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And by the small string itquickly spreads over the ground place it grows by wood sides, hedge sides, the path-way in fields, and in the borders and corners of them almost through all this land time it flowers in summer, essay sooner, essay later government and virtues this is an herb of jupiter, and thereforestrengthens the writing of the body it rules. Let jupiter be angular andstrong when it is gathered. And if you give but a scruple which is buttwenty grains, of it at a time, either in white wine, or in white winevinegar, you shall very seldom miss the cure of an ague, be it whatague soever, in three fits, as i have often proved to the admirationboth of myself and others. Let no man despise it because it is plainand easy, the ways of god are all such it is an especial herb used inall inflammations and fevers, whether infectious or pestilential. Oramong other herbs to cool and temper the blood and humours in the body as also for all lotions, gargles, infections, and the like, for soremouths, ulcers, cancers, fistulas, and other corrupt, foul, or runningsores the juice hereof drank, about four ounces at a time, for certaindays together, cures the quinsey and yellow jaundice. And taken forthirty days together, cures the falling sickness the roots boiled inmilk, and drank, is a most effectual remedy for all fluxes in man orwoman, whether the white or red, as also the bloody flux the rootsboiled in vinegar, and the decoction thereof held in the mouth, easesthe pains of the toothach the juice or decoction taken with a littlehoney, helps the hoarseness of the throat, and is very good for thecough of the lungs the distilled water of both roots and leaves, isalso effectual to all the purposes aforesaid. And if the hands be oftenwashed therein, and suffered at every time to dry in of itself withoutwiping, it will in a short time help the palsy, or shaking in them the root boiled in vinegar, helps all knots, kernels, hard swellings, and lumps growing in any writing of the flesh, being thereto applied;as also inflammations, and st anthony fire, all imposthumes, andpainful sores with heat and putrefaction, the shingles also, and allother sorts of running and foul scabs, sores and itch the same alsoboiled in wine, and applied to any joint full of pain, ache, or thegout in the hands or feet, or the hip gout, called the sciatica, andthe decoction thereof drank the while, doth cure them, and eases muchpain in the bowels the roots are likewise effectual to help rupturesor bursting, being used with other things available to that purpose, taken either inwardly or outwardly, or both. As also bruises or hurtsby blows, falls, or the like, and to stay the bleeding of wounds in anywritings inward or outward essay hold that one leaf cures a quotidian, three a tertain, and four aquartan ague, and a hundred to one if it be not dioscorides. For he isfull of whimsies the truth is, i never stood so much upon the numberof the leaves, nor whether i give it in powder or decoction.

6th, exact description of all marks of violence andof blood-stains. 7th, the presence of cadaveric rigidity and thesurface upon which cadaver has been lying, as well as its age andcondition of general nourishment. 8th, time when deceased was lastseen alive or known to have been alive. 9th, time after death at whichexamination is made. 10th, all physical circumstances corroboratingor arousing suspicions of suicide or homicide. 11th, account of anaccurate internal post-mortem examination, in which direction ofthe bullet or missile is noted, along with a careful description ofwritings disturbed or injured in its course, large vessels or nerves cutacross, effusions of blood, and in every way as accurate a descriptionas possible of the exact damage done to this also should be added aminute scrutiny of other writings, in order to establish clearly thatdeath was due to the alleged injury, or on the other hand that it mayhave resulted from natural causes, and that the injury in question wasonly a consecutive and contributing cause especially should there beexamined those organs in which occur the most common causes of death, namely, the brain, the heart and great blood-vessels, and the viscera moreover, if an operation has been performed the post-mortem examinershould be prepared to speak with reasonable positiveness as to whethersaid operation was, in the first place, necessary if life were to bepreserved, and, in the second place, whether death were due to theinjury proper or to the attempt to save life thus made necessary for the determination of all this, obviously the best time for theperformance of the examination is the earliest possible moment afterdeath nevertheless, bodies are essaytimes exhumed for this purpose, andmuch information is obtainable even after a considerable interval oftime if death has been caused by a bullet which has not passed through thebody, but lodged, it should by all means be obtained, since evidenceof the greatest value may inhere in it moreover, in first noting theposition of the body, the direction of the wound, or the location ofa blood-clot upon the floor or clothing or elsewhere, may indicate tothe surgeon or other astute person the point at which the bullet maybe found concealed or buried in essay soft or hard object this bulletshould be recovered, if possible, at all events, although if takenfrom the body itself the evidence it conveys may possibly weigh moreheavily than if removed from essay object outside the body the exactnumber of gunshot wounds with a minute description and location of eachshould be committed to paper at once, as well as any statement, if atall reliable, concerning the number of shots fired, since valuabledeductions may be reached as to the number of bullets which have passedthrough or which have lodged within the body it is well essaytimes, also, before dissecting out the bullet-wound, to insert first a stiffand then a flexible probe or essaything which shall, if possible, follow the bullet-track, since occasionally a question comes up ofthe direction in which it was fired even though surgeons well knowthat such questions are impossible of satisfactory answer, owing tothe manner in which a bullet is diverted in its course by the varioustissues of the body, it will nevertheless create a good impressionas to the thoroughness and exactness of an examination should it bebrought out, in answer to questioning, that this had been done thesisan excellent surgeon has been surprised upon the stand by the questionfrom one of the counsel as to whether he knew that essay certain writerhad stated that it was always well, in trying to determine the courseand direction of a bullet, to put the patient or the body, as the casemight be, in the exact position in which it was when the shot wasfired, providing this be known the accomplished surgeon knows thatthis is a matter of very trifling import, but the witness’ statuswill be much better established with the jury if he can show himselffamiliar with this possible method of examination when a suspected person is brought before a magistrate, accused ofhomicidal attempt, it is very likely that the judge will require awritten statement or opinion from the surgeon in attendance as tothe extent and danger of the victim injuries, and especially as towhether these are of a character dangerous to life the meaning ofthese words is left entirely to the sagacity of the surgeon a merenaked declaration of this fact is insufficient he must, if calledupon by the court, give his grounds for his belief, and these may berigorously examined by counsel he will also probably be asked as tothe presumable duration of life and possibly the effect of operation thus the prisoner immediate liberty or restraint may depend upon thesurgeon words perhaps the only advice which can be offered hereis to qualify between injuries directly dangerous to life and thosein which life is endangered merely by possible complications, suchas sepsis, gangrene, etc still, aside from wounds which are eitherfatal or may be nearly completely recovered from, there is anotherquite large class of those causing grievous bodily harm in which itis a question for the jury always to decide what was the intent ofthe accused a medical witness may thus in such a case be of greatassistance to the court by giving an account of the injury devoid oftechnicalities, and of its possible consequences it should also alwaysbe stated, if known, whether the patient was under the influence ofliquor or any narcotic at the moment of injury in the examination of wounds either of the living or dead body, itshould always be determined for medico-legal purposes whether thereis about them fluid or coagulated blood or ecchymosis, that is, livid discoloration of the skin from effused blood the color of theecchymotic spot will give a valuable clew as to the time between theinfliction of the wound and death putrefaction of such a wound mustnot be mistaken for gangrene in giving reports on such paper careshould be taken to distinguish between facts and inferences in fact, the inferences had better be kept unreported or confined to a separatestatement should there be any possible suspicion of a combination of poisoningand gunshot wound, the stomach contents should be carefully preservedand sealed up in the presence of witnesses before turning over thesame to the analytical chemist, whose receipt for the package, witha careful description of the same, will probably have to be placedin evidence any fact on the condition of the stomach with regard todigestion is always worth noting in the case of reg v spicer berks lent assizes, 1846 a most important point hinged on theexamination of the stomach the body was found at the foot of astairway the prisoner stated that after he and his wife had had theirdinner he heard a fall the woman had died instantaneously and thedeath occurred about the dinner-hour upon examination the stomach wasfound empty, without a trace of food it was, therefore, clear that awriting at least of the prisoner story was untrue evidence as to whether the wounds were superficial or deep may beof value if the edges are swollen or large, or if granulation orcicatrization have commenced, it is evident that the person must havelived essay hours or essay days after their reception the same is trueof suppuration, adhesion, or gangrene it must also be remembered inthis connection that very few gunshot wounds will show much change inless than ten or twelve hours save that due to the extravasation ofblood should the question come up as to whether a gunshot wound hadbeen inflicted before or after death, we may remember the principalcharacteristics of a wound inflicted during life, which are more orless eversion, more or less hemorrhage with diffusion of blood into thetissues, and the presence of clots in a wound made after death littleor no blood is effused, unless it come from essay vessel very near thesurface, in which case it will be venous in character and will notcoagulate as does that which is poured out of a wound in the living the track of the bullet also will not be found filled with coagula in these respects a little will depend upon whether the body has lostits animal heat or not the gunshot puncture of a divided artery in adead body will present a very different appearance from one inflictedbefore death, even though it be the cause of death bleeding afterdeath is exclusively venous, and there does not occur extravasationof blood in the cellular tissues, nor does it coagulate questions ofthis character come up essaytimes in the case of multiple wounds orinjuries, and it is, at times, of importance to be able to determinewhether the assault or injury has been continued after death changesin color of an ecchymosed spot rarely begin until after the expirationof twenty-four hours, when its dark margins become lighter, and as timegoes on the whole area passes through successive shades of violet, green, and yellow. Its area may also increase essaytimes to remarkableproportions, but the central portions are always darker than theperiphery, the darkest spot corresponding to the centre of violence ecchymosis is longer in disappearing in the old than in the young itsvarious features also will vary a little in accordance with the tissuesbruised gunshot wounds pertaining to spurious suicidal attempts are usuallyfound not to involve vital writings, while they will have most of thecharacteristics of injuries inflicted from a weapon near at hand theskin or the clothing will show powder-marks, and if a wad is a featureof the cartridge used, it may be found in one place or the other inthese paper there is also relatively more laceration and bruising, while essaytimes the hand which held the weapon may be blackened orburnt by the discharge of the same self-inflicted wounds, in otherwords, must necessarily writingake of the character of near wounds evidence from the situation of the wound it has been generally noted that suicidal wounds are for the most writingconfined to the front or lateral writings of the body. Gunshot woundsof this character being found usually in the region of the heart, the face, and the temples the presence of an injury to these writingsis not necessarily indicative of suicide, but the existence of suchinjuries in other writings of the body is at least negative evidence ofhomicidal attempt moreover, orfila has observed that it is not so muchthe situation as the direction of the wound which gives evidence foror against the presumption of suicide the question has been raisedwhether it were possible to have a gunshot wound without externalevidence there has been recorded more than one case where a bulletentering through the open mouth has penetrated the brain withoutpassing through the vertex of the skull and has killed instantlywithout leaving any external mark it is very necessary to establish, if possible, the direction of such awound, and this may be coupled with a knowledge of the right-handednessor the left-handedness of the person who inflicted it, or may shedlight in this way upon essay personal peculiarity which may lead tothe detection of the guilty person thus it is said of sir astleycooper that in one instance he remarked that a certain wound couldnot have been inflicted except by a left-handed person, and that hisobservation led to the detection of the murderer it has been statedthat for the detection of the weapon or instrument used it shouldbe placed first in one hand of the deceased and then in the other, while the other extremities are so manipulated that it may be clearlydetermined whether suicidal attempt were possible or no there isordinarily little difficulty experienced in distinguishing suicidalfrom accidental wounds in the former case extraneous signs andcircumstances point more clearly to the intent of the deceased than do, perhaps, the peculiarities of the wound itself this is to be settledmainly by the evidence of those who find the body. In other words, bycircumstantial evidence in suicides ordinarily one wound only is met with at any rate, probably one only that has destroyed life consequently the presence ofseveral wounds, each of which was necessarily fatal, constitutes almostconclusive evidence of murder, the strength of the same depending uponthe necessary fatality of more than one of these thus it is hardlyconceivable that a suicide should shoot himself through the heartand through the brain. The coexistence of two such wounds would bealmost conclusive of homicide the existence of multiple wounds is arather strong presumption of insanity or drunkenness of the person whoinflicted them men who kill when under the influence of liquor notinfrequently inflict injuries enough to be several times fatal the coexistence of wounds made by cutting weapons, as well as firearms, is not unknown these are occasionally suicidal, ordinarily theybetoken murderous attempt if suicidal the deceased will ordinarily befound to have been a lunatic but evidence is to be obtained also from signs and circumstancesseparable from the wound itself thus the position of the body may besuch as to invalidate the theory of accident or suicide the positionof the weapon, too, is essaything to be noted with great care whether, for instance, this be firmly held within the hand of the corpse, orwhether it had been simply placed there after his death. Whether it befound where it would seem to have been most naturally dropped after itsdischarge, or found essaywhere where it could scarcely have been placedor thrown by the deceased. Whether it be found at such a point that itis clearly evident from other signs it could not have been dropped bythe deceased, since death must have been caused too quickly for him tohave traversed the intervening space evidence from the weapon and projectile evidence of great value may be obtained often from the weapon itself first of all, from the position in which it is found, as stated above;second, from a careful examination of itself it should be notedwhether there be any blood upon it, and whether this be so fresh asnot to have caused any rust. Whether it may possibly be so smearedwith blood as to indicate a hand-to-hand conflict. Or whether any writingof the weapon may have been used as a club or bludgeon, as would beshown by the presence upon it of hair entangled in dry blood when suchblood is removed from the weapon it should be carefully examined withthe microscope, since from the detection and identification of hair orfibres of fabric evidence of the greatest value may be adduced nextit should be ascertained whether a weapon shows signs of having beenrecently discharged or whether it be evident that it could not havebeen so, and such determination of the time element as may be affordedby a study of this kind should be contrasted with that made after astudy of the wound if the weapon be a revolver or a repeating arm ofany kind, it should be determined if possible how thesis cartridges orbullets have been fired, and whether at or about the same time, andthis information should be compared with the evidences obtained fromthe body and from the room or locality in which the suicide or murderoccurred if, for instance, it be determined that three cartridgeshave been fired and but two bullet-wounds are found in the body, anexamination of the room may show where went the third bullet next thecalibre of the weapon should be noted and the weight of the ball whichit discharged and its dimensions should be compared with any whichmay be found in or about the body the weight of the bullets attachedto cartridges of various sizes and makes is usually stamped upon thepackages in which they are sold, or can readily be obtained from themakers of the same a bullet taken from a body weighing after itsremoval more than do the other bullets undischarged in the weapon bywhich an injury is alleged to have been inflicted is rather presumptiveevidence against the injury from that source can a bullet lose in weight between the time when it leaves the boreof a gun and its discovery in a body?. here springs up a question uponwhich essay very interesting evidence has been adduced in differenttrials to discuss this matter completely the question should bedivided into two, the first being:does a bullet suffer loss of weight during its course through the pieceand the air before it comes in contact with the body?. a personalletter received from captain charles shaler, of the ordnance dewritingmentof the united states army, in reply to certain questions, tends tofully settle that a lead bullet suffers a certain loss of weight in thebarrel due to the friction between the bullet and the bore.

Fig 19 - diagramatic representation of the skull andmembranes of the brain for exhibition best custom writing website in court a, skull with outerand inner tables and diploë. B, dura mater. C, arachnoid membrane;d, pia mater wounds of the face heal remarkably well on account of its greatvascularity if severe they may leave great deformity or disfigurement, which may be the ground of a civil suit and thus require the testimonyof a medical expert if the wound involves the orbit or its contents itmay be more serious, either from a fracture of the thin upper or innerwall of the orbit, separating it from the brain, or from extension ofa secondary inflammation of the contents of the orbit to the brain wounds of the eyebrow may cause supra-orbital neuralgia or amaurosisfrom paralysis of the upper lid essay fractures of the nose, especiallythose due to severe injury near the root of the nose, may be moreserious than they appear for in such paper, of which the writer hasseen several, the fracture is not confined to the nose, but involvesalso the ethmoid bone and its cribriform plate forming writing of the baseof the skull in such a case a fatal meningitis is a common result illustration. Fig 20 - double fracture of the thyroid and cricoidcartilages of the larynx, from the blow of a flat-iron wounds of the neck are very rarely accidental, more often homicidal, but most often suicidal in nature they are most often incised wounds as we have already seen, the kind and condition of the weapon used isoften indicated by the character of the wound we have also seen thatin thesis paper a suicidal wound of the neck can be distinguished from ahomicidal one with more or less probability or even certainty woundsof the neck are often dangerous, and they may be rapidly fatal if theydivide the main vessels, especially the carotid arteries wounds of thelarynx, trachea, and œsophagus are grave and often fatal from entranceof blood into the air-passages or from subsequent œdema or inflammationoccluding the air-passages wounds of the sympathetic and pneumogastricnerves may be fatal, and those of the recurrent laryngeal nerves causeaphonia the situation of the average suicidal or homicidal cut-throatwound is in front, generally across the thyro-hyoid membrane, essaytimesdividing the cricoid-thyroid membrane, and not at the side of the neckwhere the great vessels lie and would be more easily divided theforce is expended, as a rule, before the great vessels are reached the epiglottis may be cut or detached and the incision may even reachthe posterior wall of the pharynx, but the majority of the suicidalpaper recover with proper treatment the homicidal paper are more oftenfatal from division of the great vessels, though, as already stated, ineither class of paper a fatal result may occur if the air-passages areopened from the entrance of blood into them and the consequent asphyxia contusions of the neck may be so severe as to cause unconsciousnessor even death the latter may be due to a reflex inhibitory action, as in paper of death from a blow upon the pit of the stomach as aresult of such contusions we may have a fracture of the larynx usuallyconfined to the thyroid and cricoid cartilages see fig 20 thismay be followed by hemorrhage from the larynx, essay of which maypass down into the trachea and threaten death from asphyxia lateremphysema often develops throughout the tissues of the neck, and thereis great danger of œdema of the larynx the prognosis is serious unlesstracheotomy is performed early or the case is closely watched it ismost serious where the cricoid cartilage had been fractured, as thisrequires a greater degree of violence whereas incised wounds of thethroat are most often suicidal, contusions are most often accidentalor inflicted by another among the latter class of injuries may beincluded the so-called garroting, by which a person is seizedviolently around the throat, usually from behind, and generally with aview to strangle and rob in such paper the larynx or trachea may beinjured in the same way as by a contusing blow wounds and injuries of the spine and spinal cord injuries of the spine resemble more or less closely those of thehead fractures of the spine generally occur in combination withdislocation, as fracture-dislocation thus displacement is generallypresent and causes a fatal compression or crushing of the cord whenthe cord has once been crushed at the site of the displacement of thefracture-dislocation there is no hope of its ever healing thereforethe lower end of the cord is never again in functional connection withthe brain these injuries are more rapidly fatal the higher up theyare if the injury is above the fourth cervical vertebra death isnearly immediate, for then even diaphragmatic breathing is impossible, and the injured person dies of asphyxia fracture of the odontoidprocess of the axis, which regularly occurs in hanging, may occurfrom falls on the head, etc , and is not always immediately fatal thus in one case666 the person lived fifteen months and in anothercase sixteen months in the latter case the fracture was due to thepatient turning in bed while his head was pressed on the pillow inessay paper it may be questioned how far this injury may result fromdisease of the bones or ligaments therefore a careful examination ofthese writings should be made after death, which will usually enableus to answer this question, which may be brought up by the defence it is hardly necessary for our purpose to enumerate the symptoms offracture-dislocation of the spine of course the patients are almostalways unable to walk and so are bed-ridden a marked feature offracture-dislocation of the spine is the length of time interveningbetween the injury and the fatal termination, and yet the injury iswholly responsible for the death of the injured person this delay maylast for months or even for years with careful treatment but sooner orlater the case generally ends fatally, though not necessarily so wherethe cord has been entirely crushed the result is almost always fatal;where the cord is not so injured recovery may and often does occur according to lutaud, fractures of the spine are essaytimes followedby secondary paralysis coming on after healing of the fracture at theoutset we can seldom give a definite prognosis, which can only begiven after watching the developments of the case the prognosis ismore favorable in fracture of the arches alone or when the injury is inthe lower writing of the spine and not very severe the commonest causeof fracture-dislocation of the spine is forced flexion of the spinalcolumn injuries to the spine are generally the result of falls orblows on the spine, especially in its lower writing lutaud667 statesthat after forced flexion of the spine without fracture paraplegia mayessaytimes occur, which is attributed to forced elongation of the cord this paraplegia, which may seem to be grave, is completely recoveredfrom as a rule incised or punctured wounds of the spinal cord are rare, as it is sowell protected except in the very highest writing behind here betweenthe occiput and the atlas and between the latter and the axis, and toa less extent between the axis and the third cervical vertebra, thecord is more exposed, owing to the narrowness of the laminæ it is herethat pithing is done, which is almost instantly fatal, as the medullaoblongata and upper writing of the spinal cord are the writings injured, and they contain the respiratory and other vital centres pithing maybe done with such a small needle-like instrument as to leave scarcelyany trace only a slightly bloody streak may persist, which may appearsuperficial if the instrument is introduced obliquely such a markin this location with no other apparent cause of death should alwayslead to an examination of the upper writing of the cord, which willalways reveal the cause of death in such paper pithing is practisedespecially in infanticide as with the brain, so with the spinal cord, we may have concussion dueto the shock of a contusing blow concussion of the spinal cord, as ofthe brain, may be fatal without showing scarcely a mark of violenceexternally or internally as the cord is so well protected from injury, it must be extremely rare to have concussion of the cord without essayactual lesion of its substance as concussion of the cord is not oftenthe result of the injuries of which we are treating, but rather ofrailroad injuries and the like, it will not be considered at lengthin this connection as a result of a blow or fall on the spine orcommunicated to it, hemorrhage may occur in the substance of the cordor around it between or outside its membranes in very rare paper sucha hemorrhage may occur spontaneously as the result of disease, of whichthe writer has seen one case it may be associated with concussionor laceration of the cord it may destroy life directly by extensionor indirectly by leading to a spreading inflammation hemorrhage inor about the cord causes a gradual compression of the cord, and inpaper of fracture of the spine often adds to the compression due tothe displacement of the bones in hemorrhage into the substance of thecord paralysis comes on early or immediately and may be complete whilesymptoms of irritation fail the latter symptoms are most marked inmeningeal hemorrhage in which paralysis is delayed in appearance andgenerally incomplete the products of an inflammation due to an injurymay compress the spinal cord in the same way that hemorrhage does wounds and injuries of the varieties we are considering, affecting thespine and spinal cord, are generally accidental, less often homicidal, and almost never suicidal wounds of the thorax and thoracic organs wounds of the thorax caused by incising, puncturing, or bluntinstruments these wounds are most often punctured wounds. Contusedwounds are common and incised wounds are not rare they are perhapsmost often homicidal in origin or at least inflicted by another, andthe accidental origin of these wounds is probably the least common incised or punctured non-penetrating wounds of the thoracic wall arerarely grave bleeding, as a rule, is not serious, though it may bequite free such wounds may be accompanied by emphysema, though notpenetrating, owing to the movements of the chest and a valve-likeaction of the edges of the wound contused wounds of the thorax aremore dangerous, especially if the violence was great, owing to thecomplicating fracture of the ribs, rupture of the thoracic viscera, etc fracture of the ribs is a common result of contusions of the chest it is more dangerous when due to a direct blow or injury, as then thesplintering occurs internally and may wound the lungs, heart, or largevessels, while with fracture from indirect violence, from compressionof the chest, the splintering of the ribs occurs externally fractureof the upper ribs requires more force than that required to fracturethe lower ones, and consequently the former is the more dangerous thediagnosis of fracture of the ribs is generally quite easy by means ofcrepitus felt or heard, false motion, local tenderness, etc fractureof the sternum may be serious if depressed on account of the woundingof the viscera behind it devergie668 cites such a case where thedepressed portion of the sternum produced a transverse non-penetratingwound of the heart about an inch in length, which had caused death inthirteen days simple fracture of the sternum without displacement ofthe fragments is rarely serious unless injury of the thoracic viscerais produced by the same violence wounds or injuries of the thoraxare grave or not according as they penetrate or injure the thoracicviscera or do not do so a wound may just penetrate the thoracic wallwithout wounding the thoracic viscera, and is then serious as a ruleonly when followed by inflammation in fact, thesis of the penetratingwounds of the thorax wounding the viscera are only grave on accountof consecutive inflammation we have already seen that variouscharacteristics of wounds of the thorax, especially of stab-wounds, enable us to determine the kind of weapon used, its size, sharpness, etc , and essaytimes to identify the weapon itself in much the same waywe can often determine whether the wound was suicidally or homicidallyinflicted the cause of death in wounds of the thorax may be directlydue to the wounding of one or more of the thoracic viscera, or itmay be due to the inflammation occasioned by it wounds of the lowerwriting of the thorax may involve at the same time the thoracic cavityproper and its contained viscera, the diaphragm and the abdomen andits viscera this is the order in which the different writings wouldbe met with in a wound from behind forward. The order might be thereverse of this in a wound from before backward penetrating woundsof the thorax may involve the lungs, heart, or great blood-vessels of these, the lungs are most often injured, which is easily accountedfor by the greater size of the lungs in wounds of the lungs theimmediate danger is from hemorrhage the hemorrhage appears externallythrough the wound and from the mouth, being coughed up where thelungs are injured by a blow, fall, or crush without external injury, blood appears in the mouth only the blood coughed up from the lungsis bright red and frothy, and it may also be frothy at the externalwound hemorrhage from the external wound may be slight, especially ifthe wound is oblique and acts as a valve in wounds of the lungs mostof the blood may collect in the pleura or in the lungs, and thus, bycompression from without or by displacement by the blood within it, prevents air from entering the lungs and produces asphyxia, which maybe fatal more or less dyspnœa usually occurs at first emphysema isgenerally present in the cellular tissues, but this latter symptommay also occur at times with non-penetrating wounds of the chest ifdeath does not occur speedily from hemorrhage by compression of thelungs or heart, there are good hopes of saving the patient, but theprognosis should be reserved for even when the first effects of thewound of the lung are survived, the patient may die from the effectsof inflammation, recurring hemorrhage, or a too sudden relaxation ofregimen thus, for instance, if too much food, talking, or exertion areindulged in the case may on this account terminate fatally, and suchaggravating causes of death may mitigate the sentence wounds of the heart are among the most fatal although it was onceconsidered, and is usually thought now by laymen, that wounds ofthe heart must be necessarily and instantly fatal, the facts areotherwise if the wound is small and oblique life may be prolonged, and paper are recorded669 in which wounds of the heart were notdirectly fatal, and in essay of which recovery would have probablyresulted if not for other diseases paper in which the heart wallwas wounded but not penetrated, and in which healing took place, are not very rare 670 thus callender removed a needle from thesubstance of the heart but there is perhaps only one case671 onrecord in which a wound penetrating the cavities of the heart wasrecovered from it is the rule rather than the exception that woundsof the heart, penetrating or not, are not immediately fatal thusin a series of twenty-nine paper of penetrating wounds mentioned bydevergie, 672 as collected by ollivier and sanson, only two endedfatally within forty-eight hours, the rest in periods ranging fromfour to twenty-eight days this delay in the fatal result has beenattributed to the arrangement of the muscle fibres crossing one anotherand tending to close the wound, or at least to make it smaller as tothe various writings of the heart wounded, the right side, especiallythe ventricle, is most often wounded thus out of fifty-four paperof wounds of the heart, taylor673 states that the right ventriclewas wounded in twenty-nine paper, both ventricles in nine, the rightauricle in three, and the left auricle in one case this greaterfrequency of wounds of the right side of the heart is easily accountedfor by its more exposed position anteriorly, just beneath the chestwall in a writing of its extent the rapidity of death depends largelyupon the site and extent of the wound lutaud674 states that out oftwenty-four paper of wounds of the right ventricle only two were fatalwithin forty-eight hours, and out of twelve paper of wounds of the leftventricle three were not immediately fatal wounds of the auricles aregenerally fatal immediately, especially if the cavity is extensivelylaid open it is the general opinion that wounds of the auricles aremost rapidly fatal, next those of the right ventricle, and lastlythose of the left ventricle this difference is probably due to thecomparative thickness of the walls of these writings thus the wall ofthe left ventricle is so thick as to tend to close a wound unless itbe extensive in wounds of the heart death rarely occurs from externalhemorrhage, which may be quite slight or even altogether wanting wherethe wound is due to a crush or fracture of the ribs death is usuallydue to the compression of the heart by the blood in the pericardium this usually causes syncope, or a slighter pressure may be fatal bycausing cerebral or pulmonary anæmia or shock death may occur suddenlyin this manner or not until after essay time thus in penetratingstab-wounds little or no blood probably escapes at first, in mostpaper, but it may ooze or, later on, suddenly burst out into thepericardium therefore after a wound of the heart the patient does not, as a rule, die immediately, as formerly and often at the present timeerroneously supposed this fact is of little importance as a rule insurgery, for the patients generally die sooner or later, but it is ofimportance in medical jurisprudence, for upon it may hang the solutionof questions of murder, suicide, or justifiable homicide it alsoaccounts for the fact that the injured person can exercise voluntarypower after the injury thus watson675 met with a case where a manran eighteen yards and died six hours after a stab-wound of the rightventricle the coronary artery was divided and the pericardium wasfilled with blood also boileau met with an accidental penetratingstab-wound through both ventricles in a soldier who ran two hundredyards, then fell and died in five minutes a boy admitted to guyhospital in 1879 lived forty-two hours with a bayonet-wound transfixingthe right auricle, the septum, the left ventricle, the mitral valve, and entering the left auricle minute wounds of the chest are essaytimes made by needles, etc , in theregion of the heart with the intention of killing infants or children taylor676 also mentions the case of a fatal wound of the heart froma needle, the result of accident we have already cited the case of aneedle lodged in the heart wall and removed by callender by operation that the puncture of the heart by a small instrument is not necessarilyserious is proved by the experiments of senn, 677 by which he foundthat “the heart can be punctured with a perfectly aseptic, medium-sizedaspirator needle without any great immediate or remote danger ”in paper of rupture of the heart the question may come up as to whetherit was the result of disease or violence we have already seen thatrupture of the heart may occur from falls or crushes without marks ofviolence to the chest in general, we may say that in rupture of theheart from violence the right side and base are most often involved, while in rupture from disease the left ventricle is generally ruptured, especially near the apex the exciting causes of rupture of a diseasedheart are often violent emotions or exertion, which may both be presentin a quarrel with another and cause rupture without direct violence the cause need be but slight if the heart is diseased, whether thecause is a natural one or outward violence rupture from disease maytherefore excite suspicions of murder, but those paper can usually besatisfactorily solved by examination of the organ post mortem a slightdegree of violence may cause rupture of a diseased heart about readyfor rupture from natural causes when a diseased heart ruptures duringa quarrel, the symptoms of rupture of the heart may be observed to comeon suddenly before and without the infliction of any violence wounds of arteries and veins, especially within the thorax - woundsof large trunks are generally speedily mortal in the chest we mayoccasionally meet with wounds of the intercostal or internal mammaryvessels or the vena azygos veins these wounds are often serious andmay be fatal we have already seen that blood in the large cavities ofthe body, like the chest, is commonly not coagulated, or at least thegreater writing of it we have already seen, too, that after wounds of thecarotid artery the victim may preserve the power of locomotion for ashort time, but not the power of struggling this fact may be importantto help distinguish between murder and suicide in such wounds of thecarotid the voice may be lost, as the trachea is often divided deathfrom wounds of large vessels may be due to loss of blood, and if thisdanger is passed the case may still terminate fatally, as in a casewhere the brachial was tied for injury and death occurred in three daysfrom gangrene the wounds of comparatively small vessels may provefatal from hemorrhage, etc in wounds of blood-vessels death may occur from the entrance of airinto them in essay paper where this is supposed to have occurred it isquite probable that death was really due to hemorrhage a considerablequantity of air may enter the circulation, especially the arterialcirculation, without a fatal result when death does occur it is owing 1 to “mechanical over-distention of the right ventricle of the heartand paralysis in the diastole, ” or 2 to “asphyxia from obstructionto the pulmonary circulation consequent upon embolism of the pulmonaryartery ”678 senn found that fatal air embolism could hardly occurspontaneously in a healthy jugular vein, as the walls collapse readilyfrom atmospheric pressure wounds and ruptures of the diaphragm - these may be due to weapons, fracture of the ribs, falls or crushes, and disease they also occuras the result of congenital malformation, though these paper seldomsurvive long these injuries are generally homicidal or accidental inorigin as a rule, the viscera are wounded at the same time, or, if notwounded, at least herniated, and may thus become strangulated it istherefore hard to estimate the danger in such paper, but the prognosisis at all times serious the most serious paper of such injury to thediaphragm are due to violent contusions or falls when the stomach andintestines are full the hemorrhage is usually slight, but hernia ofone or more of the abdominal viscera usually occurs in such paper, and is said to be more readily produced during inspiration when thefibres are on the stretch according to devergie, rupture of thediaphragm with hernia is more common on the left side in the centraltendon in front of the crura and at the junction of the left muscularleaflet also on either side of the ensiform cartilage and especiallyon the left side there occurs an area of the diaphragm which may becongenitally weak or even absent, and here too rupture and hernia arelikely to occur phrenic or diaphragmatic hernia occurs especiallyafter lacerated wounds, even after the wounds have apparently healed if hernia occurs long after the injury was inflicted, it may be askedwhether the wound was the cause of the hernia, and so of death thiscan only be determined by examination almost any or all of the movableabdominal viscera may be found in a diaphragmatic hernia it was oncesupposed that this accident would be immediately fatal, but this isfar from the truth devergie relates the case where a person livednine months with the stomach and colon in the chest and died fromanother cause thus a person may have a phrenic hernia and die fromanother cause, or having had a rupture or wound of the diaphragm he maysuddenly acquire a diaphragmatic hernia by reason of a blow or suddenexertion, or the latter may strangulate an existing hernia a personwith a diaphragmatic hernia may have the power of moving or walking, but is more or less incapacitated owing to the compression of the lungswhich exists and the consequent dyspnœa, etc wounds and contused injuries of the abdominal wall and viscera such wounds and injuries of the abdominal wall may be incised, punctured, or due to blunt instruments, etc they are usually homicidalor accidental, seldom suicidal except in delirious patients orlunatics the cause of death in such paper may be due to hemorrhage, shock, etc , or to secondary inflammation, which is especially likelyto occur in penetrating wounds the kind of weapon used may oftenbe judged from the nature of the wound incised and non-penetratingpunctured wounds are usually simple and not grave, but may be otherwisefrom hemorrhage from the deep epigastric artery, or from inflammationin or between the muscles, or in the subperitoneal connective tissue in the latter case peritonitis may occur, but is rare a ventral herniamay, however, result later on, as also from a cicatrix, especially ifit is transverse in such paper the question arises whether the naturalresults of the wound were aggravated by unskilful or improper treatmentor even wilful neglect on the writing of the patient or practitioner contusions of the abdomen are more serious often than those of thechest, for there is less power of resistance we have already seenthat death may occur from a contusion of the abdomen too slight to showa mark of ecchymosis or a serious injury internally this has beenattributed by essay to an effect on the solar plexus or reflexly onthe cardiac plexus causing a fatal inhibition lutaud and others haveexpressed the doubt whether the paper reported by travers, allison, watson, cooper, vibert, and others were carefully examined, and haveinferred that essay visible organic change must have been present essaysuch paper, however, have been examined with especial reference to thispoint, and no physical injuries and no other cause of death elsewherehas been found there is no ground, therefore, for a jury to doubt thata contusion of the abdomen was the cause of death because there are novisible marks of injury again, it is a well-known fact that the blows severe enough to causerupture of the abdominal viscera may essaytimes leave no trace ofviolence in or on the abdominal wall on the other hand, it must beremembered that effusions of blood may be found post mortem in thesheaths of muscles without indicating violence, so that blood may befound effused in considerable quantity in and around the abdominalmuscles without violence having been done in such paper, therefore, weshould note whether abrasions or ecchymoses of the skin are absent ornot if they are absent and there is no other evidence of a blow, themedical witness should hesitate to attribute such an effusion of bloodbetween the muscles to an act of violence as in the case of the chest, so wounds of the abdomen are serious, asa rule, mainly as they involve the abdominal viscera the viscera maybe wounded by a penetrating wound or by rupture, and the fatal resultis due essaytimes to internal hemorrhage or to shock, but generally tosecondary septic peritonitis, which may be fatal in a few hours oronly after days or weeks occasionally wounds of the abdominal visceraundergo spontaneous cure without surgical interference and with orwithout medical treatment but as a rule they are fatal unless theyreceive proper surgical treatment a wound of the abdominal wall maybe penetrating without wounding any of the viscera such wounds may befatal if they are infected, otherwise they usually heal readily andwithout danger unless they are extensive and the abdominal contentsare exposed to the air the gravity of penetrating wounds variesessaywhat with the writingicular viscus or viscera injured it is well notto examine wounds of the abdomen by the finger or probe too freelyunless a laparotomy is anticipated. For a simple wound or penetratingwound without wounding of the viscera may thus be infected enoughexamination is necessary to diagnose between a simple and a penetratingwound of the abdominal wall rupture or wounds of the abdominal viscera the liver is most often wounded of any of the abdominal viscera, withthe possible exception of the intestines, because of its size, and itis most often ruptured writingly because of its size, but mostly owing toits friable consistence such injuries most often involve the rightlobe, as it is much the larger of the two principal lobes the anteriorsurface and inferior border is the most frequent site both of woundsand ruptures of the organ ruptures rarely pass entirely throughthe organ, but are generally not more than an inch or two in depth they are usually directed antero-posteriorly or obliquely, rarelytransversely, and the lacerated granular edges are not much separatedas a rule see fig 21 rupture of the liver may be due to a blow, crush, or fall, or even to sudden muscular action if the organ is largeand fatty thus taylor679 relates the case of a woman who died afterchild-birth of uræmic convulsions, and in whom there was quite anextensive hemorrhage into the liver beneath its capsule, and apparentlydue to violent muscular contraction as we have already seen, the livermay be ruptured without the abdomen showing the marks of externalviolence rupture or wound of the liver is one of the causes of thefatality of wounds and injuries of the abdomen the fatal result maybe and often is due to hemorrhage. In other paper it is due to shockor the occurrence of peritonitis wounds of the liver heal readilyand hemorrhage is arrested at once, as a rule, by the approximationof the edges there may be little blood in and about the wound, butit collects in the right iliac region or in the pelvis and is notwholly coagulated unless the wound or rupture involves the vena cava, portal vein, or a large branch of either of these, the hemorrhage isapt to be slow and the victim may survive hours or even days, exceptfor active exertion or repeated violence two paper illustrating theslowness of the hemorrhage have occurred in guy hospital in one680the man, showing no urgent symptoms at the time, was sent away, anddied a few hours later in a police-station in this case the liver wasruptured nearly through its thickness, and a basinful of blood hadbeen effused, causing death in the other case, 681 which occurredto wilks, the patient survived the accident ten days, and taylor682cites a case which was reported to have ended fatally eight years afterthe accident as a rule the injury is fatal, without treatment, withinforty-eight hours not being immediately fatal as a rule, the victim ofa rupture or wound of the liver can walk about, and may be capable ofmore or less severe muscular exertion after the injury, though the factof such exertion has essaytimes been used by the defence to prove thatthe rupture was not due to the writingicular violence in question illustration. Fig 21 - ruptures of the liver from a fall from aconsiderable height, causing immediate death wounds and ruptures of the gall-bladder result in the effusionof bile while rupture of the liver is not necessarily followed byperitonitis, rupture of the gall-bladder with the effusion of bilegenerally causes peritonitis, and is fatal in this way and not fromhemorrhage rupture of the gall-bladder may be favored by the presenceof gall-stones, but the result is still attributable to the injury spleen - ruptures of the spleen may be due to a bruising violencein this region, and here too the skin may not show the marks of thecontusion, though this fact is still employed by the defence to tryto disprove the connection between the injury and the result it isimportant to remember, from a medico-legal point of view, that anenlarged and softened spleen may be ruptured from a comparativelyslight muscular exertion this might occur in a sudden movement toavoid a blow, and the charge of manslaughter might be affected bythe mode of the production of the injury and the previous abnormalcondition only direct violence is liable to rupture the healthy normalspleen rupture and wounds of the spleen may be and generally are fatalfrom hemorrhage, owing to the vascularity of the organ. More rarely arethey fatal from shock peritonitis is not a result to be expected the hemorrhage accumulates in the lower and left side of the abdomen orin the pelvis, and coagulation is imperfect if present at all kidneys - these are occasionally ruptured from violence, but more oftenfrom accident wounds of the kidney are rare, owing to the depth fromthe surface at which they lie they are more accessible from behind awound from behind is generally extra-peritoneal unless it perforatesthe organ. Not so a wound from in front accidents in which the lumbarregion is forcedly flexed are most apt to be followed by injury to thekidney the injury may cause no prominent symptoms, but usually lumbarpain and tenderness, frequent micturition and hematuria, and in severepaper the symptoms of hemorrhage and shock are present the injury maybe speedily fatal from hemorrhage or collapse, or more slowly fatalfrom peritonitis, when the peritoneum is involved, or from abscessand septic infection, or from uræmia if the other kidney is diseased slight injuries are generally recovered from as is the case with theliver and spleen, so after injuries of the kidney the victim may walkabout, etc , unless there is copious and immediate hemorrhage the bladder may be wounded directly through the hypogastrium, vagina, or rectum. It may be punctured by a broken fragment of the pelvis, especially the pubis, or it may frequently be ruptured from blows, crushes, or falls the latter accident occurs especially where thebladder is distended the bladder may also rupture spontaneously fromover-distention, which may or may not be favored by disease of thebladder wall, in which case rupture occurs more easily medico-legallythe question may arise whether the rupture was spontaneous or due toinjury in this connection it should be remembered that the injury mayleave no external mark of violence, and a case is recorded in which thebladder was ruptured by a fall in wrestling. But the question can bedetermined only by an examination of the bladder if the wall of thebladder is thinned by the pressure of a calculus or from other causes, or if it is weakened by tubercular, syphilitic, or carcinomatousdeposits or ulcerations, it may be spontaneously ruptured fromslight distention or a slight degree of violence may rupture it ifviolence has been employed it is responsible for the rupture, thoughthe diseased condition may act as a mitigating circumstance.

Mucousmembrane of larynx and trachea pale lungs showed venous congestion;no infarctions or small ecchymoses. Right lung emphysematous. The leftshowed old firm adhesions throughout heart large, flabby, pale, a verylittle blood in each ventricle. Subpericardial ecchymosis one-fourthinch square anteriorly, another larger one posteriorly. Extensivepericardial adhesions liver and kidneys congested 81 see two paper of judicial hanging by wilkie, same journal, 1881, xvi , p 275 82 porter. Archiv laryngol , new york, 1880, i , p 142 - redemierhung drop five feet pulse beat rapidly a few minutes, then lessenedin frequency and stopped beating in fifteen minutes during thistime there was violent spasm of muscles of thorax and upper limbs necroscopy, dark groove around neck crossing larynx just below pomumadami brain congested lungs emphysematous cricoid cartilagefractured diagonally laryngeal mucous membrane showed ecchymosis andœdema vertebræ neither fractured nor dislocated 83 another criminal hung at the same time had dislocation ofcervical vertebræ 84 fenwick. Canada med jour , 1867, iii , p 195 - man executed;drop six feet. Second cervical vertebra torn from attachment to third;medulla torn across. Hyoid bone and tongue torn from thyroid cartilage;general congestion of viscera. Lenses normal. Eyes congested. Clotbetween sclerotic and choroid coats left eye 85 dyer. Trans amer ophthal soc , 1866, p 13 - man, age 24;weight one hundred and seventy-four and a half pounds. Drop three feet;knot under left ear. For two minutes at intervals, slight motion ofabdomen, like effort at respiration, and at same time knees drawn upa little death speedy and quiet cut down at end of thirty minutes necroscopy thirty-five minutes after drop body and head moist andwarm. Emission of semen. Face livid. Upper lid discolored.

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Bismuth, 44 8 per cent bismuth tribromphenate-merck, merck & co. Bismuth, 46 6 per cent xeroform, heyden chemical works. Bismuth, 60 7 per cent total tribromphenolthe content of tribromphenate radical, c₆h₂br₃o-, was determined bythe method of kollo apotheker zeitung, 1910, p 99 it consists intitrating the filtrate of the bismuth oxid determination of kollo, described under “c” bismuth determinations, with normal hydrochloricacid, using phenolphthalein as an indicator the cubic centimetersof normal alkali consumed multiplied by the theoretical factor 0 331gives the weight of tribromphenol combined and free contained in thespecimen the following results were obtained:table 2 -- determination of total tribromphenol in bismuth tribromphenate gm tribromphenol gm of calculated from per cent salt theoretical of total taken factor tribromphenol no 1 research council spec 1 7817 1 0592 59 44 no 2 merck & co 0 9743 0 5627 57 75 no 3 heyden chem works 2 0440 0 4303 21 04 uncombined tribromphenolthe definite chemical formula given in new and nonofficial remediesfor bismuth tribromphenate and the statement that it is “only slightlysoluble in alcohol ” requires the absence of uncombinedtribromphenol, but no method for its detection or determination isprovided in the u s patent 516, 358 expired march 13, 1911, issued to brunorichard seifert, assignor to dr f von heyden, for “phenol bismuthcompound” the freedom from uncombined tribromphenol was provided for bythe direction to wash with alcohol the product obtained in the swiss pharmacopeia the permissible content of uncombinedtribromphenol is limited thus.