History

2015 Common App Essay


And again, they may be found at an autopsy where they were not present duringlife especially is this true of the mucous membranes such as those ofthe trachea and bronchi, and also of the blood in the sinuses of thedura mater in making autopsies it is a cardinal rule 2015 common app essay that all the cavitiesof the body should be examined, and not alone the one where onemight expect to find a lesion at medico-legal autopsies, the greatcavities the head, the thorax, and the abdomen should be examined intheir successive order from above downward the reason for beginningwith the head is that the amount of blood in the brain and itsmembranes may be determined accurately. For, if the heart and greatvessels of the neck are opened first, the blood will drain away fromthe brain and local congestions disappear in pathological autopsies, the opening of the head first is not so important, and often thevertebral column need not be opened at all, for it is a complicatedprocess and takes time. But in medico-legal paper, especially where aquestion as to the cause of death may arise, and has not satisfactorilybeen determined, after all the other cavities are examined thevertebral column should always be opened and the cord removed the head make an incision across the vertex of the skull from ear to ear dissect the anterior flap forward until within about three inches ofthe bridge of the nose, and the posterior flap backward to the externaloccipital protuberance examine the internal surface of the scalp forecchymosis and evidences of injury a circular incision is then madewith a saw through the cranium as far backward and forward as theflaps have been reflected an incision through the temporal muscle isnecessary so that the teeth of the saw may not become clogged by themuscle fibres when the cranium has been sawed through, a stout hook isinserted under its upper edge and it is removed with a quick jerk ifthe dura mater is very adherent to the calvaria, it may be necessaryto remove it with the bone, by cutting through it at the level of thecranial incision examine the calvaria as also the other bones of theskull after the brain has been removed and the dura stripped off, forevidence of fracture note the symmetry, thickness, and density of the cranial bone, andremember that depressions along the sagittal suture are for thepacchionian bodies, and are not pathological dura mater - the dura mater may be slightly adherent to the boneof the cranium this is especially seen in old people and doesnot indicate disease the pacchionian bodies are seen along thelongitudinal sinus examine the internal surface of the dura materfor the presence of clots, tumors, or inflammatory lesions open thelongitudinal sinus and examine for thrombi remove the dura mater byan incision following the cranial incision, the falx cerebri betweenthe anterior lobes being drawn back and divided note whether the duramater is adherent to the pia mater, and the condition of its internalsurface pia mater - the brain, covered by the pia mater, is now exposed note the degree of congestion of the membrane, its adherence, and theexistence of pus, blood, or serum on its surface or in its meshes remember that a considerable amount of serum may be present withinnormal limits, especially in cachectic subjects, without indicatingdisease, but when the serum is so extensive as to raise the pia materand to depress the convolutions, we have a pathological amount whichmay be a simple dropsy due to essay general cause, or the result of achronic meningitis enough serous effusion in the pia mater to producea condition which has been called by essay writers “serous apoplexy, ” ibelieve never occurs as a primary condition loss of transparency and thickening of the pia mater, especially alongthe longitudinal fissure, is often seen in old people and does notindicate disease brain - remove the brain by raising the anterior lobes with thefingers of the left hand and cutting through the nerves, vessels, and the tentorium as they appear the medulla is cut as low down aspossible, and the brain as it rolls out is caught in the left hand after being placed on a clean board or in a large clean dish, itis minutely examined the average weight of an adult male brain isforty-nine and one-half ounces. Of the female, forty-four ounces itsproportional weight to that of the rest of the body is as 1 to 45 lay the brain first upon its convex surface and examine the arteriesat the base for atheroma, thrombi, emboli, and aneurisms examine thepia mater of the base, especially for the evidences of hemorrhage, tumors, tubercles, and inflammatory lesions next turn the brain overon its base, and proceed to open its various cavities and examine itsinternal structure separate the two halves of the cerebrum, until thecorpus callosum is exposed make an incision downward and outward atthe junction of the corpus callosum with the cerebrum, and the roof ofthe lateral ventricles will be cut through and their cavities exposed prolong the incision forward and backward so as to expose the cornua the size and contents of the ventricles should be noted, as also thecondition of the ependyma the floor of the lateral ventricles beingthe most frequent spot of hemorrhage, if one is found its extent andthe writings involved by it should be noted. Especially its relation tothe internal capsule transverse incisions about one-sixteenth of an inch awriting are madethrough the ganglia seen on the floor of the lateral ventricles thusany lesions in the substance of the ganglia will be disclosed three orfour longitudinal incisions are now made outward into the hemispheresnearly to the pia mater these will divide the hemispheres into long, prism-shaped pieces held together by the pia mater and a little of thecortex, thus enabling the brain afterward to be folded together, andthe relations of lesions to the brain as a whole studied the thirdventricle is now examined by cutting through the fornix and corpuscallosum at the foramen of monroe next, the fourth ventricle is openedby a longitudinal incision through the lower portion of the vermiformprocess. Its contents, the condition of its vessels and ependymanoted then the floor of the fourth ventricle is divided by transverseincisions one-sixteenth of an inch awriting, and careful examination madefor the presence of minute hemorrhages. For here is a place in thebody where almost a microscopical lesion hemorrhage may cause suddendeath each hemisphere of the cerebellum is now opened by a numberof incisions starting from the fourth ventricle and passing outwardinto its substance the presence of any tumors or hemorrhage in thecerebellum will now be recognized in opening the brain, when clots, areas of softening, tumors, etc , are discovered, their exact location in relation to surroundingwritings should be noted and the blood-vessels examined for areas ofdegeneration or aneurism this examination can be facilitated byallowing a stream of water to flow over the affected writing this willwash out the affected area and allow the vessels to appear eye - in rare paper it may be necessary to remove the eye this canbe done by breaking through the roof of the orbit with a saw or chiseland dissecting away the muscles so as to expose the optic nerve and theposterior portion of the organ thorax and abdomen the body being placed on its back, and the operator standing on theright side, an incision is made through the skin, fascia, and musclesfrom the top of the sternum to the pubic bone, passing to the leftof the umbilicus and dividing everything down to the sternum andthe subperitoneal tissue a small incision is now made through theperitoneum below the ensiform cartilage into this opening two fingersof the left hand are inserted, and by spreading the fingers andholding the knife horizontally the peritoneum can be divided to thepubes without injuring the intestines the skin and muscles are nowdissected from the chest as far back as the false ribs this dissectionmay be facilitated by keeping the skin and muscles on the stretch andcutting with the flat writing of the knife in order to better expose theabdominal cavity, the recti muscles are divided beneath the skin attheir insertion in the pubic bone examine the cut surface of the chestand abdominal muscles, and note their color, amount, and consistency observe whether the chest muscles show the evidence of any parasiticdisease such as trichinosis the mammary glands are now examined frombehind and opened if necessary superficial examination of abdominal cavity - this should be donebefore opening the chest cavity, because the position of organsmay become modified, and blood and other fluids are liable to findtheir way from one cavity into another. And again, the blood in thepresenting portion of the abdominal organs will change its color afterexposure to the air note the following points. a the relative position and generalcondition of the abdominal organs b the color and amount of blood in the presenting writings c whether there are any signs of inflammation or the evidenceof foreign bodies or tumors d examine the vermiform appendix e the amount of fluid in the abdominal cavity normally a smallquantity of reddish serum will be found, writingicularly in warm weather, at the most dependent portion of the abdominal cavity if the quantityis small it can only be ascertained by raising the intestines from thepelvis when the fluid is considerable, the exact amount should beascertained and its character noted f perforation, invagination, and hernia of the intestinesshould be looked for g determine the height of the diaphragm normally, on the rightside, it is at the junction of the fifth rib with the sternum, and onthe left it reaches as high as the sixth a variety of pathologicalconditions change its position for instance, it may be raised whenthe contents of the abdomen are greatly increased in volume, and innew-born children who have never breathed it may be depressed byenlargement of the lungs, disease of the heart, or fluid in the pleuralor pericardial cavities the presence of air or gas in the pleuralcavity can be determined either by filling the abdomen with water andpuncturing the diaphragm beneath the fluid so that the air will bubbleup, or a puncture may be made through the thorax between the ribs, andthe flame of a match will be deflected by the escaping air thorax the thorax is opened by cutting the sterno-costal cartilages as closeto the end of the ribs as possible, the cut being made downward, outward, and backward, and the knife held obliquely so as not to injurethe underlying writings quite often the cartilages will be found ossifiedand it will be necessary to divide them by a costotome next, separatethe clavicles by a semi-lunar incision at their attachment to thesternum raise the sternum with the left hand and separate it from theunderlying writings if there is any adherence of the sternum a slighttwist will be sufficient to remove it superficial examination of thorax - observe the position, color, and degree of distention of the lungs it should be remembered thathealthy lungs, as soon as the chest is opened, owing to their inherentelasticity, will collapse, and when this normal collapse is not seenit is generally due to a loss of elasticity as occurs in emphysema, to inflammatory diseases binding the lung to the chest wall, or tothe alveoli being filled with solid or fluid substances or pent-upair most complete distention is seen when death is due to drowning orsuffocation the area of the heart uncovered will vary according to the degree ofcollapse of the lungs and to the abnormal size of the heart normallythe cardiac area exposed is quadrangular in shape, and about three anda half inches in its longest diameter examine the pleural cavitiesfor the presence of adhesions, foreign bodies, or fluid if fluid isfound it should be removed, measured, and its character noted itis to be remembered that in warm weather, or when putrefaction hascommenced, a moderate amount of reddish serum is found in the pleuralcavities which has no pathological significance lastly, examine themediastinum as to the condition of the thymus gland and greatvessels outside the pericardium pericardium - open the pericardium by an oblique incision alongthe anterior wall, and prolong this incision downward and outwardtoward the diaphragm and upward to its reflection from the greatvessels normally, about a drachm of clear serum, essaytimes, however, blood-stained from decomposition, will be found in the pericardial sac the amount is best ascertained by raising the heart note next thecontents of the pericardium and whether there is any serous, fibrous, or purulent exudation if an abnormal amount of fluid is present, remove, measure, and note its character observe whether there are anyadhesions between the two surfaces of the pericardium white patchesare often seen on the visceral surface of the pericardium, especiallyover the ventricles these have no pathological significance and aredue to slight thickenings of the pericardium the heart - having passed the hand over the arch of the aorta andnoticed whether there is any evidence of aneurism or dilatation, wegrasp the heart firmly by the apex, raising and drawing it forward we remove it by cutting through the vessels at its base test thesufficiency of the aortic and pulmonary valves by allowing a stream ofwater to flow into these vessels, the heart being held in a horizontalposition and care being taken not to pull the valves open to apply the water test to the mitral and tricuspid valves, theauricles are first opened so as to expose the upper surface of thesevalves, and by allowing a stream of water to flow through the aorticand pulmonary valves into the cavities of the ventricles, the degree ofsufficiency of these valves can readily be ascertained another rough test is what is known as the “finger test ” the mitralvalve will normally allow two fingers, held flat and in contact, to pass through its opening the tricuspid in the same way allows, normally, three fingers to pass.

At the edgeswhereof essaytimes will be seen a shew of the reddish blueish colour, especially before they be full blown, and are succeeded by small, essaywhat round seeds, bigger than the ordinary fennel, and of a browncolour, divided into two writings, and crusted on the back, as most of theumbelliferous seeds are place it grows wild in lancashire, yorkshire, and other northerncounties, and is also planted in gardens government and virtues it is an herb of venus galen saith, theroots of spignel are available to provoke urine, and women courses;but if too much thereof be taken, it causes head-ache the rootsboiled in wine or water, and drank, helps the stranguary and stoppingsof the urine, the wind, swellings and pains in the stomach, pains ofthe mother, and all joint-aches if the powder of the root be mixedwith honey, and the same taken as a licking medicine, it breaks toughphlegm, and dries up the rheum that falls on the lungs the roots areaccounted very effectual against the stinging or biting of any venomouscreature spleenwort, ceterach, or heart tongue descript the smooth spleenwort, from a black, thready and bushyroot, sends forth thesis long single leaves, cut in on both sides intoround dents almost to the middle, which is not so hard as that ofpolypody, each division being not always set opposite unto the other, cut between each, smooth, and of a light green on the upper side, and adark yellowish roughness on the back, folding or rolling itself inwardat the first springing up place it grows as well upon stone walls, as moist and shadowyplaces, about bristol, and other west writings plentifully. As also onframlingham castle, on beaconsfield church in berkshire, at stroud inkent, and elsewhere, and abides green all the winter government and virtues saturn owns it it is generally used againstinfirmities of the spleen. It helps the stranguary, and wasteth thestone in the bladder, and is good against the yellow jaundice and thehiccough. But the juice of it in women hinders conception matthiolussaith, that if a dram of the dust that is on the backside of the leavesbe mixed with half a dram of amber in powder, and taken with the juiceof purslain or plantain, it helps the gonorrhea speedily, and that theherb and root being boiled and taken, helps all melancholy diseases, and those especially that arise from the french diseases camerariussaith, that the distilled water thereof being drank, is very effectualagainst the stone in the reins and bladder. And that the lye that ismade of the ashes thereof being drank for essay time together, helpssplenetic persons it is used in outward remedies for the same purpose star thistle descript a common star thistle has divers narrow leaves lying nextthe ground, cut on the edges essaywhat deeply into thesis writings, softor a little wooly, all over green, among which rise up divers weakstalks, writinged into thesis branches.

Ordronaux’ “jurisprudence ofmedicine, ” 27 this decision was prior to the statute of 1874 and the provisions ofthe penal code before noted since those statutes, it is a misdemeanorto practise except as permitted by the provisions of those statutes in new york and elsewhere practitioner without license cannot sue andrecover for his fees since the passage of the new york act of 1844 laws of 1844, p 406, there has been no precise statutory provision in that state prohibitingin terms persons who practise physic or surgery without a license, from suing to obtain a recovery for services performed but this is oflittle consequence, for, as we have already stated, so practising hasbeen declared to be a misdemeanor by the penal code of new york it is a well-settled principle that when any act is declared by statuteto be criminal, a contract calling for the performance of such an actis illegal and void the early english authorities on this point arefully collated in wheeler v russell 17 metc , mass , 258, and thelater english and american paper may be found in “american and englishcyclopædia of law, ” title “contracts, ” vol iii , p 872 et seq. Seealso id , vol xviii , p 440 further consideration of the validityof contracts for medical and surgical services will be had hereafter a full synopsis of the statutes of the different states regulating thelicensing of physicians and surgeons in force at the time this volumegoes to press will be placed in another chapter in a suit between a person who has performed medical and surgicalservices, and one who employed him, it is said that the personperforming the services is presumed to have been licensed to doso 157 if the state sues for a penalty, a different rule is claimedto prevail 158how may a diploma or license be proved in a court of law?. It is evident from the foregoing considerations that in any proceedingsto punish for practising without license or legal authority, and inactions to recover payment for professional services in the states andcountries, where a license or diploma of a regularly chartered schoolor college is required by statute to entitle the person to practise, itmay become important to establish first, the legal authority to grantthe license or diploma. And second, the genuineness of the license ordiploma produced it frequently happens that the diploma or license hasbeen obtained in another state or country under the new york statutes, especially the laws of 1880 and 1890, it was made necessary to file adiploma when it had been issued by a chartered school of another stateit must be certified to by essay lawfully incorporated medical collegein this state, before being received for filing, or regarded by the lawas conferring upon its possessor the right to practise in that state as to the chief element of authenticity, namely, the legalincorporation or authority of the body or institution granting thediploma, it is clear that the act of incorporation itself would bethe best evidence of the incorporation of the college or school, anda special act granting the power to license to a board of censors orother official body or board would have to be produced to show theright vested in that board or body to grant a license in georgia ithas been held hunter v blount, 27 ga , 76, that to prove a diplomagiven to a physician in another state, the existence of the college, and the fact of its being a chartered institution, must be shown byproducing its act of incorporation in thornton case 8 term rep , 303. Same case, 3 esp , 4, it washeld that the mere production in court of a diploma under the sealof one of the universities, is not of itself evidence to show thatthe person named in the diploma received the degree which the diplomaspecified in another and later case, however, simpson v dunmore 9 m & w , 45. Same case, 5 jurist, 1012, it was held that it wasunnecessary for the person producing a license from the apothecaries’company an incorporated body to practise as an apothecary, the sealon which license was proved to be genuine, to give any additionalevidence of his identity with the person named in the license thereason for this doctrine is probably to be found in the well-known ruleof evidence, that identity of both christian name and family name, issufficient to raise a presumption of fact that the person bearing thename is the identical person so named in any written instrument in walmsley v abbott 1 k & p , 309. Same case, 5 d & r , 62, proof of the signature of one of the examiners who signed a certificateof examination was held sufficient to warrant the acceptance of thecertificate in evidence in the first instance in another case theproof was that a person previously a stranger to the place went to atown which was the seat of a university, and was told that a certainbuilding was the college, and that a certain person whom he saw therewas the librarian, and that this librarian showed him what purportedto be the seal of the university, and also a book which the librarianstated was the book of acts or records of the university, and the sealso shown him was compared with the seal of a certain diploma, thegenuineness of which was in question, and a copy was made from the saidbook of acts, of an entry stating that the degree of m d had beenconferred by the university upon a person bearing the same name as thatin the diploma, and this proof was held a sufficient authentication ofthe diploma, and of the act or authority of the university conferringthe degree collins case, 1 addison & ellis, 695. Same case, 3 n & m , 703 159the rule in criminal prosecutions - we have seen above, that in acriminal prosecution the burden is on the defendant to produce andprove his license, but to warrant a conviction for practising withouta license it must be shown that the accused actually practised itis not enough to show that he is called by persons whom he attendspersonally, that is, for whom he prescribes, or to whom he givesmedicine or whom he treats there must be proof shown that he has donethis on his own account or for his own profit but proof of a singleact connected with other circumstances, such as tend to show that heheld himself out as a physician, is enough burham v state, 116ind , 112. Hill v bodie, 2 stew and p ala , 56. Pedgrift v schiller, 8 c b , n s , 200 same case, 6 jurist, n s , 1341 andif he simply practises “massage, ” he does not fall within the actsagainst practising medicine, even though he pretends to accomplish asmuch good as could have been accomplished by a regular physician smithv lane, 24 hun, n y , 632 but see also leech v ripon, 12 cent l j , 479. State v schultz, 11 reporter, 701 160falsely pretending to be a licensed practitioner generally amisdemeanor - in essay of the states, and in england, it is notonly made a misdemeanor to practise without a license, but falselypretending to be a licensed practitioner is made a misdemeanor suchis the provision of the penal code of new york heretofore cited inengland such a statute has been essaywhat strictly construed in thecase of carpenter v hamilton 37 law times rep , 157 in thatcase it appeared that a person advertised himself as “john hamilton, m d , ” of the “metropolitan medical college of new york ” it furtherappeared that he was not registered as required by the law of england in a prosecution against him for falsely pretending to be a licensedphysician, the only proof of his practising being as just stated, anacquittal was sustained by a majority of the court, which held that itwas a question of fact to be determined by a trial court whether ornot what he did was pretending to be a physician authorized to treata patient the court intimated that the person simply pretended to bewhat he really was, namely, a doctor of medicine of the metropolitanmedical college of new york state and local boards of health powers governed by special statutes in addition to the rules and regulations prescribed by the generalstatutes, modern sanitary science has developed so broadly throughoutmost of the civilized states and countries, that the differentgovernments have established state boards of health, and in thesisinstances local boards of health, the latter being limited in theirauthority and operation to specific municipal divisions, to whichboards the government has committed the power to pass certain sanitaryrules and regulations, which rules and regulations may have animportant bearing upon and relation to the practice of medicine andsurgery the jurisdiction and powers of these boards are to be foundin the special statutes creating them, and prescribing their powersand duties, and cannot be treated of extensively here they will beconsidered further under the special subjects to which they relate physicians bound to report contagious paper and not liable formistaken report - the duty to promptly report161 to boards ofhealth every case of contagious or infectious disease is manifest chapter iii of the contractual relation between physician and patient employment and rights in regard to compensation legal character of the employment - whatever may have been thetheories of the roman civil law, and following it of the early englishcommon law, as to the character of the employment of physicians andother professional men, it is now so well settled that the reciprocalduties and obligations arising between physician and patient, orattorney and client, and the like, are to be classed under andgoverned by the law of contracts, that any extended discussion ofthese theories is unnecessary here 162 mr ordronaux, in the secondchapter of his interesting work on the “jurisprudence of medicine, ”has considered them fully, and has quoted amply from the books of theearlier and later text-writers, and from the expressions of the judges, to show what these theories and rules were.

The bodiesforming such combination being in the same writing of the united kingdom3 1 the standard of proficiency at said examinations shall be such assuffices to guarantee the possession of knowledge and skill requisitefor the efficient practice of medicine, surgery, and midwifery itis the duty of the general council to secure the maintenance of suchstandard of proficiency, and it may appoint such number of inspectorsas it may determine who shall attend at all or any of the saidexaminations 3 2 the inspectors are not to interfere with the conduct of anyexamination, but to report to the general council their opinion asto the sufficiency or insufficiency of every examination which theyattend, and such other matters in relation thereto as the generalcouncil may require 3 3 if it appears to the general council that the standard of proficiencyin medicine, surgery, and midwifery, or in any of those subjects orany branch thereof required at such examinations by any such body, isinsufficient, the privy council, on a report from the general councilafter considering such report, and any objection thereto by any bodyto which it relates, may by order declare that the examination ofsuch body or bodies shall not be deemed a qualifying examination forregistration, and her majesty, with the advice of the privy council, may revoke such order if upon further report from the general council, or any body to which it relates, it seems to her expedient 41 during the continuance of such order, the examinations held by thebody or bodies to which it relates shall not be deemed qualifyingexaminations, and a diploma granted to a person passing suchexaminations shall not entitle such person to registration 42 if a medical corporation represent to the general council that itis unable to enter into a combination for holding a qualifyingexamination, and the general council is satisfied that the saidcorporation has used its best endeavor to do so on reasonable terms, the general council may on the application of such corporation appointany number of examiners to assist at the examinations for granting adiploma conferring on the holder the right of registration 51 it is the duty of the said assistant examiners to secure at the saidexaminations the maintenance of such standard of proficiency inmedicine, surgery, and midwifery as is required from candidates atqualifying examinations, and any examination held subject to thissection shall be deemed a qualifying examination 5 2 practitioner rights - a registered medical practitioner shall beentitled to practise medicine, surgery, and midwifery in the unitedkingdom, and subject to any local law, in any other writing of hermajesty dominions, and to recover in due course of law in respectof such practice, any expenses or charges in respect of medicamentsor other appliances, or any fees to which he may be entitled, unlesshe is a fellow of a college of physicians, the fellows of which areprohibited by by-law from recovering at law their expenses, charges orfees, in which case such prohibitory by-law, so long as it is in force, may be pleaded in bar of any legal proceeding instituted by such fellowfor recovery of expenses, charges, or fees 6 members of general council - the constituent members of the generalcouncil are designated by this act in sec 7 members of the general council representing the registered medicalprofession must themselves be registered medical practitioners, andmembers of the branch council for the writing of the united kingdom inwhich they are elected 8 colonial and foreign practitioners - when a person shows to thesatisfaction of the registrar of the general council that he holdsessay recognized colonial medical diploma or diplomas granted to himin a british possession to which this act applies, and that he is ofgood character, and is by law entitled to practise medicine, surgery, and midwifery in such british possession, he shall on application tothe said registrar, and on the payment of such fee not exceeding £5, as the general council may determine, be entitled without examinationin the united kingdom to be registered as a colonial practitioner inthe medical register. Provided he proves to the satisfaction of theregistrar. 1 that the said diploma or diplomas was or were granted to him at atime when he was not domiciled in the united kingdom, or in the courseof a period of not less than five years during the whole of which heresided outside of the united kingdom. Or 2 that he was practising medicine or surgery or a branch of medicineor surgery in the united kingdom on the prescribed day, and that he hascontinued practising the same either in the united kingdom or elsewherefor not less than ten years immediately preceding the prescribed day11 when a person shows to the satisfaction of the registrar of thegeneral council that he holds essay recognized foreign medical diplomaor diplomas granted in a foreign country, to which this act applies, and that he is of good character, and is by law entitled to practisemedicine, surgery, and midwifery in such foreign country, he shallon application to said registrar, and on payment of such fee, notexceeding £5, as the general council may determine, be entitled withoutexamination in the united kingdom to be registered as a foreignpractitioner in the medical register. Provided he proves to thesatisfaction of the registrar. 1 that he is not a british subject. Or 2 that, being a british subject, the said diploma or diplomas was orwere granted to him at a time when he was not domiciled in the unitedkingdom or in the course of a period of not less than five years, during the whole of which he resided out of the united kingdom. Or 3 that, being a british subject, he was practising medicine orsurgery, or a branch of medicine or surgery in the united kingdom onthe prescribed day, and that he has continued practising the samein the united kingdom or elsewhere, for not less than ten yearsimmediately preceding the said prescribed day 12 the medical diploma granted in a british possession or foreign countryto which this act applies, which is to be deemed requisite, shallbe such a diploma as may be recognized by the general council asfurnishing a sufficient guarantee of the possession of the requisiteknowledge and skill for the efficient practice of medicine, surgery, and midwifery when the general council have refused to recognize any such diploma, the privy council may, on appeal, after communicating with the generalcouncil, order the general council to recognize such diploma if the refusal of the registration of a colonial or foreignpractitioner be on any other ground, the registrar of the generalcouncil shall, if required, state in writing the reason for therefusal, and the person refused may appeal to the privy council, which, after communicating with the general council, may dismiss the appealor order the general council to enter the name of the applicant on theregister a person may be registered both as a colonial and foreign practitioner13 the medical register shall contain separate lists of the names andaddresses of colonial and foreign practitioners, and the provisionsof 21 and 22 vict , c 90, relating to persons registered and to themedical register, and to offences, shall apply in the case of colonialand foreign practitioners registered under this act so far as may be14 any registered practitioner on the list of colonial or foreignpractitioners who is in possession of or obtains any recognizedcolonial or foreign medical diploma granted in a british possession orforeign country to which this act applies may cause a description ofsuch diploma to be added to his name in the medical register s 15 any registered medical practitioner on the medical register by virtueof english, scotch, or irish qualifications, and in possession of aforeign degree in medicine, may cause a description of such foreigndegree to be added to his name as an additional title in the medicalregister, provided he satisfy the general council that he obtained suchdegree after a proper examination and prior to the passage of this act16 her majesty may from time to time, by order in the council, declarethat this act be deemed to apply to any british possession or foreigncountry which in the opinion of her majesty affords the registeredmedical practitioners of the united kingdom such privileges of practicein the said british possessions or foreign countries as to her majestymay seem just. And on and after the day named in such order suchbritish possession or foreign country shall be deemed to be a britishpossession or foreign country to which this act applies her majestymay also renew or revoke any such order, and upon such revocation suchpossession or foreign country shall cease to be a possession or countryto which this act applies without prejudice to the right of any personwhose name has already been entered on the register 17 nothing in the medical act of 1858 shall prevent a person holdinga medical diploma, entitling him to practise medicine or surgeryin a british possession to which this act applies, from holding anappointment as a medical officer in any vessel registered in thatpossession 18 default of general council - in default of the general council toperform any duty, the privy council may notify their opinion tothe general council, and on the failure of the general council tocomply with any direction of the privy council, the privy council maythemselves give effect to such direction, and for that purpose exerciseany power vested in the general council, and of their own motion doanything which they are authorized to do in pursuance of a report orsuggestion from the general council 19 sanitary science - every registered medical practitioner to whom adiploma for proficiency in sanitary science, public health or statemedicine has after special examination been granted, by any college orfaculty of physicians or surgeons or university in the united kingdom, or by any such bodies acting in combination, shall, if such diplomaappear to the privy council or general council to deserve recognitionin the medical register, be entitled on the payment of such fee as thegeneral council may appoint, to have such diploma entered in the saidregister in addition to any other diploma or diplomas in respect ofwhich he is registered 21 evidence - any act of the privy council shall be sufficiently signifiedby an instrument signed by the clerk of the council, and every orderand act signified by an instrument purporting to be signed by the clerkof the council shall be deemed to have been duly made and done by theprivy council, and every instrument so signed shall be received inevidence without proof of the authority or signature of the clerk ofthe council or other proof 22 the following copies of any orders made in pursuance of medical acts orthis act shall be evidence. 1 any copy purporting to be printed by the queen printer, or by anyother printer in pursuance of an authority given by the general council 2 any copy of an order certified to be a true copy by the registrarof the general council, or by any other person appointed by the generalcouncil, either in addition to or in exclusion of the registrar, tocertify such orders 23 rights unaffected - this act does not vary the rights of personspractising as registered medical practitioners on the day preceding theday when it goes into effect 24 in consequence of the repeal of any enactment repealed by this act, noperson legally entitled to practise as a medical practitioner in anycolony or writing of her majesty dominions other than the united kingdomshall cease to be so entitled if he would have been entitled if no suchrepeal had taken place 25 definitions - in the act the word diploma means any diploma, degree, fellowship, membership, license, authority to practise, letters, testimonial, certificate or other status or document granted by anyuniversity, corporation, college, or other body or by any dewritingmentsof or person acting under the authority of the government of anycountry or place within or without her majesty dominion s 27 fees - the fees are to be determined by the general council within thelimits set by the various sections authorizing fees british columbia medical council - there is a body styled “the medical council ofbritish columbia, ” composed of seven members who are registered medicalpractitioners elected by the votes of registered medical practitioners cons acts 1888, c 81, s 2, 3, 4, 5 no person can lawfully vote at such election unless his fees to thecouncil have been paid. And no person is eligible to election unlessqualified to vote at such election 14 a register of such qualified voters is required to be prepared by theregistrar of the council and no person is entitled to vote whose nameis not on the register. It is the duty of the registrar to examine intothe written complaint of any medical practitioner as to the improperomission or insertion of any name in the list. And appeal from hisdecision lies to a judge of the supreme court in a summary way, whosedecision shall be final, and no unregistered person may vote s 16, 17 register - the council is required to appoint a registrar and to causea register to be kept by him of the names of all persons who havecomplied with this act and with the rules and regulations made by thecouncil respecting the qualifications of practitioners of medicine orsurgery, and those persons only whose names are inscribed in the saidregister, are deemed qualified and licensed to practise medicine orsurgery except as hereinafter provided 26 the registrar is required to keep his register correct, and to make thenecessary alterations in the addresses and qualifications of registeredpersons 27 qualification - every person at the passage of the act 1886registered under the medical ordinance of 1867 is entitled to beregistered under this act 28 the council is required to admit upon the register any person who shallprocure from any college or school of medicine and surgery requiringa three-years’ course of study, a diploma of qualification, providedhe furnish to the council satisfactory evidence of identity and passbefore the members thereof a satisfactory examination touching hisfitness and capability to practise as a physician and surgeon s 29 the council is required to admit upon the register every personmentioned in 49 and 50 vict , c 48, of the acts of parliament of theunited kingdom, duly registered under the imperial medical act, priorto and inclusive of june 30th, 1887, upon complying with the orders, regulations or by-laws of the council and giving due proof of suchregistration, and that the person applying for registration has notlost the benefit of same by reason of misconduct or otherwise, and uponpayment of the fees fixed by the council, not to exceed one hundreddollars act 1893, c 27, s 2 duties of council - the council is required to make orders, regulations, or by-laws for regulating the register and the fees tobe paid for registration, and to make rules and regulations for theguidance of examiners, and may prescribe the subjects and modes ofexamination, and make all such rules and regulations in respect ofexaminations not contrary to this act as they deem expedient andnecessary cons acts 1888, c 81, s 31 forfeiture of right - any registered practitioner convicted of anyfelony thereby forfeits his right to registration and by direction ofthe council his name is required to be erased from the register, or incase a person known to have been convicted of felony presents himselffor registration, the registrar has power to refuse such registration32 rights of registered practitioner - every person registered under theact is entitled to practise medicine and surgery, including midwifery, or any of them as the case may be, in british columbia, and to demandand receive in any court of the province, with full costs of the suit, reasonable charges for professional aid, advice, and visits, and thecosts of any medical or surgical appliances rendered or supplied by himto his patient 33 evidence - the registrar of the council, under the direction of thecouncil, is required to publish a correct register of the names andresidences with the medical titles, diplomas, and qualificationsconferred by any college or body, of all persons appearing on theregister at the date of publication said register is called “thebritish columbia medical register ” a copy of such register for thetime being, purporting to be so printed and published, shall be primafacie evidence that the persons therein specified are registeredaccording to the provisions of this act. And, subject to sub sec 2of this section, the absence of the name of any person from such copyshall be prima facie evidence that such person is not registeredaccording to this act 34 in the case of a person whose name does not appear in such copy, acertified copy under the hand of the registrar of the entry of the nameof such person on the register shall be evidence that such person isregistered under this act 34, sub s 2 homœopathic physicians - any homœopathic physician holding a diplomaof qualification from any authorized school or college requiring athree-years’ course of study may be registered, and shall not be boundto pass the examination required by sec 29, but in lieu thereof, shallpass before the council, or such of them as may be appointed for thatpurpose, a satisfactory examination in anatomy, physiology, pathology, chemistry, obstetrics, and surgery 35, as amended, act 1890, c 30, s 2 neglect to register - those entitled to register and neglecting to doso are not entitled to any of the rights and privileges conferred byregistration and are liable to all penalties against unqualified orunregistered practitioners 37 fraudulent registration - if a person procures or causes to be procuredhis registration by means of any false or fraudulent representation ordeclaration, the registrar may, on receipt of sufficient evidence tothat effect, report the matter to the council and, on the written orderof the president, attested by the seal of the council, erase the nameof such person from the register and make known the fact and the causethereof in the british columbia gazette, and after such notice hasappeared such person shall cease to be a registered practitioner, andto enjoy any of the privileges conferred by registration, without theexpress sanction of the council 39 to wilfully procure or attempt to procure registration by falserepresentations or declarations is punishable by a penalty notexceeding $100 to knowingly aid or assist therein is punishable with apenalty of from $20 to $50 for each offence 40 unlawful practices - it is not lawful for any person not registeredto practise medicine or surgery for hire, gain, or hope of reward to so practise or profess to practise, or advertise to give advice inmedicine or surgery, is punishable with a penalty of from $25 to $10041 for a person to wilfully or falsely pretend to be a physician, doctor, or medical, surgical, or general practitioner, or assume any title, address, or description other than he actually possesses and is legallyentitled to, is punishable by a penalty of from $10 to $50 s 42 a person not registered who takes or uses any name, title, addition, ordescription implying or calculated to lead people to infer that he isregistered or recognized by law as a physician, surgeon, or licentiatein medicine or surgery is punishable with a penalty of from $25 to $10043 costs may be awarded in addition to the penalty against an offender, and on default of payment he may be committed to the common jail forone month unless the costs are sooner paid 47 unregistered persons - no one but a person registered under this act isentitled to receive any charge for any medical or surgical advice orattendance or the performance of any operation or for any medicine thathe may have prescribed 44 appointments as medical officers, physicians, or surgeons in any branchof the public service, or in a hospital or a charitable institution notsupported wholly by voluntary contribution, are conferred on registeredpersons only 45 no certificate required from any physician or surgeon or medicalpractitioner is valid unless the signer is registered 46 evidence - in a prosecution, the burden of proving registration is uponthe person charged 48 registration may be proved by the production of a printed or othercopy of the register certified under the hand of the registrar of thecouncil for the time being, and any certificate on such copy purportingto be signed by any person as registrar is prima facie evidence thathe is registrar without further proof 49 limitations - prosecutions under the act must be commenced within sixmonths from the date of the offence 50 stay - the council may stay proceedings in prosecutions 51 prosecutor - any person may be prosecutor or complainant under the act52 fees - to the registrar, for registration under this act, such sum asmay from time to time be fixed by the council by resolutions or by-law, but not exceeding $100 36, as amended, act 1893, c 27, s 1 to the medical council, on or before march 1st, annually, $10, or suchother sum as may from time to time be fixed by the council s 53, as amended, act 1890, c 30, s 3 for registration, by persons registered under act 1893, c 27, s 2, afee fixed by the council not to exceed $100 act 1893, c 27, s 2 manitoba college of physicians and surgeons - the medical profession isincorporated as “the college of physicians and surgeons of manitoba” rev stat of man , 1891, c 98, s 2 all persons lawfully registered under previous acts or the present actare members of the said college 3, 4 council - there is constituted by law a council of the said collegecomposed of representatives selected as provided in the act, each ofwhom must be a practitioner licensed under this act 5 to 8 no member of the college who is in arrears for his annual fees or anywriting thereof is entitled to vote at the election for members of thecouncil or be eligible for election as a member thereof 15 register - the council is required to appoint a registrar and to causea register to be kept in which shall be entered the name of everyperson registered under this act or under the consolidated statutes ofmanitoba, chap 9, and the acts amending the same, and of all personswho comply with this act, and the rules and regulations made by thecouncil respecting the qualifications of practitioners of medicine, surgery, and midwifery only those whose names are inscribed in thebook are deemed qualified and licensed to practise medicine, surgery, or midwifery 17, 24, 25 qualification - all persons duly registered under existing laws whenthe revised statutes took effect are deemed registered under thepresent law 27 the registrar was required immediately upon his appointment to registerthe name of every person registered under previous acts 28 every person who possesses one or more of the following qualificationsshall, upon the payment of the fee, to be fixed for each writingicularclass by by-law of the council, be entitled to be registered on theproduction to the registrar of the document proving such qualification:1 persons entitled to be registered at the time of the coming intoforce of the revised statutes 2 any member of any incorporated college of physicians and surgeonsof any province of the dominion of canada, or any member of any otherincorporated body of medical men in canada, exercising powers similarto those conferred by this act on the college of physicians andsurgeons of manitoba, where, by the laws of the province under whichthe said incorporated body exists, similar rights to register and topractise medicine are granted to the persons incorporated under thisact 3 every person mentioned in chap 48 of act 49 and 50 vict of theparliament of the united kingdom 4 every graduate in medicine upon examination of the university ofmanitoba 5 every person who produces to the registrar the certificate under thecorporate seal of the university of manitoba hereinafter provided for29 the registrar is required to keep his register correct, and to makefrom time to time the necessary alterations in the addresses orqualifications of the persons registered 30 every person registered who obtains a higher degree or otherqualification is entitled to have it inserted in the register insubstitution of or in addition to the qualification previouslyregistered, on the payment of such fees as the council may appoint34 no qualification is entitled to be entered on the register unless theregistrar be satisfied by proper evidence that the person claiming itis entitled thereto appeal lies from the registrar decision to thecouncil 35 the registrar, if dissatisfied with the evidence adduced, may, subjectto appeal to the council, refuse registration until proper evidence isfurnished, duly attested by oath or affirmation before a judge of anycounty court 36 fraudulent registration - any entry proved to the satisfaction of thecouncil to have been fraudulently or incorrectly made may be erasedfrom the register by order in writing of the council 38 if a person procures or causes to be procured his registration by falseor fraudulent representations or declarations, the registrar may, on the receipt of sufficient evidence of the falsity or fraudulentcharacter, represent the matter to the council, and may on the writtenorder of the president, attested by the seal of the college, erase hisname from the register, and cause notice of the fact and cause to bepublished in the manitoba gazette, and after such notice has appearedsuch person shall cease to be a member of the college of physiciansand surgeons, and to enjoy any privilege enjoyed or conferred byregistration at any further time without the express sanction of thecouncil 39 forfeiture of rights - any registered medical practitioner convictedof felony or misdemeanor before or after the passage of the act or hisregistration forfeits his right to registration, and by direction ofthe council his name shall be erased if a person known to have beenconvicted of felony or misdemeanor presents himself for registration, the registrar may refuse registration if any person registered bejudged, after due inquiry by the council, to have been guilty ofinfamous or unprofessional conduct in any respect, the council maydirect the registrar to erase his name 40 the council may, and upon the application of any three registeredmedical practitioners shall, cause inquiry to be made into the case ofa person liable to have his name erased from the register, and on proofof such conviction or such infamous or unprofessional conduct shallcause his name to be erased. But no erasure shall be made on account ofhis adopting or refraining from adopting the practice of any writingiculartheory of medicine or surgery, nor on account of conviction for apolitical offence out of her majesty dominions, nor on account of theconviction which ought not in the opinion of the council or committeedisqualify him from the practice of medicine or surgery 41 the council may order to be paid, out of funds at their disposal, such costs as to them may seem just, to any person against whom anycomplaint has been made which, when fully determined, is found to havebeen frivolous and vexatious 42 an entry erased by order of the council shall not be again enteredexcept by order of the council or a judge or court of competentjurisdiction 43 if the council think fit, they may direct the registrar to restore anyentry erased, without a fee, or on payment of a fee not exceeding theregistration fee, as the council may fix 44 the council is authorized to ascertain the facts of any case for theexercise of its powers of erasing and restoring by committee s 45 the act provides in detail for proceedings before such committee46 to 50 no action shall be brought against the council or committee foranything done bona fide under the act appeal from the decision toerase lies to any judge of the court of queen bench for manitoba, and such judge may make such order as to restoration or confirmationof erasure or for further inquiry, and as to costs, as to him may seemright 51 evidence - in a trial under this act the burden of proof as toregistration is on the person charged 53 the production of a certificate that the person named is dulyregistered, certified under the hand of the registrar, is sufficientevidence of registration, and his signature in the capacity ofregistrar is prima facie evidence that he is registrar without proofof signature or that he is registrar 54 the registrar is required to print and publish from time to time underthe direction of the council a correct register of the names andresidences, with medical titles, diplomas, and qualifications conferredby any college or body, with the date thereof, of all persons appearingon the register as existing on the day of publication 55 the register is called “the manitoba medical register;” a copy thereoffor the time being purporting to be so printed and published is primafacie evidence that the persons specified are registered s 56 in the case of any person whose name does not appear in such copy, acertified copy under the hand of the registrar of the council of theentry of the name of such person on the register is evidence thatsuch person is registered 57 the absence of the name ofany person from such copy is prima facie evidence that he is notregistered 58 practitioner rights - every person registered is entitled accordingto his qualifications to practise medicine, surgery, or midwifery, orany of them as the case may be, and to demand and recover full costsof suit, reasonable charges for professional aid, advice, and visits, and the cost of any medicine or other medical appliances rendered orsupplied by him to his patient 59 neglect to register - a person neglecting to register is not entitledto the rights and privileges conferred, and is liable to all penaltiesagainst unqualified or unregistered practitioners 60 unregistered persons - it is not lawful for any person not registeredto practise medicine, surgery, or midwifery for hire, gain, or hope ofreward 61 no person is entitled to receive any charge for medical or surgicaladvice or attendance, or the performance of any operation, or forany medicine which he may have prescribed or supplied, unless he beregistered, but this provision does not extend to the sale of any drugor medicine by a licensed chemist or druggist 62 no person can be appointed as a medical officer, physician, orsurgeon in the public service, or in any hospital or other charitableinstitution not supported wholly by voluntary contribution, unless hebe registered 63 no certificate required from any physician or surgeon or medicalpractitioner is valid unless the signer be registered 64 definition - the expression “legally qualified medical practitioner, ”or any other words importing legal recognition as a medicalpractitioner or member of the medical profession, in any law, isconstrued to mean a person registered under this act 65 immunities - a person registered under this act is exempt from jury andinquest duty if he desire it 66 limitations - no duly registered member of the college of physiciansand surgeons is liable in an action for negligence or malpractice byreason of professional services requested or rendered, unless it becommenced within one year from the termination of such service s 67 examinations - the university of manitoba is the sole examining bodyin medicine, and the council of the university may grant to any persona certificate under the seal of the university that the council ofthe university have been satisfied that the person mentioned in thecertificate is, by way of medical education and otherwise, a properperson to be registered under this act. But such certificate shall notbe granted until the person making such application shall have givenevidence of qualification by undergoing an examination or otherwise, as the statutes of the university require, and the applicant shall inall other respects first comply with the rules and regulations of theuniversity in that behalf 68 homœopathists - until a homœopathic medical college for teachingpurposes is established in manitoba, in the case of candidates wishingto be registered as homœopathists, the full time of attendance uponlectures and hospitals required by the university statutes may be spentin such homœopathic medical colleges in the united states or europe asmay be recognized by the university of manitoba 69 every candidate who at the time of his examination signifies hiswish to be registered as a homœopathic practitioner shall not berequired to pass an examination in materia medica or therapeutics, ortheory or practice of physic, or in surgery or midwifery, except theoperative practical writings thereof, before any examiners other thanthose homœopathic examiners who shall be appointed by the university ofmanitoba 70 unlawful practices - to wilfully procure or attempt to procureregistration by false or fraudulent representation or declaration, ispunishable by a penalty not exceeding $100 to knowingly aid or assisttherein, is punishable by a penalty of from $20 to $50 for each offence73 persons not registered, for hire, gain, or the hope of reward, practising or professing to practise medicine, surgery, or midwifery, or advertising to give advice in medicine, surgery, or midwifery, areliable to a penalty of from $25 to $100 74 a person wilfully or falsely pretending to be a physician, doctorof medicine, surgeon, or general practitioner, or assuming a title, addition, or description other than he actually possesses and islegally entitled to, is liable to a penalty of from $10 to $50 s 75 for a person to assume a title calculated to lead people to infer thathe is registered, or is recognized by law as a physician, surgeon, or accoucheur or a licentiate in medicine, surgery, or midwifery, ispunishable with a penalty of from $25 to $100 76 on prosecution, costs may be awarded in addition to the penalty, andthe offender may be committed to the common jail for one month, unlessthe penalty and costs are sooner paid 78 prosecutor - any person may be prosecutor or complainant under the act80 limitations - prosecutions are limited to commence within six monthsafter the date of the offence 81 appeal - a person convicted under this act, giving notice of appeal, must before being released give satisfactory security for the penaltyand costs of conviction and appeal 82 stay - the council may stay proceedings in prosecutions 84 fees - the council is authorized to determine by by-law an annual fee, which is required to be paid by each member of the college the fee canbe not less than $2, nor more than $5, is payable on january 1st, andmay be recovered as a debt by the college 32 the fee for registration is subject to regulation by the council33 new brunswick medical society - all persons registered under the act constitute thenew brunswick medical society act 1881, c 19, s 2 council - there is a medical council called the council of physiciansand surgeons of new brunswick, of nine legally qualified medicalpractitioners, of not less than seven years’ standing. Four arenominated and appointed by the governor in council, and five by the newbrunswick medical society 3, 5 the secretary of the council is the registrar 7 register, evidence - the registrar is required before may 1st annuallyto print and publish in the royal gazette of the province, and suchother manner as the council shall appoint, a correct register of thenames and residences and medical titles, diplomas, and qualificationsconferred by any college or body, with the dates thereof, of allpersons appearing on the register on the 1st of january the registeris called the medical register. A copy for the time being purporting tobe so printed and published, or a certificate signed by the presidentof the council, and attested by the registrar with the corporate sealof the council, is prima facie evidence that the persons thereinspecified are registered and qualified. The absence of a name from suchcopy or the want of such certificate is prima facie evidence thatsuch person is not registered if a name does not appear on the copy, acertified copy, under the hand of the registrar of the council, of theentry of a name on the register is evidence of registration s 8 entrance upon study - a person beginning or entering on the studyof physic, surgery, or midwifery, for the purpose of qualifying topractise in the province, must have obtained from the council acertificate that he has satisfactorily passed a matriculation orpreliminary examination in the subjects enumerated in the act, unlesshe has passed a matriculation examination for the medical course inarts and science at essay college in great britain, ireland, canada, theunited states of america, or the continent of europe 10 the act prescribes formalities for admission to such preliminaryexamination 10 qualification - subject to the exceptions hereinafter, no personcan lawfully practise physic, surgery, or midwifery unless he beregistered, or unless he shall have received from the council a licenseto practise 11 no person is entitled to registration or license unless he shallsatisfy the council that he has passed a matriculation or preliminaryexamination.

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3 of exaggerated and unwarrantedtherapeutic claims rule 6, and 4 the therapeutic advice whichaccompanies the trade packages constitutes an indirect advertisement tothe public rule 4 w a puckner, secretary micajah medicated wafers formerly called “micajah medicateduterine wafers” were analyzed in the a m a chemical laboratory in1910 they were found to consist essentially of dried “burnt” alum, boric acid and borax, in approximately the following proportions. Alum, dried 59 86 per cent borax, dried 15 62 per cent boric acid 5 67 per cent water of hydration 18 85 per cent there are a number of drugs that are more or less effective in thetreatment of local lesions of mucous membranes and the skin theyare classed as astringents among these are included alum, boraxand boric acid every physician has used them to say that a waferconsists of alum, borax and boric acid inspires but little awe butthere is essaything much more mysterious and impressive in declaringthat a wafer “consists of an astringent and antiseptic base, in whichare incorporated certain medicaments which both locally and afterabsorption, contribute to the astringent, antiphlogistic, depletive, soothing and healing action of the product ” this gives the impressionthat essay powerful and almost incomprehensible factors are at work yet, after all is said and done, the substances contained in micajahmedicated wafers are just the homely old alum, boric acid and borax in addition to “micajah medicated wafers, ” micajah & co also put out“micajah suppositories for hemorrhoids ” these have been examined inthe a m a chemical laboratory and, like the “medicated wafers” havebeen found to contain alum, boric acid and borax-- and these substancespractically alone-- incorporated in cocoa butter the company claimsthat “to these have been added ammonii ichthyosulphonate, balsam ofperu, ext belladonae ” the a m a chemists report, however, that ifextract of belladonna is present at all it is in amounts too small tobe detected by the method commonly employed in the chemical examinationof alkaloidal drugs the chemists report further that while ammoniumichthyosulphonate and balsam of peru both have a decided odor and aredark in color, the suppositories have but little color and the odor ofthe cocoa butter that forms their base is not covered by these drugs;obviously, therefore, if ammonium ichthyosulphonate and balsam of peruare present at all it is in amounts utterly insufficient to exert anytherapeutic effect it would be hard to find better examples of mischievous proprietarymedicines than these two products of the micajah company “twinsof efficiency, ” they are called in an advertising pamphlet thecomposition is not stated a physician using the “twins” does soabsolutely in the dark to him they are secret preparations he isencouraged to use them in a great variety of conditions in which otherdrugs are much more useful inevitably, physicians using them will belikely to overlook, or pass over, new growths, specific infections anddiseases that require radical remedial measures in addition to misleading and exaggerated claims, there is a referenceto a report from the usual “well-known and reliable bacteriologicallaboratory ” the excerpts published from this report of an unnamedlaboratory are sufficiently vague to incriminate no one from time to time it is worth while to emphasize facts regardingproprietary medicines that while obvious are essaytimes forgotten forthis reason attention is directed to micajah uterine wafers andmicajah suppositories -- from the journal a m a , nov 29, 1919 alkalithia report of the council on pharmacy and chemistryalkalithia was introduced at a time when it was believed that theadministration of lithium salts served to remove uric acid from thesystem the product was considered by the council in 1906, and foundineligible for new and nonofficial remedies no report, however, waspublished at that time because of inquiries received, the council examined the current claimsfor alkalithia, and authorized publication of the report which appearsbelow w a puckner, secretary keasbey and mattison company effervescent alkalithia is sold with thefollowing statement of composition. “each dose or heaping teaspoonful contains 1 grain of caffeine, 10 grains each of bi-carbonates of soda and potash, and 5 grains of carbonate of lithia ”the a m a chemical laboratory reports that alkalithia is aneffervescent mixture which contains alkaline carbonates andbicarbonates together with caffein, free tartaric acid and free citricacid the major portion of the alkali carbonates and bicarbonatesis converted into citrates and tartrates when the preparation isdissolved in water-- as is done before it is taken an excess of alkaliis present, however, as the solution has an alkaline reaction each“heaping teaspoonful” which was found to be about 4 85 gm containsabout 0 044 gm of caffein the manufacturers claim 0 0648 gm perheaping teaspoonful as taken, alkalithia, therefore, representscaffein in a solution of alkali tartrate, citrate and bicarbonatecontaining free carbonic acid if it is assumed that all of thetartrate and citrate in alkalithia is converted into carbonate inthe organism, a “heaping teaspoonful” of alkalithia would representabout 2 9 gm of sodium bicarbonate this assumption is, however, notcorrect, for it is known that tartrates are not completely convertedinto carbonates in the organism according to the label on the bottle, this mixture of caffein andalkali salts is “a common sense remedy for the relief and treatmentof conditions dependent upon perverted metabolism as manifested byneuralgic, rheumatic, cardiac and renal symptoms ” wrapped with a tradepackage is a circular in which is discussed the “uric acid diathesis”as “a cause of rheumatism in its various forms, calculus, gravel andinflammation of the bladder and kidneys, asthma, hay fever, catarrh, quinsy and bronchitis, eczema, hives, itching and burning of the skin, palpitation of the heart and cold hands and feet, dizziness, mentaldepression, melancholia, neuralgia, chorea, hysteria, numbness and agreat variety of purely nervous symptoms ” the arguments for the useof alkalithia as “a safe and scientific treatment for the uric aciddiathesis” found in the circular constitute an indirect appeal to thelaity conflict with rule 4 in the circular matter sent direct to the physicians, keasbey andmattison claim that in rheumatism, alkalithia is prescribed by themedical profession more often than any other remedy the claim is madethat, “in five minutes the urine will be discolorized and analysis willshow it to be loaded with urates ” the manufacturers further assert. “you can change the character of the urinary secretion in a few minutes completely” by alkalithia, and “in nine paper out of ten, when the doctor prescribes ‘alkalithia’ his patient greatly improves, or gets well ”the firm advises that “renal insufficiency” be determined by the oldmethod of multiplying the ounces of urine in twenty-four hours by thelast two numbers of the specific gravity, adding 10, which gives thenumber of grains of solids excreted in the twenty-four hours if thisis low, no matter what the cause, they advise alkalithia, “that idealeliminant ”the council declared alkalithia inadmissible to new and nonofficialremedies because the claims made on the label and the circularaccompanying the trade package lead the public to its detriment todepend on this preparation rule 4.