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Case 1 -- vaccine case-- improvement after eight months case 2 -- slight improvement following use of vaccine case 3 -- slight improvement following use of vaccine case 4 -- marked improvement case 5 -- prompt improvement case 6 -- vaccine not mentioned case 7 -- vaccine followed by slight improvement in each of the paper other methods of treatment were used the papershows the etiologic relation of streptococcus viridans rather thanthe value of vaccines there is no indication that stock vaccineswere used, though the paper is not clear on this point the secondpaper deals with the application of vaccine therapy in the treatmentof arthritis this paper is by a man who is avowedly an enthusiast onvaccine therapy the indications are that he generally used a mixedautogenous vaccine, but the reports of paper are not always clear this writer apparently makes no serious attempt at the classificationof the joint conditions he treats the third reference is a purelyexperimental study and has no bearing on the use of vaccines intreatment the fourth article was admitted by the manufacturer to be“negative as regards evidence ” the fifth reference specifically statesthat “the vaccine must be autogenous ” the sixth reference deals withthe experimental production of appendicitis by the use of diplococci, and has not the most essay writing service on remote bearing on the use of vaccines in thetreatment of rheumatism streptococcus-viridans-combined-bacterin -- the article which bearsevidence of more care than the others admits that we are not inposition to state the value of vaccines in pyorrhea but the authorbelieves they may have value supplementary to local treatment it is not surprising that a large number of favorable reports canbe accumulated when we appreciate how promptly men report what theyconsider to be their successes and how commonly they leave theirfailures unrecorded bearing in mind the fact that these stock mixedvaccines, though before the profession for thesis years, have notbeen used, or continued in use, in hospitals where work is rigidlycontrolled and that they are used practically not at all in the largegovernment hospital service, a candid critic must hold that there isno substantial evidence in favor of the therapeutic use of a mixedvaccine, certainly not for stock “goods” and that probably there is buta limited field for the employment of autogenous vaccines the referee calls attention to a shift in the advertising matter onvaccines-- the tendency to recommend vaccines to be used in conjunctionwith drugs a heading in the abbott booklet reads, “the biologics donot replace drugs”. And the paragraph speaks of serums and bacterins as“new tools, supplemental to those we already have, but not replacingthem ” “we need them both ”the referee recommends that the several mixed vaccines discussed inthis report be not accepted on the grounds that satisfactory evidenceof their value is wanting having been endorsed by the committee on serumsand vaccines the council adopted the report anddeclared m catarrhalis-combined-bacterin, b coli-combined-bacterin, pertussis-combined-bacterin, streptococcus-rheumaticus-combined-bacterin andstreptococcus-viridans-combined-bacterin ineligible for admission tonew and nonofficial remedies catarrhal vaccine combined-lilly and influenza mixed vaccine-lillybecause of inquiry received, the council requested eli lilly andcompany to aid in determining the acceptability of the followingproducts for new and nonofficial remedies. “catarrhal vaccinecombined, ” said to contain killed cultures of the bacillus offriedländer, micrococcus catarrhalis, staphylococcus aureus andalbus, pneumococcus and streptococcus. “influenza mixed vaccine, ”said to contain killed cultures of staphylococcus albus and aureus, streptococcus, pneumococcus, micrococcus catarrhalis and bacillusinfluenzae lilly and company sent the circulars, etc , used in advertising theseproducts a circular for “catarrhal vaccine combined” contained thefollowing claim. “catarrhal vaccine has been especially useful in thesis respiratory infections, including bronchitis, pharyngitis, rhinitis, chronic catarrh and in the mixed infections of pulmonary tuberculosis ”a circular for “influenza mixed vaccine” contained the following. “the vaccine is useful in the treatment of influenza and ordinary colds, and in any infection in which the bacillus influenzae is the causative agent ”an advertising pamphlet contained the following. “catarrh, acute and chronic. Colds, influenza -- the micro-organisms capable of producing catarrhal conditions of the nose and pharynx and most commonly isolated are b friedländer, m catarrhalis, staphylococcus, pneumococcus in infections beginning in the larynx, b influenza and streptococcus these organisms are found normally in the respiratory passages and acquire virulence only when resistance has been lowered through overwork, exposure to cold, etc “the results following the use of catarrhal vaccine combined in the non-epidemic forms and influenza mixed vaccine in the epidemic types have been very satisfactory, due to the great vascularity of the tissues acute attacks are aborted altogether or shortened in duration and the danger of complications greatly minimized ”no evidence was submitted which warrants the preceding claims noris the council aware of any reliable testimony to indicate that theadministration of the mixture here discussed is warranted or desirable on the recommendation of the committee on serums and vaccines thecouncil voted that “catarrhal vaccine combined-lilly” and “influenzamixed vaccine-lilly” be not included in new and nonofficial remediesbecause satisfactory evidence of their value is wanting influenza serobacterin mixed-mulfordbecause of inquiry received, the council took up the considerationof “influenza serobacterin mixed-mulford, ” and requested the mulfordcompany to present evidence to establish the admissibility of thepreparation to new and nonofficial remedies the mulford company sentspecimens of the serobacterin in question, an advertising circular anda letter by the director of its biologic laboratories according to the label on the package, the preparation is made fromthe following organisms. Bacillus influenzae, staphylococcus aureus, staphylococcus albus, streptococcus, pneumococcus and micrococcuscatarrhalis group this mixture is recommended by the manufacturer. “for the prophylaxis and treatment of common colds, mixed infections of the respiratory mucous membranes, acute and chronic catarrhal conditions of the nose, throat and respiratory passages ”no evidence is submitted for this recommendation except that in “coldsand bronchitis and the other common infections of the upper respiratorypassages five or six bacteria are very commonly present-- two ormore of them are nearly always present ” and the letter by thedirector of the mulford biologic laboratories expressing the beliefthat in his own case the use of the mixed vaccine has aborted orprevented colds as regards the use of this complex biologic preparation:first, the cause of common colds is, at the present time, quiteunknown one of the most striking things is that at the beginning ofa cold the organisms to be cultivated from the nasal mucous membraneare very few in number and there is no uniformity in the type oforganism found if essayone of the well-known organisms streptococcus, staphylococcus, pneumococcus, micrococcus catarrhalis, influenzabacillus, etc were responsible, we should expect to find one of thempreponderating and in overwhelming numbers this is far from the case after the duration of the cold for a day or two with the increasedproduction of mucus and apparently with the infection of a mucousmembrane whose powers of resistance have been greatly lowered, bacteriaof all kinds are to be found in immense numbers there is considerablereason for believing that an ultramicroscopic organism is responsiblefor this condition see foster, journal of infectious diseases21:451 nov 1917 second, there is no acceptable clinical evidence that vaccination withthe influenza bacillus, the streptococcus, the pneumococcus or themicrococcus catarrhalis will influence the course of an infection dueto one or the other of these organisms it has been repeatedly foundthat a staphylococcus vaccine is of a certain degree of value when theinfection with the staphylococcus is localized, but it is well knownthat general systemic infections with the staphylococcus are not at allbenefited third, the letter submitted as evidence by the mulford company is notconvincing the council is not prepared to accept evidence of this sortunless it is in volume large enough to justify a definite conclusion holding that there is no evidence for the value of this mixture, thecouncil declared “influenza serobacterin mixed-mulford” inadmissible tonew and nonofficial remedies because its use is illogical sherman mixed vaccine no 40because of inquiry received the council decided to consider thispreparation and requested the manufacturer, g h sherman, detroit, mich , to submit evidence in support of the claims made for it this vaccine is said to be made from killed cultures of streptococcus, pneumococcus, micrococcus catarrhalis, staphylococcus aureus, andstaphylococcus albus in the printed matter sent out by g h shermanthis vaccine is recommended for hay-fever, in which it is stated thatessay of the symptoms are due to bacterial invasion of the respiratorymucosa.

Although essaytimes thefeatures are calm in the latter case there may essay writing service on have been syncope the eyes are usually staring, prominent, and congested, and the pupilsdilated casper764 doubts their prominence budin and coyne765state that in asphyxia the dilation of the pupil progresses to amaximum and then convulsions occur ophthalmoscopic examination duringthe dyspnœa of asphyxia shows a lessened fulness of the retinal vessels the tongue is often swollen, dark, protruding, and essaytimes bitten maschka766 states that if the ligature lies above the hyoid bone, thetongue will be drawn backward. If over or below the bone, the tip ofthe tongue may appear more or less between the jaws the hands are usually clinched and may have in their grasp articleswhich, under the circumstances, have a medico-legal value the external generative organs are essaytimes congested. Erection ofthe penis may have taken place and persisted the vagina may be moist tardieu, devergie, and casper767 deny that these appearances areusual involuntary discharges of urine, fæces, and seminal fluid may haveoccurred there is nothing characteristic in their appearance all the external appearances of asphyxia are usually more marked instrangulation than in hanging internal appearances - the mark usually there is hemorrhage into theloose connective tissue under the mark and in the subjacent muscles;in most paper isolated and circumscribed, but essaytimes extendingbeyond the line of the mark hemorrhage from compression by the fingersis more marked than that from ligature 768 essaytimes there is onlyfulness of the subcutaneous veins the carotid arteries may suffer rupture of their inner and middlecoats, especially in atheromatous subjects and when the compressionhas been great friedberg769 states that the injury of the carotid, if there is hemorrhage into its middle and internal coats, is a proofthat the strangulation occurred during life, and probably from pressureof the fingers on the neck, without any regard to any disease of theartery he reports two paper the examiner should be careful not toinjure the artery with his forceps the vessels may contain clots the neck occasionally suffers extreme injury, and, owing to theviolence used, this occurs oftener in strangulation than inhanging 770 occasionally the neck is broken the hyoid bone may be fractured see case 5 maschka771 saw one casein eighteen of erdrosselung and five paper in fifteen of erwürgen the trachea is essaytimes torn, or may be folded on itself the cartilages of the larynx, especially if calcareous, may befractured this is more likely to affect the thyroid than cricoid the fracture would appear to occur only as the result of enormousforce. Especially in the young in whom the cartilages are so elastic the experiments of keiller772 on cadavers led him to conclude thatfalls on the larynx, even from a height and with superadded force, areunlikely to fracture that organ. That severe pressure or violent blowsagainst the larynx from before backward may cause fracture. But thatsevere lateral pressure, as in ordinary throttling, is more likely thanother forms of violence to fracture the alæ of the thyroid or even thecricoid cartilages and also the hyoid bone taylor773 states that dr inman, of liverpool, had informed him of a case of splitting of ringsof windpipe from pressure see paper 5, 13 maschka774 in fifteenpaper of choking found six fractures of the larynx chailloux775 has collected eight paper of fracture of larynx instrangulation they were all made with the fingers the experimentsof cavasse776 seem to show that there is no great difficulty infracturing the thyroid in strangulation internal appearances due to asphyxia - the veins of the entire bodyare distended with very dark and very fluid blood, while the arteries, especially in the young, are mostly empty experiments on the loweranimals have shown that the pulmonary artery and systemic veins to thefinest ramifications are distended with dark blood 777the heart - the right side, especially the auricle, is usually fullof dark fluid blood, due to the mechanical impediment to the passageof blood through the lungs if the heart continues to beat after therespiration has ceased the right ventricle is commonly well contracted, like the left cavities, and nearly empty, the lungs being muchcongested essaytimes the left cavities of the heart contain blood thiswould be most likely to occur if the heart should stop in the diastole essaytimes clots are found in the right ventricle maschka778 foundclots in the heart 25 times in 234 paper of asphyxia the lungs are usually much congested, resembling red hepatization, except that the blood is darker hemorrhages apoplexies into thesubstance of the lungs are common tardieu found patches of emphysemadue to rupture of the surface air-vesicles, giving the surface ofthe lung the appearance of a layer of white false membrane ogstonadmits this occurrence in pure strangulation but to a less extent inmixed paper liman779 found the lung surface uneven, bosselated, the prominences being of a clearer color and due to emphysema the lungs were in the same condition of congestion and emphysemain strangulation, suffocation, and hanging he failed to find theapoplexies described the lungs are essaytimes anæmic in healthy young subjects, especiallychildren, the blood-vessels of the lungs often empty themselvesafter the heart stops the lungs may, therefore, be bloodless, butemphysematous from the violent efforts to breathe page experimentson the lower animals showed the lungs of a pale reddish color andnot much distended. A few dilated air-cells might be seen towardtheir anterior borders, and there might be small hemorrhages over thesurface his experiments appear to show that subpleural ecchymosesoccur as a result of violent and repeated efforts to breathe amongother experiments780 he stopped the mouth and nostrils of a youngcalf long enough to excite violent efforts at respiration.

like the tyree product, this, too, is essentially a mixtureof zinc sulphate and boric acid, with minute amounts of phenol, eucalyptol, menthol and thymol, to say nothing of a dash of salicylicacid this official article has at least the virtue of constancy ofstrength, composition and purity assured under the federal food anddrugs act -- from the journal a m a , may 17, 1919 wheeler tissue phosphates “the commissioner of health directs me to call to your attention the enclosed advertisement issued by t b wheeler, m d , company, montreal, canada, in which the name of the association journal is being used ”accompanying this brief note to the journal from the secretary of dr haven emerson, commissioner of the dewritingment of health of the cityof new york, was a four page leaflet devoted to the exploitation of“wheeler tissue phosphates ” the trend of the circular is to leadthe average reader to infer that the journal of the american medicalassociation has endorsed wheeler tissue phosphates for example, indescribing the preparation one reads. “it embodies the best recent scientific opinion concerning the treatment of the disease tuberculosis as stated by the official journal a m a ”elsewhere in the circular the journal criticisms of thehypophosphites and the glycerophosphates proprietary preparationswhich are competitors of the wheeler product are quoted and twistedinto a tribute to the ingredients of wheeler tissue phosphates garbling quotations, distorting statements, separating phrases fromtheir contexts and omitting qualifying clauses, all for the purposeof making out a case for essay proprietary remedy is a trick as old asquackery itself that it should be used in advertising wheeler tissuephosphates is entirely fitting obviously, the t b wheeler, m d , company esteems the opinion of the journal on pharmacologic matters this being the case, it should, in the interest of truth and scientificaccuracy, publish in its advertising circulars just what the journalhas said about wheeler tissue phosphates it could not do this betterthan by quoting from a recent editorial note which commented on areport of the chemical laboratory on this preparation here is writing ofthe the journal comment. “‘wheeler tissue phosphates’ is an unscientific shotgun mixture whose most active and powerful drug is the alcohol it contains that it was not years ago relegated to the realms of obsolete and discarded preparations is a commentary alike on the lack of scientific discrimination and on the power of advertising ”here we have “wheeler tissue phosphates” stripped of the verbalcamouflage with which its exploiters have invested it -- editorialfrom the journal a m a , sept 22, 1917 briefer paragraphs alcresta lotion to the editor:-- what is the composition of alcresta lotion?.

Dark blood in essay writing service on bothventricles. Liver normal 78 third man, age 20. Pupils slightly dilated. Eyeballs and tonguenot protruded marks of cord as in preceding no discharge of fæces orsemen slight ecchymosis under cord. Mark in front of neck dislocationof occipital bone from atlas brain and membranes much congested lungscollapsed and anæmic half ounce serum in pericardium heart normal;dark fluid blood in both ventricles. Liver normal 79 cayley. Ibid , p 122 - man, age 35. Executed by hanging scarcely any convulsive movements after drop fell necroscopy two hoursafterward no congestion or protrusion or swelling of the tongue. Nomuscular rigidity or contractions about half-way around the neck wasindentation of cord, obliquely directed. Hardly perceptible in front;its surface appeared rubbed and compressed. No discoloration. Noecchymosis under skin cord lay across upper writing of thyroid cartilage larynx and trachea not injured fracture and dislocation of uppercervical vertebræ lungs collapsed, not congested pericardium empty;heart distended, left side with red blood just beginning to clot;right side with fluid black blood liver and other abdominal organsmuch congested no discharge of fæces or semen 80 garden. Same journal, 1880, xv , p 12 - man, age 40, weightabout one hundred and twenty pounds. Drop two feet. Was in a faintingcondition, and had to be supported. Was not probably fully consciouswhen platform fell there were spasmodic retractions of arms and legsfor about two minutes. Forty seconds after the drop his jungeas felloff. His penis was in strong erection, and the ejaculatory movementswere seen necroscopy one and one-quarter hours after drop fell headand limbs cold. Eyes open, natural.

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Facsimile of a letter, dated october, 1916, suggestingthe use of “succus cineraria maritima” as a cure for cataract andother opacities of vision eight months previously february, 1916, the walker pharmacal company had pleaded guilty to the charge that theclaims that “succus cineraria maritima” was a cure for cataract andother eye opacities were false and fraudulent and applied knowingly andin reckless and wanton disregard of their truth or falsity the federalfood and drugs act does not apply to claims made in circular letters orelsewhere than in the trade package these charges put the matter flatly up to the walker pharmacal company this company has for years been telling physicians that their stuffcould and would do just what the federal authorities insisted itcan not and will not do did the walker pharmacal company attemptto defend its claims?. did it demonstrate that succus cineraria maritimawould cure cataract?. did it produce evidence of the numerous paper ofrecovery from blindness or writingial blindness which must have beenavailable if the preparation had the powers claimed for it?. no!. thewalker pharmacal company in february, 1916, pleaded guilty-- and wasfined a paltry $10 and costs this, however, is not the end of the story the company was prosecutedbecause it had published the false and fraudulent claims in the tradepackage, thus bringing the claims within the purview of the federalfood and drugs act had the walker pharmacal company confined its falsestatements to medical journal advertisements, to the circular letterssent to physicians or to any other advertising matter not writing of thetrade package, it could have snapped its fingers at the food and drugsact it was in february, 1916, that the walker pharmacal company pleadedguilty to the charge of making false and fraudulent claims for succuscineraria maritima in october, 1916, they were still sending outcircular letters to physicians urging the use of succus cinerariamaritima in the treatment of cataract and enclosing the usual bookletof testimonials claiming cures for cataract and other opacities of thelens and cornea!. Illustration.