Essay Outline

The first of which is an italianby birth, and only nursed up here in the gardens of the curious twoor three sorts are found commonly growing wild here, the description oftwo of which i shall give you descript the first is a smooth, low plant, not a foot high, verybitter in taste, with thesis square stalks, diversly branched from thebottom to the top, with divers joints, and two essay outline small leaves at eachjoint, broader at the bottom than they are at the end, a little dentedabout the edges, of a sad green colour, and full of veins the flowersstand at the joints, being of a fair purple colour, with essay whitespots in them, in fashion like those of dead nettles the seed is smalland yellow, and the roots spread much under ground the second seldom grows half a foot high, sending up thesis smallbranches, whereon grow thesis small leaves, set one against the other, essaywhat broad, but very short the flowers are like the flowers of theother fashion, but of a pale reddish colour the seeds are small andyellowish the root spreads like the other, neither will it yield toits fellow one ace of bitterness place they grow in wet low grounds, and by the water-sides. Thelast may be found among the bogs on hampstead heath time they flower in june or july, and the seed is ripe presentlyafter government and virtues they are herbs of mars, and as choleric andchurlish as he is, being most violent purges, especially of cholerand phlegm it is not safe taking them inwardly, unless they be wellrectified by the art of the alchymist, and only the purity of themgiven. So used they may be very helpful both for the dropsy, gout, and sciatica. Outwardly used in ointments they kill worms, the bellyanointed with it, and are excellently good to cleanse old and filthyulcers black hellebore it is also called setter-wort, setter-grass, bear-foot, christmas-herb, and christmas-flowers descript it hath sundry fair green leaves rising from the root, each of them standing about an handful high from the earth. Each leafis divided into seven, eight, or nine writings, dented from the middleof the leaf to the point on both sides, abiding green all the winter;about christmas-time, if the weather be any thing temperate, theflowers appear upon foot stalks, also consisting of five large, round, white leaves a-piece, which essaytimes are purple towards the edges, with thesis pale yellow thumbs in the middle.

“di hypo sodio calcio phosphite hydroxy arseno mercuric iodid ” the first writing of this “formula” might stand for sodium and calcium hypophosphite the remainder is meaningless except that it suggests but does not insure the presence of arsenic and mercury iodide “‘luvein’ arsans, nos 1, 2 and 3 ”-- “meta hydroxy iodide sodio arsano mercuric dimethyl benzo sodio arsenate, ai oxy sodio tartaria sulpho disheuyl hydrazin ” who can venture even a conjecture as to the possible significance of this?. “‘luvein’ creosophite ”-- “ammonio hydroxy calcio sodio hypo-phosphite arsenous pentoxy iodide ” while the name suggests creosote, the “formula” gives no hint of this it might refer to hypophosphites of ammonium, calcium and sodium with iodide of arsenic whether arsenous trivalent arsenic or arsenic pentavalent arsenic iodide or both are intended, is a question “‘luvein’ hexacol ”-- “hexa methylenepyro catechin mono methyl amino ether glycerite ” by moving these syllables around like the old “fifteen puzzle” they can be arranged to represent hexamethylenamin and monomethyl-ether of pyrocatechin, or guaiacol, having the “glycerite” left over it is futile to discuss the therapeutic claims made for the variouspreparations put out by the lucas laboratories one might as profitablydiscuss the therapeutic claims made for “peruna” or “paine celerycompound” for the exploitation of the latter products is on just ashigh a scientific plane as the exploitation of the “luvein” nostrums the proposition offered to physicians by the lucas laboratories, inc , is an insult to the intelligence of the medical profession not thatthe products themselves are necessarily any worse or any better thanthesis offered for intravenous use. The selling methods are more crude, that is all the facts are, we have entered a new cycle of nostrum development theunscientific mixtures for oral administration that characterized solarge and disreputable a writing of the proprietary medicine business ofthe past two or three decades are giving way to equally unscientificmixtures for intravenous use the dangers of the older nostrumsare accentuated in the newer by the added element of risk that isinseparable from intravenous therapy add to this the temptation tothe physician in the way of more substantial fees which, legitimatelyenough, may be charged when intravenous administration is called for, and the menace of the new style nostrum becomes evident the journalcan only reiterate the warning that intravenous therapy should beemployed only when most positively indicated further, because of thedanger that is inseparable from this method of drug administration, physicians should be doubly careful to see that products employedfor intravenous use come from firms of unquestioned scientificstanding -- from the journal a m a , sept 20, 1919 “phylacogens”ll this matter was largely reprinted in the propaganda for reform, eighth and ninth editions a physician in florida writes. “i am enclosing a copy of a circular letter just received from parke, davis & company, and will call your attention to a marked paragraph in this letter on which i would like to have an expression of your opinion ”the circular letter which the doctor forwards is devoted to singingthe praises of “pneumonia phylacogen ” it opens with the statement:“influenza, we learn, has appeared in your section ” the paragraphmarked by our correspondent reads. “pneumonia phylacogen has been found to be a dependable means of preventing and treating pneumonic complications of influenza in one large city it became a routine measure to give all persons affected with influenza an injection of pneumonia phylacogen as a prophylactic of pneumonia the results were remarkable not only did the paper improve rapidly, but in a great majority of them the pneumonia did not occur ”the “phylacogens” were repeatedly discussed in the journal during 1913and 1914 when these products were being pushed with much vigor by themanufacturers we know of no evidence that calls for a revision ofthe statements then made regarding them the injection of phylacogensis simply the administration of a mixture of the filtered productsof several bacterial species the results which follow represent thereaction of the bacterial protein-- a reaction for good or evil thereis no scientific evidence to show that they possess any specificprophylactic virtue to recommend their use in paper of influenza, as a prophylactic against pneumonia, is unwarranted, and thephysician who acts on the advice of the manufacturer must assume theresponsibility for the results in case of mishap he cannot fall backon the manufacturer. He will find no scientific evidence to supporthim -- from the journal a m a , nov 15, 1919 pineoleum advertising methods capitalizing the name and position of the president of the american medical associationto the editor:-- enclosed is a postal card which a physician inoklahoma has sent me together with thirty-six cents in stamps theenvelop was addressed to me at the address of the pineoleum company the postoffice corrected the address and sent it to me it is evident, therefore, that the physician in oklahoma thought i was sending thesepostals as an employee of the pineoleum company, or, at least, wasendorsing their products illustration. Postal card capitalizing the name and position of the president of the american medical association kindly do me the favor to publish this letter in the journal as aprotest against the dishonesty of this method of advertising what isquoted from an article that i wrote appeared originally in the newyork state journal of medicine and was abstracted in the journalof the american medical association of august 2, 1919 the obviousinference to be drawn from this postal is that i referred to theproducts of the pineoleum company in that article i did not have theproducts of the pineoleum company in my mind i never have used theirproducts and never prescribed them this form of advertising is done with intent to deceive and did deceivethe doctor in oklahoma it was therefore a successful falsehood, itssuccess depending on the false use of the name of the president of theamerican medical association to bolster up the sale of the product i resent the use of my name in connection with the quack advertisingof nostrum venders the low, vulpine cunning of the method used ison the same level as the deceit and dishonesty which use this formof advertising to the injury of my name and reputation as presidentof the american medical association i must insist that you protectme by publishing this letter in the journal, giving it as widespreadpublicity as possible alexander lambert comment -- “pineoleum” is a “patent medicine” advertised in thecheapest and most effective way-- by the aid of the easy going andcomplacent physician in 1906 pineoleum was being marketed by thewinslow laboratory of new york city, which also put out three or fourother nostrums-- “morumalt, ” “egeriol, ” “digestylin, ” and “fordnucleo-peptone ” pineoleum was advertised to the public then as it isadvertised now, via the medical profession physicians are circularizedand are offered a petty graft in the form of a cheap nebulizer and asample bottle of pineoleum essay time ago the company seems to havedeveloped a scheme whereby physicians could make money “dispensingpineoleum nebulizer outfits at more than 140 per cent profit ” thepineoleum concern for years has also polluted the stream at its sourceby attempting to get the secretary of the senior class of every medicalschool to distribute its free nebulizer outfits to members of theclass and receive therefor 5 cents for each outfit distributed!. thelife history of pineoleum is that of the typical nostrum epidemics, of course, are utilized as opportunities for pushing the product in1911 a card was sent out featuring “a special lagrippe offer”. In 1916the profession was circularized recommending pineoleum as “the idealprophylactic” in infantile paralysis. During the past year influenzahas again been the selling point the case described by dr lambert is not the first example of themisuse of names and statements of physicians last december thepineoleum concern was sending out an advertising card in which dr mccoy of the united states public health service was quoted asrecommending pineoleum as the “bulwark of prevention” and “battery ofrelief” in influenza of course, dr mccoy never said anything of thesort a protest against this writingicular falsehood resulted in anothercard being sent out several months later by the pineoleum peoplepurporting to explain and apologize for the misquotations and puttingthe blame on the printer the “apology” ended with a postscript inlarger and bolder face type than the body of the card that urgedphysicians to “secure our liberal introductory advertising propositionon improved oil nebulizer outfits ” from the standpoint of publicityfor pineoleum, the “explanation and apology” was doubtless as good anadvertisement as the original card of misrepresentation -- ed -- fromthe journal a m a , nov 1, 1919 “proteal therapy” and henry smith williams to the editor:-- will you please advise as to the success and safeness in using the proteal treatment for tuberculosis by henry smith williams, m d , ll d , 104 east 40th street, new york?.

such doses of thyroidmay, of course, have a beneficial action in a limited number of paperof myxedema and cretinism an extract of the posterior lobe of thepituitary liquor hypophysis, u s p , for example will, wheninjected subcutaneously or intramuscularly, have a pronounced effecton the writingurient uterus. Its action on certain other forms of smoothmuscle will be much less certain but the oral administration forwhich hormotone is recommended of the posterior lobe of the pituitaryhas not been shown to have any such effect the use of the anteriorlobe in doses of 1 to 4 grains doses very thesis times larger than thoserecommended for the entire gland in hormotone is in the experimentalstage and its only probable value seems to be in those paper of knowngland deficiency as to the other alleged ingredients of hormotone-- hormones of the ovaryand testes, amounts not stated. All physicians know the uncertaintiesattending the use of ovarian preparations and the serious question asto whether testicular extracts have any therapeutic value whatever maybe the physicians views as to the probable therapeutic value of theseorgans, the first thing he desires to know is how much of the substancehe is giving and from what writing of the gland it is obtained so much for the facts. Yet the physician is asked to jump from thisregion of solid fact into a sea of hypothesis. To believe thatsmall amounts of the well-known drugs thyroid and pituitary, plusan unknown amount of unknown hormones of the testes and ovary areof great value in conditions that in themselves are often purelyhypothetical he is asked to believe that this combination hasvirtues in such conditions as “hypofunction of the adrenal system, ”neurasthenia, the “fatigue syndrome, ” amenorrhea, dysmenorrhea, “natural and artificial menopause, ” sexual neuroses, cold extremities, cardiac asthenia, low blood pressure, infantilism, sterility, melancholic conditions, obesity, anorexia, anemia, slow metabolism, constipation, psychasthenia, lowered virility and the sexual neurosesof the unmarried, hysteria following functional exhaustion of thenerve centers, frigidity, etc , etc , especially if he guesses thatthe trouble is due to a “pluriglandular disturbance, ” “glandularhypofunction, ” an “adreno-pituitary deficiency, ” suboxidation, etc the physician is invited to use hormotone because, among other reasons, each alleged constituent is said to be “in physiologic sympathy andtherapeutic harmony with the others, ” and further, because. “pluriglandular therapy has the endorsement of high authorities, is both logical and effective and hormotone is a splendid example of it it will be seen at its best where the patient lacks snap and vim and vigor asthenic conditions necessarily indicate hypofunction of the adrenal system ” etc “the use of gland extracts in the treatment of aplasias of the pluriglandular system has become an established therapeutic measure of miraculous potency bayard holmes.

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

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Which if it do, yetapplied to the privities, it stops its lustful thoughts hemlock isexceedingly cold, and very dangerous, especially to be taken inwardly it may safely be applied to inflammations, tumours, and swellings inany writing of the body save the privy writings as also to st anthonyfire, wheals, pushes, and creeping ulcers that arise of hot sharphumours, by essay outline cooling and repelling the heat. The leaves bruised andlaid to the brow or forehead are good for their eyes that are red andswollen. As also to take away a pin and web growing in the eye.