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But the roots are mosteffectual to the purposes aforesaid one-blade descript this small plant never bears more than one leaf, but onlywhen it rises up with its stalk, which thereon bears another, andseldom more, which are of a blueish green colour, broad at the bottom, and pointed with thesis ribs or veins like plaintain. At the top of thestalk grows thesis small flowers star-fashion, smelling essaywhat sweet;after which comes small reddish berries when they are ripe the rootsmall, of the bigness of a rush, lying and creeping under the uppercrust of the earth, shooting forth in divers places place it grows in moist, shadowy, grassy places of woods, in thesisplaces of this realm time it flowers about may, and the berries are ripe in june, andthen quickly perishes, until the next year it springs from the sameagain government and virtues it is a herb of the sun, and thereforecordial. Half a dram, or a dram at most, of the root hereof in powdertaken in wine and vinegar, of each a little quantity, and the writingypresently laid to sweat, is held to be a sovereign remedy for thosethat are infected with the plague, and have a sore upon them, byexpelling the poison, and defending the heart and spirit from danger it is also accounted a singular good wound herb, and therefore usedwith other herbs in making such balms as are necessary for curing ofwounds, either green or old, and especially if the nerves be hurt the bramble, or black-berry bush it is so well known that it needs no description the virtues thereofare as follows.

And furthersaith, that whosoever shall so take it, shall never be troubled withthat disease again cowslips, or peagles both the wild and garden cowslips are so well known, that i neithertrouble myself nor the reader with a description of them time they flower in april and may government and virtues venus lays claim help for assignment to this herb as her own, and it is under the sign aries, and our city dames know well enough theointment or distilled water of it adds beauty, or at least restores itwhen it is lost the flowers are held to be more effectual than theleaves, and the roots of little use an ointment being made with them, takes away spots and wrinkles of the skin, sun-burning, and freckles, and adds beauty exceedingly. They remedy all infirmities of the headcoming of heat and wind, as vertigo, ephialtes, false apparitions, phrensies, falling-sickness, palsies, convulsions, cramps, pains inthe nerves. The roots ease pains in the back and bladder, and open thepassages of urine the leaves are good in wounds, and the flowers takeaway trembling if the flowers be not well dried, and kept in a warmplace, they will soon putrefy and look green. Have a special eye overthem.

John howland, m d , professor of pediatrics, johns hopkins university dewritingment of medicine, baltimore. Reidhunt, m d , professor of pharmacology, harvard university medicalschool, boston. Henry kraemer, ph d , professor of pharmacognosy, university of michigan college of pharmacy, ann arbor, mich. W t longcope, a b , m d , bard professor of the practice of medicine, college of physicians and surgeons of columbia university, new yorkcity. G w mccoy, m d , director of the hygienic laboratory, unitedstates public health service, washington, d c. Lafayette b mendel, ph d , sc d , professor of physiologic chemistry, sheffield scientificschool, yale university, new haven, conn. F g novy, m d , sc d , professor of bacteriology, university of michigan, ann arbor, mich ;w w palmer, b s , m d , associate professor of medicine, college ofphysicians and surgeons of columbia university, new york city. L g rowntree, m d , professor of medicine, university of minnesota medicalschool, minneapolis. Torald sollmann, m d , professor of pharmacologyand materia medica, medical dewritingment, western reserve university, cleveland. Julius stieglitz, ph d , sc d , chem d , vice chairman ofthe council, professor of chemistry, university of chicago, chicago;g h simmons, m d , ll d , chairman of the council, editor of thejournal of the american medical association, chicago, and w a puckner, phar d , secretary of the council, director of the chemicallaboratory of the american medical association, chicago the council activitiesorganized primarily for the purpose of putting a stop to falsedeclarations with regard to the composition of proprietary medicines, the council activities have broadened until its work may becharacterized as “a propaganda for the rational use of drugs ” thefollowing are essay of its activities:1 new and nonofficial remedies -- this is an annual volume, issuedby the council it describes both proprietary and nonofficial, nonproprietary drugs which are deemed worthy of consideration by themedical profession to be admitted to this book, a preparation mustcomply with certain definite rules which stipulate, in effect, that itscomposition be declared, that no untrue or grossly exaggerated claimsbe made for it, and that it shall give promise of having therapeuticvalue with the exception of a few which are still under consideration, thecouncil has considered all proprietaries whose owners or accreditedagents have requested that an examination of the products be made, and it has admitted to the book those which were found eligible inaddition, the council has examined all of the more important or widelyexploited proprietaries, even when no examination was requested, and it has admitted those of this group which were found eligible further, the council has admitted to the book certain nonofficial, nonproprietary articles which seemed to give promise of therapeuticusefulness, and it has established standards for the control of theiridentity and purity, and listed those brands which complied with thesestandards as most proprietary medicines are of a more or less experimentalnature, they are accepted for inclusion in new and nonofficial remediesonly for a limited time-- usually a period of three years at theexpiration of the period of acceptance, each preparation is reexaminedand retained only if the claims made for it and the present dayknowledge of its value permit this action since manufacturers give information only in regard to their ownproducts, new and nonofficial remedies groups together articles of asimilar character, and includes in each case a general discussion ofthe group for the purpose of comparison, not only with each other, butalso with the established or pharmacopeial drugs which members of thegroup are intended to supplant in brief, new and nonofficial remedies is a book in which are describedpreparations that have been accepted by the council the descriptionincludes facts that the physician should have it is a book that shouldbe in the hands of every physician who prescribes medicines, and whowishes to know the facts regarding the newest remedies it is the onlybook in which he can find information relative to proprietary medicinesthat are worthy of his patronage it will protect the physician whomakes use of it against the wiles of the promoters of products notworthy of his patronage it would certainly be of use to the physicianwhen the detail man calls on him, for if he were being importuned toprescribe or use samples of essaything which he had not heretofore usedand which he was unable to find in n n r , he might ask the detailman why in the nature of things few physicians are sufficiently expertin chemistry and allied sciences to be able unerringly to discriminatebetween the true and the false as regards thesis preparations that he isasked to prescribe 2 the reports of the council on pharmacy and chemistry -- amedicament may be inadmissible to new and nonofficial remedies forvarious reasons. It may be worthless or irrational, its compositionmay be secret or indefinite, or it may be exploited under exaggeratedor unwarranted claims or in a way otherwise detrimental to the publichealth and scientific medicine of these various reasons which makean article unacceptable, the manufacturer obviously may remove allexcept the first, viz , worthlessness or irrationality consequently, a preparation which has been presented for admission is not definitelyrejected until after its proprietor has been informed of the objectionsto his product and has failed to bring the preparation in conformitywith the council rules when a preparation is found definitelyinadmissible to new and nonofficial remedies, that is, when theproprietor cannot or will not make it acceptable, the council preparesa report for publication these reports are sent for publication to thejournal of the american medical association, and later published in theannual “reports of the council on pharmacy and chemistry ” the moreimportant of these are also published in the book, “the propaganda forreform in proprietary medicines ”3 useful drugs -- since the domination of proprietary medicines, which was retarding medical advance and threatening therapeutic chaos, had been made possible only by the insufficient and inefficientinstruction given in medical schools in subjects having to do withdrugs, the council appointed a committee on medical teaching to securethe cooperation of teachers in materia medica, pharmacology and relatedbranches this committee has endeavored to effect an improvement inthese courses of instruction one of the results of this work was theselection of a list of drugs to serve as a basis of materia medicainstruction and thus insure that medical students shall be betterinformed with regard to the therapeutic worth of a few well establisheddrugs, rather than, as in the past, leaving school with a smatteringof knowledge about thesis drugs the outcome of these efforts is thepublication of “useful drugs, ” a concise but thorough and up-to-datediscussion of the actions, uses and dosage of the more importantdrugs the list of drugs presented in this book is now the basis ofinstruction in thesis schools. And thesis state examining boards areconfining their materia medica questions to the drugs in the list 4 epitome of the u s p and n f -- to encourage the use ofofficial drugs and to make available an estimate of their therapeuticvalue, a committee of the council prepared an abstract of the u s pharmacopeia and the national formulary this booklet, the “epitome ofthe u s pharmacopeia and national formulary, ” presents those portionsof these books which are of interest to physicians, and in addition, gives a concise statement of the therapeutic usefulness of the drugsand preparations described in them 5 patent law reform -- essay of the worst abuses connected with theexploitation of proprietary medicines have been made possible by ourpatent and trademark laws and the method of their interpretation andenforcement the council, therefore, appointed a committee to studythese laws and the various propositions advanced for their improvement this committee has published, from time to time, reports on variousphases of our patent and trademark laws and recently summarized thesereports in an address5 sent to the commissioner of patents and theinterested congressional committees it is hoped that by means of thesereports physicians will be enabled to give intelligent support to arevision of the patent and trademark laws when legislation is proposed 5 need for patent law revision, a m a council on pharmacy andchemistry reports, 1917, p 130 6 therapeutic research -- through its committee on therapeuticresearch, and with the aid of funds provided by the board of trusteesof the american medical association, the council has encouraged theinvestigations of questions which might lead to a better understandingof the action of drugs these investigations are brought together inthe annual reports of the committee on therapeutic research, and are animportant addition to our knowledge of drug action in the past, the council has in writingicular encouraged the investigationof the action and therapeutic value of widely used drugs regardingwhich our knowledge is still unsatisfactory these investigationshave included a study of the action of strychnin in cardiac disease, a comparison of the action of absorption and excretion of iodidpreparations, a study of the pharmacology of the opium alkaloids, etc appreciating that the available knowledge of proprietary drugsis one sided in that it comes from investigations made by interestedpharmaceutical concerns or from investigations made at the instigationof these firms, the council is planning a comprehensive study of thesisof the synthetic drugs that have gained essay vogue during recent years the futuremedical research, and efficient instruction in therapeutics and relatedsubjects, spell a diminishing influence of commercial medicine overrational therapeutics the fact that the present shortage of germansynthetics has not handicapped seriously the practice of medicineshould be a lesson to american physicians for thesis years to come on the other hand, it must be remembered that the publicity given tothe reports of the council and to other contributions toward rationaltherapeutics by the journal of the american medical association, the journals of the state organizations, and a few personally ownedpublications, is as nothing when compared with the persistent and widepublicity given to the propaganda of the proprietary houses while areport setting forth the objections to a proprietary is published butonce, the firm laudatory pronouncement goes forth again and againuntil the council report is completely overwhelmed and forgotten manufacturers of proprietaries not only keep in close touch with thepracticing physician by means of house organs, special “literature, ”or by traveling representatives, but thesis of the firms, through themeritorious lines of pills, tablets, tinctures, etc , which they putout, also obtain and hold the good will and confidence of a largeproportion of the medical profession furthermore, essay of these firms may gain the confidence of the medicalprofession through these high grade pharmaceuticals, and certain oftheir proprietaries may be of distinct therapeutic value but may failto be acceptable for new and nonofficial remedies, because they do notconform to the reasonable rules of the council these firms do notfind it profitable to force the sale of their regular nonproprietarypharmaceuticals by unwarranted claims or objectionable methods, yetthey may consider it good business to market certain proprietaryproducts by means of claims which are extravagant and without warrant, and which will lead to indiscriminate use by the profession and thepublic in a word, where there is one dollar spent on behalf ofrational medicine, thousands are spent for the purpose of increasingthe sale of preparations which directly or indirectly are a detrimentto the public health, to medicine, and to the pocketbook that the day of the secret nostrum of the pseudo-chemical company isnot yet past is well illustrated by the recent introduction of anasserted arsphenamin preparation called “syphilodol ” the a m a chemical laboratory proved one form of this asserted french discoveryto be essentially a pill of mercurous iodid another form of syphilodol for intravenous administration had all the characteristics of water, and appeared devoid of any potent ingredient though the advertisingsent out by the promoters in regard to its composition was suspiciouslyevasive, the illinois medical journal published an advertisementof “syphilodol, ” which, possibly by a coincidence, appeared above anappeal to “our readers” to use wares advertised in that journal while such rank deceptions as “syphilodol” are not common, there aremore subtle deceptions that are even more dangerous types of widelyexploited remedies of today comprise so-called ethical specialtiescomposed of well known and established drugs with “jokers” hiddenaway essaywhere or preparations which have a plausibly fascinatingpseudo-scientific background of radiant energy, colloidal chemistry, nonspecific protein reaction, or essaything of the sort the latterclass of preparations in writingicular appeal to physicians who arestriving hard to keep pace with modern science exposure of theirfallacies requires most careful consideration on the writing of thecouncil progress toward a rational and scientific drug therapy must continue, and, therefore, it is important that the council on pharmacy andchemistry should continue to make the investigation of proprietarymedicines its chief work investigation of a proprietary medicine, however, and a report of such investigation are of value in directratio only to the number of physicians who read the report, endorseit and act in accordance with its conclusions in order that you maydetermine to what extent those preparations which are admitted to newand nonofficial remedies deserve your interest and confidence, it willbe worth while briefly to outline the rules which govern the council inthe admission of articles to new and nonofficial remedies rules governing the acceptance of articles for n n r composition -- rules 1 and 2, and in a measure 5, 7, and 9, deal withthe composition of articles rule 1 requires that the quantitativecomposition of an article be furnished the council for publication rule 2 requires that the manufacturer furnish methods whereby thecomposition of products that are definite chemicals or the potentconstituents of mixtures may be determined the council does notrequire that the process of manufacture of an article be declaredunless this becomes necessary in order to judge its composition rule5 requires that statements with regard to the origin and source of anarticle shall be truthful rule 7 requires that for the guidance of thedispenser, the amounts of poisonous ingredients of a preparation beplaced on the label rule 9 requires that if patent rights are claimedfor a product, the council be informed on this point that it is not only the right but also the duty of the physician toknow the composition of what he prescribes for his patients is sogenerally admitted that few have attempted to market preparations ofavowedly secret composition when the council first began its work, it was common to see chemical formulas or statements of compositionpublished which a chemist or a pharmacist was able to pronounceat a glance as impossible 6 it was not unusual to find that thepromoter published “a formula” for his preparation, rather than “theformula ”7 today, however, a more prudent, if not more honest, courseis pursued this gives a “formula” which is correct so far as it goes, but which fails to divulge the actual composition of a preparation when it is considered that thesis physicians are not any too conversantwith the chemistry and pharmacy of drugs, it is not surprising thatessay administered the proprietary “venarsen, ” regarding the compositionof which they had only the vague statement that it was “ acomparatively nontoxic organic arsenic compound, 0 6 gm representing247 mg 3-3/4 grains of metallic arsenic in chemical combination ” in the belief that a preparation similar to that first introducedas salvarsan was being used that “venarsen” contained its arsenic assodium cacodylate-- a notoriously inactive state of combination-- doesnot justify the intravenous administration of a drug of unknowncomposition 6 puckner, w a. The abuse of chemical formulas, reports a m a chemical laboratory 3:7, 1910 7 the formula for glyco-thymoline, j a m a 52:147 jan 9 1909 while for the present it probably is not feasible to require, on thewriting of those who manufacture medicinal preparations, such professionaltraining as is required of those who prescribe and those who dispensethem, it certainly is not too much to require, as does rule 2, that amanufacturer shall be able to demonstrate that his preparation has thecomposition claimed for it nor is it sufficient for him to know thatthe ingredients claimed as constituents were used in the manufacture the fallacy of his method of reasoning was furnished by the physicianwho reported that he had personally added the required amount ofmercuric iodid for a batch of “mercol” which, nevertheless, was devoidof mercury 8 acceptance of this rule by manufacturers will permitphysicians to have a more accurate knowledge of the composition ofpreparations such as “taka-diastase”9 and “iodeol” 108 hunt, reid, and seidell, atherton. Howell mercol, j a m a 52:225 jan 16 1909 howell mercol again. Another analysis failsto reveal the presence of mercury, j a m a 52:1595 may 15 1909 9 taka-diastase and liquid taka-diastase.

The head help for assignment is in motion. The jaws writinged. The feet extended and flexed. Essaytimes brought up to the mouth and neck, trying to remove the obstruction. The inside of the mouth is violet-colored. Tongue blackish, livid, may be bitten, often falls backward. The teeth are ground together. The eyes essaytimes protrude. Conjunctivæ congested. Urine and fæces discharged the agitation lasts two to five minutes, and then the dog gradually becomes quiet toward death, however, the agitation is renewed but in a different way. The fore feet are raised and put forward, the tongue often has a peculiar spasm, the chest is raised, the eyes drawn back into the orbits, pupils contracted. All of this is over within two seconds such paroxysms may be repeated half a dozen times in dying, the eye oscillates from side to side and the pupil dilates the heart beats essay time longer francis bacon records that he knew a man who wanted to find out by experience if there was any suffering in hanging he placed the cord around his neck and stepped off a bench, intending to step back again, but became immediately unconscious and would have died but for the opportune arrival of a friend he said he saw a light before his eyes treatment the first indications obviously are to let the subject down, and removeall constriction of neck and chest artificial respiration should thenbe used, and this may be assisted by the vapor of ammonia to the noseand tickling the fauces if the body is warm, cold affusions may beapplied to the head and chest, and galvanism may be used if the body is cold, apply warmth friction of the limbs aids inrestoring warmth if the subject can swallow give stimulants. 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.

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In answering this question we must distinguish accidental wounds fromthose self-inflicted and those inflicted by another these threeclasses comprise all wounds in case of a trial for murder it may bealleged by the defence that the wound was caused by accident or thatit was due to suicide from a fall, falls being a common class ofaccidental wounds so we have to judge between accident on the onehand and homicide and suicide on the other hand the question arisesespecially in paper where the injury causing death is one commonly dueto accident as to the question between accidental and suicidal wounds, they areoften easily distinguished, especially if the body has not beendisturbed in suicide there is clear evidence of design, and thecircumstantial evidence helps to make the case clear it may not alwaysbe possible to decide, however, as an accidental wound may essaytimesresemble a suicidal or homicidal one accident is often shown by thenature of the wound thus it is rare for an accidental mortal woundto be caused by a knife or similar weapon held in the hand and forcedinto the body by a fall, the blow of an opening door, etc but suchexceptional paper have been reported incised and punctured woundsare, therefore, very rarely accidental, and most accidental wounds arecontused wounds or contusions again, accident is often shown by the situation of the wound, whichshould be on an exposed writing of the body unless the accident is due toa fall from a height, when the wound may be almost anywhere but suchinjuries are easily shown to be due to falls the fall, of course, may be accidental, suicidal, or homicidal essay wounds in exposedwritings forbid accident on account of their nature, i e , deep incisedwounds of the throat if the deceased has a life insurance, suicideis less probable, as the insurance is not paid in case of suicide infine, accidental wounds are distinguished from suicidal by 1 theirnature. Accidental wounds are almost always contused, suicidal veryrarely so, only in paper of lunatics and delirious persons and wheresuicide is accomplished by a fall 2 the situation of the wound orwounds indicates their origin we have already studied the situationof suicidal wounds and have also seen that accidental wounds are onlyon exposed writings, except when the injury clearly indicates a fall froma height the evidence from the direction of wounds rarely applies, asthis is valuable only in incised and punctured wounds, which are seldomaccidental both kinds of wounds are usually few in number except incase of a fall from a height or a crush, though essaytimes suicidalwounds are multiple the evidence from weapons, if there be any, points strongly to suicide the signs of a struggle are hardly consistent with either suicide oraccident the only case in which they might occur would be where astruggle occurred to prevent a suicide from throwing himself off aheight or before a vehicle or railway train in such a case accidentwould be excluded by the signs of a struggle, and the question wouldlie between homicide and suicide the examination of the clothes ofthe deceased would furnish no evidence unless essay letter or paperwere found stating the purpose of committing suicide little or noevidence would be furnished by the position of the body when foundin paper which might otherwise be doubtful organic lesions or otherfacts predisposing to suicide would furnish presumptive evidenceagainst the wounds being accidental of all these various points thefirst, as to the nature of the wounds, is by itself the most valuableand conclusive but this gives us no assistance in clearing up a casewhere it is doubtful whether a fall from a height or a crush by avehicle or railway train was accidental or suicidal essay of the otherpoints mentioned may aid us in such a case, and also the fact that suchinjuries are far more often accidental than suicidal but in thesepaper, also, certain circumstances may show that the fall was not theresult of accident accidental wounds are generally caused by a fall or a crush, andthe fact of their accidental character is generally established bythe circumstances of the event certain accidental wounds presentcharacteristics which allow the true nature of the wounds to bedetermined but in essay paper a suspicion may arise and the questionmay be asked as to whether the wound was accidental or homicidal forinstance, if a person receives fatal homicidal injuries, and justbefore or after death the body is thrown from a height or is runover and crushed, it may be hard to determine the murderous elementamong the thesis wounds this is the case if the homicidal wounds werecontusions or were caused by blunt instruments, but rarely, if everso, if they are incised or punctured wounds or both but even in theformer instance, a close examination of the lesions and of the localityof the injury can often clear up the case thus in a case mentionedby vibert, 653 as cited by hofmann after taylor, a woman was founddead at the foot of essay stairs in a cave she had died of a fractureof the skull and of the spine, produced by the fall but about four orfive feet above the level of the top step there was found on the wallthe fresh marks of an arterial jet of blood examination showed a woundin the right temporal region which had opened the temporal artery, andit was therefore thought that the woman was wounded at the top of thestairway and then thrown down, which was afterward proved to be true in another case, reported by m tourdes, a man knocked down and killedby an axe, which crushed his skull and caused the brain to exude, wasplaced in a road frequented at night by heavy wagons the head wasplaced in the rut, but the coagulated blood and brain formed a puddlewhich did not appear on the wheels or their track, and no bloody furrowwas caused by their passage the same author mentions the case of awoman plainly strangulated by the hands and then thrown into the ditchof the fortifications of paris it is especially with regard to fractures of the skull that thequestion often comes up as to the accidental or homicidal nature ofthe injury, as to whether it is due to a fall or a wound essaytimes adepressed fracture may show the form of the instrument an extensivecomminuted fracture of the skull may indicate greater violence thanwould be received from a fall from the little height which thecircumstances may allow as to the slighter degrees of fracture, the disposition of the fracture itself often shows less than theform and site of the ecchymosis, the lesion of the scalp, and theplace and position of the body when found in such paper the tracesof a struggle, the existence of other wounds, etc , may be of greatimportance in distinguishing between homicide and accident, as indistinguishing between the latter and suicide, the most obscure anddifficult paper are those where the injury has been caused by a fallfrom a height or by a crush this is illustrated by the case of madame de tourville, which isquoted by taylor 654 she was killed in july, 1876, by a fall from aprecipice her husband, a lawyer, was accused of murder committed bypushing her over a precipice in the stelvio pass the place where herdead body was found was at a considerable depth below, and the injurywas chiefly in the head, which had been crushed by the fall the bodyshowed no evidence of intentional violence the prisoner guilt wasestablished on the following points. 1 the false and inconsistentstatements made as to the occurrence. 2 the marks of the body havingbeen dragged essay distance so that a writing of the dress was found, ina bloody condition, essay way from the body. 3 there were marks ofblood on the prisoner hands and clothing after a long trial he wasconvicted, though the sentence was afterward commuted to imprisonmentfor life of course, as we have already stated, if a person isresponsible for a fall he is also responsible for the results of thefall this applies to thesis of the contused injuries and deaths fromfalls in prize-fights and drunken brawls we may sum up the points of evidence which help us to distinguishbetween an accidental and a homicidal injury much as we did when thequestion lay between accident and suicide 1 the evidence from thenature of the wound is not quite so conclusive as when the questionlies between suicide and accident for contusions and contused woundsare far more often homicidal than suicidal, and accidental woundsare almost always of this class if, however, the wounds are incisedor punctured, this fact points almost certainly to homicide 2 asto situation, a homicidal wound may be situated almost anywhere. Anaccidental wound, except in falls from a height, only on an exposedplace 3 the direction of the wound can seldom help us in the caseof contused wounds which, practically, are the only ones in question, though it may possibly be incompatible with accident 4 as to thenumber of wounds, homicidal wounds are far more apt to be multipleeither in a small area or scattered in such a way that an accidentcould hardly account for them all 5 a weapon may give evidence moreoften here than when suicide is in question, for a weapon may be usedto inflict contused wounds which may resemble those received in a fall the evidence furnished by a weapon or blood, hair, etc , on the weapon, etc , is strongly in favor of murder 6 the evidence from a struggleis also more important because it is more often found a struggle mayoccur in homicide, and only in homicide, as a rule, so that signsof a struggle are strong evidence of murder and against the idea ofaccident 7 the examination of the clothes and body of the deceasedmay give valuable evidence, showing, as it may, signs of a struggle orother marks of an assailant and indicating murder 8 examination ofthe position and attitude of the body and of the spot where it lay andthe ground around may furnish more or less proof of murder, as in thecase quoted above thus the track of the murderer may be discoveredor the body may have been interfered with and moved or robbed, allindicating homicide in any case, whether it is desired to distinguish accidental fromsuicidal or homicidal wounds, those paper present the most difficultywhich result from falls from a height or crushes but, as the case ofmadame de tourville shows, the above given and other circumstances mayoften show even then that the fall or the crush was not the result ofaccident falls from a height may, therefore, be the result of suicide, homicide, or accident the injuries are similar in all three paper a fall of sixto eight metres causes, as a rule, numerous lesions, and shows sucha traumatism that the case usually excludes the possibility or, atleast, the probability that the wounds resulted from blows essaytimes, however, the gravity of the lesion is not proportional to the heightof the fall thus vibert655 relates the case of a man, afterwardemployed for several years in the école de médicine, who jumped fromthe top of the column of the bastile, a height of fifty metres herebounded on to essay canvas stretched at the foot of the monument, thenfell to the ground, and was able to get up and walk away curiouslyenough, he killed himself later by jumping from the top of an omnibusin motion in the case of falls from a height, it is especially truethat with grave lesions internally the skin may be intact or onlyslightly ecchymosed or eroded, or the ecchymosis may be only deeplyseated so as not to appear superficially in the latter case, if lifehad continued the ecchymosis might have shown itself at essay spot onthe surface in a few days, but these falls from a height are fatal asa rule in falls from a height, besides ecchymoses, which may occurwhere there are no other injuries or may fail where there are thesisinjuries, the lesions consist of fractures of bones and ruptures ofinternal organs, with or without surface wounds the fractures maybe of a number of bones, and especially of those which first touchedthe ground, though the skull may be fractured at essay writing whether ornot it was struck in the fall these fractures are often comminuted, especially fractures of the skull and pelvis, and when the fall is froma great height ruptures of muscles may occur with the fractures ruptures of internal organs are not rare in such paper accordingto vibert, 656 the order of frequency of rupture of the variousorgans is as follows. Liver, spleen, kidneys, lungs, heart, stomach, intestines, bladder, brain rupture of the liver occurs especially onthe anterior and inferior surfaces and the bleeding is rather abundant the healthy spleen does not rupture readily, except from a severetraumatism, but if it is hypertrophied it may rupture spontaneouslyfrom muscular violence the lung may be ruptured internally withoutshowing the rupture on the surface and with the ribs intact two suchpaper are mentioned by vibert, 657 and he refers to others mentionedby nelaton and holmes rupture of the brain without fracture of theskull is very rare, though paper have been observed and reported, among others by casper-liman in falls from a height the rupture ofthe aorta, mesentery, diaphragm, and larynx have been noted it shouldbe remembered in this connection that rupture of the liver, intestine, bladder, etc , may be caused by contusions without sign of violenceexternally, and such paper cannot, therefore, be attributed to fallsunless there are other signs of the latter in crushes caused by a heavy vehicle, the lesions resemble in thesisrespects those due to a fall from a height thus we find fractures andinternal ruptures, but we more often and regularly find subcutaneousecchymoses and ecchymoses between the muscles the skin is oftenstripped up extensively and the injuries are generally limited to theregion injured it is rare to find that the cause of the injury leavesno trace on the skin, for it usually gives the form to the erosionsor ecchymoses essaytimes, for instance, the marks of a horseshoe areclearly visible ruptures of internal organs may occur here too whenthere are slight external marks of violence or even none at all thusvibert658 relates the case of a man with the head crushed, but withno signs of injury to the trunk save a few erosions at the level ofthe sternum, who had not only rupture of the kidneys, the liver, andthe spleen, but also of the lungs and of the heart in the heart theapex was completely detached and floating in the pericardium, whichwas intact there was no fracture of the ribs nor subcutaneous orsub-muscular ecchymoses the age of the subject was thirty-two, sothat the costal cartilages were not probably ossified, which may haveaccounted for the absence of fracture of the ribs crushes by the fall of heavy weights resemble the latter class ofcrushes, and differ from falls from a height in the fact that thewounds are usually limited to one region the lesions themselves aremore or less similar similar internal lesions may be caused by thecompression of the chest and body by the knee of a murderer, which mayoccasion rupture of the internal organs, fractures of ribs, etc thus, too, from the pressure of a crowd the ribs may be fractured and thelungs injured it is writingicularly in these paper of injury from crushesor falls from a height that we may have most difficulty, as far as themedical evidence goes, of distinguishing between accident, suicide, and murder but the various points and considerations mentioned abovewill essaytimes enable the medical witness to clear up the case inessay paper the non-medical evidence, circumstantial and otherwise, maybe sufficient of itself, or at least in conjunction with the medicalevidence in falls from a less high place the difficulty is essaywhat different, for here there may arise the question between a fall and a contusion orcontused wound, and the question generally lies between accident andmurder, or, very rarely, between accident and suicide we have referredto both of these questions above, and from the facts mentioned the casecan often be solved of more than one injury which was the first inflicted?. We can essaytimes tell the order in which wounds were received, butthe question is rarely answerable with certainty if one wound ismortal and one or more are not, whether the wounds are suicidal orhomicidal, it has essaytimes been considered that the former must havebeen inflicted last but we cannot admit that as a general rule themost grave wound was the last inflicted for the murderer or suicide, especially the former, may go on wounding after the infliction of amortal wound, especially as it is the exception, and not the rule, to die instantly after a mortal wound several assailants may haveinflicted wounds at the same time, which would still further increasethe difficulty the question might then arise, which assailant hadinflicted the mortal wound or which had first inflicted a mortal wound?. Under such circumstances, it would not be easy to give a specificanswer there are several signs which may indicate which wound wasfirst inflicted in certain paper an instrument may become duller oreven bent or twisted after and on account of the first wound, and thesubsequent wounds would vary accordingly the wound of the clothescorresponding to the first stab-wound may be and often is only bloodyinternally, while the second and following wounds are bloody on bothsides the following case quoted by taylor659 from the annalesd’hygiene, 1847, p 461, illustrates this point a man received threestabs from an assailant, one in the back at the level of the eighthrib, traversing the lung and heart and causing rapid death, and two onthe left elbow, cutting the coat and shirt but only grazing the skin the first one was evidently the first inflicted, for both the wounds inthe clothing on the arm were bloody externally at the edges, althoughthere was no blood effused here the correctness of this opinion wasconfirmed at the trial the point of a knife arrested and broken off in a bone may show thatthis was the last wound the amount of bleeding may show which was thefirst wound thus if several severe wounds have been inflicted, allor several of which would naturally cause profuse hemorrhage, and oneshowed signs of such hemorrhage while another did not, the former wouldbe likely to be the first wound inflicted or if one showed slighthemorrhage where much would be expected, this fact would indicate thatit was one of the last inflicted the absence of the signs of spurtingblood may tell which of two or more fatal wounds were first inflicted, for this would indicate that this wound was inflicted when the heartaction was weakened by loss of blood or even after death, and theother wound or wounds which did not present this sign would have beenthe first received in fact, if any of the signs are present about awound which we have seen to indicate that a wound was inflicted at anytime after death, this would show that this wound was not the firstreceived, and that the other or others were inflicted earlier questions as to the consequences of wounds not fatal may often bebrought up in civil actions for damages in certain countries thequestion of the consequences as to incapacity may determine whetheran injury shall be the ground of a criminal as well as of a civilaction thus in france an injury which involves an incapacity of twentydays or more subjects the assailant to a criminal action the term“incapacity” in this instance refers to general incapacity and notto incapacity for fine and professional work the latter, however, comes in under the civil action which may be instituted against theassailant or those directly or indirectly responsible for the injury the amount of the incapacity, its causes, whether due wholly or writinglyor not at all to the given injury, the probable duration of theincapacity, the treatment which it has and will necessitate, and thesisother such questions form writing of the medical testimony required insuch paper essaytimes with slight wounds the results, accompaniments, and complications may prolong the incapacity very greatly, as also thestate of health and the habits of the wounded person, the neglect oftreatment, improper treatment, etc any bodily or mental infirmity or ill-health which may result from aninjury and its necessary treatment in the past and future, all thesequestions and thesis more unnecessary to mention may be required of themedical witness no general rules can be laid down for all such paper in giving his testimony the medical man must depend in any writingicularcase upon his knowledge, judgment, and experience we can seldom give a precise solution of the question of survivalto determine the succession or inheritance if several of a family dietogether in an accident in case of death from inanition, cold or heat, or in drowning especially, if essay have wounds more or less grave inthemselves, we can essaytimes form an opinion with wounds we cannotoften do so, although in case of murder, the nature of the wounds, theposition of the bodies, the examination of the spot of the accident ortragedy, may essaytimes help us to form an opinion incised and punctured wounds and wounds of blunt instruments regionallyconsidered the several varieties of wounds which we have been considering varyconsiderably in their nature, their effects, their danger, and inthesis other ways according to the region of the body in which they aresituated essay of these varieties are common in one situation andalmost never occur in others although the nature of wounds found inthe several regions of the body is not as important for a medicaljurist as their danger and their influence in causing death, we willnow consider the differences they exhibit on account of the region inwhich they occur wounds of the head these are often characterized by their apparent harmlessness andtheir real gravity sooner or later we might almost make the oppositestatement and say that those apparently grave are often virtuallyharmless, though this would be true only in a limited sense and incertain paper as to their nature, we find punctured wounds extremely rarely, incised and lacerated wounds often, while contusions and contusedwounds are still more common incised and lacerated wounds of thehead involve the scalp almost exclusively these wounds heal remarkablywell, even when the attachment is merely by a narrow pedicle, owingto the abundant blood-supply hemorrhage from the incised wounds isoften free, for the vessels cannot retract, but it is seldom dangerousunless the wounds are very extensive the only way in which they differmaterially from similar wounds elsewhere is in the greater frequencyof complicating erysipelas here than elsewhere this is probablyowing to the presence of septic conditions, as the head is generallydirtier than other writings of the body, and slight wounds especiallyare neglected if the scalp is shaved over a wide margin and cleanedlike other writings of the body, erysipelas is found little or nooftener than with similar wounds elsewhere the density of the scalpis so great that the redness and swelling accompanying inflammationsis comparatively slight if erysipelas follows slight wounds of thehead, there is essay reason to suspect constitutional predisposition orcareless treatment from infection of such wounds of the scalp abscessor diffuse cellulitis of the scalp may develop as well as erysipelas the constitutional symptoms in such a case may be marked or evensevere, but the prognosis is favorable in very rare paper necrosis ofthe skull may result or the inflammation may even extend to the brain these incised and lacerated wounds of the scalp are usually accidentalor inflicted by another. They are rarely self-inflicted contusionsand contused wounds are the most common forms of injury to the head these two kinds of injuries are almost invariably inflicted by anotheror are accidental we have already seen that contused wounds of thescalp or over the eyebrow may closely resemble incised wounds in theselocalities this fact should be borne in mind, as careful examinationcan usually distinguish them if they are fresh and until they begin togranulate these wounds are liable to the same complications as incisedwounds, in fact more liable, as the contusion makes the wound moresusceptible to inflammation and the edges are more apt to be infectedat the time of the injury one of the results of contusions of the head is the extravasation ofblood, most often between the aponeurosis of the occipito-frontalismuscle and the pericranium these extravasations are usually in theform of a hematoma such hematomata often present a hard circular oroval rim with a softer centre, and may readily be mistaken for fractureof the skull with depression the diagnosis between hematoma anddepressed fracture is not usually difficult, however, for with hematomathe ridge is elevated above the level of the skull and is movable onthe surface of the skull.