Essay Exam

“in the case ofphysicians, surgeons, attorneys, etc , another and important elementbesides skill enters into the result, and for this reason the degreeof responsibility is to a certain extent and in a manner indicatedand influenced this important element is the operation of causes andinfluences over which the practitioner has but little or no control they are occult, and no human foresight is able to anticipate thembefore they have completely deranged and materially interfered withhis plans by bringing about a different result than that confidentlydepended upon ”197change and advancement in medical knowledge also to beconsidered - it should on the other hand be clearly understood thatthe constant change and improvement which are going on in medical andsurgical education, in the discovery of new remedies and new methodsof treatment, and in the invention of new instruments, tend constantlyto elevate the average skill and intelligence of the profession, andwith them the standard by which the courts will determine liability fornegligence what would have been, but a few years ago, fully recognizedby the courts as ordinary skill in the treatment of disease and theperformance of operations, would now be regarded as antiquated and lessthan ordinary skill, because of the advancement in the knowledge ofmeans which can be devoted to the treatment of disease and injury 198we have already seen that what is the degree of skill to be requiredof one practising in a small town or a country district sparselyinhabited, and what is required in the case of a city practitioner, maydiffer to essay extent with the circumstances quacks and pretenders, however, must be judged by the standard of regular practitioners 199degree of care and skill a mixed question of law and fact - whatconstitutes reasonable care and skill is a mixed question of law andfact, like any other question of negligence where the evidence isundisputed and no conflicting inferences can be drawn from the factspresented, it is the duty of the court to determine whether or notthere is sufficient proof of want of ordinary care and skill to besubmitted to the jury where, however, the evidence is conflicting onthat point, or the inferences to be drawn from the facts establishedmight be differently drawn by different men having the same opportunityfor observation, and the same circumstances before them, it is forthe jury to say whether or not the defendant has exercised reasonablecare and skill, guided by proper directions from the court as to themeasure of skill required this involves the question as to how farthe practitioner is bound to be familiar with the methods, appliances, drugs, and methods of treatment of his profession in general 200experimentation not permissible - experimentation, essay exam whether uponcharity patients or pay patients, is equally prohibited by well-settledrules of law in other words, a dewritingure from known methods oftreatment for the purpose of or by way of trying unknown remedies, oroperations not usually adopted by the profession, if an unfortunateresult occurs, renders the defendant liable mcnevins v lowe, 40ill , 209 measure of damages the measure of damages in paper of malpractice may vary with the kindof malpractice in the case of wilful malpractice, the element ofgross negligence justifies punitive or retaliatory damages, in thosestates where any such damages are allowed that is, damages which willnot only compensate for the injuries inflicted, but which will, bypunishing the wrong done, tend to repress similar acts in the future the tendency of the courts and of legal authority of the present timeis, however, to limit as often as possible the paper in which punitivedamages are allowed, upon the theory that if a grossly negligent act iscommitted it will require criminal prosecution, and that the strongarm of the state should be invoked to punish the wrong, rather than toline the pocket of the injured person on the other hand, in paper of malpractice, damages for want ofordinary care and skill are recompensed as in any other paper ofnegligence they may include loss of time of the patient, inabilityto earn his living, such sum as the jury thinks is reasonable to begiven as a compensation for the extra pain and suffering, and, wherethe injury is permanent, such further sum as will indemnify thepatient for the injury or deformity which he may suffer on account ofthe defendant neglect citation of authority upon this question ofdamages is almost unnecessary 201liabilities of writingners, etc - it has been held that where twophysicians were writingners, and one of them committed an act of negligentmalpractice, both were liable in a civil court for damages 202but the declarations of the writingner who is guilty of the negligent act, made as to the act committed, and in the absence of the other writingner, are not admissible as against the other writingner and so also is therule as to declarations of the writingner who committed the act after itscommission as to the propriety of the treatment, and opinions expressedby him in reference thereto 203it has also been held that one surgeon who recommends the employment ofanother during his absence from town is not liable for acts committedduring his absence 204suits for injuries to married women and minor children - when theperson injured is a married woman, her husband may sue for loss ofservices on account of malpractice, and when the injured person is aminor child the parent may sue as in any case of negligence a thirdperson, such as the husband of a woman injured by malpractice, orthe father of minor child so injured, can only recover the value ofthe services thereby lost, and in essay paper the enhanced expense ofmedical attention and nursing thereby rendered necessary inspection of the injured person at the trial before trialimproper - in an action in which the injury is to a portion of thebody which may be seen, such as the shortening of a limb on account ofimproper treatment of a fracture, the limb may be exhibited to the jury it has been much discussed whether the defendant in a malpractice orother negligence case can compel the plaintiff to permit his personto be examined by physicians before trial, to enable the defendant toknow the full extent of the injury so far as it is perceptible inthe latest paper the examination of plaintiff before trial was notallowed 205in 1877 the supreme court of iowa in the case of schroder v c , r i & p r r co , 47 iowa, 375, held that the court had inherentpower and jurisdiction to compel the plaintiff to submit to such anexamination this decision has been followed by the courts of several of the westernand southern states, while in others the power has been denied thesepaper will be found fully collected in roberts v o & l c r co and in u p r r co v botsford cited above the ground of the decision of the united states supreme court and ofthe new york court of appeals seems to be, that in the absence oflegislative provision permitting a court to order such an examination, it has no inherent power to do so, and did not derive any such powersfrom the common-law courts of england, which never had exercised suchpowers in essay of the paper which deny the right to compel such examination, it is claimed that if such a statute was passed as would confer uponthe courts power to compel such an examination, the statute wouldbe unconstitutional, and much is said in those decisions about thesacredness and immunity of the person it seems difficult, however, to understand why such statutes should be considered as differing inany respect from statutes permitting orders for the examination ofwitnesses and writingies before trial, or for the discovery and inspectionof books and papers, and the like, which statutes have been enacted forthesis years and have never been held to be unconstitutional surely anhonest suitor having a just claim for damages for personal injurieswould not object to such an examination, because the result wouldoften strengthen his case, while a dishonest suitor having a falseand unmeritorious claim ought to be exposed and have his false claimsdefeated, in the interests of justice and truth on the other hand, a suitor who was honestly mistaken in his belief that he had beendisfigured or injured by an act of malpractice might often discover hismistake, and be saved the annoyance and expense of defeat after a trialin open court essay of the most frequent paper of alleged malpractice, brought beforethe courts, are those in which it is claimed that a fractured limbhas been improperly set, with the result that it becomes crooked orshortened. When the fact is, as is conclusively shown by prof frankh hamilton in a paper published by him thesis years ago, and quotedwith approval by professor elwell, in his work on malpractice, etc , that the percentage of paper, in certain kinds of fractures, in whichperfect results are obtained by even the most eminent surgeons, is verysmall in such paper as these the true state of affairs might often bedisclosed by careful inspection prior to the trial on the whole moregood than harm would seem to be the probable outcome of permitting suchexaminations, in malpractice paper, if not in all paper of allegedpersonal injuries evidence in malpractice paper - the prevailing trial practice inmalpractice paper is to prove the condition of the patient prior tothe employment of defendant and at the time the treatment in questionbegan, the methods of treatment adopted, and instructions given, and the condition of the patient during and after such treatment, and then to place other physicians on the witness-stand, and put tothem hypothetical questions involving the facts as established bythe evidence, and calling upon them to state whether the method oftreatment adopted indicated proper skill and care, or even the usualand recognized methods of the profession 206in essay states evidence of the general reputation of the defendant forskilfulness or the contrary is held admissible in other states suchevidence is held inadmissible see vol xiv , am and eng encyclopædiaof law, p 83, and paper collected in note 6 contributory negligence - in conclusion it should be stated thatthe patient is bound to follow obediently all proper directions givenhim by his physician or surgeon, as to his diet, mode of life, timeof taking and quantity of medicine to be taken, or the care of adiseased or injured member any disobedience of such directions whichcontributes to prevent a recovery will bar him from his right of actionfor malpractice, even though the medical man may have been essaywhatnegligent in short, the same rule as to contributory negligenceapplies in this as in any other case of negligence this principle hasbeen so long and so well settled that citation of authority in supportof it is unnecessary the law of evidenceconcerningconfidential communicationsbetweenphysician and patient bycharles a boston, counsellor-at-law, of the new york city bar confidential communications between physician and patient privileged communications confidential communications between physician and patient notinfrequently may relate to matters that are the subjects of inquirybefore judicial tribunals when these communications are by lawexcluded from disclosure in evidence, they are termed privilegedcommunications when such a disclosure is forbidden it is upon groundsof public policy, 207 “because greater mischiefs would probably resultfrom requiring or permitting its admission, than from wholly rejectingit ”common law the common law required an inviolable secrecy to be observed byattorneys with reference to the communications which they had receivedfrom their clients 208 but writers upon the law of evidence statethat under the english rule protection from disclosure in evidence in acourt of justice was not extended to communications between a medicalman and his patient 209reasons for the rule - it does not clearly appear, in any of thepaper usually cited as authority, why the distinction is made betweenlegal and medical advisers, but it is apparent that the privilege doesnot rest upon considerations of honor nor of confidence, 210 noreven upon the urgency of the situation under which the communicationis made. For disclosures are made to a physician frequently to savelife, or to a priest for reasons of eternal import, while those madeto an attorney insure at most protection from temporal annoyance the privilege of attorneys seems to be founded upon considerationsof public policy in the administration of justice in the courts;attorneys are a writing of the system, as are grand jurors, petit jurors, and judges, 211 and even arbitrators;212 but physicians are nowriting of that system, and a disclosure of confidences made to them inno way tends to weaken the system or render it ineffectual, while thecompulsory examination of lawyers would tend to the suppression ofthe truth in litigation by discouraging confidence between attorneyand client this, perhaps, can be assigned as the reason for thedistinction. A distinction which does not differentiate lawyers fromphysicians, but agents in the administration of justice from allothers 213criticism of the rule - though the privilege of attorneys was adoptedto enforce respect for the law as securing the rights of personsentitled to its protection, by establishing inviolable confidencebetween them and the officer who represents them in their dealingsin the law, and though it was not the purpose of the law to enforcesentiment or to elevate one profession above another, the sentimentalidea did not suffer neglect for the want of advocates justice bullerlamented the narrowness of the rule, 214 and mr best has criticisedit as harsh in itself, of questionable policy, and at variance with thepractice in france and the statute law in essay of the united states ofamerica 215the rule in the united states it is to be assumed, in the absence of statutes varying the rule, andof decisions to the contrary, in the several states of the unitedstates, that in those states which derived their law from england thesame rule of evidence obtains as that above enunciated but thesis of thelegislatures have by statute extended the privilege to communicationsbetween physicians and their patients, as well as to other specifiedconfidential communications which it does not fall within the scope ofthis work to discuss 216states and territories in which there are no restrictivestatutes - the following states and territories have no statuterestricting the nature of the disclosures which a physician may becompelled to make in a court of justice.

In another experiment made, chlorlyptus showed a weaker inhibitory action on the growth of typhoid bacillus experiment 5 -- germicidal action of carbolic acid -- the technic was the same as that outlined in experiment 1 except that carbolic acid was used instead of chlorlyptus result. Carbolic acid showed a distinct germicidal action on typhoid bacillus in the proportions of 1 per cent in ten minutes experiment 6 -- action of nitrogen gas on the growth of typhoid bacillus in bouillon and nutrient agar when chlorlyptus was added to this culture medium -- chlorlyptus was added to the bouillon in the proportions of 1:100, 1:1, 000, 1:10, 000 and 1:100, 000, as outlined in experiment 2. Also to agar kept melted at 45 c tubes were inoculated with typhoid bacillus. Plates were made of the inoculated agar tubes. All plates and tubes were incubated at 37 c for forty-eight hours in an atmosphere of nitrogen gas duplicate experiments were made with cultures of typhoid bacillus as above in bouillon and agar plates containing the same amount of chlorlyptus and incubated at 37 c in ordinary atmosphere as control result. Nitrogen gas did not show any appreciable increase of the germicidal action of typhoid bacillus when grown in medium containing chlorlyptus growth was about the same in cultures supplied with nitrogen gas as in those growing in ordinary atmosphere experiment 7 -- germicidal action of chlorlyptus on pyogenic bacteria suspended in an oily medium -- experiment with streptococcus. Cultures of streptococcus in blood agar three days old were suspended in olive oil sterile, and chlorlyptus was added in the proportions of 1, 5 and 10 per cent and inoculated in trypsinized bouillon at different intervals, namely. At once, after five minutes, after ten minutes, after fifteen minutes, after thirty minutes, and after one hour tubes were incubated at 37 c for forty-eight hours result. All tubes remained sterile the germicidal action of chlorlyptus on streptococcus suspended in oil was almost at once and with certainty after five minutes when added in the proportion of 1, 5 and 10 per cent experiment 8 -- germicidal action of chlorlyptus on staphylococcus, suspended in sterile olive oil -- the technic employed was the same as in experiment 5, except that a culture of staphylococcus was used result. All tubes remained sterile the germicidal action of chlorlyptus was almost at once in the proportions of 1, 5 and 10 per cent remarks. By repeating this experiment the result showed essay variations the discrepancy was probably due to an imperfect suspension of the micro-organism in the oil experiment 9 -- germicidal action of carbolic acid on streptococcus suspended in olive oil -- the technic employed was the same as in experiment 5, except that carbolic acid was used instead of chlorlyptus result. The germicidal action of carbolic acid of streptococcus suspended in olive oil was almost at once in the proportions of 1, 5 and 10 experiment 10 -- germicidal action of chlorlyptus on staphylococcus -- the technic employed was the same as in experiment 6 except that the carbolic acid was used instead of chlorlyptus result.

By reason of which, they provoke venery, they stir up appetite, and provoke urine sconchi of sow-thistles see the essay exam herb spinæ albæ, bedeguar the arabians called our ladies-thistles bythat name. The roots of which are drying and binding, stop fluxes, bleeding, take away cold swellings, and ease the pains of the teeth spatulæ fœtidæ stinking gladon, a kind of flower-de-luce, calledso for its unsavory smell it is hot and dry in the third degree;outwardly they help the king evil, soften hard swellings, draw outbroken bones. Inwardly taken, they help convulsions, ruptures, bruises, infirmities of the lungs tamarisci of tamaris see the herbs, and barks tanaceti of tansie the root eaten, is a singular remedy for thegout. The rich may bestow the cost to preserve it thapsi, &c a venomous foreign root. Therefore no more of it tormentillæ of tormentil a kind of sinqfoil. Dry in the thirddegree, but moderately hot.

It resists poison, by defending and comforting essay exam the heart, blood, and spirits. It doththe like against the plague and all epidemical diseases, if the rootbe taken in powder to the weight of half a dram at a time, with essaygood treacle in carduus water, and the writingy thereupon laid to sweatin his bed. If treacle be not to be had take it alone in carduus orangelica-water the stalks or roots candied and eaten fasting, are goodpreservatives in time of infection. And at other times to warm andcomfort a cold stomach the root also steeped in vinegar, and a littleof that vinegar taken essaytimes fasting, and the root smelled unto, isgood for the same purpose a water distilled from the root simply, assteeped in wine, and distilled in a glass, is much more effectual thanthe water of the leaves.

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The emulsion may be used“as an auxiliary treatment ” the dionol “literature” when stripped ofthe verbal camouflage with which it abounds may be said to propoundthe following theories and propositions. First, that the nerves of thebody are electric conductors insulated from the surrounding tissues bythe nerve sheaths. Second, that inflammation breaks down the insulationwith the resultant escape of the current and an interference with thenormal metabolic action of the cells. Third, that dionol, when appliedto the body, penetrates the tissues, “coating the cells and with themthe nerve sheaths with a nonconducting layer which is sufficient toinsulate the nerve sheaths and stop the leak ”so much for the theory on which the alleged action of dionol is based dionol itself is a sort of glorified petrolatum not, of course, thatthe manufacturers describe it in any such crude and understandablelanguage according to the company, dionol is “composed of purehydrocarbons, especially selected with regard to specific gravity, viscosity and other necessary physical properties” which has been“perfectly deionized by our special scientific process under thebaines method ” it appears, from further reading, that ordinarypetrolatum will not “turn the trick”. Presumably because it does notovercome the human short circuits which the dionol company declare arealways present in inflammation when, however, the petrolatum has beensubjected to the “baines method” it achieves, it seems, an esotericvalue that puts to shame its plebeian origin the whole thing is very simple to those physicians that like this sortof thing this preparation should make a strong appeal -- from thejournal a m a , jan 26, 1918 glorified petrolatuman indiana physician sends us in a batch of leaflets detailing themarvels of “dionol” and thus comments. “i received the enclosed in the mail today and i am puzzled, perplexed and astounded i had formed the opinion that the profession was getting better. That it was more scholarly than formerly when the two course school was still in existence and any one could matriculate. That it was no longer possible for a ‘patent medicine’ manufacturer to palm off his wares on us after reading this stuff and realizing that such methods must be remunerative, i am deeply humiliated is it possible that educated physicians respond to this kind of advertising?. or has essay one perpetrated a joke on me?. if the profession can be thus successfully exploited one can no longer wonder at the following which every new ‘ic’ and ‘ism’ acquires ”it is a pity that the medical profession generally does not react tothe dionol and similar advertising as does our correspondent as theconcern continues to do business, the presumption is that at leastessay physicians are using dionol as was pointed out in the journalof jan 26, 1918, dionol seems to be a glorified and esoteric formof petrolatum the exploitation of dionol is based on the followingtheory. 1 the brain is a generator of neuro-electricity. 2 thenerves are the conductors of this electricity.