law Union of Weymouth for many years and, at the age of 63, was struggling to cover an area 15 miles across. His role was intended to ensure that the poorest in society always had access to some level of medical care. For a small retainer salary, Poor Law Medical Officers had to be ready at all hours of the day and night to supply advice and medicines (at their own cost) to those in receipt of parish relief. The lack of resources and pressure of the role frequently took the blame for inadequacies of patient care; in exceptional cases it could end in tragedy.
Puckett was perhaps a little old-fashioned in his treatment methods and he had only the most humble of qualifications – the Licence of the Society of Apothecaries, obtained in 1819 – but he was locally respected as a kind and conscientious practitioner.
John Cox, a labourer, lived with his elderly parents and two brothers in a two-room cottage in Sutton Poyntz. In the summer of 1862, when he was about 35, he developed a distressing condition involving fits and violent psychotic episodes that included regular threats to ‘beat the brains out’ of family members. His mother was ‘quite wearied down by it’. He told the local vicar that God had said to him ‘John Cox, I have come to take thee.’
Puckett diagnosed phrenitis, or ‘brain fever’ and kept an eye on Cox. Owing to the demands of his large Union area, however, he could not visit Cox as often as he wished, and was unaware just how bad things had become. Although the relieving officer, Zachariah White, wondered if the patient needed to be in an asylum, Puckett felt that a week or two in the workhouse infirmary would set him right and, on 8 July, he and White went to bring Cox in. That morning, Cox had stripped naked and covered himself in butter, and was in no mood to go anywhere. Perhaps he knew something was up, for a few days previously he had told his mother he would ‘sooner be carried anywhere than the Union.’ Puckett was confident he could keep Cox calm and, despite the warnings of White and old Mr Cox, he entered the cottage.
Next door neighbour, Mary Ann Hanham, listened at the window and heard the doctor calmly encouraging Cox to dress and come out for some fresh air. Meanwhile, Zachariah White had gone to the nearby pub to borrow a cart for taking Cox to the workhouse. This was the last moment of uneasy peace. As Cox’s mother, Mary, later testified, ‘The sweat came out of Mr Puckett as big as peas, he appearing to see that he was in danger.’ Cox became enraged. ‘Don't bide there chaffing me,’ he threatened, ‘or I'll beat your brains out.’
The neighbours next saw Puckett outside the front of the house, pulling the door towards him with all his strength as Cox tried to break out.
As Puckett clung to the door handle, he heard the shattering of glass; his patient was at the window shouting murderous threats. Puckett didn't know that the window had iron bars stopping Cox from getting through. Fearing that his assailant was almost upon him, he abandoned the door and ran for it, inadvertently allowing Cox the freedom to follow. Cox emerged with two lengths of wood ripped from the bedstead and, soon catching up with the doctor, felled him with a blow to the head.
The terrified neighbours dared not approach the wounded man while Cox remained nearby, even though some thought they could see Puckett breathing and hear him groan. Cox came to their window and asked for some brandy, which they gave him, and he went into his own home. He reappeared with a handsaw, which he used to sever Puckett's head. After throwing it into the road, he did the same to a hand and foot. Cox wandered away from the scene, wearing nothing but a shirt, and was soon afterwards apprehended in a stable at The Plough inn, Osmington. He did not try to deny what he had done – on being questioned by a police superintendent the same night, he said:
I did it. I should not have murdered the old b------ if he had not pulled my hand quite so tight—he twisted my arm.
… I found the saw, and I cut his hand off, and his foot, and his head, and I threw them all over into the road, and his old head sounded like a d----d old pumpkin.
During his trial at Dorchester Crown Court on 25 July 1862, John Cox ‘held up his hands in a supplicating attitude’ and appeared to shake with fear. That he had committed the murder was in no doubt; the question for the jury was whether he was of sound enough mind to have been aware of his actions. He had recently been in gaol for poaching and exhibited symptoms of mania while there – there was so much evidence for him being seriously ill that the jury took only a few minutes to find him not guilty on the grounds of insanity.
The horrific circumstances of the murder were enough for it to be widely reported, but Puckett's role as a Union surgeon added a dimension of medical interest and criticism of his working conditions. Puckett happened to be a friend of the medical reform campaigner Richard Griffin, who established a fund to support his widow. Griffin revealed that Puckett had been responsible for a large union and the demands on his time had made it impossible to visit Cox frequently enough to see how unwell he really was. Griffin described his friend as ‘a hard-working, kind-hearted man—an apothecary of the old school’, but a district 15 miles across was too much for one person. From his salary of £116 a year, Puckett had to provide medicines for all the Poor Law patients and pay for the upkeep of a horse, so there was not much left to support his disabled wife and family. According to Griffin, Puckett had only 21 shillings to his name at the time of his death. Within a month of the fund being launched, it had raised £400.
Although John Cox was acquitted, the judge ordered him to remain in custody indefinitely. In 1865 he was transferred to the new Broadmoor Criminal Lunatic Asylum, where he lived for the next 53 years. He died there in 1918 at the age of 91.