History

Custom Speech Writing


The jaw returns toits infantile shape from loss of teeth and atrophy of custom speech writing the alveolarprocesses. The bodies of the vertebræ according to essay authoritiesbevel off in front. Osteophytes are formed, and the neck of the femurapproaches the horizontal see abortion and infanticide determination of sex in the matter of sex there should be no difficulty, after noting theproof furnished by the aggregate characteristics of both male andfemale skeletons the points of contrast between the two skeletonsare not so striking before the age of puberty generally speaking thecranial capacity of an adult woman is less, although it is contendedthat since the great majority of males of the human species are taller, heavier, and larger than the females, it follows that if due allowancebe made for these variations, it will appear that the brain capacityof woman is relatively very little, if at all, inferior to that ofman the mastoid processes of the female skull are smaller. The lowerjaw-bone is relatively smaller and lighter.

For it must have beenobvious to even the most stupid observer that his well-being dependedto a great extent upon the action of the sun from this perceptionto the idea that other heavenly bodies were also intended to exert adecisive influence upon things terrestrial was only a short step forthe ancient civilized peoples. For here the conclusion from analogy wasactually so closely and so enticingly under every one nose that allhe had to do was but to pitch upon the powers which rule all earthlylife and neatly box them up in a well-constructed system but as theconclusion from analogy was always considered in the ancient worldas the most certain, never-failing path to knowledge, it was readilyfollowed in this connection also and thus astrology, like the greaterwriting of medico-physical knowledge, was based, we think, upon thetreacherous ground of a conclusion per analogiam besides, our opinion that the warming and vitalizing power of the sunformed one of the most important factors in the origin of astrologyis confirmed by the utterances of astrologists themselves thus, forinstance, ptolemy points to the sun and moon as the sources of life tomankind, and hermes and almansor repeat the dictum this is furthermoreproved by the unparalleled popularity which astrology has enjoyed inall phases of civilization there is no civilized people, eitherof ancient or of modern times, which has not adhered to astrologicdoctrines with the fullest confidence and most unswerving faith babylonians, egyptians, greeks, romans, germans, romanians in short, all nations have professed their belief in astrology such a conformityof opinion would, however, be inexplicable amid such a dissimilarity ofreligious and cultural ideas as characterized the different peoples, unless a common principle had decisively influenced all nations in thesame manner this principle was acknowledged in the influence of thesun every human being was bound to observe the animating power of thesun on his own bodily sense and from his own observation, and would beat once led to the conclusion that a similar power resided also in theother celestial bodies this conception, which to a great extent was brought about byconclusions from analogy, provided a method of inference concerningvarious other phenomena man meditated, speculated, concluded, untilthe required sidereal relation of each organ and each function of thehuman body was determined thus astrology may serve as one of themost telling examples of scientific delusions to which the ancientdiagnostico-theoretical methods were bound to lead, with theirconclusions from analogy and their deductive modes of procedure the above survey indicates, altho only in very general outlines, the origin of astrology we shall now consider more in detail theacquisition for which the art of medicine is especially indebted toastrology babylonico-assyrian civilization possessed in its earliest ages awell-developed system of astrologic medicine, as is evident fromwritings bequeathed to us from antiquity campbell-thompson hasrecently published, from the great stock of cuneiform tablets in thecollection of the british museum, 276 inscriptions of an astrologicalnature belonging to the so-called kouyunjik collection sudhoff hascompiled them, so far as they refer to medicine, and has subjected themto critical analysis we take the liberty of repeating certain extractsfrom these cuneiform tablets, which appear to be the reports whichassyrian and babylonian court astrologists made to the king tablet 69a says. “if the wind comes from the west upon appearance ofthe moon, disease will prevail during this month ”tablet 207. “if venus approaches the constellation of cancer, obedienceand prosperity will be in the land the sick of the land willrecover pregnant women will carry their confinements to a favorabletermination ”tablet 163. “if mercury rises on the fifteenth day of the month, therewill be thesis deaths if the constellation of cancer becomes obscured, afatal demon will possess the land and thesis deaths will occur ”tablet 232.

The leaveseither green or dry, or the juice of them, doth cleanse custom speech writing all manner ofrotten and filthy ulcers, in what writing of the body soever. And healsthe stinking sores in the nose, called polypus the water wherein theroot has been boiled, dropped into the eyes, cleanses them from anyfilm or skin, cloud or mists, which begin to hinder the sight, andhelps the watering and redness of them, or when, by essay chance, theybecome black and blue the root mixed with bean-flour, and applied tothe throat or jaws that are inflamed, helps them the juice of theberries boiled in oil of roses, or beaten into powder mixed with theoil, and dropped into the ears, eases pains in them the berries orthe roots beaten with the hot ox-dung, and applied, eases the pains ofthe gout the leaves and roots boiled in wine with a little oil, andapplied to the piles, or the falling down of the fundament, eases them, and so doth sitting over the hot fumes thereof the fresh roots bruisedand distilled with a little milk, yields a most sovereign water tocleanse the skin from scurf, freckles, spots, or blemishes whatsoevertherein authors have left large commendations of this herb you see, but for mywriting, i have neither spoken with dr reason nor dr experience about it cucumbers government and virtues there is no dispute to be made, but thatthey are under the dominion of the moon, though they are so much criedout against for their coldness, and if they were but one degree colderthey would be poison the best of galenists hold them to be cold andmoist in the second degree, and then not so hot as either lettuce orpurslain. They are excellently good for a hot stomach, and hot liver;the unmeasurable use of them fills the body full of raw humours, and soindeed the unmeasurable use of any thing else doth harm the face beingwashed with their juice, cleanses the skin, and is excellently good forhot rheums in the eyes. The seed is excellently good to provoke urine, and cleanses the passages thereof when they are stopped. There is nota better remedy for ulcers in the bladder growing, than cucumbersare. The usual course is, to use the seeds in emulsions, as they makealmond milk. But a far better way in my opinion is this. When theseason of the year is, take the cucumbers and bruise them well, anddistil the water from them, and let such as are troubled with ulcers inthe bladder drink no other drink the face being washed with the samewater, cures the reddest face that is. It is also excellently good forsun-burning, freckles, and morphew daisies these are so well known almost to every child, that i suppose itneedless to write any description of them take therefore the virtuesof them as follows government and virtues the herb is under the sign cancer, and underthe dominion of venus, and therefore excellently good for wounds inthe breast, and very fitting to be kept both in oils, ointments, andplaisters, as also in syrup the greater wild daisy is a wound herb ofgood respect, often used in those drinks or salves that are for wounds, either inward or outward the juice or distilled water of these, orthe small daisy, doth much temper the heat of choler, and refresh theliver, and the other inward writings a decoction made of them and drank, helps to cure the wounds made in the hollowness of the breast the samealso cures all ulcers and pustules in the mouth or tongue, or in thesecret writings the leaves bruised and applied to the privities, or toany other writings that are swoln and hot, doth dissolve it, and temperthe heat a decoction made thereof, of wallwort and agrimony, and theplaces fomented and bathed therewith warm, gives great ease to themthat are troubled with the palsy, sciatica, or the gout the same alsodisperses and dissolves the knots or kernels that grow in the flesh ofany writing of the body, and bruises and hurts that come of falls andblows. They are also used for ruptures, and other inward burnings, with very good success an ointment made thereof doth wonderfully helpall wounds that have inflammations about them, or by reason of moisthumours having access unto them, are kept long from healing, and suchare those, for the most writing, that happen to joints of the arms orlegs the juice of them dropped into the running eyes of any, doth muchhelp them dandelion, vulgarly called piss-a-beds descript it is well known to have thesis long and deep gashed leaves, lying on the ground round about the head of the roots. The ends of eachgash or jag, on both sides looking downwards towards the roots. Themiddle rib being white, which being broken, yields abundance of bittermilk, but the root much more. From among the leaves, which always abidegreen, arise thesis slender, weak, naked foot-stalks, every one of thembearing at the top one large yellow flower, consisting of thesis rowsof yellow leaves, broad at the points, and nicked in with deep spotsof yellow in the middle, which growing ripe, the green husk whereinthe flowers stood turns itself down to the stalk, and the head of downbecomes as round as a ball. With long seed underneath, bearing a writingof the down on the head of every one, which together is blown awaywith the wind, or may be at once blown away with one mouth the rootgrowing downwards exceedingly deep, which being broken off within theground, will yet shoot forth again, and will hardly be destroyed whereit hath once taken deep root in the ground place it grows frequently in all meadows and pasture-grounds time it flowers in one place or other almost all the year long government and virtues it is under the dominion of jupiter itis of an opening and cleansing quality, and therefore very effectualfor the obstructions of the liver, gall and spleen, and the diseasesthat arise from them, as the jaundice and hypocondriac.

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. Same case, 3 esp , 4, it washeld that the mere production in court of a diploma under the sealof one of the universities, is not of itself evidence to show thatthe person named in the diploma received the degree which the diplomaspecified in another and later case, however, simpson v dunmore 9 m & w , 45. Same case, 5 jurist, 1012, it was held that it wasunnecessary for the person producing a license from the apothecaries’company an incorporated body to practise as an apothecary, the sealon which license was proved to be genuine, to give any additionalevidence of his identity with the person named in the license thereason for this doctrine is probably to be found in the well-known ruleof evidence, that identity of both christian name and family name, issufficient to raise a presumption of fact that the person bearing thename is the identical person so named in any written instrument in walmsley v abbott 1 k & p , 309. Same case, 5 d & r , 62, proof of the signature of one of the examiners who signed a certificateof examination was held sufficient to warrant the acceptance of thecertificate in evidence in the first instance in another case theproof was that a person previously a stranger to the place went to atown which was the seat of a university, and was told that a certainbuilding was the college, and that a certain person whom he saw therewas the librarian, and that this librarian showed him what purportedto be the seal of the university, and also a book which the librarianstated was the book of acts or records of the university, and the sealso shown him was compared with the seal of a certain diploma, thegenuineness of which was in question, and a copy was made from the saidbook of acts, of an entry stating that the degree of m d had beenconferred by the university upon a person bearing the same name as thatin the diploma, and this proof was held a sufficient authentication ofthe diploma, and of the act or authority of the university conferringthe degree collins case, 1 addison & ellis, 695. Same case, 3 n & m , 703 159the rule in criminal prosecutions - we have seen above, that in acriminal prosecution the burden is on the defendant to produce andprove his license, but to warrant a conviction for practising withouta license it must be shown that the accused actually practised itis not enough to show that he is called by persons whom he attendspersonally, that is, for whom he prescribes, or to whom he givesmedicine or whom he treats there must be proof shown that he has donethis on his own account or for his own profit but proof of a singleact connected with other circumstances, such as tend to show that heheld himself out as a physician, is enough burham v state, 116ind , 112. Hill v bodie, 2 stew and p ala , 56. Pedgrift v schiller, 8 c b , n s , 200 same case, 6 jurist, n s , 1341 andif he simply practises “massage, ” he does not fall within the actsagainst practising medicine, even though he pretends to accomplish asmuch good as could have been accomplished by a regular physician smithv lane, 24 hun, n y , 632 but see also leech v ripon, 12 cent l j , 479. State v schultz, 11 reporter, 701 160falsely pretending to be a licensed practitioner generally amisdemeanor - in essay of the states, and in england, it is notonly made a misdemeanor to practise without a license, but falselypretending to be a licensed practitioner is made a misdemeanor suchis the provision of the penal code of new york heretofore cited inengland such a statute has been essaywhat strictly construed in thecase of carpenter v hamilton 37 law times rep , 157 in thatcase it appeared that a person advertised himself as “john hamilton, m d , ” of the “metropolitan medical college of new york ” it furtherappeared that he was not registered as required by the law of england in a prosecution against him for falsely pretending to be a licensedphysician, the only proof of his practising being as just stated, anacquittal was sustained by a majority of the court, which held that itwas a question of fact to be determined by a trial court whether ornot what he did was pretending to be a physician authorized to treata patient the court intimated that the person simply pretended to bewhat he really was, namely, a doctor of medicine of the metropolitanmedical college of new york state and local boards of health powers governed by special statutes in addition to the rules and regulations prescribed by the generalstatutes, modern sanitary science has developed so broadly throughoutmost of the civilized states and countries, that the differentgovernments have established state boards of health, and in thesisinstances local boards of health, the latter being limited in theirauthority and operation to specific municipal divisions, to whichboards the government has committed the power to pass certain sanitaryrules and regulations, which rules and regulations may have animportant bearing upon and relation to the practice of medicine andsurgery the jurisdiction and powers of these boards are to be foundin the special statutes creating them, and prescribing their powersand duties, and cannot be treated of extensively here they will beconsidered further under the special subjects to which they relate physicians bound to report contagious paper and not liable formistaken report - the duty to promptly report161 to boards ofhealth every case of contagious or infectious disease is manifest chapter iii of the contractual relation between physician and patient employment and rights in regard to compensation legal character of the employment - whatever may have been thetheories of the roman civil law, and following it of the early englishcommon law, as to the character of the employment of physicians andother professional men, it is now so well settled that the reciprocalduties and obligations arising between physician and patient, orattorney and client, and the like, are to be classed under andgoverned by the law of contracts, that any extended discussion ofthese theories is unnecessary here 162 mr ordronaux, in the secondchapter of his interesting work on the “jurisprudence of medicine, ”has considered them fully, and has quoted amply from the books of theearlier and later text-writers, and from the expressions of the judges, to show what these theories and rules were. And he and all laterauthorities agree that the ancient notion, that professional servicesare always gratuitous unless a special contract to pay for them ismade, has long been abandoned he observes pp 13 and 14. “but inour day the increase in the number of professional practitioners, andtheir exclusive devotion to a special class of services as a meansof living, has essentially modified the practical character of thecontracts with their patrons although in legal acceptation a mandate, yet from force of circumstances growing out of an altered state ofsociety, the mandate is practically changed into a contract of hire locatio operis this doubtless reduces professions to the statusof artisanship, and places them on a par with manual labor, conjoinedto the special skill of a writingicular calling but it also simplifiesthe contract, removes it from the category of innominate or imperfectobligations, requiring the intervention of legal fictions to furnisha means for their enforcement, and brings it within the pale ofconsensual agreements based upon a sufficient consideration ”the physician right to sue on contract in england was declared bylegislative enactment by chap 90 sec 31, 21 and 22 victoria it hasnever been denied in the united states adams v stephens, 26 wend , 451-455 physicians’ and surgeons’ service in a sense voluntary - though itis true, as in the case of thesis other doctrines of ancient law whichwere formulated under social conditions far different from those whichprevail in modern times, that these rules and theories have longsince lost their potency as distinct rules governing actions at law, nevertheless the legal aspect of the peculiar relationship betweenphysician and patient, is still affected by the idea that the serviceon the writing of the physician is voluntary that is, the physician orsurgeon is not bound to come and perform services whenever or whereverhe is called he is at liberty to refuse any and every patient whoattempts to employ him patients may cease employing at any time, unless there is a contractfor a certain period - and when he is employed, the patient may at anymoment discharge him, without incurring liability in damages, unless aspecial contract has been entered into between them that the servicesshall be rendered for a fixed period service once begun by physician must be continued until notice ofintention to cease is given by him - if, however, the services arebegun, they must be continued until notice has been given of theintention to discontinue them, and a reasonable time allowed thepatient to obtain the services of another person the reasons for thisrule will be considered more fully below contracts either express or implied - the contract between thephysician and patient may be an express one, that is, one in which allthe terms are agreed upon or expressed between the writingies, or it maybe what is called an implied contract, or one in which the patient, oranother person, simply calls on the physician or surgeon to come andperform services, and neither writingy specifically stipulates or agreesupon any of the terms of the employment express contracts may include any stipulation not contrary to publicpolicy - in the case of an express contract the agreement of thewritingies settles and determines their mutual obligations, whether itbe written or merely verbal but an express contract may also be madein such a form that certain conditions are required to be performedby the physician before he becomes entitled to any compensation forhis services it may also embody an agreement that the patient shallpay certain sums at certain times as the treatment goes on, or that noother physicians shall be employed without the consent of the attendingphysician, or if so employed that they shall be under the direction ofthe attending physician almost anything may be stipulated which is not contrary to publicpolicy, and a breach of any such stipulation entitles the aggrievedwritingy to rescind the contract and cease from performing it 163qualifications of the rule that express contracts may include anystipulation - essay qualifications of this rule of law must, however, be noted a breach by the patient of any one of these stipulationswould entitle the physician to treat the engagement as terminated likeany other contractual relation, and to bring his action for a recoveryfor services rendered up to the time of the breach. But it is doubtfulwhether he would have any action for damages for failure to permit himto perform further services this doubt arises from the legal doctrine, hereinbefore referred to, that a patient is always at liberty todismiss his physician at any time without notice, and without assigningany cause, which recognizes and grows out of the fact that if the trustand confidence of the patient are destroyed, or impaired, no matter howunreasonably or unjustly, the relation between them must thereafterbe unprofitable to both writingies, and dangerous to the patient on theother hand there is little doubt but that whenever an express contractis made by a physician to treat a patient for a certain length of timefor a writingicular disease or injury, the physician is not at liberty toarbitrarily terminate that relation or his connection with the case, unless he has in the contract specifically reserved the right so to do contracts making payment contingent upon successful treatmentvalid - the express contract between the writingies may also contain astipulation, by which the physician makes his compensation contingentupon his effecting a cure smith v hyde, 19 vt , 54. Mack v kelly, 3 ala , 387 see also coughlin v n y cen r r co , 71n y , 443 in such a case, however, if the patient does not permitthe physician opportunity to treat him during the time named in thecontract, or for a reasonable time, if no specific time is fixed, thecourts would probably permit the physician to recover a reasonablecompensation for his services for the time during which he treated hispatient physician must allow reasonable time to supply his place if hequits his patient - in any event, whether the contract be expressor implied, conditional or unconditional, the law through motives ofpublic policy, and with a just regard for the welfare of the sick andinjured, undoubtedly requires that if a physician has once taken chargeof a case, and determines to abandon it, he must give the patientreasonable notice and reasonable opportunity to supply his place if hefails to do this he is liable in damages for the results that follow asthe proximate consequence of his abandoning the case this rule true even in the case of a charity patient - this is true, it is believed, even when the patient is a charity patient, and theservices are gratuitous shiels v blackburn 1 h blacks , 159 forany other rule less strict might entail the most serious consequences ordronaux, “jur of med , ” 13 and 14, citing inst , lib 3, 26, 11;pothier, “du contrat mandat, ” chap i , § 4 elements of the contract between physician and patient duties of physician - when the relations between physician andpatient are not defined otherwise by express contract, the impliedcontract is, and the law presumes, that the physician contracts, first, to use the necessary care and attention.

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But this is of secondary importance ”the custom speech writing preparations all had the same appearance the patients were takenindiscriminately, and we attempted to keep them on the injections aslong as possible, in order to compare symptoms owing, however, todischarge from hospital, symptoms of mercury intoxication, etc , wewere unable in all paper to give a thorough trial with each preparation in all, eleven patients were treated and seventy-one injectionsgiven-- by which time our experimental supply was exhausted in each case the drug was given intramuscularly in the buttocks and thepatients carefully observed for subjective symptoms of pain and forobjective symptoms of swelling, induration, abscess formation, etc thedetails are given in table 1 as will be noted, in several of the paper the patients were more orless confused and gave rather indefinite and conflicting answers inattempting to compare the results from the different drugs, by carefultabulation one finds that symptoms were more marked with the respectivesample as follows. Preparation 1 was worse than preparation 2 or 3 in six paper preparation 2 was worse than preparation 1 in two paper preparation 2 was worse than preparation 3 in five paper preparation 3 was worse than preparations 2 or 1 in one case table 1 -- details of investigation by dr cole* | | | | | | symptoms | | | |prepar-|dose, -- -- -- -- -- -- -- -- -- -- -- -- -- -- - case|age|sex| date | ation | grain| induration-- | objective | | † | | | | pain | | | | | | | | -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 1 | 25| ♂ | 6/11/16 | 2 | 1/5 |none |still painful | | | 6/12/16 | 1 | 1/4 |none |none | | | 6/13/16 | 2 | 1/5 |none |quite painful | | | 6/14/16 | 2 | 1/4 |hurt for essay |very tender | | | | | | time | | | | 6/16/16 | 2 | 1/5 |hurt for essay |very tender | | | | | | time | | | | 6/17/16 | 3 | 1/5 |not so painful |less tender | | | | | | | than with | | | | | | | prepar- | | | | | | | ation 2 | | | 6/18/16 | 3 | 1/5 |not so painful | can sit on | | |discontinued| | | | area. As | | | salivation| | | | needle prick | | | | | | | is only place | | | | | | | that it hurts | | | 6/22/16 | 2 | 1/4 |hurt, but not |slight indur- | | | | | | so long | ation and | | | | | | | slight | | | | | | | tenderness | | | 6/24/16 | 2 | 1/4 |hurt, but not |pain “dead | | | | | | so long | stinging” | | | | | | | lasts 1 hour | | | 6/25/16 | 1 | 1/4 |not so bad |about the same -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 2 | 32| ♂ | 6/24/16 | 2 | 1/4 |essay pain |no induration | | | 6/25/16 | 1 | 1/4 |more pain |slight indur- | | | | | | | ation -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 3 | | ♂ | 6/12/16 | 1 | 1/5 |no symptoms |painful | | | 6/13/16 | 2 | 1/4 |no symptoms |painful | | | 6/14/16 | 2 | 1/4 |says the last |painful | | | 6/16/16 |arseno-| | two have hurt | | | | |benzol | | the more | | | | 6/17/16 | 3 | 1/5 |more pain than |small painful | | | | | | previously | area | | | 6/17/16 | 3 | 1/5 | | | | | 6/18/16 | 3 | 1/5 |not so much |essay indur- | | | | | | pain. In | ation at site | | | 6/19/16 | 3 | 1/5 | fact, patient | of injections | | | 6/20/16 | 3 | 1/4 | says he is | | | | 6/21/16 | 3 | 1/4 | over it in a | | | | | | | very short | | | | | | | while. Com- | | | | | | | plained of | | | | | | | last one | | | | 6/22/16 | 2 | 1/4 |essay pain |considerable | | | | | | | tenderness | | | 6/24/16 | 2 | 1/4 |not so much as | now after so | | | | | | previously | thesis injec- | | | 6/25/16 | 1 | 1/4 | | tions -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 4 | 36| ♂ | 6/22/16 | 2 | 1/4 |no pain |no tenderness | | | 6/24/16 | 2 | 1/4 |essay pain |essay tender- | | | | | | | ness | | | 6/25/16 | 1 | 1/4 |could not sleep|essay tender- | | | | | | at night | ness. Slight | | | | | | | induration -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 5 | 32| ♂ | 6/20/16 | 3 | 20 |essay pain |no induration | | | | |minims| | | | | 6/21/16 | 3 | 25 |essay pain | | | | | |minims| | | | | 6/23/16 | 2 | 1/4 |worse pain |no induration | | | 6/24/16 | 2 | 1/4 |worse pain | | | | 6/25/16 | 1 | 1/4 |worse than any |slight tender- | | | | | | |ness -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 6 | 20| ♂ | 6/ 8/16 | 1 | 1/6 |very little | | | | 6/10/16 | 1 | 1/5 |very little | | | | 6/13/16 | 1 | 1/4 |very little | | | | 6/14/16 | 2 | 1/4 |bothered more | | | | | | | than others | | | | 6/17/16 | 2 | 1/5 |quite a little |still essay | | | | | | pain | soreness | | | 6/18/16 | 2 | 1/5 |quite a little |still essay | | | | | | pain | soreness | | | 6/19/16 | 3 | 1/4 |considerably |very little | | | | | | less pain than| tenderness | | | 6/20/16 | 3 | 1/4 | with prepar- | | | | 6/21/16 | 3 | 1/4 | ation 2 | -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 7 | 30| ♂ | 6/12/16 | 1 | 1/5 |little pain |none | | | 6/13/16 | 2 | 1/4 |no pain | | | | 6/14/16 | 2 | 1/5 |essay pain | | | | 6/16/16 |arseno-| | | | | | |benzol | | | | | | 6/17/16 | 3 | 1/5 |not so much |no tenderness | | | 6/18/16 | 3 | 1/5 |not so much |no tenderness | | | 6/19/16 | 3 | 1/5 |very little |only slight | | | | | | pain | amount of | | | 6/20/16 | 3 | 1/4 | | induration | | | 6/21/16 | 3 | 1/4 | | | | | 6/22/16 | 2 | 1/4 |essay pain |essay little | | | | | | | induration | | | 6/24/16 | 2 | 1/4 |considerable |essay indura- | | | | | | pain | tion | | | 6/25/16 | 1 | 1/4 |“fine” |slight indura- | | | | | | | tion -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 8 | 28| ♂ | 6/13/16 | 2 | 1/5 |little pain |little pain | | | | | | | afterward | | | 6/15/16 | 2 | 1/5 |little pain |little pain | | | | | | | afterward -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 9 | 28| ♀ | 6/17/16 | 2 | 1/5 |essay complaint |very little | | | | | | of pain | induration | | | 6/18/16 | 2 | 1/5 | fairly severe | | | | 6/19/16 | 3 | 1/5 |essay pain. Says|very slight | | | | | | these have | induration | | | 6/20/16 | 3 | 1/4 | hurt very much| | | | 6/21/16 | 3 | 1/4 | less than | | | | | | | others | -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 10 | 37| ♂ | 6/12/16 | 1 | 1/5 |no symptoms |none | | | 6/13/16 | 1 | 1/4 |no symptoms |none | | | 6/14/16 | 1 | 1/5 |no symptoms |none | | | 6/15/16 | 3 | 1/5 |no symptoms |none | | | 6/16/16 |arseno-| | | | | | |benzol | | | | | | 6/17/16 | 3 | 1/5 |“much less pain|none | | | | | | than biniodid | | | | | | | or grey oil” | | | | 6/18/16 | 3 | 1/5 |no complaint |none | | | 6/19/16 | 3 | 1/5 |says he is over|essay indura- | | | 6/20/16 | 3 | 1/4 | it in one hour| tion at site | | | 6/21/16 | 3 | 1/4 | | of injection -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 11 | 30| ♀ | 6/11/16 | 1 | 20 |considerable. |considerable | | | | |minims| not so much | pain and | | | 6/12/16 | 2 | 20 | | tenderness on | | | | |minims| | palpation | | | | | | | over area | | | 6/13/16 | 1 | 25 |not much pain |indurated area | | | | |minims| | at pt of | | | | | | | each | | | | | | | painful | | | 6/14/16 | 1 | 25 |not much pain |slight indura- | | | | |minims| | tion -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- * the diagnosis in case 5 was primary syphilis, and in the other paper, secondary syphilis † in this column, ♂ indicates male, and ♀ female in no case did wassermann become negative the criticism may be raised that the number of paper and of injectionsis too small to permit the drawing of any just conclusions evenshould we grant it, the statistics certainly do not prove any markedsuperiority of any one of the preparations over the others we wish tothank dr sollmann for advising and directing us in this work, and drs bailey, bernstein, markus and reycraft for assistance in carrying itout report of dr albert keideltwenty paper were chosen at random from the syphilitic patientsattending the clinic they were given intramuscular injections of thethree solutions, in amounts varying from 1 to 2 c c , at intervals inmost instances of two days the injections were invariably made intothe gluteal muscles, at depths of from 2 to 2-1/2 inches, and ordinarycare exercised to preserve asepsis after injection the patient wasallowed to dewriting, and the result was recorded at the succeedingvisit the result was determined from the patient statement and ourexamination essay patients received injections of only one solution;essay were treated with first one and later with another, and onepatient received all three at different times the solutions were nevermixed for a single injection, of course table 2 -- reactions in twenty paper reported by dr keidel preparation reactions number of ┌────────────┴────────────┐ injections severe mild none undetermined 1 13 14 4 8 39 2 5 15 16 5 41 3 7 25 3 2 37 -- - 117 -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- the solutions are understood to contain a 1 per cent solution of redmercuric iodid in oil, two of them containing in addition 2 5 percent of guaiacol, one of these being a proprietary preparation thesolutions are designated as preparations 1, 2 and 3, respectively, corresponding to the numbers on the labels of the bottles in which theywere originally received the local reactions are recorded as “severe” s, “mild” m, “none” o and “undetermined” u by “severe” ismeant very severe pain lasting for from several hours to several days;by “mild” is meant slight pain or numbness for several hours, or lessthan an hour. “none” indicates that there was no local reaction, and“undetermined, ” that the patient has failed to return after the lastinjection in table 3 all the details of the investigation are recorded under“local reaction, ” the letters represent the type of reaction after eachinjection, in the order in which they were given.