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That is, of apocynum, strophanthus and squill with elder it is difficult to know just what idea the statement that it is a“scientific combination” of these drugs is intended to convey, forit is unscientific to mix three drugs of this group for use in fixedproportion in a wide range of conditions, if indeed, there is ever anyindication for their use the great disadvantages of strophanthus and apocynum pertain to theextreme uncertainty of their absorption from the gastro-intestinaltract strophanthus is occasionally absorbed promptly, essaytimesso slowly that the therapeutic effects are not induced until anamount equal to several best resume writing services chicago times that which would prove fatal if all ofit were absorbed into the circulation has been administered, and, unfortunately, one cannot control the absorption which may continueuntil a fatal effect is induced this is true to an even greater degreeof apocynum, and it was due to the recognition of this fact thatapocynum was not admitted to the u s pharmacopeia ix, the committeeon dosage having agreed that no safe and effective dose could be given the council previous findingsin 1907 the council on pharmacy and chemistry examined the literatureused in the exploitation of anasarcin and anedemin and published itsreport anasarcin tablets, it was pointed out, were said to containthe active principles of oxydendron arboreum sour wood, sambucuscanadensis elder and urginea scilla squill, and the followingclaims were made for the nostrum. “does what dropsy medicaments have hitherto failed to accomplish ” “superior to digitalis, strophanthus, scoparius, squills, acetate of potash and the hydragogue cathartics all put together ” “the only known relief and permanent cure of dropsies ” “unrivaled heart tonic ” “the most powerful agent known ” “safe in administration ” “non-toxic as ordinarily administered ” “will nauseate essay persons, ” but “the reaction from the temporary depression is prompt ” “in bright disease, both the interstitial and parenchymatous forms of nephritis, acute or chronic, no remedy to equal it in efficacy ” “without increasing the debility of the patient or interfering with nutrition by producing loss of appetite ” “this treatment is to be continued without cessation until all symptoms of dropsy have disappeared ”a comparison of the earlier claims with those now being made seeadvertisement reproduced from the new york medical journalillustrates one of the results of the work of the council today thenostrum exploiter avoids the cruder forms of obvious misstatement, butcontinues to make, by inference, claims that are equally misleading it will be observed in this case that a more cautious pen worded thelater advertisement, but there is still evident the intent to convincethe reader that anasarcin is superior to the official drugs in thetreatment of cardiovascular diseases the facts are that anasarcin isat best a dangerous remedy in the hands of the average clinician inthe treatment of such conditions, and its use is at all times to becondemned no competent investigator has ever investigated the pharmacologyof sour wood oxydendron arboreum, and it appears to have notherapeutic value other than that due to a slight acidulousness elder sambucus canadensis contains a trace of a volatile oil as its mostimportant constituent, according to the british pharmaceutical codex of1911 p 908, but it is difficult to explain why a trace of volatileoil should be considered important elder may be dismissed withoutfurther consideration in connection with anasarcin tablets the pharmacology of squillthis leaves only squill among the constituents of anasarcin forconsideration sollmann manual of pharmacology, 1917, p 409 indiscussing the advantages claimed for squill over other drugs of thedigitalis group, says. “dixon, 1906, points out that any superiorityis outweighed by its disadvantages. Uncertain absorption. Stronggastro-intestinal irritation ” squill was formerly used as anexpectorant and diuretic, the activity having been attributed to twoamorphous glucosids, scillipicrin and scillitoxin, but ewins, 1911, found these to be impure mixtures a later investigator claimed tohave isolated two glucosidal agents from squill, but similar claimshave often been made only to be disproved later, and we know ofno confirmation of the claims regarding the isolation of any pureprinciples from squill having any true typical digitalis action the statement quoted from sollmann is accepted by practically allpharmacologists, and we may say with certainty that squill is decidedlyinferior to digitalis in the treatment of cardiovascular, andcardiorenal diseases, and certainly no active principles of squill wereknown to the scientific world at a time that the remarkable claims werefirst made for anasarcin by an obscure pharmacist of winchester, tenn indeed, if anasarcin were all that it was claimed to be, its discoverywould have made winchester as famous as a certain wisconsin city wassaid to have been made by a popular beverage it has been abundantly demonstrated, and it is now almost universallyaccepted among well informed pharmacologists and clinicians, that alldigitalis principles exert the same kind of action on the heart afterthey enter the circulation in effective doses, though they differto an extraordinary degree in the intensity of their action and intheir undesired sideactions, such as nausea and vomiting when theuse of anasarcin squill is followed by immediate improvement afterdigitalis has failed, it merely shows that the dosage of digitaliswas insufficient or that it was discontinued and the squill mixturewas substituted before the full therapeutic effects of the digitalisdeveloped when the digitalis group is contraindicatedif the administration of a sufficient dose of digitalis is not followedby improvement in the circulation, it shows that the heart is incapableof responding to such treatment and the further use of any of the drugsof this group is distinctly contraindicated this is confirmed by theexperience of nearly every competent observer of digitalis therapy, andnumerous fatalities have resulted from the failure to appreciate thisfact and further administer essay other member of the group, such asstrophanthus or squill it is now well known that the cardiac effects of toxic doses of squill, and other members of the group, resemble closely those of cardiacdisease, and it is often impossible to determine whether the behaviorof the heart in a given case is attributable to insufficient dosage, toexcessive dosage, or to the progress of the cardiac disease itself ifthis occurs when one uses the best known members of the group, it iscertain that it occurs even more frequently when others that are lessunderstood are employed in the light of this knowledge of the dangersattending the incautious use of any member of the digitalis group, and more especially the use of impure principles, such as are commonlyobtained from squill, it is impossible to condemn sufficiently therecommendation that the use of anasarcin should be continued withoutcessation until all symptoms of dropsy have disappeared digitalis bodies are not suited for the treatment of all cardiacdisturbances, and it is, of course, self-evident that a time mustcome in the treatment of chronic cardiac disease when the heart isincapable of responding to any form of treatment with improvement but, unfortunately, it never loses its response to toxic doses, and to pushthe administration of any drug or mixture containing any drug of theentire digitalis group-- and especially those, like squill, in which theside actions are most prominent-- beyond the point of tolerance is tocourt certain disaster the treatment of cardiac dropsywhile it is quite certain that thesis lives have been sacrificed to thefailure to understand this phase of cardiac therapy, it is equallycertain that thesis lives have been sacrificed because of insufficientdosage, and one can steer a safe course between these dangers only byusing the best known preparation available. And in the present stateof our knowledge it is indisputable that digitalis and the tincture ofdigitalis are best suited for the treatment of cardiac disease exceptin those few paper in which intramuscular or intravenous administrationmust be employed temporarily for immediate effect illustrationthe secret of prescribing successfully for the relief of dropsy incardiac disease consists in understanding the effects of digitalison the heart, in administering it until these effects indicate thatthe desired object has been obtained, and stopping, or interrupting, the administration at that point until the effects begin to wear off cumulation, so called, is a positive advantage in such paper itmerely means that the desired therapeutic effects once induced persistfor a time, and that further medication is unnecessary during suchpersistence of action eggleston has recently shown arch int med 16:1 july 1915. Abstr , j a m a 44:459 july 31 1915 thatthe full therapeutic effects of digitalis can be induced in suitablepaper within a few hours even with oral administration we are not aware of a single publication in which a careful, detailedclinical study of anasarcin has been reported the claims made foranasarcin, past and present, indicate either a deliberate purposeto mislead or crass ignorance of the rudiments of pharmacology andtherapeutics the exploiters of the nostrum claim that thousandsof physicians have found anasarcin tablets of unsurpassed remedialvalue in the treatment of disorders of the circulatory system and ofascitic conditions 244 it must be admitted that too thesis physicianshave prescribed anasarcin, otherwise the manufacturers would not havecontinued to spend thousands of dollars in advertising it in medicaljournals during a period of more than ten years 244 former estimates of the number of physicians who prescribedanasarcin appear to have been too high, possibly based on the ratioobtaining in winchester, tenn inquiry at five fairly busy drug storesin a large eastern city showed that in no instance was the pharmacisteven acquainted with the name one pretended to be, and manifested pityfor the inquirer ignorance in supposing that it could be importedduring the war!. he was obviously merely less honest than the others, who frankly admitted they had never heard of it doctor, this article is meant to be a candid discussion with you, whether you use anasarcin or not, because every clinician is vitallyinterested in the customs that obtain in the practice of medicine, andwe wish to put a hypothetic question to you answer it, at least toyourself, in exactly the spirit in which it is put suppose that youprescribe anasarcin for a patient who is critically ill with cardiacdisease he dies are you willing to tell the relatives frankly justwhat you used and the nature of the evidence on which you based yourchoice of this nostrum?. let the supposition be carried further and saythat the case was hopeless, and agree that digitalis and all otherdrugs would have been equally ineffective granting all this, wouldyour explanation satisfy?. would you in all candor dare to offer such anexplanation?.

The work of the best resume writing services chicago digestive glands, 1912 32 bayliss and starling. Jour physiol 28:325, 1902 33 wertheimer. Compt rend soc de biol 54:475, 1902 34 enriquez and hallion. Compt rend soc de biol 55:233, 363, 1903 35 fleig. Arch internat de physiol , 10:206, 1910 36 matuso. Jour physiol 45:477, 1913 37 huston. Ann et bull soc roy de sc méd et nat 70:178, 1912 properties of secretinprosecretin -- secretin is soluble in water, yet a watery extract ofintestinal scrapings is without action, 32 even after being submittedto acid treatment 38 starling therefore holds that secretin existsin the intestinal mucosa in an inactive form, as “prosecretin ” thecontent of the intestine in prosecretin decreases from the duodenumdown, so that one is unable to demonstrate any prosecretin in the last2-1/2 feet of the ileum prosecretin is insoluble in water, acetone, absolute alcohol or ether secretin, on the other hand, is readilysoluble in water, normal salt solution and diluted alcohol 70 percent , but likewise insoluble in absolute alcohol and ether 38 starling.

H p loomis, m d. Roswell park, m d. Irving c rosse, m d. f p vandenbergh, m d. J h woodward, m d. george woolsey, m d volume one new york william wood & company 1894 copyright, 1894, by william wood & company press of the publishers’ printing company 132-136 w fourteenth st new york contents pageintroduction, v medical jurisprudence, 1 the legal relations of physicians and surgeons t c becker, 3 the law of evidence concerning confidential communications chas a boston, 89 synopsis of the laws governing the practice of medicine w a poste and chas a boston, 135 forensic medicine thanatological, 293 the legal status of the dead body t c becker, 295 the powers and duties of coroners a becker, 329 medico-legal autopsies h p loomis, 349 personal identity j c rosse, 383 determination of the time of death h p loomis, 437 medico-legal consideration of wounds g woolsey, 457 medico-legal consideration of gunshot wounds roswell park, 591 death by heat and cold e v stoddard, 627 medico-legal relations of electricity w n bullard, 661 medico-legal consideration of death by mechanical suffocation d s lamb, 705 death from submersion or drowning j c rosse, 793 death from starvation e v stoddard, 813introduction the terms forensic medicine, legal medicine, and medical jurisprudencehave heretofore been used interchangeably to apply to those branchesof state medicine and of jurisprudence which have to deal with theapplications of medical knowledge to the elucidation of questions offact in courts of law, and with the legal regulation of the practice ofmedicine medico-legal science therefore includes all subjects concerning whichmembers of the legal and medical professions may seek information ofone another, each acting in his professional capacity it consistsof two distinct branches. That treating of medical law, to whichthe designation of medical jurisprudence properly applies. And thatrelating to the application of medical, surgical, or obstetricalknowledge to the purposes of legal trials, forensic medicine 1the term state medicine, which is essaytimes erroneously used assynonymous with forensic medicine, properly applies to a more extendedfield of medical inquiry. I e , to all applications of medicalknowledge to the public welfare state medicine, therefore, whileexcluding medical jurisprudence, includes, besides forensic medicine, public hygiene, medical ethics, medical education, and military andnaval medicine toxicology, the science of poisons, may be divided into medicaltoxicology, whose object is the prevention or cure of all forms ofpoisoning, and forensic toxicology, whose aim is the detection ofcriminal poisoning in its last-named relation toxicology differs fromforensic medicine in one important writingicular in all paper other thanthose of poisoning in which questions involving medical knowledgearise, the answers are entirely within the functions of the physician, the surgeon, or the obstetrician, but the problems of forensictoxicology require for their solution the further aid of the chemistand the pharmacologist forensic medicine is an applied science, writingly legal, writingly medical, calling for information and investigation in widely divergent lines, and becoming more minutely ramified with the progressive advances inmedical knowledge and in those sciences of which medicine is itselfan application its development has been dependent writingly upon theslow though progressive tendency of medicine from the condition of anempirical art toward that of an exact science, and writingly upon themore rapid and more advanced development of criminal jurisprudence medical jurisprudence had reached a high development during the earlyhistory of the roman empire, and at a period long anterior to the firstrecognition of forensic medicine although the literature of modern medico-legal science is verylargely written from the medical point of view and by physicians, itsearlier history is to be found in fragmentary form, writingly in medicalliterature, but principally in the writings of historians, in theearlier criminal codes, and in the early records of legal proceedings in the earliest historical periods the functions now exercised bythe priest, the lawyer, and the physician were performed by thesame person, who, presumably, made use of what medical knowledge hepossessed in the exercise of his legal functions among the egyptiansat a very early period it is certain that medical questions of factwere considered in legal proceedings, and that the practice of medicinewas subject to legal regulation according to diodorus, 2 “when apregnant woman was condemned to death, the sentence was not executeduntil after she was delivered ” the same author tells us3 that “thephysicians regulated the treatment of the sick according to writtenprecepts, collected and transmitted by the most celebrated of theirpredecessors if, in following exactly these precepts which arecontained in the sacred books, they did not succeed in curing the sick, they could not be reproached, nor could they be prosecuted at law. Butif they have proceeded contrary to the text of the books, they aretried, and may be condemned to death, the legislator supposing that butfew persons will ever be found capable of improving a curative methodpreserved during so long a succession of years and adopted by the mostexpert masters of the art ” with the system of legal trial in use amongthe egyptians4 it is difficult to imagine that the question of theexistence of pregnancy in the one case, or of malpractice in the other, would not be the subject of contest, and, if contested, determinedwithout the testimony of obstetricians or of physicians 5medical knowledge among the hindoos was further advanced than amongthe egyptians in the rig veda about 1500 b c occur a few medicalreferences, among which is the statement that the duration of pregnancyis ten lunar months the earliest purely medical sanskrit texts are the ayur vedas ofchraka and sûsruta, which were probably written about 600 b c , butwhich are undoubtedly compilations of information which had been handeddown during thesis centuries before that time in each of these is asection devoted to poisons and their antidotes kalpa, in which it iswritten that a knowledge of poisons and antidotes is necessary to thephysician “because the enemies of the rajah, bad women, and ungratefulservants essaytimes mix poison with the food ” full directions arealso given for the recognition of a person who gives poison, and todifferentiate the poisons themselves, whose number, from all thekingdoms of nature, is legion the age at which women may marry isfixed at twelve years, while men may not marry before twenty-five theduration of pregnancy is given as between nine and twelve lunar months, the average being ten the practice of medicine is restricted tocertain castes, and requires the sanction of the rajah, and the methodof education of medical students is prescribed 6it is singular that the greeks were apparently destitute of anyknowledge of legal medicine although medicine and jurisprudence werehighly developed among them, allusions to any connection between thetwo are of very rare occurrence and uncertain the hippocratic writings ca 420 b c contain thesis facts whichare of medico-legal interest.

The results obtained may be briefly summarized as follows. 1 0 1 per cent to 5 per cent coagulen did not accelerate the coagulation time of blood and oxalate plasmas in the majority of tests any more than the controls of saline, while 0 1 per cent cephalin was found to shorten the coagulation time from 1/3 to 1/2 2 there was no difference between the behavior of old and fresh specimens 3 no acceleration of coagulation in vitro was observed even with the highest concentrations tried, namely 25 and 50 per cent 4 irrigations made with fresh dry coagulen in solution and sterile solution in ampoules on superficial bleeding from the foot-pads of 3 normal and peptonized dogs and local application to hemorrhages from dissected femoral arteries and bone and liver wounds of 3 dogs showed that coagulen was no more active than normal saline toxicity. Subcutaneous and intravenous injections of different doses of coagulen solutions fresh ampoules and dry coagulen in solution in 8 guinea-pigs produced definite anaphylactoid symptoms with injury to the circulatory and respiratory systems as indicated by cardiac dilatation, abdominal congestion and pulmonary hemorrhages, congestion, distention and essaytimes thrombi on the other hand, the control animals injected with saline and cephalin remained practically unharmed conclusions. The results obtained justify the following conclusions. 1 coagulen is entirely inactive as a thromboplastic and hemostatic agent 2 coagulen is distinctly injurious when injected systemically 3 the claims of hemostatic efficiency and harmlessness for coagulen by the manufacturer appear exaggerated and unjustified recommendations. Because of its uncertain composition, the possible dangers when injected systemically, and its inactivity as a thromboplastic and hemostatic agent when tested by several different methods, coagulen merits no recognition as a therapeutic agent for inclusion in new and nonofficial remedies the detail evidences used as the basis of this brief report concerning coagulen will be published shortly in the journal of pharmacology, 138 together with the results with other thromboplastic agents 138 since the report was sent to the manufacturers, the resultshave been published hanzlik, p j , and weidenthal, c m , plasmaand blood clotting efficiency of thromboplastic agents in vitro andtheir stability, j pharmacol and exper therap 14:157 october1919. Hanzlik, p j , karsner, h t , and fetterman, j , anaphylactoidconditions, j pharmacol and exper therap 14:189 oct 1919;hanzlik, p j , karsner, h t , and fetterman, f , anaphylactoidphenomena from thromboplastic agents, j pharmacol and exper therap 14:229 nov 1919 the preceding report was sent to the american agent for the society ofchemical industry, sept 8, 1919 in reply the american agent, ciba co , inc , on march 22, 1920, sent the council “essay additional clinical reports on the use ofcoagulen-ciba in the treatment of hemorrhages supporting our claims ofthe merits of coagulen-ciba ”the material submitted by the ciba co , contains no objective evidencefor or against the efficiency of coagulen-ciba but merely opinions asa rule these opinions are favorable though conditional and hedging andquite unconvincing nothing was submitted to offset or challenge thefindings of dr hanzlik report since the evidence indicates that coagulen-ciba has little, if any, efficacy as a hemostatic, the council directed its omission from newand nonofficial remedies -- from reports of council on pharmacy andchemistry, 1920, p 53 ferric cacodylate omitted from new and nonofficial remedies report of the council on pharmacy and chemistrythe council has authorized publication of the report which appearsbelow, explaining the omission of ferric cacodylate from new andnonofficial remedies w a puckner, secretary iron cacodylate, the ferric salt of cacodylic acid, was admitted to newand nonofficial remedies in 1917 it is required to contain from 39 7to 44 9 per cent of arsenic as the following statement of the action, uses and dosage of ironcacodylate appears in the 1920 edition of new and nonofficial remedies. “actions and uses -- ferric cacodylate has the properties of iron salts and of arsenic its use has been proposed in conditions in which the effects of iron and the mild arsenic action of cacodylates is desired “dosage -- from 0 015 to 0 1 gm 1/4 to 1-1/2 grains ”the period for which the iron cacodylate preparations now in new andnonofficial remedies were accepted coming to an end with the close of1920, the council decided to determine if sufficient evidence for thevalue of ferric cacodylate has accumulated to warrant its continuedrecognition the following is the report of the referee of thecommittee on therapeutics to whom the matter was assigned.

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Is in quality, cold and dry, melancholy, and under the dominion of saturn the smelling resides in the nose, is in quality hot and dry, choleric, and that is the reason choleric creatures have so goodsmells, as dogs it is under the influence of mars the taste resides in the palate, which is placed at the root of thetongue on purpose to discern what food is congruous for the stomach, and what not. As the meseraik veins are placed to discern whatnourishment is proper for the liver to convert into blood in essay veryfew men, and but a few, and in those few, but in few instances thesetwo tasters agree not, and that is the reason essay men covet meats thatmake them sick, viz the taste craves them, and the meseraik veinsreject them. In quality hot and moist, and is ruled by jupiter the feeling is deputed to no writingicular organ, but is spread abroad, over the whole body. Is of all qualities, hot, cold, dry, and moist, and is the index of all tangible things. For if it were only hot alone, it could not feel a quality contrary, viz cold, and this might bespoken of other qualities it is under the dominion of venus, essaysay, mercury. A thousand to one, but it is under mercury the four administering virtues are, attractive, digestive, retentive, and expulsive the attractive virtue is hot and dry, hot by quality, active, orprincipal, and that appears because the fountain of all heat isattractive, viz the sun dry by a quality passive, or an effect ofits heat. Its office is to remain in the body, and call for what naturewants it is under the influence of the sun, say authors, and not undermars, because he is of a corrupting nature, yet if we cast animwritingial eye upon experience, we shall find, that martial men callfor meat none of the least, and for drink the most of all other men, although thesis times they corrupt the body by it, and therefore i seeno reason why mars being of the same quality with the sun, shouldnot have a share in the dominion it is in vain to object, that theinfluence of mars is evil, and therefore he should have no dominionover this virtue. For then, 1 by the same rule, he should have no dominion at all in the body ofman 2 all the virtues in man are naturally evil, and corrupted by adamfall this attractive virtue ought to be fortified when the moon is infiery signs, viz aries and sagitary, but not in leo, for thesign is so violent, that no physic ought to be given when the moon isthere. and why not leo, seeing that is the most attractive sign ofall.