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In most of the paper the œsophagus and trachea were not penetrated in the animals first killed and then buried, the substance had not passed into the mouth or nose in one case only he found ashes in the buy custom research papers larynx and trachea of a rabbit which had been buried thesis hours after death in a box of ashes matthyssen934 held a guinea pig, head downward, with its nose under mercury. The lungs were full of globules of mercury which has a specific gravity of 13 5 a dog was plunged head first into liquid plaster-of-paris. The plaster was found in the bronchial tubes illustrative paper accidental 1 huppert. Vier ger med und öff san , 1876, xxiv , pp 237-252 - two paper a man choked by piece of bread in pharynx second, an epileptic, suffocated by flexion of chin on larynx inboth paper seminal fluid was found in urethra near meatus, unexpelled;determined by microscope 2 johnson. Lancet, 1878, ii , p 501 - boy swallowed penny, becameblack in face. Eyeballs protruded.

Fig 9 - angular stab-wounds of the anterior chest wallcaused by a strong pocket-knife dupuytren remarks that stab-wounds are smaller than the weapon owingto the elasticity of the skin, but a lateral motion of the weapon maycause considerable enlargement of the wound if a stab-wound hastraversed a writing of the body, the wound of exit is smaller than that ofentrance the depth of a punctured wound may be any writing of the length of theweapon, or it may even be deeper than the length of the weapon owing toa depression of the surface by the force of the blow, or the pressureof the handle of the weapon or the hand holding it we have alreadyseen that this may occur in a marked degree in penetrating wounds ofthe abdomen involving one of the movable viscera, also in wounds ofthe thorax, writingly from depression of the surface and writingly from anexpansion of the thorax when opened at the autopsy, thus increasing themeasured depth of the wound punctured wounds of the third class madeby instruments with ridges or edges, like foils, files, etc , presentmore or less the shape of the weapon if the edges are cutting, butnot always so if the direction of the wound be oblique or the writingsunevenly stretched if the edges are not cutting they cause wounds moreor less like the first class of punctured wounds, but we can oftendistinguish them from the latter by little tears in the edges theentrance and exit wounds may not be alike wounds made by bits of glass and earthenware have irregular anduneven edges taylor637 relates a case, reg v ankers warwicklent ass , 1845, where the wound was attributed to a fall on essaybroken crockery, but the wound was cleanly incised and the prisonerwas convicted as it may be alleged in defence that a given wound wascaused by a fall on broken crockery or other substances capable ofproducing a punctured wound, it is important to notice whether theedges are lacerated and irregular or smooth and clean the authorquoted above cites another case which occurred to watson, where theprisoner alleged that a deep, clean-cut wound of the genitals of awoman which had caused her death was due to a fall on essay brokenglass the character of the wound disproved this defence anotherfeature of such wounds, especially if they be deep in comparison totheir length, is that they are very apt to contain small writingicles ofthe glass or earthenware which caused them in fact, in all wounds itis well to search for any small fragments which will throw light uponthe weapon used wounds caused by scissors are often of characteristic shape if thescissors were open we find two symmetrical, punctured diverging wounds, presenting more or less clearly the form of the blades of the scissors if the blades have been approximated there is a triangular intervalbetween the punctures, the apex of which is truncated if any skinremains between the punctures lacerated wounds may not indicate the weapon used as clearly aspunctured wounds, but the agent which produced them is often indicatedby the appearance of the wound they are generally accidental butwhere they occur, as they not infrequently do, on the bodies ofnew-born children, they may give rise to the charge of infanticide in essay paper the weapon which caused the wound fits the woundproduced, and thus important evidence may be furnished the prosecution taylor638 cites the case of montgomery omagh sum ass , 1873, wherea bill-hook which fitted the injuries on the skull of the deceased wasfound buried in a spot to which the prisoner was seen to go thesefacts connected the prisoner with the weapon and the weapon with themurder in other paper the wounds may be so lacerated or contused thatthe indications of the weapon are obscured contusions and contused wounds - the shape of a contusing body isessaytimes reproduced by the contusion and the ecchymosis thus we areenabled to distinguish the marks of a whip, the fingers, the fist, etc this is best seen when the ecchymosis is fresh, for soon the edgesextend and the outline is less clearly marked plaques parcheminées, which we have already described as the marks of contused erosions, may show the form of finger-nails, etc contused wounds like simplecontusions may show the shape of the weapon if the contusing body has a large area, the whole of this area cannotoften strike the body at once, so that the outline of the contusiondoes not represent that of the weapon but in general, severecontusions present greater difficulties than the preceding classes ofwounds we must generally be content if we can determine whether thewound was caused by a weapon, including the fist, or by a fall, andwe are often unable to say even this a fall is often alleged by thedefence as the cause of the injury, but of course if the prisonerwas responsible for the fall he is responsible for the results of thefall if there are contusions or contused wounds on several writingsof the head, or if the wounds are on the vertex of the head, it ispresumptive of the use of weapons we cannot often swear that eachand every wound on the head was due to the use of a weapon on theother hand, the presence of grass, sand, gravel, etc , in a wound ispresumptive of a fall and of the origin of the wound in this manner in case of a fall from a height the wound or wounds might be in almostany writing of the body, on the vertex or elsewhere such a fall may bethe result of accident, suicide, or murder it is not unusual forfemale complainants to ascribe their wounds to a fall to exculpatethe prisoner, especially if this happens to be her husband we shouldremember that in the scalp or over the eyebrows a contused wound causedby a blunt instrument may resemble an incised wound as already stated, however, if the wound is fresh careful examination will lead to acorrect opinion, and the use of a sharp instrument may be disproved if the wound is not recent there is great difficulty in judging ofthe cause it is well to caution against accepting the interestedstatements of others in regard to the use of a weapon, unless thecharacter of the wound bears them out very strongly there may be a badmotive for imputing the use of a certain weapon to the assailant it isfar better to rely solely upon the evidence furnished by the wound insuch paper it would be useful if we could lay down essay general rules todiscriminate between wounds caused by the blow of a weapon and thosecaused by falls, but this we are unable to do so as to cover all paper each case must be judged by itself if the question is asked which of two weapons caused certaincontusions or contused wounds, we are still less likely to be able toanswer it in such a case we must make an accurate examination of theform of the wound and compare it closely with that of the weapon insuch paper also the second source of information on which we base ouropinion as to the relation of a weapon to the wound may be of use, namely, the examination of the weapon the presence of blood, hair, cotton or woollen fibres on one of two weapons indicates that this wasthe weapon used the presence of blood is writingicularly to be lookedfor, and in those writings of the weapon from which it could be washed offleast easily we should further note the condition of the point andedge of the weapon, and if the edge is broken or nicked at all, whetherthis condition is old or recent the sharpness of the edge shouldfurther be noted, and if the edge is sharp note whether it has recentlybeen sharpened all these points have a certain bearing on the case also the location, shape, depth, etc , of the wound should be carefullynoted to see if an accidental fall would be likely to account for it for these features of the buy custom research papers wound may be such that no fall could cause it we see, therefore, that in incised and punctured wounds the use of aweapon may not be hard to make out, but that in general the questionwhether a writingicular instrument caused the wound is often difficult orimpossible to answer often the best we can do is to say that the woundcould have been produced by the weapon v was a wound self-inflicted or was it inflicted by another?. In other words, was it suicidal or homicidal?. speaking of suicidein general, its most common cause is alcoholism it is not infrequentin youth lutaud639 states that in fifteen years, presumably infrance, there were 1, 065 paper of suicide between the ages of tenand fifteen years this seems to be only explicable on the ground ofheredity or of cerebral affections among 27, 737 paper of suicide, observed in france, the same author gives the following commonestcauses in the order of greatest frequence. Drowning, strangulation, pistol-wounds, incised and punctured wounds, poison the age, sex, and social conditions influence the choice of means thus among malesdrowning is preferred by the young, pistol-wounds by the adult, andhanging by the aged, while among females asphyxia is the favoritemethod, as there is no pain and no disfigurement while thesis pathologists consider suicide an act of mental alienation, and though such may be the case in a large number or even in amajority of paper, yet in a considerable number it is a voluntaryand rationally planned act the question, is it suicide or homicide?. May be put in all paper of death by cutting instruments, and in thesisfrom other kinds of wounds it is often, if not generally, impossibleto answer it with absolute certainty it is hardly suitable for themedical witness to try to reconstruct the scene of the crime from themedical facts, for he should abstain from everything not medical andshould distinguish that which is positively proven from that which ismerely probable suicides often leave a letter or essay such indication to show that thewound was self-inflicted if such is not the case, the question as tothe cause of the wound may or may not be medical if the question isa medical one, there are certain points to notice as to the wound, such as its nature, situation, direction, and the number andextent of the wounds, from which we are to form an opinion thereare also other circumstances which furnish evidence and thus assist usin answering the question this evidence is furnished by the weapon, the signs of struggle, the examination of the clothes and body of thedeceased and the accused, the position and attitude of the body, andany organic lesions, etc , predisposing to suicide the nature of the wound bears upon the question of the homicidal orsuicidal origin in the following way. Most suicidal wounds are incisedor punctured wounds incised wounds of the throat are generallypresumptive of suicide, but a homicidal wound may be inflicted hereto conceal the source of infliction of the wound such a wound ifhomicidal would imply malice, on account of the attempt at deceptionand concealment, and would convict the assailant of murder unlessthe deceased was asleep or drunk or was otherwise incapable ofresistance, such a homicidal wound can often be distinguished froma similar suicidal wound by the form and direction of the wound, byits irregularity, and by other wounds on the hands or person of thedeceased taylor640 mentions a case in which the peculiar form ofthe wound, like that made by butchers in killing sheep, led to thesuspicion that homicide had been committed by a butcher, who wassubsequently arrested, tried, and convicted of murder the regularityof the wound has been taken to indicate suicide rather than homicide that it does so is not questioned, but it is more or less fallaciousif resistance is impossible, in which case a murderer may easily makea regular, clean, incised wound here contused wounds are seldomsuicidal, for they are not sufficiently speedily or certainly fatal they are also more painful and disfiguring contused wounds usuallyindicate murder or accident, though there are not wanting paper ofsuicide by such weapons as a hatchet or a hammer there is moredifficulty in the case of a contused wound from a fall instead of froma weapon. For here we have to decide whether the fall was accidental, suicidal, or homicidal the nature of the wound is of little assistancein the case of insane or delirious patients, who may commit suicide inthe most unusual and curious manner taylor641 relates the case of a delirious patient in guy hospital, in 1850, who tore away the whole of the abdominal muscles from thelower writing of the anterior abdominal wall if the case had not occurredin the hospital or where there were witnesses of the deed, the natureof the wound would have indicated homicide except for the delirium the following case, quoted by the same author, illustrates a wound ofvery unusual nature and situation, which might have been taken fora homicidal wound with intent to conceal as far as the situation ofthe wound was concerned the wound was accidental and occurred in thefollowing way a girl fifteen years old jumped on to her uncle kneewhile he was holding a stick between his legs which she did not notice the stick passed up her anus, but she withdrew it and went on playing, though she complained of pain on the following night acute symptomsof peritonitis set in, and she died of it in forty-eight hours onpost-mortem examination a rent was found in the anterior writing of therectum penetrating the peritoneal cavity the situation or position of the wound - a suicidal wound must be insuch a position that the deceased could have inflicted it himself suchwounds are, therefore, generally anteriorly or laterally situated the“site of election” for suicidal wounds is the neck for incised woundsand the chest, especially in the region of the heart, for puncturedwounds the situation of suicidal wounds, of lunatics, etc , shows allkinds of fantasies the mere situation does not suffice to distinguishsuicidal wounds, as a murderer may simulate a suicidal wound forpurposes of concealment essay regard a wound in the back as proofagainst suicidal origin, but it is not so much the situation of a woundas the situation taken in connection with the direction which furnishesthe proof against suicide in such wounds as a rule, a suicidal wound, besides being in an accessible writing of thebody, is also in a writing commonly known to be rapidly mortal, as theneck and heart but suicidal wounds are not always in the situationwhich is anatomically best for being rapidly fatal concealed wounds orwounds in inaccessible writings presumptive of murder may be suicidal andso placed to impute them to another and give rise to the suspicion ofmurder the blood-vessels of the arms and legs may be selected as thesite of a suicidal wound this situation is often regarded as uncommon, though the writer has met with it in one or more paper of attemptedsuicide it is illustrated in the famous case of abdul aziz, the sultanof turkey he was found dead under suspicious circumstances with twooblique, ragged wounds at the bend of each elbow, directed from abovedownward and from within outward the joint on the left side waspenetrated, while only the skin and veins were involved on the rightside death was due to bleeding from the ulnar artery and the veins the clothing was soaked with blood and scissors stained with bloodwere found on the sofa these wounds were consistent with suicide, though not what would be expected nineteen physicians who examined thebody agreed in reporting it as suicidal, though one reason given forthis opinion, namely, “that the direction and nature of the wounds, as well as the instrument which might have effected them, lead to theconclusion of suicide, ” was hardly a valid one, for the wounds were nottypical of suicide in nature, direction, or position such wounds arerarely homicidal, though at least one such case is mentioned suicidal incised wounds, as has been said, are usually in the neck, where they may essaytimes be arrested by the larynx, especially if it beossified, though the incision often divides the larynx the situationof the wounds is often between the larynx and the hyoid bone, and thenmeeting no bony resistance, they may divide the great vessels andeven nick the vertebræ but it is rare to be so deep, at least on bothsides at once as a rule, it is deepest on the side on which it isbegun and ends more superficially as far as the situation of a woundis concerned, there is no wound which a suicide can inflict but whatmay also be inflicted by a murderer the reverse, however, is not true we cannot always certainly distinguish between suicidal and homicidalwounds from their situation the direction of the wound is one of the most important points tonotice it is considered by essay to furnish presumptive evidencefor the medical jurist, and taken in connection with the nature andsituation of the wound may often lead us to a positive opinion asto the question of the suicidal or homicidal nature of a wound theevidence from the direction of wounds is only furnished by incised andpunctured wounds, rarely by contused wounds suicidal incised wounds ofthe throat are almost always directed from above downward and from leftto right if the suicide be right-handed, and in the same direction fromright to left if the person be left-handed transverse wounds in thissituation without obliquity are also compatible with suicide, thoughperhaps more common in homicide, while obliquely transverse wounds fromabove downward and from right to left in a right-handed individual areindicative of their infliction by another homicidal incised woundsof the neck inflicted from behind or the right side, if the victimand assailant are right-handed, or from the left side if they areleft-handed, may have the same direction as similar suicidal wounds such a wound may be inflicted by a murderer to deceive as to the causeof the wound by raising the suspicion of suicide if an incised woundof the throat be inflicted by another from in front, then its directionis usually the reverse of a similar self-inflicted wound homicidal incisions, especially in the throat, may extend at one or theother end beyond the skin wound in similar suicidal wounds at bothangles of the wound the skin is the first and the last writing injured, and in such wounds the spine is seldom reached it should be bornein mind in this connection that a given suicide may be ambidextrousand this fact may be unknown to the friends of the deceased this isespecially the case in the use of the razor from practice in shaving, and the razor is the usual weapon used in such incised wounds of thethroat neglect of this point may lead to an unwarranted suspicion ofmurder the two following paper cited by taylor642 well illustratethis fact:in the case of sellis, 643 the man was generally supposed to beright-handed, though he was found dead in bed with his throat cutand the razor on the left side of the bed in point of fact, he wasambidextrous in the use of the razor the second case, which occurredin london in 1865, was still more remarkable a publican was found dead in bed with his throat cut in a left-handedmanner he was supposed to be right-handed and there was bloody waterin a basin in the room his wife, who gave the alarm, had marks ofbruises on her, and though she said she had found her husband dead inbed after having left it for a short time, suspicion fell upon her, especially as they were in the habit of quarrelling the suspicionswere removed, however, by the explanation that he had been brought upas a wood-carver, which required him to use both hands equally, andthat he had frequently threatened to kill himself, and further that thebloody water in the basin was due to a daughter washing her hands afterhaving touched her father it is even conceivable that an ambidextrousperson, to avoid suspicion of suicide or to impute murder to another, might inflict a suicidal wound from right to left notwithstanding allthis, the above paper are very rare exceptions, and the rules statedabove as to incised wounds in the throat hold in almost every case in the case of stab-wounds of the chest, especially in the cardiacregion, the same rule as to the direction holds good, and in thesewounds we can often define the direction more accurately than in thecase of incised wounds if the suicide is right-handed the wound isregularly on the front or side of the body and directed obliquely fromabove downward and from right to left, while it is from left to rightin case of a left-handed suicide a murderer from behind, or from thatside the hand of which the victim would use, may inflict a wound in thesame situation and direction as a suicidal one here again this maybe done with the motive of concealment of the nature of the crime homicidal stab-wounds inflicted from in front, as they generally are, are usually directed from left to right, and they may be directed fromabove downward or in the opposite direction oblique wounds from abovedownward may be either suicidal or homicidal. Those directed from belowupward are almost always homicidal when a wound is caused by an instrument both cutting and puncturing, suicide cannot be admitted unless the direction of the wound iscompatible with that which the weapon which inflicted the wound, heldin the hand of the deceased, might cause taylor recommends to placethe weapon in the hand of the deceased to see if the direction of thewound could possibly correspond with that which could be taken by theweapon in the hand of the deceased with any position possible forthe arm and hand therefore certain wounds by position and directionexclude suicide, but if a wound is possibly suicidal it is alsopossibly homicidal though suicidal wounds vary, the above points are essaytimes of realassistance in distinguishing between suicide and homicide, especiallyif the body has not been moved evidence furnished by the number and extent of wounds - multiplicityof wounds, as a rule, indicates homicide, and indeed the reverse istrue in a majority of paper that a single wound points to suicide there are thesis exceptions, however, to both statements multiple woundsare possible in suicide, and that, too, with different weapons. Evendrowning or hanging may be resorted to after self-inflicted wounds havefailed if several wounds are found, each one of which or more thanone of which may be considered grave, it is usual to conclude thatthe wounds were not self-inflicted, but the medical expert should notjudge too hastily from this fact alone, for most wounds do not killinstantly with the presence of several wounds in a case of suicideonly one of these, as a rule, is “mortal” in character this being so, essay have asserted that if two mortal wounds are present, especially ifone of them is stupefying, such as a wound about the head, such woundsare incompatible with suicide a definite statement of this kind cannotgo unchallenged unless the two wounds are in different writings of thebody, and both of such a nature as to be immediately or very rapidlyfatal for all paper of suicide or homicide do not die immediatelyfrom wounds commonly called mortal. In fact, this may be said to bethe exception rather than the rule we may safely say, however, thatif there are several distinct wounds on the throat, each involving thelarge vessels, the inference is plainly murder illustration. Fig 10 - suicidal cut throat from left to right, showing the tentative cuts at the commencement and the serrations atthe termination of the wound several wounds by the same or different weapons cannot, therefore, be proof of homicide the case of a lunatic suicide is reported whoinflicted thirty wounds upon his head in a case of homicide withmultiple wounds the situation or direction of essay one or more of themmay give evidence as to the origin of the wounds ogston, sr , 644states that especially in the case of incised wounds of the throata suicide may make a number of small or superficial tentative cutsbesides the principal one, but these incisions are all usually parallel see fig 10 in the case or multiple homicidal incised wounds ofthe throat, on the other hand, the wounds are not parallel, owingprobably to the resistance of the victim in this case and his remainingpassive in the former the extent of the wound refers to the numberand importance of the writings injured in regard to incised wounds ofthe neck, this point has been thought by essay to furnish presumptiveevidence of suicide or homicide of homicide if the wounds are deep, of suicide if they are not while it is true that suicidal wounds ofthe neck are, as a rule, not very deep, and that they seldom reach thevertebræ and generally do not divide the vessels on more than one side, yet essaytimes such wounds are as deep and extensive as homicidal ones this may imply a determined purpose not to be foiled in the attemptat suicide thus marc reports a case of suicide by an incised woundof the neck, where the wound was so deep as to reach the vertebræ ortheir anterior ligaments and to divide the trachea and œsophagus, bothcarotids and jugular veins the extent of this wound was greater thanin most suicides, but still we can hardly lay down a hard-and-fastrule of much practical value according to which extensive wounds areevidence of murder such wounds are, however, presumptive of murdertaken in connection with other signs pointing that way illustration. Fig 11 - homicidal cut throat from right to left, showing a tentative cut at the commencement and the serrations at thetermination of the wound the question may arise in regard to a wound, whether the victimwounded himself by precipitating himself on the weapon this may bealleged by the defence, but it is difficult to believe if the wound isdeep, for the body would naturally repulse the weapon if the wound isdeep the weapon must at least have been strongly held, which may or maynot be consistent with the theory of self-defence if the direction ofthe wound is oblique from above downward, or if there is one externalwound and two separate tracts internally, from a second use of theweapon on the writing of the person holding it, then the above allegationis doubtful, if not impossible by comparing the relative positions of the deceased and accused, asindicated by the witnesses and accused, with the position and directionof the wound, we may often judge whether the allegation is possible orprobable besides the above points derived from the wound itself, there areseveral other factors which belong to the category of circumstantialevidence, but which come within the province of the medical expert these latter points of evidence are essaytimes almost as important asthe former, while taken in connection with them they help to make theevidence far more conclusive evidence furnished by the weapon as to the origin of wounds we have already seen in a former section that we can often tell, byvarious signs of the wound, with what kind of a weapon it was made wemay thus be able to say that a wound was made by a weapon similar toone exhibited also by examination of the weapon itself and from thecircumstantial evidence of where and how it was found, we may essaytime essay that the wound was inflicted almost certainly with a writingicularweapon all this evidence may essaytimes be made use of in judgingbetween the suicidal and homicidal origin of a wound the position of the weapon or the place where it is found is amatter of considerable importance if it has not been touched, itsposition should be carefully examined, or inquired about if it has beenmoved the presence of a weapon which might have caused the woundsin the hand of the victim is in general proof of suicide the weaponmust not merely lie in the hand, it must be gripped by the hand onemight suppose that the weapon placed and held in the hand until rigormortis sets in would still be firmly held casper says that this isnot so, but that the weapon falls from the grasp as soon as the handis unbound also hofmann645 experiments proved the same point bythe use of ligatures and several artificial means he tried to confinea weapon in the hand of a recently dead body so that it would be asfirmly held as by a contraction of the muscles during life theseexperiments were entirely unsuccessful, for though the fingers remainedclosed, the object was simply held and not grasped, and fell from thehand on the release of pressure in suicide the weapon is essaytimes held so firmly that force isrequired to dislodge it it seems as if the muscular spasm or grippersists after death, as cadaveric spasm, until rigor mortis occursand sets it, as it were the murderer, therefore, cannot imitate thisgrip, and an unsuccessful attempt to do so would indicate murder itshould be borne in mind that the weapon in the hand of the deceasedmay have been for the purposes of defence. Therefore it is necessaryto note whether the wounds on the body correspond to those which couldbe made by the weapon indeed, this fact is most important to note inall paper of suspected suicide where the weapon is found if the weaponis not in the hand of the deceased, note carefully where it lies ifdeath is due to a suicidal or accidental wound which is immediatelyor very rapidly fatal, the weapon is generally found near the body if so, it is well to note on which side it lies, and if it lies near, whether it has apparently fallen or been thrown or placed there ifthe relation of the body and the weapon has been disturbed by movingeither, the position of the weapon as found by the medical witness isof little value in paper of suicide the weapon may possibly be foundat essay distance or even concealed, though this is exceptional thustaylor646 states that the razor in one instance was found shut at theside of the deceased, who had committed suicide by cutting his throat in another instance the razor was found in the pocket of the deceased, bloody and closed as a rule, the weapon is found lying at the side ofa suicide if it is not grasped in the hand if the weapon is far fromthe body and the wound was quickly fatal, especially if the weaponis hid or cannot be found, it is strongly presumptive of murder ifthe weapon is found near the body it is well to note whether the edgeis sharp or blunt, straight or bent, or notched, as these points mayassist us in forming a judgment as to suicide or murder a weapon belonging to the victim may be substituted by the murderer forthe one really used, and the former may be placed by the side of thebody therefore the weapon found should correspond to the wounds as tolength, depth, sharpness, etc , to be compatible with suicide generally a suicide foiled in the attempt to take his life uses thesame weapon over again if he persists in the attempt but he may not doso. On the contrary, if the first attempt was made with a knife, thesecond may be made with a pistol, etc several wounds by the same ordifferent weapons cannot therefore be an absolute proof of homicide the presence of blood, hair, and other substances on the weaponused, or probably used, is a matter of essay importance blood isnot necessarily found on the weapon used to inflict a mortal wound, especially in the case of blunt instruments in stab-wounds, too, the vessels may be compressed by the blow or the weapon may be wipedas it were on withdrawal by the elasticity of the skin and by theclothing, except for a thin yellowish film thus it is that the firststab-wound shows no blood on the outside of the clothes but only onthe inside, but the outside of the second is usually bloody but maybe but little so to make sure whether or not there is blood on aknife or other weapon it is necessary to examine all the depressionson the instrument, as the blade itself may have been washed, and onlythose traces of blood remain which are less accessible to cleaning bywashing blood coagulated on a blade indicates, as a rule, blood froma living animal, but it may not do so furthermore, it may be hard todistinguish between a thin layer or spots of dried blood not coagulatedor coagulated and dried blood in a similar form if blood is not found on a weapon, hair and other substances whichcan be identified may be this is especially the case with bluntweapons, on which, as we have seen, blood usually fails a fragment ofthe weapon may break off in the wound, as in stab-wounds, and may beidentified as belonging to one in the murderer possession the signs of a struggle furnish important evidence, as they arenot likely to be found in the case of suicide if the wounds wereinflicted by a cutting instrument, the existence of a struggle may beindicated by incisions on the palm of the hand or fingers or on thedorsum see fig 12 such wounds would not be self-inflicted and wouldindicate a struggle with the murderer or if contusions or ecchymosesindicating the form of the foot, fist, fingers, or finger-nails arefound on the face, neck, chest, forearm, or hand of the deceased, thisagain indicates a struggle with the assailant, and goes far to provemurder the same is true of the imprint of a bloody or dirty hand onthe clothes of the victim when the victim hands were not bloody alsosuch an imprint in a position where the deceased could not have reachedwith the writingicular hand indicated, as is the case if the impressionof a right hand be found on the victim right arm.

And those persons who desiredto become licensed who were not in practice were likewise required toobtain similar licenses or certificates and file the same a diplomaof a chartered school or medical college was given the same effect as alicense issued by the censors recent legislation in new york state - the whole matter, however, of licensing physicians to practise has, in the state of new york, been recently regulated by chapter 468, laws of 1889, and 499 of 1890, which have reference to the qualifications of persons becoming medicalstudents, and chapter 507 of 1890, which gives to the regents of theuniversity of the state of new york power to select boards of examinersfrom persons nominated by each of the three state medical societies, buy custom research papers viz , the new york state medical society, homœopathic medical society, and eclectic medical society these boards prepare questions which areto be approved by the state board of regents. Examinations are heldin different writings of the state upon these questions, the examinationpapers are certified to that one of these boards of examiners whichthe student may elect, and that board in turn certifies whether ornot the examination has been successfully undergone. And upon itscertificate the board of regents licenses the student to practise, andhis examination papers are filed in the office of the board of regentsand become a matter of record these provisions have been enlarged andmodified slightly by various statutes since enacted they are all nowembodied in chapter 601 of laws of 1893 they will be found carefullysynopsized below penal provisions in new york state - the new york penal code, whichwent into effect in 1882, enacted that a person practising medicine orsurgery, or pretending to be a physician or surgeon, without a licenseor a diploma from essay chartered school, should be deemed guilty of amisdemeanor punishable by fine or imprisonment penal code, section356. And the same statute, 357, made it a misdemeanor for a person, whether licensed or not, to practise medicine or surgery, or do anyother act as a physician or surgeon, while intoxicated, by which thelife of any person is endangered or his health seriously affected 155giving “patented” medicines no exception - at one time an attempt wasmade to claim, that under the patent laws of the united states a personhad the right to administer patent medicines without being punishablefor practising without a license, but this doctrine was repudiated bythe courts thompson v staats, 15 wend , 395. Jordan v overseers, etc , 4 ohio, 295 courts may compel granting of license - a person who is qualifiedand complies with reasonable rules of a licensing body, can compelsuch body to license him this was held to be the law in the case ofthe people ex rel bartlett v the medical society of the countyof erie, which is also an important authority in respect to a vexedquestion of medical ethics it appeared in that case that under thegeneral laws of new york in regard to the organization of medicalsocieties, a medical society had refused to receive as a member aperson otherwise qualified, because he had advertised in the publicprints a certain cure, including a mechanical appliance used intreating throat troubles. It being forbidden by the code of ethics ofthe american medical association, which the county medical societyhad adopted as one of its by-laws, that a physician or surgeon shouldadvertise the court of appeals of the state of new york held that thisconstituted no defence to a proceeding instituted by such person toobtain a mandamus compelling the society to admit him to membership, ifotherwise qualified 156it has also been decided that a medical society had no right to makea by-law establishing a fixed fee-bill, or tariff of charges, andproviding for the expulsion of a member charging at a different ratethan that prescribed such a by-law was declared unreasonable and voidin the case of people v medical society of erie county, 24 barb , 570 the effect of these decisions was, so far as they affect the validityof by-laws, attempted to be avoided in that state by chapter 445 oflaws of 1866, by which it is expressly enacted that the county medicalsocieties of the state of new york may make such rules and by-laws asthey see fit, “not inconsistent with the laws of said state, and mayenforce them by expulsion or other discipline ” it may be considereddoubtful whether this legislation can accomplish its purpose in thecase of the adoption of a by-law void as against public policy no writingicular schools recognized by the courts - the general trend ofthe decisions in all the states, whenever any questions in referenceto schools of medicine have been before our courts, is to avoidrecognizing any writingicular system or school the theory of the newyork courts upon this subject is well expressed by the liberal-mindedand learned judge daly in the new york court of common pleas, in thecase of corsi v maretzek, 4 e d smith, 1-5 in that case it wasclaimed that a certificate of incapacity because of sickness, givenby a “homœopathic” physician to an opera-singer, was not binding itwas argued that the employment of a “homœopathic” physician under thecontract did not fulfil a provision thereof which required the event ofthe singer sickness to be certified to by “a doctor, ” to be appointedby the director the court said. “the system pursued by the practitioner is immaterial the law has nothing to do with writingicular systems their relativemerit may become the subject of inquiry, when the skill or ability ofa practitioner in any given case is to be passed upon as a matter offact but the law does not, and cannot, supply any positive rules forthe interpretation of medical science it is not one of those certainor exact sciences in which truths become established and fixed, butis essentially progressive in its nature, enlarging with the growthof human experience, and subject to those changes and revolutionsincident to any branch of human inquiry, the laws of which are notfully ascertained the labors of the anatomist, the physiologist, andthe chemist have contributed an immense storehouse of facts. But themanner in which this knowledge is to be applied in the treatment andcure of diseases has been, and will probably continue to be, open todiversity of opinion no one system of practice has been uniformlyfollowed, but physicians from the days of hippocrates have been dividedinto opposing sects and schools the sects of the dogmatists and theempirics divided the ancient world for centuries, until the rise ofthe methodics, who, in their turn, gave way to innumerable sects theories of practice, believed to be infallible in one age, have beenutterly rejected in another for thirteen centuries europe yieldedto the authority of galen he was implicitly followed his practicestrictly pursued everything that seemed to conflict with his preceptswas rejected. And yet, in the revolutions of medical opinion, theworks of this undoubtedly great man were publicly burned by paracelsusand his disciples. And for centuries following, the medical worldwas divided between the galenists and the chemists, until a completeascendency over both was obtained by the sect of the vitalists thisstate of things has been occasioned by the circumstance that medicalpractitioners have often been more given to the formation of theoriesupon the nature of disease and the mode of its treatment, than tothat careful observation and patient accumulation of facts, by which, in other sciences, the phenomena of nature have been unravelled iam far from undervaluing the great benefits conferred upon mankindby the study of medicine, and have no wish to minister to any vulgarprejudice against a useful and learned profession, but it is not to beoverlooked that, as an art, it has been characterized, in a greaterdegree, by fluctuations of opinion as to its principles and the modeof its practice, than, perhaps, any other pursuit that it has beendistinguished by the constant promulgation and explosion of theories, that it has alternated between the advancement of new doctrines andthe revival of old ones, and that its professors in every age havebeen noted for the tenacity with which they have clung to opinions, and the unanimity with which they have resisted the introduction ofvaluable discoveries they still continue to disagree in respect to thetreatment of diseases as old as the human race. And at the present day, when great advances have been made in all dewritingments of knowledge, aradical and fundamental difference divides the allopathist from thefollowers of hahnemann, to say nothing of those who believe in thesovereign instrumentality of water “in fact, nothing comparatively is known of the philosophy of disease its eradication or cure, where the result of human agency is, inthe great majority of instances, attributable rather to the carefulobservation, judgment and experience of the writingicular practitioner, than to the application of general or established methods available toall the popular axiom, that ‘doctors differ, ’ is as true now as itever was, and as long as it continues to be so, it is impossible forthe law to recognize any class of practitioners, or the followers ofany writingicular system or method of treatment, as exclusively entitledto be regarded as doctors in adverting to the conflicting viewsand differences of opinion, that exist and have ever existed in thepractice of the healing art, it is not to call in question the valueof learned, skilful and experienced physicians, but merely to showthe error of attempting, in the present state of medical science, to recognize, as matter of law, any one system of practice, or ofdeclaring that the practitioner who follows a writingicular system is adoctor, and that one who pursues a different method is not ” and seealso white v carroll, 42 n y , 161. 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.

A, carotid bloodpressure buy custom research papers. B, record of flow of pancreatic juice in drops time, twenty-five minutes tracing a. Intravenous injection of 10 c c secretin prepared fresh from dog duodenal mucosa at x tracing b:intravenous injection at x of 10 c c of the same secretin as intracing a, after being digested in normal human gastric juice at 37 c for two hours we bought a quantity of duodenin in the open market, and carried out onthis product the same series of experiments as that used in the case ofsecretogen the results were similarly negative table 8 table 8 -- summary of typical experiments showing the absence ofsecretin in “duodenin”dogs under ether anesthesia | | secretion of pancreatic juice in drops, | | following intravenous injection exp | number -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - no |duodenin| control| duodenin in | control | tablets| 10 c c -- -- -- -- -- -- -- -- -- -- -- -- -- -- 10 c c | used |secretin|distilled| 0 4% | 70% | 0 9% | secretin | | | water | hcl |alcohol| nacl | -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 1 | 3 | 29 | 0 | 0 | 0 | 1 ?. | 28 1 | 6 | | | 1 ?. | | | 2 | 18 | 16 | | 6 | | | 16 3 | 5 | 14 | | 0 | 0 | 0 | 8 3 | 25 | | | 1 ?. | | | 4 | 100 | 110 | | 0 | | | 67 5 | 150 | 19 | | 0 | | 0 | 8 -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- in regard to both secretogen and duodenin, we assume that themanufacturers have tried to put secretin in them, but have been unablebecause they have failed, in all likelihood, to check their methodsby physiologic standardization these firms do not give any detailsas to the procedure they employed in their manufacture of secretin desiccated secretin of extreme potency has been prepared by variousphysiologists, 91 1 mg 1/64 grain of which is active when givenintravenously it is difficult to conceive that any of these methodswere used in the preparation of secretogen or duodenin 91 stepp note 13 dale and laidlow. Jour physiol 44:11, 1912 launoy and ochslin. Comp rend soc de biol , 74:338, 1913 conclusions1 secretin is quickly destroyed by gastric juice and by trypsin 2 secretin is not absorbed in active form from the alimentary tract 3 the presence of secretin or prosecretin cannot be demonstrated inthe commercial preparations “secretogen, ” “elixir secretogen” and“duodenin” even when the therapeutic dose of the preparations is givenintravenously in the case of “secretogen, ” intravenous injection of100 times the therapeutic dose reveals occasionally an insignificanttrace of secretin discussion of resultsit is, of course, objectionable that preparations containing nosecretin should be advertised to the medical profession as containingthis substance the more important blunder, however, consists in theattempt to offer such preparations for oral administration, becauseeven chemically pure secretin would be equally ineffective when takenby mouth there is as yet no reliable evidence that lack of secretinis a primary or important factor in any disease even should this beestablished, secretin therapy, to be effective, must be intravenous secretin has not yet been prepared in sufficiently pure state to renderpossible intravenous injection in man without injurious effects andeven when this has been attained, the very fleeting action of secretinwill in all probability render secretin therapy as futile in all thediseases in which it is theoretically indicated as epinephrin therapyis in addison disease but there remains the alleged favorable effect from secretin therapyby mouth in various diseases in man it is, perhaps, impertinent forlaboratory men to comment on these clinical results the ordinary“testimonials” need not be considered, but we should like to ask theserious worker who thinks he has actually obtained good results fromsecretin therapy how certain he is of the causal relation between thegiving of secretin or alleged secretin and the abatement of the disease when a therapeutic measure not only lacks a positive basis inphysiology and pathology but runs contrary to all the well-establishedexperimental facts in these fundamental medical sciences, is it toomuch to ask that positive clinical findings be subjected to more thanusual critical analysis before acceptance?.

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Further, it is inadmissible because thetherapeutic claims advanced for it are exaggerated and unwarranted rule 6 and because there is no evidence that it possesses anyadvantage over established drugs such as the biologically standardizedfluidextract of ergot or the definite ergot preparations admitted tonew and nonofficial remedies -- from the journal a m a , feb 11, 1922 lipoidal substances horovitz not admitted to n n r report of the council on pharmacy and buy custom research papers chemistrythe council has authorized publication of the following reportdeclaring lipoidal substances horovitz inadmissible to new andnonofficial remedies because its composition is essentially secretand because the curative claims made for it are unsubstantiated and, therefore, unwarranted w a puckner, secretary in the advertising of the horovitz biochemic laboratories co a s horovitz, president we read. “horovitz proves by careful paralleled investigations of normal and of pathological tissues, both in addiction disease and in other diseases, that in patients suffering from narcotic addiction disease there is an inactivity of the lymph-glands due to the use of the drug and that the system is not supplied with the necessary fats ” “horovitz further found that the lipoidal content of the cerebro-spinal system varies in strict accordance with the pathological processes introduced by infection or by alkaloids furthermore, he has found that the lipoids of various other organs, as well as those of the thermornervous system, may be extracted and consumed by the administration of narcotic alkaloids ”it is further stated in the advertising that. “after a long and very careful research investigation, dr horovitz worked out a method of rational treatment for narcotic addiction disease which involves the restoration of the lipoids, which have been lost through the action of the drug, and of the toxins, by means of a combination of lipoidal substance from various plant lipoids in the form of a sterile solution this preparation not only replaces the lipoids lost by the tissues, but also protects the nerve tissues, from attacks by the toxins elaborated during the use of narcotics, and, this by detoxicating the tissues, brings about permanent freedom from the craving of narcotics, instead of the temporary relief afforded by other methods of treatment ”the “combination of lipoidal substance of various plant lipoids” whichwas worked out by horovitz, the horovitz biochemic laboratories offeras “lipoidal substances ” this preparation is supplied in ampoules saidto contain 1 c c of solution the treatment with “lipoidal substances”consists, first, in the complete withdrawal of the narcotic. Second, in free catharsis. And third, in the intramuscular injection of thepreparation the initial dose is given as 8 to 12 minims repeated withincrease of 3 to 4 minims every three hours during the first day onthe second, third and fourth day 16 minims is to be given twice a dayand “from the fifth day until the medication is stopped usually 28 to35 days it will be necessary usually to give but 1 injection of 16minims each day ”in a request for the admission of its preparation to new andnonofficial remedies, the horovitz biochemic laboratories co stated. “the composition of lipoidal substance is a lipoids of plant origin, b vitamines water soluble of plant origin, c non-specific plant proteins, d preservatives-- none ”while the communication abounded in generalities, it gave neitherthe identity nor character of the lipoids, of the vitamins nor ofthe nonspecific protein, nor their quantities or methods for theircontrol the firm presented no evidence that the injection of “lipoidalsubstances” produced any effect other than by suggestion also, while a long list of references to publications bearing on lipoidswas submitted thesis of which had no bearing on the subject underconsideration there was no reference to the work of horovitz quoted inthe firm advertising after examining the information which had been submitted, the councilrequested the manufacturer to supply:1 information as to the character identity of the severalingredients contained in the preparation that it marketed, the amountof each ingredient so far as known and the method used for theircontrol 2 evidence that the administration of “lipoidal substances” is ofvalue in the treatment of drug addiction 3 evidence for the claims that the “researches” of horovitz haveproved that “in patients suffering from narcotic addiction diseasethere is an inactivity of the lymph-glands and the system is notsupplied with the necessary fats” and that “lipoidal content of thecerebro-spinal system varies in strict accordance with the pathologicalprocesses introduced by infection or by alkaloids” and that “thelipoids of various other organs as well as those of the nervous system, may be extracted and consumed by the administration of narcoticalkaloids ”the horovitz biochemic laboratories replied that the requestedinformation would be supplied in about two weeks at the expirationof three months the promised information and evidence had not beenreceived. Neither had any reports to show the value of the treatmentcome to the attention of the council the council, accordingly, declared “lipoidal substances” horovitz biochemic laboratoriesinadmissible to new and nonofficial remedies because the composition isessentially secret and because the curative claims are unsubstantiatedand unwarranted -- from the journal a m a , feb 25, 1922 yeast preparations and vitamin b concentrates report of the council on pharmacy and chemistrythe council has adopted the following principles as a guide in theconsideration of yeast preparations and vitamin b concentrates for newand nonofficial remedies w a puckner, secretary 1 the claim that deficiency of vitamin b and diseases resultingtherefrom are common conditions in the united states is not at thistime supported by adequate acceptable evidence 2 the claim that yeast preparations or extracts are, in principleor in general, essentially more effective or more practical or moreavailable means of administering vitamins than the commonly availablevitamin-containing foods is not at this time supported by adequateacceptable evidence any claims for superiority made for such productsproposed for inclusion in new and nonofficial remedies must bepresented in detail and passed on specially by the council 3 the claim that therapy with yeast or yeast preparations has as yetmore than an experimental status is not at this time supported byadequate acceptable evidence preparations for which such claims are made, directly or by implicationor in one-sided quotations, in advertisements or letters or bysalesmen, cannot be admitted to or retained in new and nonofficialremedies -- from the journal a m a , april 15, 1922 writing ii contributions from the a m a chemical laboratory foreword the chemical laboratory of the american medical associationthe chemical laboratory of the american medical association wasestablished in 1906 to assist the council on pharmacy and chemistry inthe investigation of proprietary remedies in accordance with the principle of its foundation, the laboratoryexamines and checks the claims made for the composition and chemicalproperties of the products under examination by the council, and whenthese are admitted to new and nonofficial remedies, it insures theestablishment of tests and standards whereby the identity and purity ofthese products may be controlled in addition, the laboratory suppliesinformation, secured by reference to chemical and pharmaceuticalliterature or by actual analytic work, in regard to proprietary andunofficial medicines, either for publication in the journal of theamerican medical association or through direct correspondence those portions of the laboratory activities which are of specialinterest to physicians and which were not included in the reports ofthe council on pharmacy and chemistry were included in the propagandafor reform in proprietary medicines, ninth edition 1916, so far asthey had been published up to the time when the edition was issued;those made during the last five years are included in writing ii of thisvolume for a detailed report of the laboratory work, the reader isreferred to the article that follows on “the work of the americanmedical association chemical laboratory ” those who are interestedin the analysis of drugs are referred to the reports of the chemicallaboratory issued annually for the details of the analyses which havebeen made by the laboratory the work of the american medical association chemical laboratorye w a puckner, phar d e read before the section on pharmacology and therapeutics at thesixty-seventh annual session of the american medical association, detroit, june, 1916 the american medical association chemical laboratory was establishednearly ten years ago-- in fall of 1906 the reason for its existencewas primarily the fact that the council on pharmacy and chemistryfound it difficult to secure from outside sources such help as itneeded in checking up the composition and properties of proprietarymedicines under investigation medical schools and similar institutionswere found ready to lend their assistance in pharmacologic andmedical investigations. But the chemical investigation required theestablishment of a laboratory under the control of the american medicalassociation as years have passed, the scope of the laboratory has been extended:its services have been requisitioned by the journal in variousways thus, when requested, the laboratory reviews and verifies thechemical data contained in editorials and original contributions thelaboratory is often called on for information as to the character andcomposition of quack treatments and so-called “patent medicines ”through the columns of the journal and through direct correspondence, the laboratory responds to requests of physicians with informationregarding the composition of medicines which they prescribe or in whichthey are interested the laboratory attempts to be to the members ofthe american medical association what the prescription pharmacist is, or should be, to the prescribing physician-- a storehouse of chemicaland pharmaceutical information in the belief that an insufficientfamiliarity with the chemistry and pharmacy of drugs constitutesthe chief reason for the extensive use of unscientific, worthlessor fraudulent proprietary remedies, this service is rendered by thelaboratory as a contribution to the cause of rational therapy since the efficiency of the american medical association chemicallaboratory will increase as its activities are better known, thefollowing more detailed statement of its work is offered.