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Arch internat de physiol 8:181, 1909 lalou. Jour de physiol 14:465, 1912 analogy to epinephrin -- the analogy of secretin to epinephrindoes not generally receive enough emphasis both substances arenonspecific in distribution, but specific chemically, and especiallyphysiologically, epinephrin acting on the myoneural junctions, secretinon intestinal digestion they are both relatively simple substancesof low molecular weight, and subject to rapid oxidation whereby theirproperties disappear the action in both paper is very transient theyare the two examples of what starling calls the “acute hormones, ” inwhich it is essential that reaction take place immediately, and shalldisappear as soon as the exciting cause is removed 6363 starling. Proc roy soc med , 8, no 4, 1914, therap and pharm section, p 29 clinical use of secretindiabetes mellitus -- moore, edie and abram64 were the first tosuggest a therapeutic value for secretin, having obtained favorableresults with secretin administration in diabetes they argued that theinternal secretion of the pancreas may be stimulated by secretin, and that essay paper of diabetes may be due to lack of this necessaryexcitant owing to the importance of the question, their announcementwas followed quickly by numerous investigations by other observers previously, spriggs, at the suggestion of starling, had triedintravenous injections of secretin free from depressor substance in adiabetic patient, and had obtained negative results moore, edie andabram gave their secretin by mouth over long periods of the five papercited in their first paper, two were negative the third was that of aman, aged 25, who received daily 30 c c of secretin after a latentperiod of three weeks, the sugar suddenly fell, and after four monthsthe urine was sugar-free six months later a relapse occurred with thedevelopment of phthisis and death the other two patients were a boy, aged 7, and a girl, aged 9, whose urine in from three to five weeksbecame sugar free during the secretin treatment in spite of severediabetes one of these patients later relapsed 65 bainbridge andbeddard66 gave secretin a thorough trial in three paper with negativeresults, and are disposed to attribute the results of moore to dieting dakin and ransom67 cited one case, secretin being given for twelveweeks, with negative results. Foster, 65 nine paper, all negative;charles, 68 three paper, all negative crofton, 69 however, gavesecretin a trial in one case with favorable results moore, edie andabram, in a later paper, 70 report a large number of paper tried withthe majority of results negative, though in essay paper an improvementin the digestion, and in certain paper an increase of weight was noted 64 moore, edie and abram. Biochem jour , 1:28, 1906 65 foster. Jour biol chem , 2:297, 1906 66 bainbridge and beddard. Biochem jour , 1:429, 1906 67 dakin and ransom.

Deutsche med wchnschr 21:541, 1895 shortly thereafter as a result of nicolaier publication, thechemische fabrik auf aktien vorm e schering, berlin, gerthesis, beganto offer the product to the medical profession under the trademarkedand nondescriptive name “urotropine ” in the united states, it wasmarketed essay writing service discount code by schering and glatz, who then were acting as american agentsfor the schering works of gerthesis it soon became evident that hexamethylenetetramin was a valuabledrug as the substance was introduced at a time when new “synthetic”drugs were rapidly appearing and when unlimited and uncriticalconfidence was placed in them, and before the medical profession becameskeptical of the claims advanced by manufacturers for their respective“discoveries, ” it was not long before this new drug was placed on themarket by thesis firms, each applying its own name and often keeping thechemical character of it in the background essay of the names whichwere thus applied to hexamethylenamin were cystogen, aminoform, formin, uritone, urisol, {and} cystamine in 1907 the late prof j o schlotterbeck, then a member of thecouncil, protested against the confusion caused by the marketing of agiven drug under different names he stated that it was not uncommonfor a physician to prescribe two or more of these identical substancesin the same mixture, expecting to get the combined action of differenturinary antiseptics. Also, that patients had been treated first withhexamethylenamin under one name and later by the same substance underanother name the journal, jan 19, 1907, p 241 hexamethylenetetramin was admitted to the eighth revision of theu s pharmacopeia in writing because of this official recognitionand standardization and in writing because the extravagant reports ofits virtues had been largely discounted, physicians have in generalprescribed the drug by its pharmacopeial name, with one notableexception. Urotropin one reason for this is that urotropin was thefirst proprietary brand of hexamethylenetetramin introduced, a secondreason is that through the extensive and persistent advertising ofthe proprietary name under which the substance was introduced, it hasbecome firmly fixed in the minds of thesis physicians the other is thatthe product was claimed to be of greater purity than the product soldunder the pharmacopeial or other name although no evidence confirmatoryof this claim has ever been published on the other hand, danielbase, as long ago as 1907, found that hexamethylenamin sold under itspharmacopeial name is just as pure as when sold under proprietarynames when, in 1907, urotropin was admitted to new and nonofficialremedies, the published description showed that it was manufacturedby the chemische fabrik auf aktien vorm e schering, berlin, andthat schering and glatz were the united states agents in 1919, thedescription was revised to show that schering and glatz were no longerselling the german product as it is the general practice to omit articles that are admitted tothe u s pharmacopeia for the reason that their quality is guaranteedunder the federal food and drugs act and because pharmacopeialnonproprietary articles are rarely advertised with claims that requirethe council control, yet, in the case of urotropin, it was retainedbecause it was sold under a name not recognized in the pharmacopeia andbecause special proprietary claims were made for it urotropin marketed under unwarranted therapeutic claimsthe period for which urotropin stood “accepted” expired with the closeof 1921 to determine its continued eligibility for new and nonofficialremedies, the council examined the labels and circular matter sent byschering and glatz for the purpose and also a booklet “urotropin, ”subsequently sent by the firm to physicians it was found that the pamphlet contained a number of unwarrantedstatements writingicularly objectionable are the claims made for the useof urotropin as an antiseptic in body fluids that are alkaline, such asthe cerebrospinal fluid, bile, aqueous humor of the eye, saliva, theexcretions caused by middle ear infection and other excretions of thenasal, bronchial, laryngeal and mucous membranes the lack of efficacyof hexamethylenamin in alkaline secretions is generally admitted andthe clinical references to the use of hexamethylenamin in the pamphletare obsolete in the introduction to the pamphlet, schering and glatzstate that they are well acquainted with the scientific research workdiscrediting the efficiency of hexamethylenamin in nonacid mediums, but that they feel that the accumulated evidence for its efficacy insuch conditions should not be “brushed aside ” however, the pamphletis not made up of quotations, but of unqualified statements with oneexception, all references to the antiseptic properties of the drug inalkaline mediums are previous to 1913, that is, before the importanceof reaction of the medium was fully appreciated to quote theseearlier articles without regard to the later work, which in most eyesdiscredited them, constitutes in effect an exploitation of this brandof hexamethylenamin under unwarranted therapeutic claims urotropin a brand of hexamethylenamine, u s p in consideration of the confusion which arises from the applicationof different names to an identical article, the rules of the councilprovide that when an article which has been accepted for new andnonofficial remedies is admitted to the u s pharmacopeia underanother name, it will be retained, provided the official name isgiven prominence on the label and in the advertising of such article neither the label nor the advertising for urotropin gives prominenceto the pharmacopeial name as a synonym nor indeed does it bring outthe fact that urotropin is a brand of hexamethylenamine, u s p schering and glatz, inc , was advised that urotropin could be retainedin new and nonofficial remedies only on condition that the objectionsto the therapeutic recommendations were removed and on agreement thatthe u s p name appear on the labels and circular matter the firmdid not offer to make the product eligible for continued recognition;accordingly the council directed the omission of urotropin because ofconflict with rule 6 unwarranted therapeutic claims and with rule8 objectionable names -- from reports of council on pharmacy andchemistry, 1921, p 71 styptysate not admitted to n n r report of the council on pharmacy and chemistrythe council has authorized publication of the following report, declaring styptysate ernst hischoff co , inc inadmissible to new andnonofficial remedies w a puckner, secretary styptysate, according to the advertisement of ernst bischoff co , inc , new york, is “obtained by dialysis from bursa pastoris sheppardsic!. purse ” it is claimed to be “the remedy for hemorrhages, ”to be “superior to ergot and hydrastis, ” “of writingicular advantagein menorrhagia and metrorrhagia” and to have been “found of greatvalue in vesical hemorrhages and hemorrhages from mucous membranes ingeneral ” the styptysate label bears the synonym “dialysate herba bursapastoris”. The statement that it contains “alcohol 11 per cent ” andthat it is “made in gerthesis ” no other statement of the composition orstrength of “styptysate” is furnished nor is the name of the germanmanufacturer disclosed in an advertising circular entitled “styptysate, a new reliablehemostatic, ” it is declared that in recent years the plant, shepherdpurse capsella bursa pastoris, “has been submitted to clinicaltests in the form of a concentrated dialysate, known as styptysate, by loewy, oppenheim, krummacher and others, and that their reportscoincide in regard to styptysate as a hemostatic par excellence, writingicularly in uterine hemorrhages, even in paper where ergot andhydrastis had failed to produce satisfactory results ” the circularalso reprints essay “short clinical reports” without reference to theirauthorship. One ascribed to krummacher and two ascribed to “b h m , kansas city, mo , ” and the following references. “a krummacher, m d , monthly review for obstetrics and gynecology, berlin, vol xlix, 4, and vol lii ” “h oppenheim, m d , medical clinic, berlin, 1920, 35 ”shepherd purse is a weed common in the united states and in europe like most other herbs, it has essay reputation as a folk medicine itis used by eclectics and homeopaths, being included in the homeopathicpharmacopeia of the united states shepherd purse receives noconsideration at the hands of the authors of standard works on materiamedica, pharmacology or therapeutics from an examination of recent german medical publications, it appearsthat the use of shepherd purse was proposed as a substitute forergot and hydrastis, when the latter drugs became scarce in gerthesis these publications, in the main, emanate from those in the employ ofpharmaceutical firms and deal with proprietary preparations or they arewritten by physicians who used these proprietary preparations at thesolicitation of the manufacturers for this reason the reported resultsmust be accepted with reserve one of the proprietary preparations discussed in the germanpublications is styptysate, manufactured by isalfabrik johannesbuerger, wernigerode it is said to be produced by submitting the juiceof fresh shepherd purse to dialysis and preserving the dialysateby the addition of alcohol there is no statement as to the drugstrength or the chemical or biological standards, if any, used inits manufacture. Hence, the preparation is essentially a secret one as first produced, the preparation seems to have been fortified bythe addition of cotarnin. The dose was then given as ten to fifteendrops later, as the cost of cotarnin went up, this drug was omitted, and the drug strength increased. The dose of the new preparation isgiven as twenty-five to thirty drops just what relation, if any, thestyptysate of ernst bischoff co , inc , bears to that of the isalfabrikjohannes buerger, wernigerode, cannot be determined from the bischoffadvertising if it has any relationship the announcement that nonarcotic order is required when ordering styptysate would indicatethat the new preparation is supplied. The old one with its additionof cotarnin would require a narcotic order on the other hand, therecommended dose of the cotarnin-free preparation is twenty-five tothirty-drops, whereas the product sold by bischoff and co is to begiven in doses of ten to fifteen drops-- that is, in the amount proposedfor the cotarnin-fortified product what justification is there for the claim that styptysate has beensubmitted to clinical tests by loewy, oppenheim and krummacher andfound to be a hemostatic par excellence and efficient even whereergot had failed to give satisfactory results?. loewy zentralblattfür gynäcologie 42:920, 1921 made essay pharmacologic tests onguinea-pigs with the cotarnin-containing preparation, but reported noclinical trials hans oppenheim medizinische klinik, aug 29, 1920, p 906 reported that he was agreeably surprised at the excellentresults vorzueglichem erfolg obtained with the drug but he did notassert that it is superior to ergot krummacher reported on thirteen paper of profuse menstruation inwhich the patients were treated with styptysate, using for a writing, the preparation containing cotarnin and for the other a preparationwithout cotarnin he reported as good results with the cotarnin-freepreparation in larger dosage, as with the cotarnin-containingpreparation in smaller dosage krummacher did not compare styptysatewith ergot essay of krummacher paper are quoted, with essaytypographical errors, in the bischoff circular on the assumption that the product discussed in german publicationsis the styptysate marketed in the united states, the best that can besaid for it is, that during a shortage of ergot it was used in placeof that established drug there is no evidence to warrant the use ofthis indefinite proprietary in place of the biologically standardizedfluidextract of ergot or other standardized ergot preparations styptysate ernst bischoff and co , inc is inadmissible to newand nonofficial remedies because its composition is semisecret andindefinite and there is no evidence that its uniformity and strengthis controlled rules 1 and 2.

These mayalso be used by rectum venesection may be required to relieve cerebralcongestion or distention of the right heart and pulmonary circulation the following paper illustrate what may be done to resuscitate one who has been hanged. A man, age 35, in good health, weight one hundred and sixty pounds, was executed with a drop of over six feet. The rope slipped behind the mastoid process after three minutes his struggles ceased. The radial beat ceased at six and one-half minutes. All signs of life at ten and one-half minutes, and the body was blue fourteen and one-half minutes, body let down.

Theshape of the object and its size being indicated by the form of theburn metallic substances heated to a temperature of 100° c 212° f are capable of producing redness and vesication and other injuriouseffects at this temperature the albuminous elements of the blood andother fluids undergo coagulation essay bodies require to be heated toredness, or nearly so, in order to produce a defined burn very hot and writingially-fused solids cause burns of greater severitythan where the heated body is of a character favoring prompt removal in such paper their adhesion to the skin involves the tearing awayof the superficial portions of the derma in their removal, or theyby their adherence prolong the contact of the heated body, thusintensifying their destructive action metals in a state of fusion produce burns which cannot be easilydistinguished from those caused by solid bodies such burns are classedas scalds their effects may vary in any degree between slight rednessand complete destruction of the tissues with charring burns caused bymelted solids are less regular in form and outline than those caused byheated solids they are usually of greater severity on account of thehigh temperature to which they have been raised 700boiling water - scalds by boiling water may be so slight as toproduce redness only, or they may be so severe as to cause marked andcharacteristic symptoms those noted in severe paper are an ashy hueof the skin, accompanied by a soaked or sodden appearance and theproduction of blisters occasionally these features are not easilydistinguished from those of burns from other sources blackening of theskin and charring of the tissues never result from burns by boilingwater as in all burns, a large surface involved renders an early fatalissue probable in severe paper, not necessarily fatal, gangrene of thewritings injured essaytimes occurs most of those met with are accidental, yet paper of scalding by hot water with intent to injure are notuncommon, aside from injuries and death resulting from explosionof boilers, bursting of steam-pipes, etc occasional instances arerecorded of death of children, the insane or feeble persons byinadvertent immersion in a bath of hot water case 21 severe and fatal burns of the mouth, fauces, and larynx in youngchildren occur from inhaling steam or swallowing boiling water from ateapot or kettle in an attempt to drink case 5 burns by burning oil produce effects and appearances similar to thoseby melted metals burns by flame are specially characterized by scorching of thesurface hairs upon the writing actually burned are scorched and usuallyalso those in the vicinity of the burned patches such conditionscould not result from scalds by hot water, boiling oil, or from a hotbody only burns by petroleum or its derivatives resemble the burns from flame, except that the injured portions of the body are not only scorched butblackened and are usually burned more severely than by flame alone, asthe clothing holds the burning substance in contact with the writings theodor of the agent is also very noticeable burns by acids and corrosive agents - the injury produced by amineral acid, the caustic alkalies, etc , has frequently been thesource of judicial inquiry “vitriol-throwing, ” as it has been termed, has been and occasionally is resorted to with malicious intent toinjure no case of death resulting directly and solely from this causeis recorded, but grave injuries, involving loss of sight, etc , haveresulted a case is referred to by taylor701 where sulphuric acidwas poured into the ear of a woman while asleep by her husband deathensued, after six weeks, from disease of the brain resulting indirectlyfrom the use of the acid the appearances of a burn by a mineral acid are distinguished from heatburns with little difficulty the eschar which results is not dry andleathery, as in a burn by heat, but soft and readily sloughing away there is no redness around the site of the injury, the color of theburn being uniform, and no blisters are formed there is no blackeningof the skin and the hairs are not scorched the color of the skinaround the injured portion may afford valuable evidence of the natureof the agent employed nitric acid produces a yellow stain, sulphuricacid a dark brown, and chlorohydric acid a brownish-yellow stain 702the clothing also is capable of affording characteristic evidence bythe discolorations produced. And the destructive agent employed may bedetermined by a chemical analysis of the fabric 703it is not possible to distinguish a post-mortem from an ante-mortemburn by an acid when no vital reaction has taken place the classification of burns a classification of burns according to the severity of the injuryinflicted is the most practical course upon this plan, burns may bedivided into four general classes:i burns in which the skin or subcutaneous cellular tissues only areinjured ii burns which involve the muscles, nerves, and blood-vessels iii burns involving the internal organs and bones iv burns in which the other three classes are variously mixed class i - the skin in paper such as may occur from a brief contact witha hot body or water near the boiling-point shows a slight redness orscorching with no enduring mark pain is considerable class ii - in the mildest paper the cutis is destroyed in its wholethickness, and the writings injured are occupied by eschars of ayellowish-gray or brownish color the surrounding skin is reddened, and the formation of blisters occurs either immediately or after aninterval of a few hours in these paper a shining cicatrix remainsafter the healing, without contraction of surrounding writings in theseverer paper the subcutaneous cellular tissue and underlying musclesand nerves are destroyed the blackish eschars formed are insensibleand separate by suppurative process, leaving a granulating surfacebelow extensive redness of surrounding tissues, with more or lessvesication, is usually noted the resulting cicatrices, together withthe skin and adjoining structures, are prone to contraction, resultingin considerable deformity, according to location and extent so greatis the deformity in injuries of the extremities, or even essay writings ofthe head and trunk, that extensive surgical operations become necessaryto relieve it class iii - burns of this class are so severe that an immediatelyfatal issue is usually the result such instances involve a prolongedexposure to flame or to a source of intense heat the appearancesdescribed as belonging to the preceding class are in writing found herewith the addition of charring or carbonizing the writings destroyed effects of burns the effects of burns may be considered as i , local, and ii , constitutional local effects - in different instances the effects vary in accordancewith the extent and severity of the burn redness, blisters, destruction of the cuticle and of the subcutaneous cellular tissue, blackening of the skin, scorching of the hair, and roasting of portionsof the body are met with in varying degrees in essay severe paper allthese are found upon a single body the redness produced varies inintensity and extent, according to the nature of the agent producingthe burn, its form, and the length of time the writing was exposed very soon after the infliction of the burn a special line of rednessappears between the burned writings and the uninjured skin this red lineof demarcation is formed by intensely injected vessels and becomes avery important medico-legal sign in essay paper the vesication may besingle or multiple, consisting of one or two large and full blistersor a number of large and small ones, scattered over the portionsburned, essay unbroken and still holding their contents, others brokenand denuded of cuticle or with breaks from which their serum hasescaped upon the surrounding writings in essay paper of burning cracksor fissures in the skin occur, due to the effect of the heat, makingit dry and brittle and causing it to rupture by the movements of thepatient case 8 these fissures are most frequently noted in proximityto the joints 704 they resemble wounds, and it occurs occasionallythat it is important to accurately distinguish their character inessay paper the skin only is fissured. In others the subjacent tissuesare also involved this difference depends upon the depth of the burn in the first condition the skin splits, leaving the subcutaneous fatexposed, which in essay instances is writingially melted by the heat andflows out over the edge of the crack upon the surrounding skin paper8, 13 the blood-vessels in such paper usually are not burned and, owing to their elasticity, remain stretching across the fissure case14 the smaller may be seen by careful examination with a lens:they should always be looked for in the second class of injuriesthe vessels are involved in the burn and break with the cracking ofthe skin the importance of careful observation of these fissures isemphasized in paper of apparent wounds associated with burning it maybe necessary to decide whether the wounds are the result of the actionof heat as above described or were caused by essay sharp instrument orweapon careful inspection of the edges of the wounds will show whetherthey are ragged, as the result of fissure, or clean-cut by essay sharpinstrument the absence of evidences indicating hemorrhage upon thesurrounding writings and the detection of uncut blood-vessels extendingacross the fissure will establish the differential diagnosis wounds ofthe above character resulting from the action of fire may exist on thesame body with wounds of actual violence it is important, therefore, in all paper to examine each wound with special care and record itsposition, shape, depth, and other characteristics constitutional effects - as in all sudden and violent injuries, theeffect of a severe burn upon the nervous system is very marked thisis manifest in the symptoms of “shock, ” with pallor and coldness ofthe surface of the body, a feeble pulse, chills or shivering, and atendency to collapse in other paper, proving immediately fatal, thesesymptoms are followed by obstructed respiration with death from comasucceeding in other paper convulsions precede death, while in such asare not immediately fatal a reaction more or less imperfect ensues uponthe first constitutional symptoms death from cerebral congestion or effusion may result before anydefinite evidence of reaction appears in essay instances pulmonarycongestion or œdema occurs, with or without pleural effusion, terminating in death before reaction this period usually coversthe first two days in essay paper immediate death results fromthe depression produced by the severity of the pain during thesubsequent two weeks a period of inflammatory reaction succeeds, wheninflammations of the thoracic and abdominal viscera, with ulcerativeprocesses in essay organs, are developed and induce a fatal termination paper 10, 11, 16 causes of death the causes of death are due to several conditions this factis explained in writing by the relation which exists between thecerebro-spinal and sympathetic nervous systems, and of the nervoussupply of the surface to that of the internal organs, which in paperof extensive injury proportionately modify the conditions of thevisceral organs as death in burning results from various causes, it isconvenient to consider them under two classes:1st those immediately fatal 2d those fatal after an interval the first division would include paper in which the deprivation offresh air and the presence of asphyxiating products of combustion carbon monoxide and carbon dioxide were the immediate causes of deathby suffocation or asphyxia paper 9, 18 accidents in endeavoring to escape or injuries by falling wallsor timbers may cause death immediately, and burning the body occursubsequently immediate death may result from syncope or collapse from theviolence of the shock to the nervous system by the pain resulting fromthe burns the second division includes those conditions where death may resultearly, from a series of causes less immediate than those just mentioned cerebral congestion and effusion, resulting in death from coma, is not unusual case 15 in this connection taylor705 cites a caseof alleged poisoning by opium, in the treatment of a burn, in a childdying comatose, and emphasizes the undesirability of administeringopium or its preparations to children in paper of burns of anyseverity the danger claimed to exist is hardly to be considered in the case referred to, abernethy, who was a witness in the case, ascribed death to coma induced by the effect of the burn thepowerfully depressing influence of the pain in sensitive organizationsand liability to death from shock therefrom must be remembered inflammatory conditions of the respiratory tract or organs arecommon results. Pneumonia, bronchitis, and sudden congestion orœdema of the lungs are frequent paper 11, 15, 16 inflammation of the intestines, inducing peritonitis andulcerations of the intestines with or without resulting hemorrhage, occurs as a frequent lesion case 10 gangrene or septicæmia causes death in other instances exhaustion, from extensive and prolonged suppuration or from severeand long-continued pain and other conditions, terminates other paper case 12 legally, burns and scalds are included among injuries endangering life, but are not described as wounds they may be considered dangerousaccording to the extent of surface which they cover, rather than thedepth to which they involve the tissues the extensive injury to the sensory nerve structures and thesuspension of function or destruction of a considerable portion of theperspiratory tracts render large superficial burns far more fatal thanthose confined to a small writing of a limb, for example, which may bedeeply burned from a medico-legal point it is desirable to establishthe fact of how large a surface must be injured to prove fatal theeffort to reduce the subject to a statement of an exact minimum area ofsquare inches seems very objectionable and liable to lead to erroneousconclusions it is possible to make a general statement, subject to essayqualifications, which may serve as a basis of conclusion, as eachindividual case must be considered in its own circumstances a burn involving two-thirds of the body may be regarded as necessarilyfatal. But the injury of a much less proportion, even one-fourth ofthe surface, has resulted in death the qualifications to be madein burns of less extent are pronounced the writing affected is ofmuch importance burns of the trunk are more fatal than those of theextremities. And those of the genital organs706 and lower writing of theabdomen are especially so case 7 the character of the burn, whether single and continuous or multipleand scattered over various portions of the body, is a very importantmodifying circumstance, involving the questions of excessive pain andthe difficulty in insuring necessary treatment for all writings injured the physical condition of the patient and sensitiveness of the nervoussystem to pain exert a powerfully determining influence burns inchildren and sensitive, nervous females are specially serious and callfor an unfavorable prognosis spontaneous combustion - spontaneous combustion of the human bodyhas been seriously discussed in this connection, and explanations ofpopularly reported paper have been attempted the writer refers tothe subject here for the sole purpose of stating that no trustworthyevidence of the possibility of any such condition or result exists treatment in paper of severe burns the constitutional as well as the localconditions demand attention locally, a great variety of applicationshas been employed. Starch, gum, oxide of zinc, solution of caoutchou, collodion, cotton wadding, a mixture of linseed oil and lime-wateron cotton or lint, and thesis other agents are used the importantconsideration is to exclude the air from and to afford a protectivecovering for the injured surface the constitutional treatment variesin different paper. But its main object is to relieve pain, inducereaction from the shock, and support the depressed nervous system for the first opium or its preparations in proper doses is indicated alcoholic stimulants in essay paper are demanded in addition afterthe stage of reaction has occurred the therapeutics must be governedby inflammatory conditions. Or later by the exhaustion from continuedpain, suppuration, etc post-mortem appearances in the external post-mortem examination of a burned body carefulnote should be made of the sex, probable age, and every circumstanceleading to the establishment of the identity of the individual thewritings burned should be specially examined as to their condition, whether exhibiting redness, vesication, or charring the amount ofsurface covered by the burns should be computed. Also the relation ofthe burned writings to those uninjured, whether separated by a sharplymarked line of redness or merging into the sound skin without a lineof demarcation the condition of the blisters should be examined asto whether they are full or empty and their contents as to whetherconsisting of clear or turbid serum internally - in essay paper no lesions are found on examination theseare usually paper where death occurred from shock or severe pain case12 ordinarily the mucous membrane of the respiratory tracts iscongested in essay instances, however, no redness has been discernible where death occurred by suffocation and asphyxia, the trachea andbronchial tubes have been found to contain a dark smoky or sootymucus707 case 9 the serous membranes of the brain, thorax, and abdomen are in thesispaper found reddened with effusions, more or less considerable, into the ventricles of the brain and the pleural, pericardial, andperitoneal cavities from the sudden inflow of blood from the surface, caused by the local injuries when the body has been badly charred or incinerated the skeletonusually remains, and it is possible to determine the age from the sizeand development of the bones and the sex from the shape of the bonesof the pelvis careful search should be made for special articles ofidentity false teeth, 708 a watch and chain, buttons, etc , havealone been sufficient to identify the incinerated remains case 23 where the whole body and even the bones have been reduced to ashes, essay portions of bone, etc , may be found on careful search siftingthe ashes will give essay pieces of bone, etc , which may be sufficientto disclose the presence of human remains709 case 24 a chemicalanalysis of the ashes also will aid in establishing this fact in paperwhere cremation of the body has been resorted to to conceal crime, thelength of time necessary to entirely consume the human body may becomean important question a period of less than ten hours has been provensufficient 710period of the occurrence of death as already indicated, death may occur from direct causes during thefirst forty-eight hours after the infliction of the burn, or may takeplace during a period extending from the second day to the fifth oreven the sixth week in the great majority of paper the fatal resultoccurs during the first five or six days in essay instances it may beimportant to establish the fact as to how long after the infliction ofthe burn the person may have survived inflammation and suppuration would not ordinarily begin until aboutthe third day, hence the existence of this condition would indicatethat the person had probably lived two days or more. And the state ofadvancement of these processes would afford essay further evidence theexistence of intestinal inflammations and ulcerations, which requireessay days for their appearance and development, would also give essayindication of the probable time elapsing was the burn ante mortem or post mortem?. In describing the anatomical characters of a burn occurring duringlife, vesication, the formation of blisters, is regarded as a markedsymptom while it is not an invariable result in a burn of the living body, it is so constant as to become one of the most important factors inanswering the question as to the ante-or post-mortem infliction ofthe burn where the burn has been caused by a scalding fluid, or byburning of the clothing, or the direct application of flame, blistersare more likely to occur than where contact with a highly heated bodyhas taken place in the formation of a blister the cuticle is raisedfrom the derma or true skin by the effusion of a highly albuminousserum, and the surrounding skin is of a bright or coppery red color the time of the appearance of such a blister is not fixed it may occuralmost immediately or may not do so for several hours, an intervalsufficiently long for death to occur from shock it must be rememberedthat a burn inflicted in a condition of great depression of the vitalpowers with insensibility may be followed by no vesication or redness, but upon reaction and return of sensation both redness and blistersmay appear case 17 in the absence of blisters, therefore, it cannotbe decided that for this reason the burn was post mortem if from ablister formed on the living body the cuticle be carefully removed, the site of the blister will present an intensely reddened base inthe dead body, if the cuticle be removed, no red base appears, but thesurface of the blister becomes dry and of a grayish color on the other hand, if the presence of blisters is noted, can it beconcluded that the burn was ante mortem?. while their presence affordsreason for an affirmative answer, careful examination of the blistersas to their character and contents must be made in order to decide. Thepresence of apparent blisters is not alone sufficient paper 20, 18;plate ii elaborate experiments have been made in order to decide the possibilityof producing blisters post mortem leuret, 711 in experiments upon dropsical subjects twenty-four hoursafter death, shows the possibility of raising a blister post-mortem, but one which can be distinguished from one of ante-mortem production, in that it contains a reddish serum very slightly albuminous he urgesextreme care in deciding this question christison712 found it impossible to produce a blister a few hoursafter death in a patient unconscious from narcotic poison, heatapplied four hours before death produced a blister and a red line wasformed around the burns in the burns produced half an hour afterdeath, in the same patient, blisters formed in two places only, andthese were covered by dry skin and contained air no redness appearedaround them champouillon713 agrees with leuret in his conclusions, fromexperiments upon dropsical subjects kosack714 considers blisters with albuminous contents diagnostic ofburns during life, but states the necessity for care in deciding in theabsence of other signs of reaction wright715 was able to produce blisters three and a half hoursafter death containing a small quantity of pale serum on the samebody, similar experiments fifteen hours after death produced blisterscontaining no serum caspar716 states, as a result of experiments, that blisters may beproduced by flame after death. That they result from vaporization ofthe fluid beneath the cuticle by the heat employed. That they are notfound to contain serum and no line of redness is found at their base the presence after death of vesications containing serum and surroundedby a reddish base is an evidence that the burn was inflicted antemortem he distinctly says.

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Fig 12 - incised wounds of right hand in the struggleof defence homicide the examination of the clothes and body of the deceased and theaccused may furnish important evidence if suicide is accomplished by a weapon like a knife, it is rare for thehand not to be bloody if it is not bloody we may well suspect a caseof supposed suicide the presence of blood on the hand does not provesuicide, though its absence may disprove it, as the hand is generallybloody in case of murder by being carried to the wound the examination of the clothing of the deceased is of greatimportance as we have noticed before, a suicide generally opens them, a murderer rarely a suicide is often writingly or even wholly undressedwhen he inflicts the wound, while murder is usually committed on thoseentirely dressed the wound of the clothes should correspond to that ofthe body in case of murder in suicide the wounds of the body and ofthe clothes may not correspond, especially if there exists a motive tofalsely impute the crime the clothes of the deceased as well as thoseof the accused may indicate a struggle, as we have already noticed ofcourse, in regard to the clothes examined, it is necessary to clearlyprove that they were worn at the time by the deceased or accused, otherwise serious mistakes may be and essaytimes are made in examiningthe blood-spots on the clothing, note whether the blood occurs in largepatches or sprinkled essay writing service discount code as by a spurting vessel or by continued violence the body of the accused may present scratches, marks of nails, contusions, bites, or other wounds indicative of a struggle it wouldbe well to ask the accused how he received the wounds or scars, to seeif his explanations tally with the injuries it is hard to tell whenwounds which have cicatrized were inflicted. We can only distinguishbetween old and recent ones, and thus control the statements of theaccused an examination of the finger-nails of the prisoner soonafter the crime may reveal blood underneath when the rest of thehands and person are free from it note also the site and shape ofthe blood-spots, if they exist, and whether or not they came from anarterial jet these spots may be on the body or clothes of the accused the account of the accused as to these spots may or may not correspondto the facts as indicated by them the above leads us to the more orless important question:could the assailant have escaped without stains?. It is possible for the murderer to escape without being spotted withblood, but the probability of this occurrence depends on the natureof the wound and the relative positions of the deceased and theassailant at the time the wounds were inflicted this latter fact isvery largely, if not altogether, a matter of speculation as far asthe medical evidence goes it is a popular, though false, idea thata murderer clothes must be bloody, and the police may be misled inexpecting to find them so in every instance taylor1 cites severalpaper in which either no blood was found on the murderer clothes, or only small spots wholly out of proportion to the amount of bloodwhich must have spurted or flowed from the wound absence of blood onthe prisoner clothes is often made use of by the defence to provethe prisoner innocence, whereas, besides the possibilities of havinghad no spots in the first place, the clothes may have been changedor washed before the examination was made this has occurred in morethan one murder trial taylor648 mentions the following paper inillustration:it was alleged that the absence of blood-stains on the prisonerclothing was a strong proof of his innocence in the trial ofsub-inspector montgomery for the murder of mr glasse omagh ass , july, 1873 in this case the weapon was a bill-hook which had producedcontused wounds on the head there was blood on the floor about thebody, but the wounds were not likely to have been accompanied by muchspurting yet it was assumed that the assailant in this case musthave been covered with blood much stress was laid upon the absenceof blood-stains on the first two trials the jury could not agree, owing chiefly to the absence of blood-stains, but on the third trialhe was convicted and afterward admitted that he had removed theblood-stains from the clothes with cold water also in the case ofreg v courvoisier c c c , 1840 the accused, who was tried forthe murder of lord william russel, had no blood-stains on his clothes all the vessels of the throat of the deceased had been cut to thevertebræ while he was asleep it was contended most strongly that theaccused could not possibly have committed the crime, as he had noblood-stains but after conviction he confessed that he wore no clotheswhen he committed the murder, and he only had to wash his hands and thecarving-knife he used again, in the case of reg v thompson durhamwint ass , 1863 the defence mainly relied on the absence of blood onthe prisoner clothing the wound in the throat of the wife of theaccused was five inches long, directed from left to right, dividingall the vessels and nerves of the neck the medical witness statedjustly that no such wound could be self-inflicted it was rapidlyfatal no weapon was found near the body the prisoner was convicted the same author cites the case of a prisoner on whose trousers wornsoon after the murder no blood-marks were found, but the trousersactually worn by him were found with blood upon them juries have evenacquitted the prisoner apparently only because no marks of blood werefound, though the other circumstances were explicable only on thetheory of murder it should be remembered in this connection that blood-stains may befound on the clothing of thesis, especially on the coarse clothingof working-people this may be accounted for by the occupation, flea-bites, accidental circumstances, or it may occur withoutdefinite explanation such persons may be accused of murder and yetthe blood-stains be consistent with innocence too much importanceshould not, therefore, be attached to them, even if the accused cannotsatisfactorily explain them and if he does not attempt to do so ina suspicious way that blood on the clothing even under suspiciouscircumstances may be consistent with innocence is illustrated by thecase of a suicide by cutting the throat, in 1872, cited by taylor 649in this case the son first found his father dead, and thought that hehad broken a blood-vessel he raised the body, staining his hands andclothes, then went for help at the inquest he was closely questionedas to the presence of the blood-stains, but there could be no doubtthat the case was one of suicide in general, we may say that a murderer is much more likely to escapewithout blood-stains in contused wounds, and more likely in the caseof punctured wounds than in incised wounds, for in punctured woundsthe bleeding is much less free and is less likely to spurt from thewound in the case of incised wounds he is most apt to escape withoutstains if he is behind or to the side of the victim when he inflictsthe wound in other words, when a writing of the body of the deceasedwas between the assailant and the wound inflicted furthermore, theassailant is more likely to escape without blood-stains if there is asingle wound than if there are several, and each additional wound makesit more likely that he will be spotted with blood the examination of the ground or floor and the furniture, etc , mayfurnish essay evidence as to the nature of the crime, and also helpthe witness to answer the questions which may essaytimes be asked, i e , at what spot was the victim wounded?. and where did he die?. This question is essaytimes settled by examination of the spot wherethe deceased lay and the furniture, etc , about essaytimes the flooror ground and the furniture or surrounding objects at a distance givethe requisite evidence the examination of the cracks and corners ofthe floor and furniture should not be neglected, and taylor instancesa case where the hair of a dog helped to clear up the case if thebody has not been disturbed the most blood is usually found wherethe deceased died if the victim succumbs at the spot where he waswounded, blood is found only in the immediate neighborhood, except forarterial jets, which may be as far distant as two metres the separateblood-spots of an arterial jet are circular if the jet strikes theobject perpendicularly, oval or wedge-shaped with the larger end awayfrom the body if it strikes the object obliquely if the blood-stains are more diffused and are found in other places, careful notice should be taken as to whether the different placescommunicate with one another by traces of blood if they do notcommunicate, it goes to show that the body was moved after activebleeding had ceased, that is, after death, but this indication isnot absolutely positive if traces of blood do connect the largerblood-spots, it is of interest and importance to know where thedeceased was wounded and where he died, also whether he moved orif he was moved before or after death this question is not alwayscapable of solution essay injuries exclude the possibility of activemotion stupefying contused injuries of the head or an incised woundopening a great artery are both inflicted where there is the greatesthemorrhage, and the spot where the deceased was wounded and died shouldbe identical in such paper a second large spot of blood, connectingor not with the first wound, indicates that the body has been moved but if the wound does not bleed much or rapidly, the wounded personmay fall at a distance from the spot where he was injured, and deathoccurs, as a rule, where there is the greatest amount of blood.