History

Dream Essay


Despite thesis obstacles thrown into its path, the council on pharmacyand chemistry has serenely pursued its allotted tasks, correctedits mistakes, improved its methods, and today stands as the onlymedium to which the honest physician may turn for information-- notmisinformation-- regarding proprietary articles during the war thecouncil and the chemical laboratory were in close cooperation withthe surgeon-general office, testing and investigating every articleoffered to the government for the treatment of sick soldiers thevariety and the number of fakish and fraudulent stuff offered to thesurgeon-general was a pitiable exhibit of the mental gymnastics ofessay people just now the council and the laboratory have a new andimportant field before them, i e , to protect the physicians againstworthless and useless serums, vaccines and synthetics it will be thecouncil unpleasant duty to expose the fraudulent and useless amongthese articles and stamp truth on those found worthy we seem to have wandered from the topic in our caption, but not so inreality, because the burden of our thought is to lend our influence tothe spread of the motto of the advertising clubs of the world, namely, “truth in advertising ” it is our purpose to stimulate a larger degreeof enthusiasm for the work of the council on pharmacy and chemistryand the chemical laboratory, a more generous flow of inquiriesconcerning articles unfamiliar to the physician, and writingicularly tourge that the words “accepted by the council on pharmacy and chemistryof the american medical association” be printed on the label and onall advertising circulars of proprietary articles that have beenadmitted to new and nonofficial remedies then, when pamphlets andcirculars are received by physicians they will read the statements ofmanufacturers with sympathetic understanding and with full confidencein the verity of the declarations the importance of creating justthat sort of receptivity in the mind of the prospective buyer is sowell known to the astute publicity expert that it is needless forus to dwell on its advantages every proprietary article advertisedin our journal, in the journal of the american medical association, and in the other state association journals, as well as in severalwell-edited privately owned journals, does in effect say to the readerthat the articles so advertised are accepted by the council becauseonly proprietary articles so accepted are accepted by us the fact isfurther acknowledged when these firms are permitted to exhibit theirgoods at our annual sessions for again the rule is enforced that onlyproprietary articles which have been approved by the council may beplaced on display why not complete the circle of ideas-- it would not be a “viciouscircle”-- by printing on labels, in advertisements and circulars, thewords. “accepted by the council on pharmacy and chemistry”?. -- from thejournal a m a , aug 2, 1919 helping the councilif they were built that way, the members of the council on pharmacy andchemistry of the american medical association might become discouragedat the apparent indifference of thesis members of the medical professionto their efforts there are thesis physicians who, while figurativelypatting the council on the back, actually do nothing to aid itsefforts on the other hand, there are men in the profession who givethe council active support instead of merely passive appreciation the letter that follows was written by such a man to a pharmaceuticalconcern. I am receiving circular advertising from you concerning -- -- -- -- solution, and i am writing to suggest that until these products have been approved by the council on pharmacy and chemistry of the american medical association, you are wasting your postage on the practice aside from the fact that these products do not appeal to me personally, i feel that i am not in a position to judge the value of such products and i depend entirely on the large clinical opportunities of the council on pharmacy and chemistry of the american medical association in addition to their laboratory facilities, in such matters as these i may, therefore, with all due respect, suggest that it will pay you to eliminate my name from your mailing list the members of the council on pharmacy and chemistry are working weekin and week out without remuneration few appreciate how much thesescientific men are doing for rational therapeutics. Fewer still realizehow much has been accomplished through their efforts, or how much morecould be accomplished if every physician who at least believes in thework of the council would give it his full support -- editorial fromthe journal a m a , nov 6, 1920 delays in passing on products report of the council on pharmacy and chemistrythe council has adopted the following report and authorized itspublication w a puckner, secretary the council frequently receives inquiries-- essay of them accompanied byexpressions of impatience-- concerning articles, reports on which appearto be delayed it therefore seems advisable to make a statement of essayof the factors which enter into this problem the council fully realizes the importance of giving prompt informationto the profession with regard to proprietary medicines underconsideration it therefore acts as soon as sufficient informationis available to justify a definite judgment, and publishes itsconclusions as soon as possible when adequate information is availableat the outset, there is no delay in the publication of the councilconclusions unfortunately, but very naturally, there are thesis paper in which theinformation available at the time the product is submitted is notsufficient to justify the council in coming to definite conclusions foror against the preparation in essay paper the manufacturer possessesthe required information, but to obtain it from him takes time.

The tonsils were badly infected dream essay there was a positive wassermannreaction there were syphilids of both arms and shins. Marked papulareruption. Malaise, and a slight trace of albumin in the urine iplaced the patient on mercurials and at last give him three salvarsaninjections three weeks awriting the result was a negative wassermannreaction, the skin was clear and the patient felt fine case 3 -- d c , woman, aged 21, single, seamstress, had an initiallesion on the left side of the cervix, and a macular eruption on theface, neck and shoulders, and also, though faint, on the forearms thirty injections of sodium cacodylate of 5 grains each were given theinitial lesion disappeared in one week mucous patches of the mouthappeared and persisted the wassermann reaction was positive i gavemercurials and potassium iodid for seven months, and salvarsan once the wassermann reaction is now negative my conclusion after two trials of the use of sodium cacodylate in smallor large doses is that it has no effect toward curing the condition. Infact, the throat symptoms were seemingly increased in severity by itsuse it has no effect on syphilids of the forearms and shins, and ifanything makes them worse it improves the appetite, as one would expect it has essay effect onthe kidneys, as noted in case 2. It has essay effect in healing theinitial lesion, as noted in all three of this series. Why, i do notknow i am entirely satisfied that it has no beneficial effect on syphiliticsand have discontinued its use entirely in my practice i am glad to have read cole excellent article, as it shows me that iwas correct in my decision not to use it again, as it was worthless william g ward, m d , lynn, mass to the editor:-- dr william g ward letter the journal, feb 3, 1917, p 390, and the recent admirable article by dr harold n cole the journal, dec 30, 1916, p 2012 recall to mind dr j b murphyclinical note on the use of sodium cacodylate in the treatment ofsyphilis the journal, sept 24, 1910, p 1113, and the experimentalwork of cap h j nichols, u s army the journal, feb 18, 1911, p 492 the results of nichols’ work conclusively proved, at leastfrom a laboratory standpoint, that this drug was of very little valueas a spirocheticide in combating syphilis prior to the publication ofdr murphy letter i had employed sodium cacodylate extensively as aremedy in psoriasis, and i still continue to use it in selected paperof the disease adopting dr murphy suggestion, i gave the agent an extensive trialin syphilis in all stages of the disease the results were extremelydisappointing, from both clinical and serologic points of view morerecently, during the scarcity of salvarsan, i gave the drug a secondtrial, employing it in large dosage in the hope that the previousfailure had been due to the employment of insufficient amounts theresults were not tabulated, but, judging roughly from my experience ina score of paper, its therapeutic value as an antisyphilitic was nil afew of the patients underwent a temporary improvement, probably owingto the tonic effect of the drug, but in every instance the serologicfindings were unaffected r l sutton, m d , kansas city, mo -- correspondence in the journal a m a , feb 3, 1917 tablets. Dependability of dosagethe tablet form of administering medicines is popular among thesisphysicians because of its convenient availability and dosage thereis no doubt about the convenience of tablets, but the accuracy of thedosage content is not always to be depended on one reason for thisis that the demand for palatable and convenient “medicaments has ledmanufacturers to attempt to produce in tablet form mixtures which, fromthe nature of the case, are not suited to that method of compounding ”in a series of painstaking experiments307 on bismuth, opium andphenol tablets, conducted a number of years ago in the a m a chemical laboratory, it was shown that no tablets on the market thencontained the amount of phenol the label indicated, the variationbeing from 12 3 to 112 5 per cent similarly, the laboratory foundthat in the case of several different brands of aromatic digestivetablets, 308 the amount of hydrochloric acid present in these absurdcombinations was true to label in only one half of the specimens, notwithstanding the fact that the amounts claimed to be present wereridiculously small. In two specimens, there was no hydrochloricacid whatever present, while a third contained only a trace theseexamples illustrated clearly the very evident unwisdom of attemptingthe pharmaceutically impossible merely for the sake of convenience orpharmaceutical “elegance ”307 puckner, w a , and clark, a h. Examination of tablets ofbismuth, opium and phenol, the journal a m a , july 25, 1908, p 330 puckner, w a , and hilpert, w s. Tablets of bismuth, opiumand phenol, dec 17, 1910, p 2169, may 6, 1911, p 1344 unreliablepharmaceutical products, editorial, may 6, 1911, p 1335 308 puckner, w a , and warren, l e. Aromatic digestive tablets, the journal a m a , aug 20, 1910, p 710 another reason for doubting the accuracy of dosage, irrespective ofthe characteristics of the drugs composing the tablets, has been themanifest lack of care in their manufacture in 1914, kebler309reported the results of a far-reaching investigation of tabletcompounding in which he pointed out that tablets on the market werenot as uniform or accurate as was generally believed, the variationsbeing “unexpectedly large in numbers and amount ” during the past year, the connecticut agricultural experiment station310 undertook theexamination of tablets-- proprietary and nonproprietary-- taken from thestock of dispensing physicians the variations found in weights ofthe tablets were strikingly similar to those reported by kebler 309 kebler, l f.

60. 770 march8 1913. 60. 1480 may 10 1913. 61. 1737 nov 8 1913 what is liquid petrolatum?. The use of liquid petrolatum in chronic constipation, which hasrecently become the vogue, has naturally been commercialized. As aresult, also naturally, claims of superiority of one brand over anotherhave been made essay of these claims may have been well founded. Otherscertainly are not essay have claimed superiority for those productsmade from russian oil over those made from american oils as naphthenehydrocarbons predominate in russian crude petroleums, and paraffinhydrocarbons in thesis or most american crude petroleums, it was assumedthat the petrolatums derived from these sources differed from oneanother in like manner both the naphthenes and the paraffins arechemically inert. But essay unexplained therapeutic superiority has beenassumed to reside in the naphthenes consequently, it has been urgedthat the american liquid petrolatums should not be used internally sofar these claims and counterclaims have been based on much theory andlittle fact the journal publishes this week a contribution by benjamint brooks, senior fellow in charge of petroleum investigations atmellon institute, pittsburgh brooks calls attention to the fact thatmarcusson, in 1913, pointed out that most of the so-called “mineraloils” used for therapeutic purposes contain no paraffin hydrocarbonswhatever. That they consist solely of naphthenes and polynaphthenes brooks confirms this statement so far as american liquid petrolatumsare concerned he states that thesis american petroleums, such as mostof those from the gulf region, are like the russian in containing noparaffin. And that, in the case of those petroleums that do containit, the customary refinery method of removing paraffin is sufficientto produce true naphthene and polynaphthene petrolatums “the claimthat only russian oils belong in this class, ” he says, “has no basisin fact and has been advanced presumably for business reasons ” thename “paraffin oil” applied to these liquid petrolatums, then, is amisnomer the new name, “white naphthene oils, ” suggested by brooks, seems superfluous, however, since the pharmacopeial title, “liquidpetrolatum, ” is subject to no such objection -- editorial from thejournal a m a , jan 1, 1916 the lowenthal postgraduate course which tells how to make diagnoses accurately, scientifically check the christian scientists and increase your earning powerduring the past year the journal has received letters from physiciansin various cities asking for information regarding the “post graduatecourse of lectures and clinics on nervous and mental diseases” whichwas going to be given in their respective cities by dr albert a lowenthal of chicago the following inquiries are typical. “to the editor -- please note the enclosed letter from the american organotherapy company which appears to be conducted by lowenthal the proposition of conducting these clinics impresses me as a piece of colossal gall which is amazing even in these days do you know anything about this matter?. ” “to the editor -- who the dickens is albert a lowenthal, m d ?.

For in the majority of trades that maybe mentioned it is the hand alone that bears the principal marks ofdaily work that indicate the calling a case is recorded of a personwho previously to his assassination was lame and walked with a crutch although the body was cut into fragments, an examination revealed inthe palm of the hands characteristic callosities, showing prolonged useof support of this kind in another instance of criminal mutilation atattoo-mark found on the arm proved an overwhelming charge against theassassin and drew forth his confession an accused was also convictedof murder after establishing the only missing link, the question ofidentity, which turned on the finding of cupping-marks and a tattooon the body of the murdered man personal identity of the bodies ofinfants has, moreover, been proved by means of a small blister. By apatch of downy hair. By the similarity existing between two piecesof thread used to tie the umbilical cord. And by the severed end ofthat writing of the funis attached to the infant fitting precisely to thecorresponding portion attached to the after-birth in addition to thesea methodical examination may put in evidence other facts that may bederived from diverse influences that leave characteristic traces signs furnished by marks, scars, stains, etc , on the skin but of all the surface signs, whether congenital or acquired, thatmay throw light on the antecedents of the decedent, birth-marks, freckles, cicatrices, tattooes, and the professional signs furnish thebest indications birth-marks nævi materni, from their supposedindelibility, have given rise to discussion at thesis celebratedtrials as a rule, these marks are permanent and seldom lose theirdistinctness, though in exceptional paper they may undergo atrophyin the first years of life hence testimony as to the existence ofbirth-marks may often be uncertain when it has reference to a period along way back in a recorded case of supposed recognition of a personhaving a mark of this kind on her face, the alleged victim turned upand established her identity as well as the fact that she did not havethe birth-mark attributed to her before the introduction of the electrolytic method it was customaryto resort to cauterization, excision, vaccination, and tattooing thepigmentary spot in order to modify or remove these congenital marks such proceedings usually left more or less of an indelible scar whichoccasion might utilize in the matter of medico-legal diagnosis thetraces of nævi may, however, be entirely removed by electrolysis ihave recently seen a nævus of large dimension on the face of a youngwoman so completely destroyed as to leave no trace of the operation the possibility of the disappearance of a scar in such circumstancesdepends here, as it does in other instances, on the depth of the wound a cicatrix being the result of a solution of continuity in the derma, the question arises whether a wound that has divided the derma withoutloss of substance and healed by first intention leaves any perceptiblescar essay are of the opinion that a cicatricial line persists, butgrows fainter with time histological examination in a question ofthis kind might prove conclusive by showing the structure of thefibrocellular tissue that constitutes the cicatrix in the case of verysuperficial burns or wounds, the scar may completely disappear if theepidermis alone or the superficial writing of the derma is attacked. Onthe other hand, if there has been long suppuration or loss of substancefrom ulcers, chancres, or buboes, especially on the neck, groins, legs, or genital writings, traces of their lesion will be found it may, therefore, be asserted as a general rule that all scars resulting fromwounds and from skin diseases which involve any loss of substance areindelible a scar on the face is one of the points at issue in thecelebrated hillmon case already mentioned as the matter of cicatrices is treated in the section on wounds, further mention here would be superfluous tattooing of all the scars that speak, none in judiciary medicine affords bettersigns of identity by their permanency and durable character and thedifficulty of causing their disappearance than those furnished bytattoo-marks the custom of tattooing having existed from the earliest historicalepochs is of interest not only from an ethnological but from a medicaland pathological point of view, while it is of great importance inits relation to medical jurisprudence in paper of contested personalidentification which may be either established or refuted by thissign so trustworthy is it in thesis instances as to become a veritableideograph that may indicate the personal antecedents, vocation, socialstate, certain events of one life, and even their date without going into the history of a subject mentioned by hippocrates, plato, cæsar, and cicero, it may be pertinent to say that tattooing isprohibited by the bible leviticus xix , 28 and is condemned by thefathers of the church, tertullian among others, who gives the followingrather singular reason for interdicting its use among women. “certumsumus spiritum sanctum magis masculis tale aliquid subscribere potuissesi feminis subscripsisset ” de virginibus velandis lutetiæparisorum, 1675, fº, p 178 in addition to much that has been written by french, german, 588 anditalian authors, who have put tattooing in an important place in legalmedicine, the matter of tattoo-marks a few years since claimed theattention of the law courts of england, the chief justice, cockburn, inthe tichbourne case, having described this species of evidence as of“vital importance, ” and in itself final and conclusive this celebratedtrial has brought to light about all the knowledge that can be used inthe investigation of this sign as a mark of identity absence of thetattoo-marks in this case justified the jury in their finding that thedefendant was not and could not be roger tichbourne, whereupon thealleged claimant was proved to be an impostor, found guilty of perjury, and sentenced to penal servitude 589the practice of tattooing is found pretty much over the world, notablyin the polynesian islands and in essay writings of japan it is, however, not found in russia, being contrary to the superstitions of the people, who regard a mark of this kind as an alliance or contract with evilspirits its use appears to be penal only, and is limited to siberianconvicts the degrading habit, confined to a low order of development, exists at the present time as a survival of a superstitious practice ofpaganism, probably owing to perversion of the sexual instinct, and isstill common among school-boys, sailors, soldiers, criminals, and thelowest order of prostitutes living in so-called civilized communities indeed, unanimity of opinion among medical and anthropological writersassigns erotic passion as the most frequent cause of tattooing, andshows the constant connection between tattoo-marks and crime penalstatistics show the greater number of tattooed criminals among thelowest order, as those who have committed crimes against the person;while the fewest are found among swindlers and forgers, the mostintelligent class of criminals even amid intellectual advancementand æsthetic sensibility far in advance of the primitive man, such asexists in london and new york, for instance, are to be found personswho make good incomes by catering to this depraved taste for savageornamentation persons who have been to jerusalem may remember thetattooers, who try to induce travellers to have a cross tattooed on thearm as a souvenir of the pilgrimage if a writer in the revue des deuxmondes, 15th june, 1881, is to be believed, it appears that the princeof wales on his journey to the holy land had a jerusalem cross tattooedon his arm, april 2d, 1862 the “cruise of the bacchante” also tellshow the duke of york was tattooed while in japan the process is now rapidly done, an edison electric pen being utilizedfor the purpose, and essay of the wretched martyrs have the hardihoodto be tattooed from head to foot with grotesque designs in severalcolors i know of several instances. One of a man in providence, r i. Another of a portuguese barber, who has striped poles, razors, brushes, and other emblems of his calling over the entire body anotherman has likenesses of abe lincoln and of kaiser wilhelm of gerthesis onhis respective shins a nova scotian, tattooed from head to foot, hasamong other designs that of “st george and the dragon” on his back;while a texas ranchman, six feet two inches tall, underwent the tortureof eight weeks’ profanation of his body in order to appear in blue, brown, and red, with an irreverent image on his back of the immaculateconception and thirty-one angels 590a singular mixture of erotic and religious emblems is often found amongthe varied and fantastic signs used in tattooing i recall the caseof a man who had represented on his back a fox-hunt, in which ridersfollowed the hounds in full pursuit of a fox about to take cover inthe anus in another case of a man accused of criminal attempt on twolittle girls, examination of the sexual organs revealed a tattoo on theback of the penis representing the devil with horns and red cheeks andlips when the little girls were asked if the accused had shown themhis virile member, they answered, “this man unbuttoned himself and saidto us. ‘i am going to make you see the devil ’” in the face of suchaffirmations, the accused confessed his crime and was condemned othertattoo signs of the grossest emblems of unnatural passion have beenfound among low prostitutes, pederasts, and tribades statistics founded on numerous facts show thesis paper of tattooingof the penis and even of the labia majora in the lowest order ofprostitutes, but these unclean images and revelations of lustfulinstinct do not occur in the same order of frequency as those notedon the forearm, the deltoid, or the inferior extremities so valuableare these marks in their bearing on the class, vocation, character, and tastes of a person that the finding of anchors and ships wouldindicate a sailor. While flags, sabres, cannon, and other warlike signswould indicate a soldier, etc it is also noticeable that in thetattooing practised by lunatics the image relates in essay way to thenature of the peculiar form of mental disease from which they suffer, and it is chiefly among the more severe and incurable paper of mentaldegeneration that these signs are found see dr riva article, “iltatuaggio nel manicomio d’ancona, ” cronica del manicomio d’ancona, november, 1888 almost always the motive that prompts these disfigurements of theskin is the result of impulse, of thoughtlessness, or of orgy, andalmost all the tattooed come to repent of their folly the subjectof détatouage has of late taken a polemic turn in essay of thecontinental journals there are besides thesis paper on record ofsevere accidents and complications following the operation, such assevere inflammation, erysipelas, abscess, and gangrene dr beuchongives statistics of forty-seven paper, in which four were followedby mutilation and eight by death either directly or in consequenceof an amputation a certain proportion of what is known as syphilisinsontium is to be found among the reported statistics of tattooing dr bispham, of philadelphia, informs me that while at blockleyhospital he saw thirty paper of syphilis that had been communicated bythe same tattooer tattooing may essaytimes be accidental i have seen a dewritingmentalclerk with an elongated tattoo on the back of his hand caused byaccidental wounding with an inked pen a bursting shell during anaval engagement has caused a characteristic tattoo on the face of awell-known officer to be seen any day in washington two paper of thebluish-black discoloration of the skin from taking nitrate of silverhave also come under my observation both occurred in medical men, one of whom lives in florida, the other in the district of columbia silver discolorations of this kind are indelible, but i learn fromone of these gentlemen that large doses of iodide of potassium causetemporary fading of the discoloration, which returns on stopping themedicine 591the indelibility of tattoo-marks is such that their traces may beeasily recognized in the cadaver, though in a essaywhat advancedstage of putrefaction they have even been recognized on a gangrenouslimb essaytimes, however, it is impossible to recognize at firstsight whether there has or has not been a tattoo a strong light anda magnifying glass and a microscopic examination of the neighboringganglia to detect the presence of coloring matter may assist inremoving doubt it has been found on the bodies of tattooed cadaversthat the ganglia are filled with grains of coloring matter of thesame nature as that employed in making the tattoo attempts to removetattoo-marks generally leave a vicious scar that is equally indelible an efficacious method is to tattoo the mark with a solution oftannin, which is followed by brushing over with nitrate of silver a red cicatrix follows, and when the epidermis separates the tattoodisappears a better method, however, is by means of the electricneedle already mentioned in speaking of the electrolysis of nævi that a tattoo-mark may disappear by the effects of time and leave notrace is a matter that cooper reports after examining the mutilatedremains of a cadaver, and the statistics of caspar, tardieu, andhutin place it as high as nine in the hundred an officer of theunited states revenue marine lately called my attention to severalsuperficial tattooes on the back of his hand which had disappeared thedeeper ones, however, remained the spontaneous disappearance of atattoo seems to be possible when the operation has been done in sucha superficial way as not to have passed the rete malpighii, or whenthe tattooing has been done with essay substance not very tenacious, as vermilion, which appears to be easily eliminated but when thewritingicles of coloring matter penetrate into the fibro-elastic tissue ofthe derma, the disappearance of the tattoo is rare in seventy-eight individuals tattooed with vermilion alone, hutinfound eleven upon whom the tattoo had disappeared out of one hundredand four tattooes made with a single color, india-ink, writing ink, blue or back, not a single one had completely disappeared the resultsare identical if the tattooes are made with two colors thus in 153tattooes with vermilion and india-ink, one instance showed a fading ofthe black, in another it had completely disappeared, the red being wellmarked. Twenty times the red was writingly effaced, the black being wellmarked. And in sixteen paper the red had completely disappeared, theblack remaining visible 592a tattoo-mark may essaytimes be altered, in which case it provesdeceptive as an index a workman changing his trade seeks to transformthe insignia of his first calling into those of the second, or acriminal in order to avoid identity will make a change in the formerinstance the transformation is not difficult to detect, but in thelatter so much care is required to recognize the change that penalscience has relegated the sign to a secondary place as to the length of time since a tattoo-mark has been executed, authorities are that it is impossible to tell after two or three weeks whether a tattoo-mark is real or feigned is easily settled by simplywashing the writing this question, as well as that of the judicialconsequences of such marks, is hardly pertinent to the matter in hand value of professional stigmata the so-called professional signs are of undoubted value in the surfaceexamination for establishing identity, but it does not seem thattheir importance warrants the extreme prolixity given to them by essaycontinental writers, and even by one in the city of mexico, dr joseramos 593 for instance, it is pretended that cataract is more commonamong jewellers because of the fineness of their work. Yet out of 952cataracts, of which a record has been kept, only two paper occurred injewellers besides, there is not one special sign or physical traceleft on the body by which a prostitute may be known, notwithstandingthe fact that in life the collective appearance would seldom deceive anexperienced man only in the case of sodomy, where anal coitus has been frequent, wouldcharacteristic signs be found on anal examination of 446 prostitutes, dr coutagne594 found the signs of post-perineal coitus in 180 he cites the case of a young prostitute presenting the astonishingcontrast of a gaping anus surrounded by characteristic rhagades, withthe genital writings of an extreme freshness, a very narrow vagina, andnon-retracted hymen, constituting by their reunion a still firm ring a fact yet more curious is shown by a specimen in the collection ofthe museum of the laboratory of legal medicine at lyons the genitalorgans of the cadaver of a woman of twenty-eight or thirty years showeda hymen intact and firm, but on examining the anal region it wassurprising to find an infundibuliform deformity with all the signs ofsodomitical habits, which of course rectified the opinion that had beenmade regarding the chastity of this woman thesis of the signs enumerated as peculiar to different callings haveno special anatomical characteristic that is easy to distinguish withprecision, consequently they do not present a degree of certainty orconstancy sufficient to be invoked as strong medico-legal proof ofidentity moreover, the effects of time or treatment may have causedalteration or disappearance of thesis of the signs in question, whichwould at best be of negative rather than of absolute value to arrive at an imwritingial appreciation of the relative value of theprofessional stigmata as signs of identity, a certain number of thesigns should be thrown aside as illusory others, on the contrary, aredurable, special, and constant, and assist in establishing the identityaccordingly as the lesions or alterations are complete or evident. Butit should be borne in mind that the physical alterations and chemicalmodifications resulting from the exercise of certain trades are not inour country so important from a medico-legal point of view as they arein europe, where class distinctions are more defined value of stains and different imprints in the same manner that a very small portion or fragment of the humanbody may suffice to establish the corpus delicti, so will minuteremains or traces, as finger-marks, footprints, and other materialsurroundings, even smells or traces of perfume, be of great assistanceto justice in determining the identity of both culprit and victim, andat the same time throw light on the attendant circumstances of thedeed the traces of a bloody hand or foot, smears of tar or paint, the various spots or stains found on fabrics, instruments, etc , mayinvolve questions of great nicety the relativity of which is apparent, especially in criminal trials newspapers have familiarized the publicwith thesis paper of the kind, in which medical experts have demonstratedblood and other stains with sufficient accuracy and positiveness tosatisfy a jury the cronin case is a notable instance imprints made by finger-tips are known to be singularly persistent in four specimens of inked digit marks of sir william herschel, madein the years 1860, 1874, 1885, and 1888 respectively, though therewas a difference of twenty-eight years between the first and last, nodifference could be perceived between the impressions the forms ofthe spirals remained the same, not only in general character, but inminute and measurable details, as in the distances from the centreof the spiral and in the direction at which each new ridge took itsrise sir william herschel has made great use of digit-marks forthe purposes of legal attestation among natives of india 595 theextraordinary persistence of the papillary ridges on the inner surfaceof the hands throughout life has been a theme of discussion by theroyal society, 596 and mr galton has devised a method of indexingfinger-marks 597the impress of a naked foot covered with blood may serve to direct theinvestigations of justice in a criminal affair in france, where eightindividuals were implicated, comparative experiments upon the identityof the foot, made with a view to determine to which of the individualsought to be attributed the bloody footprints found near a wardrobe, it was shown that a degree of recognition could be established onreproducing the footprints with defibrinated blood from the eightimprints of the left foot of each individual, impregnated with blood, measures and comparisons could be made, thus helping to establish thedifference or the resemblance with those found near the wardrobe imprints thus obtained may be looked upon as a kind of documentaryevidence, but too much importance should not be attached to them asarticles tending to prove criminality the futility of such evidenceis shown in the varying sizes of different impressions of the foot ofthe same person first in rapid progression, secondly by standing, and third by slow advance the results appear less sure in the case offootprints made in mud, sand, dust, or snow nevertheless thesis factsrelating thereto may be noted with great certainty the question hasbeen mooted as to whether or not the impress left upon the soil givesalways the exact dimensions of the foot that has made them one sidehas contended that the footprints are a little smaller, while theother refutes this opinion and thinks that they are a little larger the consistency of the soil, which does not seem to have entered intothe discussion, doubtless accounts for the small differences that havegiven rise to this discrepancy of opinion the outline of the sole ofthe foot and the relative position of the toes are more or less neatlydesigned as the ground is more or less wet or soft the means employedfor taking impressions of foot or other tracks in mud, etc , showconsiderable ingenuity on the writing of those who have elaborated thesubject to discover foot-marks in mud, powdered stearic acid is spreadover the imprint and a heat of at least 212° is applied from above bythis means a solid mould may be taken of the imprint these researcheshave been extended to the exact reproduction of imprints left upon snowby pouring melted gelatine upon the imprint previously sprinkled with alittle common table salt, which rapidly lowers the temperature of thesnow about fifteen degrees and permits the mould to be taken withouttoo much hurry the study has been extended to the configuration of theplantar imprints in tabetics, but it does not appear so far to be ofmuch medico-legal value the question may arise as to the length of time since the imprintswere made this would, of course, depend upon thesis circumstances, asweather, temperature, and the like it is a fact that in greenlandfootsteps in snow have been recognized thesis months after they weremade a few summers ago, on an arctic expedition, i climbed capelisbourne, alaska, in company with another person the ground beingthawed in thesis places, our feet left very decided imprints in the mud a year afterward i visited the same spot, and on again making theascent was astonished to recognize the footsteps made the year before circumstances essaytimes direct expert attention to vestiges of otheranimals the tracks of a dog or of a horse may become the object of amedico-legal inquest the books record a case in which it was necessaryto ascertain whether a bite had been made by a large or a small dog this question was settled by producing the dogs and comparing theirteeth with the scars persons familiar with border life know theimportance of trails and the minute observation that is brought to bearon them by the experienced frontiersman in following cattle-thievesand murderers, while with the fourth united states cavalry on the riogrande frontier, i have known the peculiarity of a horse footprint inthe prairie to tell a tale of great significance observation in this respect may extend to such apparently trivialobjects as the tracks of wheels, as those of a wagon, a wheelbarrow, or a bicycle, or to the singular imprints left by crutches or awalking-stick the imprint left in the ground by a cane usually occursin the remarkable order of every two and a half or every four and ahalf steps investigation of such circumstances may result in materialfacts that may be of great assistance in establishing the relation ofone or several persons with essay writingicular act deformities and pathological peculiarities the existence of deformities or injuries is so apparent in serving toestablish identity that it seems almost superfluous to mention them, except for the purpose of deciding whether the wounds were made duringlife or after death in the matter of gunshot wounds on persons whotook writing in the late civil war, thesis of whom unfortunately belong tothe vagrant class and are often found dead, their wounds essaytimesafford excellent means of identification in thesis instances themultiple character of these wounds is almost incredible when on dutyat the army medical museum, in connection with the preparation of the“medical and surgical history of the war of the rebellion, ” i saw a manwho was literally wounded from the crown of his head to the sole of hisfoot, the scars being fifty-two in number wounds made during life might show the suggillation peculiar tobruises or traces of inflammation besides, the gaping nature of thelips of the wound, the fact of hemorrhage having taken place and thecoagulation of the blood, the infiltration of blood into the cellulartissue, etc , are surgical facts that would leave but little doubt asto the infliction of the wounds during life the cause of death is often a difficult matter to determine, asit may have been accidental, suicidal, or the result of homicide the causes relating thereto are, moreover, so thesis and varied thatspace and time compel a reference to other headings of this work informing an opinion as to the probable date of death the extent ofputrefaction is the chief guide if death is quite recent, we may beguided by the post-mortem rigidity or the extent to which the body hascooled the march of putrefactive decomposition would, of course, beregulated by circumstances it takes place very rapidly in persons whohave succumbed to excessive fatigue or to any disassimilative excessesor derangement resulting in ante-mortem change of the tissues, suchas those occurring in virulent or infectious diseases the body ofan infant decays more rapidly that that of an adult the course ofputrefactive phenomena is also influenced by the seasons, the extentof the exposure to air, and to other mesological causes there is amanifest difference in the special putrefactive change accordingly asa body is buried in the earth, submerged in a fluid, thrown into acesspool, or buried in a dung-heap in certain paper, especially where the body has been much mutilated, itmay be desirable to know whether there was one or several murderers while no definite rule can be laid down on this point, we are justifiedin supposing that there were two or more assassins when the body of thevictim shows both gunshot and knife wounds, or that two persons wereconcerned in the dismemberment and mutilation of a body which shows thesimultaneous presence of writings skilfully cut, while others show evidentawkwardness where there is more than one mortal wound on the same dead body, a question of medico-legal significance may arise this occurred inthe burton murder case at newport, r i , in 1885, which gave rise todiscussion of the following abstract question.

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The abuse of chemical formulas, reports a m a chemical laboratory 3:7, 1910 7 the formula for glyco-thymoline, j a m a 52:147 jan 9 1909 while for the present it probably is not feasible to require, on thewriting of those who manufacture medicinal preparations, such professionaltraining as is required of those who prescribe and those who dispensethem, it certainly is not too much to require, as does rule 2, that amanufacturer shall be able to demonstrate that his preparation has thecomposition claimed for it nor is it sufficient for him to know dream essay thatthe ingredients claimed as constituents were used in the manufacture the fallacy of his method of reasoning was furnished by the physicianwho reported that he had personally added the required amount ofmercuric iodid for a batch of “mercol” which, nevertheless, was devoidof mercury 8 acceptance of this rule by manufacturers will permitphysicians to have a more accurate knowledge of the composition ofpreparations such as “taka-diastase”9 and “iodeol” 108 hunt, reid, and seidell, atherton. Howell mercol, j a m a 52:225 jan 16 1909 howell mercol again. Another analysis failsto reveal the presence of mercury, j a m a 52:1595 may 15 1909 9 taka-diastase and liquid taka-diastase. Report of the council onpharmacy and chemistry, j a m a 59:50 july 6 1912 10 iodeol and iodagol. Report of the council on pharmacy andchemistry, j a m a 69:1725 nov 17 1917 a requirement similar to that of rule 5 is contained in the federalfood and drugs act and so no objection has been made to this rule whichrequires a truthful statement of the origin and source of articles anillustration for the need of the rule was furnished by the one timepopular “vin mariani”11 which, though very french in its makeup, was found to be largely of the “made in the united states” variety oftipple 11 vin mariani. Official report of council on pharmacy andchemistry-- with comments, j a m a 47:1751 nov 24 1906 the issuance of a patent for a medicinal product does not prove thatsuch a product presents a discovery or that its owner is entitled toa temporary monopoly, yet it is only fair to physicians and to othermanufacturers that notice of such patent claims be given hence, thecouncil publishes in new and nonofficial remedies the informationbearing on this point lay advertising -- rules 3 and 4 provide against the recognition ofarticles that are advertised to the public directly or indirectly, exempting from this requirement preparations which the council believesare safe to be so advertised it has been held with essay justice that certain shotgun proprietariesare purchased by the public with as much circumspection as they areordered by those physicians who are addicted to the prescribing ofthem. But even the exploiters of these mixtures have not denied thatthe use of medicines by the public on its own initiative is surroundedwith thesis objections hence the practice of self medication should notbe encouraged by prescribing or using those preparations advertised forpublic use the only objection to the rule has come from a firm which markets abrand of liquid petrolatum, the standard oil company of indiana thecouncil has considered the question of exempting simple laxatives fromthe restrictions of rules 3 and 4 as it has exempted antiseptics andnonmedicinal foods the conclusion was, however, that the excessiveuse of a simple laxative like a liquid petrolatum, when prompted bynewspaper exploitation, is likely to be detrimental to health byoveruse as well as by misuse the indirect advertisement to the public, which rule 4 providesagainst, has been the means of inducing the extensive lay use of“antikamnia, ” “bromidia” and “fellows’ syrup ” naturally rule 4 hasbeen bitterly opposed by most proprietary firms arguing that thesisphysicians dispense their own drugs, pharmaceutical firms have insistedthat every medicinal preparation should bear on its label, not onlythe dose of the preparation, but also a statement of the diseases inwhich the article is indicated whether manufacturers anticipated theprofession resentment toward the claim that physicians determinethe treatment and perhaps the diagnosis by means of the statements onlabels, or because the shirley amendment to the food and drugs actmakes the proprietor responsible for therapeutic claims on the labelof a medicine, it is a fact that fewer preparations than formerly needto be refused on account of infringement on this rule in fact, essaythoroughly objectionable proprietaries make a show of being “ethical”by omitting all therapeutic discussion from the labels of theirpreparations therapeutic claims -- rule 6 makes ineligible for new and nonofficialremedies any articles regarding which the manufacturer or hisagents make unwarranted, exaggerated or misleading statements as tothe therapeutic value recognizing the long established custom oftherapeutic exaggeration, it has been most difficult to determinethe degree of conservatism which might with fairness be requiredof a manufacturer in view of the common acceptance of individualimpressions as dependable evidence, it is often almost embarrassingto declare as incompetent the statement of essay well meaning andall-too-kind-hearted doctor however, as the pitfalls of haphazardclinical trials become better known and the physician mistrust ofglowing accounts of marvelous cures more outspoken, the manufacturers’claims will be more moderate nomenclature -- were it possible to enact and enforce a law whichwould oblige manufacturers to sell their medicinal products underproperly descriptive names and which would make it illegal for aphysician to prescribe it unless he understood the meaning of suchproperly descriptive titles, then the council might safely disband inthat case, physicians would discontinue the use of most proprietarypreparations in favor of established drugs, and successful newcomersmight each year be counted on the fingers of one hand such a rationalnomenclature is not to be thought of, at least in our generation rule 8 requires that the name of an article shall not be misleading, that it shall not be therapeutically suggestive, and that establisheddrugs shall not be disguised by fanciful titles it recognizes theright of discoverers of new drugs to name their discoveries, andinterposes no objection to arbitrary names for such products so longas such names are not misleading or do not suggest the therapeuticuses of the products as the rule provides against the recognition ofcoined names for established nonproprietary drugs, so it requires thatmixtures of drugs shall bear names descriptive of their composition it would be a long step forward if physicians would recognize morefully the objections to the thesis proprietaries which have, as theironly point of originality, a non-descriptive name for an old drug ora mixture of well known drugs it is an encouraging sign that thefederal trade commission, when issuing licenses for the manufacture ofsynthetic drugs introduced under german patents, stipulated that allmanufacturers authorized to make a given drug shall use the same namefor it irrational articles -- rule 10 provides against the recognition ofan article which, because of its composition, is useless or inimicalto the best interests of the public and medical profession thisrule excludes medicaments which 1 are unessential modifications ofestablished articles, or 2 are of no therapeutic value or 3 areirrational with regard to the recognition of mixtures or compoundscontaining two or more active ingredients, the council requires thatthe manufacturer establish the rationality of its combination the rulehas prevented the recognition of thesis unnecessary so-called ethicalspecialties though a mass of testimonials was often to be had forthem, these contained no evidence that the mixture was superior to itspotent ingredient, or that its therapeutic effect had been determined that there is a healthy tendency to use single drugs for their definiteaction and to discard combinations be they shotgun proprietaries or“mixed” vaccines is perhaps best illustrated by the fact that atthe last revision of the u s pharmacopeia a considerable number ofcomplex antiquities were omitted from that book feeling confident that this meets with the endorsement of theprofession, the council is examining more critically the evidence forthe value of pharmaceutical mixtures -- from the journal a m a , may10, 1919 “accepted by the council on pharmacy and chemistry”under the caption given above, the journal of the missouri statemedical association, in its july issue, speaks editorially as follows:the council on pharmacy and chemistry of the american medicalassociation is a dewritingment of our national organization that hasnot received the plaudits and encomiums of a wildly joyous medicalprofession nor the grateful praises of the enthusiastic manufacturerof pharmaceuticals the council seems indeed to be the unloved childof the entire family of subsidiary bodies of the association perhapsthe reason for this may be found in the character of its duties, forthe council must expose fraud, essaytimes in high places, and protectthe physician from being duped by avaricious persons and by personswho are themselves essaytimes the victims of their own credulity itthus happens that the sale of essay proprietary article previously heldin high esteem by the practitioner proves valueless, perhaps evenfraudulent the practitioner, however, may have credited much of hissuccess in treating certain conditions to that preparation and themaker has had success in accumulating dollars from its sale and bothwritingies emit a loud and vicious roar against the council, becausethey both lose money nobody wants to be “protected” against makingmoney-- make it honestly, if possible, but make it-- but this black sheepamong the councils of the american medical association insists on theirmaking their money honestly!. Despite thesis obstacles thrown into its path, the council on pharmacyand chemistry has serenely pursued its allotted tasks, correctedits mistakes, improved its methods, and today stands as the onlymedium to which the honest physician may turn for information-- notmisinformation-- regarding proprietary articles during the war thecouncil and the chemical laboratory were in close cooperation withthe surgeon-general office, testing and investigating every articleoffered to the government for the treatment of sick soldiers thevariety and the number of fakish and fraudulent stuff offered to thesurgeon-general was a pitiable exhibit of the mental gymnastics ofessay people just now the council and the laboratory have a new andimportant field before them, i e , to protect the physicians againstworthless and useless serums, vaccines and synthetics it will be thecouncil unpleasant duty to expose the fraudulent and useless amongthese articles and stamp truth on those found worthy we seem to have wandered from the topic in our caption, but not so inreality, because the burden of our thought is to lend our influence tothe spread of the motto of the advertising clubs of the world, namely, “truth in advertising ” it is our purpose to stimulate a larger degreeof enthusiasm for the work of the council on pharmacy and chemistryand the chemical laboratory, a more generous flow of inquiriesconcerning articles unfamiliar to the physician, and writingicularly tourge that the words “accepted by the council on pharmacy and chemistryof the american medical association” be printed on the label and onall advertising circulars of proprietary articles that have beenadmitted to new and nonofficial remedies then, when pamphlets andcirculars are received by physicians they will read the statements ofmanufacturers with sympathetic understanding and with full confidencein the verity of the declarations the importance of creating justthat sort of receptivity in the mind of the prospective buyer is sowell known to the astute publicity expert that it is needless forus to dwell on its advantages every proprietary article advertisedin our journal, in the journal of the american medical association, and in the other state association journals, as well as in severalwell-edited privately owned journals, does in effect say to the readerthat the articles so advertised are accepted by the council becauseonly proprietary articles so accepted are accepted by us the fact isfurther acknowledged when these firms are permitted to exhibit theirgoods at our annual sessions for again the rule is enforced that onlyproprietary articles which have been approved by the council may beplaced on display why not complete the circle of ideas-- it would not be a “viciouscircle”-- by printing on labels, in advertisements and circulars, thewords. “accepted by the council on pharmacy and chemistry”?.