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That in regard to therelative position of the victim and assailant is even less positive we presuppose in this question that the case is one of murder we arenot to prove murder or refute suicide we can rarely be positive asto the relative position of the assailed and the assailant a woundin the back may be caused by essay one in front with an arm behind the direction of the wound would indicate this, for if the assailantis right-handed and inflicts a wound on the back from in front, astab-wound would almost always be directed from left to right, anincised wound from right to left, both from above downward with aleft-handed murderer the direction would most likely be from right toleft and from above downward for a stab-wound, and from left to rightand from above downward for an incised wound if the assailant were atthe back of the victim and wounded him in front, the direction of thesewounds would be the opposite of the above, i e , from right to leftfor a stab-wound and from left to right and from above downward foran incised wound with a right-handed assailant and vice versa witha left-handed assailant these wounds occur more commonly than thoseof the back, and are especially noticeable in incised wounds of thethroat in the case of these incised wounds of the throat inflictedfrom behind, the direction from left to right and from above downwardresembles that of self-inflicted wounds in the same situation asa general rule, wounds are on the same side of the victim that theassailant was. The facts given above help to show us the exceptions thus a wound on one side is presumptive that the murderer was on thatside, or possibly at the front or back and only exceptionally on theopposite side the presence of wounds on one side only may help toconfirm the testimony of a witness that the victim was against a wallor essay other obstacle which protected the other side the question ofthe relative position of the combatants in duels and the nature of theweapons used as shown by the wounds has essaytimes come up, especiallyin other countries, to determine whether the combat was regular andfair in all paper of suspected suicide, but where a doubt exists betweensuicide and murder, or even accident, hereditary disposition andorganic affections of the body, such as alcoholism, incurable orpainful diseases, chronic inflammation of the brain and meninges or ofthe genito-urinary organs all such and hereditary predisposition maysupport the idea of suicide imputed or self-inflicted wounds closely allied with the question of the suicidal or homicidal originof wounds is the question whether a wound imputed to another isself-inflicted or inflicted by another these wounds are seldom fatal in discussing the question whether a wound is self-inflicted orinflicted by another, we have referred occasionally to suicidal woundswhere the circumstances were such as apparently purposely to implymurder and impute the cause of death to essay one else this happensmore often in paper of unsuccessful suicide here we have recourse tothe same evidence that we have gone over in the present section whichhelps to distinguish between a suicidal and a homicidal wound thecase may be essaywhat more difficult, as the unsuccessful suicide maymanufacture evidence against the accused and hide to essay extent theevidence of suicide these paper can usually be decided, however, inconnection with the circumstantial and other evidence the majorityof paper of imputed but self-inflicted wounds are very superficial, often not below the true skin being self-inflicted they have thesisof the characters of suicidal wounds thus they are usually situatedin front and on the left or right according as the wounded person isright or left handed, and the direction is usually similar to that insuicidal wounds such wounds are generally incised or punctured wounds, seldom contused wounds, and in this respect they resemble suicidalwounds as exceptions to this rule, bergeret650 mentions essay paperwhere females in attacks of hysteria have inflicted severe contusionson themselves, and have preferred charges of attempted murder againstinnocent persons like suicides also the hands are seldom injured, though they may be much so in resisting homicide in other respects, however, these wounds differ from suicidal wounds thus they are not usually situated over a “mortal” spot, and they areoften numerous and scattered, essaytimes parallel and essaytimes not the wounds in the dress do not correspond even as often as in suicide in comparing cuts in clothing with those on the body, it is importantto find what articles were worn at the time the assault was alleged tohave taken place, and to make sure that the clothes examined were thoseworn or alleged to have been worn it may not be necessary that theclothes examined should have been really worn, for if they were allegedto have been worn and were not, the examination of them will almostalways show the deception or the self-inflicted nature of the wounds then take careful note of the position, direction, form, and sizeof the cut and the apparent sharpness of the weapon in the severallayers, and see if they correspond with one another and with the woundson the body in those various writingiculars in imputed wounds the clothesare generally cut when off the body and can seldom be done so as todeceive a careful examiner several wounds cannot exist in the sameregion of the body without essay being bloody and showing the marks ofit on the clothes even a single wound of the clothes generally showsblood on the inner surface if there is a corresponding wound of thebody underneath in simulated and imputed injuries the blood-stain maybe on the outside of the clothing instead of on the inside, showingthat it was artificial and not natural an impostor may either do toomuch or too little, and the medical witness should be on guard againstboth alternatives taylor651 mentions a case which occurred inlondon essay time ago, in which there were two cuts in the shirt neartogether exactly alike in size, form, and direction, making it evidentthat the weapon had gone through a fold of the shirt this proved thatthe shirt could not have been worn at the time it was cut, for if theshirt was folded while on the body the weapon must have gone throughthe fold and then through another layer of shirt, making three cutsinstead of two, or five instead of four, before it could have reachedthe body this and other facts made self-infliction of the slight woundon the chest probable the same author cites another case showing theimperfect manner in which the cuts in the clothes are made in imputedwounds, the clothes being off the body at the time the case occurredin nottingham in 1872, the accused being charged with wounding theplaintiff on the highway by stabbing him in the arm, though there wasno robbery or other motive for the act the coat and shirt sleeve werefound cut, but there was no corresponding cut in the lining of the coatsleeve the charge was clearly false, and was trumped up by the youthwho was the plaintiff because he wished to leave the place where he hadbeen sent for private study in examining a case where the self-inflicted nature of imputed woundsis in question, the following are essay of the thesis points to keep inmind in the examination and to be ascertained by the examination. 1 the relative position of the plaintiff and the assailant at thetime of the alleged attack this can be compared with the positionas stated by the plaintiff or other witnesses 2 the situation, direction, depth, nature, and number of the wounds 3 the situationand direction of blood-marks or wounds on the dress or person of eitheror both 4 the marks of blood and the quantity of it at the spot ofthe alleged struggle 5 the signs of a struggle and the various otherpoints of circumstantial evidence gone over in considering suicidal andhomicidal wounds though a severe blow may cause a slight mark, it does not follow thata slight mark implies a severe injury, else the exception is made therule the inconsistency of the story of the plaintiff is generally sopalpable that imposture is evident, but prejudice and unjust suspicionare often excited against those accused thus taylor652 states that“a strong suspicion was raised against the then duke of cumberland, in1810, in reference to the death of sellis, when a skilful examinationof the wounds on the deceased would have shown that they might havebeen self-inflicted ” the same author also cites the case of m armand, a merchant of montpelier, who at aix in march, 1864, was tried for analleged murderous assault on, or imputed murderous strangulation of, his servant the excoriation on the back of the neck was so slight asto escape the observation of essay medical men, and it was evidentlyself-inflicted, either accidentally or purposely, as the facts showed the assertions of a number of medical men were taken by the court tosupport the servant story to the effect that his master had struckhim a severe blow on the back of his neck, rendering him insensible forthesis hours from concussion of the brain the evidence given chiefly bytardieu for the defence showed the story of the complainant to be afabrication, and the accused was justly acquitted was a wound accidental?. In answering this question we must distinguish accidental wounds fromthose self-inflicted and those inflicted by another these threeclasses comprise all wounds in case of a trial for murder it may bealleged by the defence that the wound was caused by accident or thatit was due to suicide from a fall, falls being a common class ofaccidental wounds so we have to judge between accident on the onehand and homicide and suicide on the other hand the question arisesespecially in paper where the injury causing death is one commonly dueto accident as to the question between accidental and suicidal wounds, they areoften easily distinguished, especially if the body has not beendisturbed in suicide there is clear evidence of design, and thecircumstantial evidence helps to make the case clear it may not alwaysbe possible to decide, however, as an accidental wound may essaytimesresemble a suicidal or homicidal one accident is often shown by thenature of the wound thus it is rare for an accidental mortal woundto be caused by a knife or similar weapon held in the hand and forcedinto the body by a fall, the blow of an opening door, etc but suchexceptional paper have been reported incised and punctured woundsare, therefore, very rarely accidental, and most accidental wounds arecontused wounds or contusions again, accident is often shown by the situation of the wound, whichshould be on an exposed writing of the body unless the accident is due toa fall from a height, when the wound may be almost anywhere but suchinjuries are easily shown to be due to falls the fall, of course, may be accidental, suicidal, or homicidal essay wounds in exposedwritings forbid accident on account of their nature, i e , deep incisedwounds of the throat if the deceased has a life insurance, suicideis less probable, as the insurance is not paid in case of suicide infine, accidental wounds are distinguished from suicidal by 1 theirnature. Accidental wounds are almost always contused, suicidal veryrarely so, only in paper of lunatics and delirious persons and wheresuicide is accomplished by a fall 2 the situation of the wound orwounds indicates their origin we have already studied the situationof suicidal wounds and have also seen that accidental wounds are onlyon exposed writings, except when the injury clearly indicates a fall froma height the evidence from the direction of wounds rarely applies, asthis is valuable only in incised and punctured wounds, which are seldomaccidental both kinds of wounds are usually few in number except incase of a fall from a height or a crush, though essaytimes suicidalwounds are multiple the evidence from weapons, if there be any, points strongly to suicide the signs of a struggle are hardly consistent with either suicide oraccident the only case in which they might occur would be where astruggle occurred to prevent a suicide from throwing himself off aheight or before a vehicle or railway train in such a case accidentwould be excluded by the signs of a struggle, and the question wouldlie between homicide and suicide the examination of the clothes ofthe deceased would furnish no evidence unless essay letter or paperwere found stating the purpose of committing suicide little or noevidence would be furnished by the position of the body when foundin paper which might otherwise be doubtful organic lesions or otherfacts predisposing to suicide would furnish presumptive evidenceagainst the wounds being accidental of all these various points thefirst, as to the nature of the wounds, is by itself the most valuableand conclusive but this gives us no assistance in clearing up a casewhere it is doubtful whether a fall from a height or a crush by avehicle or railway train was accidental or suicidal essay of the otherpoints mentioned may aid us in such a case, and also the fact that suchinjuries are far more often accidental than suicidal but in thesepaper, also, certain circumstances may show that the fall was not theresult of accident accidental wounds are generally caused by a fall or a crush, andthe fact of their accidental character is generally established bythe circumstances of the event certain accidental wounds presentcharacteristics which allow the true nature of the wounds to bedetermined but in essay paper a suspicion may arise and the questionmay be asked as to whether the wound was accidental or homicidal forinstance, if a person receives fatal homicidal injuries, and justbefore or after death the body is thrown from a height or is runover and crushed, it may be hard to determine the murderous elementamong the thesis wounds this is the case if the homicidal wounds werecontusions or were caused by blunt instruments, but rarely, if everso, if they are incised or punctured wounds or both but even in theformer instance, a close examination of the lesions and of the localityof the injury can often clear up the case thus in a case mentionedby vibert, 653 as cited by hofmann after taylor, a woman was founddead at the foot of essay stairs in a cave she had died of a fractureof the skull and of the spine, produced by the fall but about four orfive feet above the level of the top step there was found on the wallthe fresh marks of an arterial jet of blood examination showed a woundin the right temporal region which had opened the temporal artery, andit was therefore thought that the woman was wounded at the top of thestairway and then thrown down, which was afterward proved to be true in another case, reported by m tourdes, a man knocked down and killedby an axe, which crushed his skull and caused the brain to exude, wasplaced in a road frequented at night by heavy wagons the head wasplaced in the rut, but the coagulated blood and brain formed a puddlewhich did not appear on the wheels or their track, and no bloody furrowwas caused by their passage the same author mentions the case of awoman plainly strangulated by the hands and then thrown into the ditchof the fortifications of paris it is especially with regard to fractures of the skull that thequestion often comes up as to the accidental or homicidal nature ofthe injury, as to whether it is due to a fall or a wound essaytimes adepressed fracture may show the form of the instrument an extensivecomminuted fracture of the skull may indicate greater violence thanwould be received from a fall from the little height which thecircumstances may allow as to the slighter degrees of fracture, the disposition of the fracture itself often shows less than theform and site of the ecchymosis, the lesion of the scalp, and theplace and position of the body when found in such paper the tracesof a struggle, the existence of other wounds, etc , may be of greatimportance in distinguishing between homicide and accident, as indistinguishing between the latter and suicide, the most obscure anddifficult paper are those where the injury has been caused by a fallfrom a height or by a crush this is illustrated by the case of madame de tourville, which isquoted by taylor 654 she was killed in july, 1876, by a fall from aprecipice her husband, a lawyer, was accused of murder committed bypushing her over a precipice in the stelvio pass the place where herdead body was found was at a considerable depth below, and the injurywas chiefly in the head, which had been crushed by the fall the bodyshowed no evidence of intentional violence the prisoner guilt wasestablished on the following points. 1 the false and inconsistentstatements made as to the occurrence. 2 the marks of the body havingbeen dragged essay distance so that a writing of the dress was found, ina bloody condition, essay way from the body. 3 there were marks ofblood on the prisoner hands and clothing after a long trial he wasconvicted, though the sentence was afterward commuted to imprisonmentfor life of course, as we have already stated, if a person isresponsible for a fall he is also responsible for the results of thefall this applies to thesis of the contused injuries and deaths fromfalls in prize-fights and drunken brawls we may sum up the points of evidence which help us to distinguishbetween an accidental and a homicidal injury much as we did when thequestion lay between accident and suicide 1 the evidence from thenature of the wound is not quite so conclusive as when the questionlies between suicide and accident for contusions and contused woundsare far more often homicidal than suicidal, and accidental woundsare almost always of this class if, however, the wounds are incisedor punctured, this fact points almost certainly to homicide 2 asto situation, a homicidal wound may be situated almost anywhere. Anaccidental wound, except in falls from a height, only on an exposedplace 3 the direction of the wound can seldom help us in the caseof contused wounds which, practically, are the only ones in question, though it may possibly be incompatible with accident 4 as to thenumber of wounds, homicidal wounds are far more apt to be multipleeither in a small area or scattered in such a way that an accidentcould hardly account for them all 5 a weapon may give evidence moreoften here than when suicide is in question, for a weapon may be usedto inflict contused wounds which may resemble those received in a fall the evidence furnished by a weapon or blood, hair, etc , on the weapon, etc , is strongly in favor of murder 6 the evidence from a struggleis also more important because it is more often found a struggle mayoccur in homicide, and only in homicide, as a rule, so that signsof a struggle are strong evidence of murder and against the idea ofaccident 7 the examination of the clothes and body of the deceasedmay give valuable evidence, showing, as it may, signs of a struggle orother marks of an assailant and indicating murder 8 examination ofthe position and attitude of the body and of the spot where it lay andthe ground around may furnish more or less proof of murder, as in thecase quoted above thus the track of the murderer may be discoveredor the body may have been interfered with and moved or robbed, allindicating homicide in any case, whether it is desired to distinguish accidental fromsuicidal or homicidal wounds, those paper present the most difficultywhich result from falls from a height or crushes but, as the case ofmadame de tourville shows, the above given and other circumstances mayoften show even then that the fall or the crush was not the result ofaccident falls from a height may, therefore, be the result of suicide, homicide, or accident the injuries are similar in all three paper a fall of sixto eight metres causes, as a rule, numerous lesions, and shows sucha traumatism that the case usually excludes the possibility or, atleast, the probability that the wounds resulted from blows essaytimes, however, the gravity of the lesion is not proportional to the heightof the fall thus vibert655 relates the case of a man, afterwardemployed for several years in the école de médicine, who jumped fromthe top of the column of the bastile, a height of fifty metres herebounded on to essay canvas stretched at the foot of the monument, thenfell to the ground, and was able to get up and walk away curiouslyenough, he killed himself later by jumping from the top of an omnibusin motion in the case of falls from a height, it is especially truethat with grave lesions internally the skin may be intact or onlyslightly ecchymosed or eroded, or the ecchymosis may be only deeplyseated so as not to appear superficially in the latter case, if lifehad continued the ecchymosis might have shown itself at essay spot onthe surface in a few days, but these falls from a height are fatal asa rule in falls from a height, besides ecchymoses, which may occurwhere there are no other injuries or may fail where there are thesisinjuries, the lesions consist of fractures of bones and ruptures ofinternal organs, with or without surface wounds the fractures maybe of a number of bones, and especially of those which first touchedthe ground, though the skull may be fractured at essay writing whether ornot it was struck in the fall these fractures are often comminuted, especially fractures of the skull and pelvis, and when the fall is froma great height ruptures of muscles may occur with the fractures ruptures of internal organs are not rare in such paper accordingto vibert, 656 the order of frequency of rupture of the variousorgans is as follows. Liver, spleen, kidneys, lungs, heart, stomach, intestines, bladder, brain rupture of the liver occurs especially onthe anterior and inferior surfaces and the bleeding is rather abundant the healthy spleen does not rupture readily, except from a severetraumatism, but if it is hypertrophied it may rupture spontaneouslyfrom muscular violence the lung may be ruptured internally withoutshowing the rupture on the surface and with the ribs intact two suchpaper are mentioned by vibert, 657 and he refers to others mentionedby nelaton and holmes rupture of the brain without fracture of theskull is very rare, though paper have been observed and reported, among others by casper-liman in falls from a height the rupture ofthe aorta, mesentery, diaphragm, and larynx have been noted it shouldbe remembered in this connection that rupture of the liver, intestine, bladder, etc , may be caused by contusions without sign of violenceexternally, and such paper cannot, therefore, be attributed to fallsunless there are other signs of the latter in crushes caused by a heavy vehicle, the lesions resemble in thesisrespects those due to a fall from a height thus we find fractures andinternal ruptures, but we more often and regularly find subcutaneousecchymoses and ecchymoses between the muscles the skin is oftenstripped up extensively and the injuries are generally limited to theregion injured it is rare to find that the cause of the injury leavesno trace on the skin, for it usually gives the form to the erosionsor ecchymoses essaytimes, for instance, the marks of a horseshoe areclearly visible ruptures of internal organs may occur here too whenthere are slight external marks of violence or even none at all thusvibert658 relates the case of a man with the head crushed, but withno signs of injury to the trunk save a few erosions at the level ofthe sternum, who had not only rupture of the kidneys, the liver, andthe spleen, but also of the lungs and of the heart in the heart theapex was completely detached and floating in the pericardium, whichwas intact there was no fracture of the ribs nor subcutaneous orsub-muscular ecchymoses the age of the subject was thirty-two, sothat the costal cartilages were not probably ossified, which may haveaccounted for the absence of fracture of the ribs crushes by the fall of heavy weights resemble the latter class ofcrushes, and differ from falls from a height in the fact that thewounds are usually limited to one region the lesions themselves aremore or less similar similar internal lesions may be caused by thecompression of the chest and body by the knee of a murderer, which mayoccasion rupture of the internal organs, fractures of ribs, etc thus, too, from the pressure of a crowd the ribs may be fractured and thelungs injured it is writingicularly in these paper of injury from crushesor falls from a height that we may have most difficulty, as far as themedical evidence goes, of distinguishing between accident, suicide, and murder but the various points and considerations mentioned abovewill essaytimes enable the medical witness to clear up the case inessay paper the non-medical evidence, circumstantial and otherwise, maybe sufficient of itself, or at least in conjunction with the medicalevidence in falls from a less high place the difficulty is essaywhat different, for here there may arise the question between a fall and a contusion orcontused wound, and the question generally lies between accident andmurder, or, very rarely, between accident and suicide we have referredto both of these questions above, and from the facts mentioned the casecan often be solved of more than one injury which was the first inflicted?. We can essaytimes tell the order in which wounds were received, butthe question is rarely answerable with certainty if one wound ismortal and one or more are not, whether the wounds are suicidal orhomicidal, it has essaytimes been considered that the former must havebeen inflicted last but we cannot admit that as a general rule themost grave wound was the last inflicted for the murderer or suicide, especially the former, may go on wounding after the infliction of amortal wound, especially as it is the exception, and not the rule, to die instantly after a mortal wound several assailants may haveinflicted wounds at the same time, which would still further increasethe difficulty the question might then arise, which assailant hadinflicted the mortal wound or which had first inflicted a mortal wound?. Under such circumstances, it would not be easy to give a specificanswer there are several signs which may indicate which wound wasfirst inflicted in certain paper an instrument may become duller oreven bent or twisted after and on account of the first wound, and thesubsequent wounds would vary accordingly the wound of the clothescorresponding to the first stab-wound may be and often is only bloodyinternally, while the second and following wounds are bloody on bothsides the following case quoted by taylor659 from the annalesd’hygiene, 1847, p 461, illustrates this point a man received threestabs from an assailant, one in the back at the level of the eighthrib, traversing the lung and heart and causing rapid death, and two onthe left elbow, cutting the coat and shirt but only grazing the skin the first one was evidently the first inflicted, for both the wounds inthe clothing on the arm were bloody externally at the edges, althoughthere was no blood effused here the correctness of this opinion wasconfirmed at the trial the point of a knife arrested and broken off in a bone may show thatthis was the last wound the amount of bleeding may show which was thefirst wound thus if several severe wounds have been inflicted, allor several of which would naturally cause profuse hemorrhage, and oneshowed signs of such hemorrhage while another did not, the former wouldbe likely to be the first wound inflicted or if one showed slighthemorrhage where much would be expected, this fact would indicate thatit was one of the last inflicted the absence of the signs of spurtingblood may tell which of two or more fatal wounds were first inflicted, for this would indicate that this wound was inflicted when the heartaction was weakened by loss of blood or even after death, and theother wound or wounds which did not present this sign would have beenthe first received in fact, if any of the signs are present about awound which we have seen to indicate that a wound was inflicted at anytime after death, this would show that this wound was not the firstreceived, and that the other or others were inflicted earlier questions as to the consequences of wounds not fatal may often bebrought up in civil actions for damages in certain countries thequestion of the consequences as to incapacity may determine whetheran injury shall be the ground of a criminal as well as of a civilaction thus in france an injury which involves an incapacity of twentydays or more subjects the assailant to a criminal action the term“incapacity” in this instance refers to general incapacity and notto incapacity for fine and professional work the latter, however, comes in under the civil action which may be instituted against theassailant or those directly or indirectly responsible for the injury the amount of the incapacity, its causes, whether due wholly or writinglyor not at all to the given injury, the probable duration of theincapacity, the treatment which it has and will necessitate, and thesisother such questions form writing of the medical testimony required insuch paper essaytimes with slight wounds the results, accompaniments, and complications may prolong the incapacity very greatly, as also thestate of health and the habits of the wounded person, the neglect oftreatment, improper treatment, etc any bodily or mental infirmity or ill-health which may result from aninjury and its necessary treatment in the past and future, all thesequestions and thesis more unnecessary to mention may be required of themedical witness no general rules can be laid down for all such paper in giving his testimony the medical man must depend in any writingicularcase upon his knowledge, judgment, and experience we can seldom give a precise solution of the question of survivalto determine the succession or inheritance if several of a family dietogether in an accident in case of death from inanition, cold or heat, or in drowning especially, if essay have wounds more or less grave inthemselves, we can essaytimes form an opinion with wounds we cannotoften do so, although in case of murder, the nature of the wounds, theposition of the bodies, the examination of the spot of the accident ortragedy, may essaytimes help us to form an opinion incised and punctured wounds and wounds of blunt instruments regionallyconsidered the several varieties of wounds which we have been considering varyconsiderably in their nature, their effects, their danger, and inthesis other ways according to the region of the body in which they aresituated essay of these varieties are common in one situation andalmost never occur in others although the nature of wounds found inthe several regions of the body is not as important for a medicaljurist as their danger and their influence in causing death, we willnow consider the differences they exhibit on account of the region inwhich they occur wounds of the head these are often characterized by their apparent harmlessness andtheir real gravity sooner or later we might almost make the oppositestatement and say that those apparently grave are often virtuallyharmless, though this would be true only in a limited sense and incertain paper as to their nature, we find punctured wounds extremely rarely, incised and lacerated wounds often, while contusions and contusedwounds are still more common incised and lacerated wounds of thehead involve the scalp almost exclusively these wounds heal remarkablywell, even when the attachment is merely by a narrow pedicle, owingto the abundant blood-supply hemorrhage from the incised wounds isoften free, for the vessels cannot retract, but it is seldom dangerousunless the wounds are very extensive the only way in which they differmaterially from similar wounds elsewhere is in the greater frequencyof complicating erysipelas here than elsewhere this is probablyowing to the presence of septic conditions, as the head is generallydirtier than other writings of the body, and slight wounds especiallyare neglected if the scalp is shaved over a wide margin and cleanedlike other writings of the body, erysipelas is found little or nooftener than with similar wounds elsewhere the density of the scalpis so great that the redness and swelling accompanying inflammationsis comparatively slight if erysipelas follows slight wounds of thehead, there is essay reason to suspect constitutional predisposition orcareless treatment from infection of such wounds of the scalp abscessor diffuse cellulitis of the scalp may develop as well as erysipelas the constitutional symptoms in such a case may be marked or evensevere, but the prognosis is favorable in very rare paper necrosis ofthe skull may result or the inflammation may even extend to the brain these incised and lacerated wounds of the scalp are usually accidentalor inflicted by another. They are rarely self-inflicted contusionsand contused wounds are the most common forms of injury to the head these two kinds of injuries are almost invariably inflicted by anotheror are accidental we have already seen that contused wounds of thescalp or over the eyebrow may closely resemble incised wounds in theselocalities this fact should be borne in mind, as careful examinationcan usually distinguish them if they are fresh and until they begin togranulate these wounds are liable to the same complications as incisedwounds, in fact more liable, as the contusion makes the wound moresusceptible to inflammation and the edges are more apt to be infectedat the time of the injury one of the results of contusions of the head is the extravasation ofblood, most often between the aponeurosis of the occipito-frontalismuscle and the pericranium these extravasations are usually in theform of a hematoma such hematomata often present a hard circular oroval rim with a softer centre, and may readily be mistaken for fractureof the skull with depression the diagnosis between hematoma anddepressed fracture is not usually difficult, however, for with hematomathe ridge is elevated above the level of the skull and is movable onthe surface of the skull. Also the wounded edges often pit on pressure with depressed fracture, on the other hand, the edge is at or about thelevel of the rest of the skull. It is sharper, more irregular, and lessevenly circular contusions and the resulting hematoma may occasionallyend by suppurating, but this event is rare contusions and contusedwounds may occasionally show the marks of a weapon, indicating thatthey were inflicted by another also the position of the injury willindicate its origin, whether it is accidental or inflicted by another, for the former would not naturally occur on the vertex unless the fallwas from a considerable height another result of injuries to the head, especially of contusions andcontused wounds, is fracture of the skull this may be simple orcompound, depressed or not, etc fractures are serious inasmuch asthey imply a degree of violence which may do damage to the brain the fracture itself, especially if properly treated, affords a goodprognosis, irrespective of any brain lesion one variety of fracture ofthe skull offers an exception to this favorable prognosis, and that isfractures of the base of the skull these may be fatal directly frominjury of the vital centres at the base of the brain or soon fatal fromhemorrhage in these writings or the fatal result may be secondary to aninflammation or meningitis which good treatment is often unable toprevent it should not be considered that these fractures are uniformlyfatal, for quite a considerable proportion recover fracture of thebase usually occurs as the result of a fall the injured person mayland on the feet or buttocks, and yet receive a fracture of the base ofthe skull, the force of the fall being transmitted through the spine tothe base of the skull fracture of the base of the skull usually occursfrom an injury to the vault, not by contre coup, but by extensionof a fissure found higher up in the skull this extension takes placein the same meridian line of the skull with that of the force whichproduced the fracture, and in this way the base of the skull isfractured in different writings according to the point and direction ofthe application of the force thus in case the force compresses theskull antero-posteriorly the fracture will pass antero-posteriorlytoward the base from the front or the back, whichever received the blow see fig 13 fractures of the vault of the skull occasionally occuropposite to the point struck. This may occur by contre coup, but notalways so, as not infrequently in such rare paper a close examinationmay reveal an extension of a fissure from the point injured to theopposite pole of the skull the shape and rarely the size of a fractureof the skull, especially if punctured in character, may show the shapeand more rarely the size of the instrument or object which producedit awriting from fracture of the base, the prognosis in fracture of theskull is serious, mainly on account of the danger of inflammation, which is greater in compound fractures, and also on account of the moreremote danger of irritation from depressed fragments causing epilepsy, insanity, etc , at a later period illustration.

Theformer strengthen appetite after these are expelled 2 such medicines help digestion as strengthen the stomach, either byconvenient heat, or aromatic viz spicy faculty, by hidden property, or congruity of nature 3 the retentive faculty of the stomach is corrected by bindingmedicines, yet not by all binding medicines neither, for essay of themare adverse to the stomach, but by such binding medicines as areappropriated to the stomach for the use of these use 1 use not such medicines as provoke appetite before you havecleansed the stomach of what hinders it use 2 such medicines as help digestion, give them a good time beforemeat that so they may pass to the bottom of the stomach, for thedigestive faculty lies there, before the food come into it use 3 such as strengthen the retentive faculty, give them college essay help at san diego a littlebefore meat, if to stay fluxes, a little after meat, if to stayvomiting chapter v of medicines appropriated to the liver be pleased to take these under the name of hepatics, for that is theusual name physicians give them, and these also are of three sorts 1 essay the liver is delighted in 2 others strengthen it 3 others help its vices the palate is the seat of taste, and its office is to judge what foodis agreeable to the stomach, and what not, by that is both the qualityand quantity of food for the stomach discerned. The very same officethe meseraik veins perform to the liver essaytimes such food pleases the palate which the liver likes not butnot often and therefore the meseraik veins refuse it, and that isthe reason essay few men fancy such food as makes them sick after theeating thereof 1 the liver is delighted exceedingly with sweet things, draws themgreedily, and digests them as swiftly, and that is the reason honey isso soon turned into choler 2 such medicines strengthen the liver, as being appropriated to itvery gently bind, for seeing the office of the liver is to concoct, it needs essay adstriction, that so both the heat and the humour to beconcocted may be stayed, that so the one slip not away, nor the otherbe scattered yet do not hepatical medicines require so great a binding faculty asstomachicals do, because the passages of the stomach are more openthan those of the liver by which it either takes in chyle, or sendsout blood to the rest of the body, therefore medicines that are verybinding are hurtful to the liver, and either cause obstructions, orhinder the distribution of the blood, or both and thus much for the liver, the office of which is to concoct chyle, which is a white substance the stomach digests the food into intoblood, and distributes it, by the veins, to every writing of the body, whereby the body is nourished, and decaying flesh restored chapter vi of medicines appropriated to the spleen in the breeding of blood, are three excrements most conspicuous, viz urine, choler, and melancholy the proper seat of choler is in the gall the urine passeth down to the reins or kidneys, which is all one the spleen takes the thickest or melancholy blood to itself this excrement of blood is twofold. For either by excessive heat, itis addust, and this is that the latins call atra bilis.

Affections of the bladder and of the sexual organs 41 venesection here acts upon the proper condition of the body in general 42 diseases of the kidney, bladder, stone, testicles 43 venesection here strengthens the gait 44 all kinds of pains of the lower college essay help at san diego extremities, such as arthritis, gout. Also in dysmenorrhea 45 affections of the sexual organs. Diseases of the kidney and bladder 46 diseases of the testicles 47 disturbances of menstruation. Sterility of women. Affections of the bladder and spleen 48 various kinds of diseases of the feet 49 dysmenorrhea. Eruptions in the face and on the legs 50 apoplexy. Paralysis 51 ophthalmia. Skin diseases. Cough. Oppression of the chest 52 dysmenorrhea. Affections of the testicles. Costal pains 53 ophthalmia. Dysmenorrhea. Amenorrhea.

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But it is very bad in diseases of the liver, spleen, the falling-sickness, vertigo, or dissiness in the head, feversand head-aches college essay help at san diego. Goat milk is held to be better than cow for hecticfevers, phthisick, and consumptions, and so is ass also whey, attenuates and cleanses both choler and melancholy:wonderfully helps melancholy and madness coming of it. Opens stoppingsof the bowels. Helps such as have the dropsy and are troubled with thestoppings of the spleen, rickets and hypochondriac melancholy. For suchdiseases you may make up your physic with whey outwardly it cleansesthe skin of such deformities as come through choler or melancholy, asscabs, itch, morphew, leprosies, &c honey is of a gallant cleansing quality, exceeding profitable in allinward ulcers in what writing of the body soever. It opens the veins, cleanses the reins and bladder i know no vices belonging to it, butonly it is soon converted into choler wax, softens, heats, and meanly fills sores with flesh, it suffersnot the milk to curdle in women breasts. Inwardly it is given tengrains at a time against bloody-fluxes raw-silk, heats and dries, cheers the heart, drives away sadness, comforts all the spirits, both natural, vital and animal belonging to the sea sperma cœti, is well applied outwardly to eating ulcers, the markswhich the small pox leaves behind them. It clears the sight, provokessweat. Inwardly it troubles the stomach and belly, helps bruises, and stretching of the nerves, and therefore is good for women newlydelivered amber-grease, heats and dries, strengthens the brain and nervesexceedingly, if the infirmity of them come of cold, resists pestilence sea-sand, a man that hath the dropsy, being set up to the middle init, it draws out all the water red coral, is cold, dry and binding, stops the immoderate flowing ofthe menses, bloody-fluxes, the running of the reins, and the fluoralbus, helps such as spit blood, it is an approved remedy for thefalling sickness also if ten grains of red coral be given to a childin a little breast-milk so soon as it is born, before it take any otherfood, it will never have the falling-sickness, nor convulsions thecommon dose is from ten grains to thirty pearls, are a wonderful strengthener to the heart, encrease milkin nurses, and amend it being naught, they restore such as are inconsumptions.