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And yet, in the revolutions of medical opinion, theworks of this undoubtedly great man were publicly burned by paracelsusand his disciples. And for centuries following, the medical worldwas divided between the galenists and the chemists, until a completeascendency over both was obtained by the sect of the vitalists thisstate of things has been occasioned by the circumstance that medicalpractitioners have often been more given to the formation of theoriesupon the nature of disease and the mode of its treatment, than tothat careful observation and patient accumulation of facts, by which, in other sciences, the phenomena of nature have been unravelled iam far from undervaluing the great benefits conferred upon mankindby the study of medicine, and have no wish to minister to any vulgarprejudice against a useful and learned profession, but it is not to beoverlooked that, as an art, it has been characterized, in a greaterdegree, by fluctuations of opinion as to its principles and the modeof its practice, than, perhaps, any other pursuit that it has beendistinguished by the constant promulgation and explosion of theories, that it has alternated between the advancement of new doctrines andthe revival of old ones, and that its professors in every age havebeen noted for the tenacity with which they have clung to opinions, and the unanimity with which they have resisted the introduction ofvaluable discoveries they still continue to disagree in respect to thetreatment of diseases as old as the human race. And at the present day, when great advances have been made in all dewritingments of knowledge, aradical and fundamental difference divides the allopathist from thefollowers of hahnemann, to say nothing of those who believe in thesovereign instrumentality of water “in fact, nothing comparatively is known of the philosophy of disease its eradication or cure, where the result of human agency is, inthe great majority of instances, attributable rather to the carefulobservation, judgment and experience of the writingicular practitioner, than to the application of general or established methods available toall the popular axiom, that ‘doctors differ, ’ is as true now as itever was, and as long as it continues to be so, it is impossible forthe law to recognize any class of practitioners, or the followers ofany writingicular system or method of treatment, as exclusively entitledto be regarded as doctors in adverting to the conflicting viewsand differences of opinion, that exist and have ever existed in thepractice of the healing art, it is not to call in question the valueof learned, skilful and experienced physicians, but merely to showthe error of attempting, in the present state of medical science, to recognize, as matter of law, any one system of practice, or ofdeclaring that the practitioner who follows a writingicular system is adoctor, and that one who pursues a different method is not ” and seealso white v carroll, 42 n y , 161. Ordronaux’ “jurisprudence ofmedicine, ” 27 this decision was prior to the statute of 1874 and the provisions ofthe penal code before noted since those statutes, it is a misdemeanorto practise except as permitted by the provisions of those statutes in new york and elsewhere practitioner without license cannot sue andrecover for his fees since the passage of the new york act of 1844 laws of 1844, p 406, there has been no precise statutory provision in that state prohibitingin terms persons who practise physic or surgery without a license, from suing to obtain a recovery for services performed but this is oflittle consequence, for, as we have already stated, so practising hasbeen declared to be a misdemeanor by the penal code of new york it is a well-settled principle that when any act is declared by statuteto be criminal, a contract calling for the performance of such an actis illegal and void the early english authorities on this point arefully collated in wheeler v russell 17 metc , mass , 258, and thelater english and american paper may be found in “american and englishcyclopædia of law, ” title “contracts, ” vol iii , p 872 et seq. Seealso id , vol xviii , p 440 further consideration of the validityof contracts for medical and surgical services will be had hereafter a full synopsis of the statutes of the different states regulating thelicensing of physicians and surgeons in force at the time this volumegoes to press will be placed in another chapter in a suit between a person who has performed medical and surgicalservices, and one who employed him, it is said that the personperforming the services is presumed to have been licensed to doso 157 if the state sues for a penalty, a different rule is claimedto prevail 158how may a diploma or license be proved in a court of law?. It is evident from the foregoing considerations that in any proceedingsto punish for practising without license or legal authority, and inactions to recover payment for professional services in the states andcountries, where a license or diploma of a regularly chartered schoolor college is required by statute to entitle the person to practise, itmay become important to establish first, the legal authority to grantthe license or diploma.

Dillon v dillon, 3 curtis, 96, 102 see also dickinson v fitchburg, 13 gray, 546 testimony of expert, how impeached - essaytimes, on cross-examinationor otherwise, the fact becomes known that the witness who is proposedas an expert has expressed an opinion on the subject in hand contraryto that which he has given upon the witness-stand, and the question hasbeen raised as to establishing that fact at the outset and before histestimony goes before the jury, in order to enable the trial judge todetermine whether he is competent the rule in that case is that thetestimony as to his prior expression of opinion is not to be receivedat that time, but will come properly up as rebuttal, he having beenasked upon his cross-examination, giving time and place, whether hehas made the statements attributed to him an expert witness may inother respects be impeached like any other witness, that is, by theoaths of persons who know him and have known his reputation, and whotestify that his reputation for truth and veracity is bad and that theywould not believe him under oath he may also be impeached by producingwitnesses to prove that his special knowledge or technical mba assignment help skill isnot reliable or adequate to the undertaking which he has assumed butthis testimony must be from personal knowledge of the man and notfrom general reputation wharton on evidence, sec 437. Le rose v commonwealth, 84 pa st , 200 183general rule as to required amount of skill and experiencestated - the general rule may be stated thus, as derived from theseand other authorities:the extent of the previous study and investigation, and the amount ofskill and information which must be shown, will depend upon the factsof each writingicular case but essay special and peculiar knowledge orskill must be established, the amount of it to be determined by thetrial judge in his discretion the possession of such knowledge andskill is presumed in medico-legal paper if the witness is a licensedpractitioner essay practical suggestions as to conduct of witnesses on thestand - in this preliminary examination, the conduct and demeanorof the witness are of no little importance, because it is then andthere that he makes his first impression upon the court and jury he should be perfectly open and unreserved in stating his means ofspecial information, in explaining what are the limits of his personalexperience and the extent of his reading. But, at the same time, itwould be well for him to avoid all appearance of self-glorificationand all tendency to exaggerate his individual acquirements often hasit occurred that expert witnesses of undoubted capacity and honesty, who are unfortunately grandiose and self-assertive in their manner, have, however honest and able they might be, lost entirely their weightwith the court and jury by undue self-complacency and exaggeration oftheir personal qualifications, during their preliminary examination this is a matter requiring tact and judgment and nerve, and should befully understood between counsel calling him and the witness, beforethe witness is placed upon the stand in that event, it will be quitesafe for the witness to closely follow the questions of counsel by hisanswers, and to volunteer little or nothing if his answers are notfull and complete enough, counsel can renew the question in the same orin other form or carry the matter into greater detail if, on the otherhand, his answer is too full or he appears too eager, he may createa prejudice against him which nothing can overthrow, and which theart of counsel upon the other side in cross-examination and in makingcomments upon his testimony when summing up before the jury, will veryeffectually use to destroy his weight as an expert 184scope and extent of examination of expert witnesses - having statedhow experts may be summoned and qualified, it remains to consider thescope and extent to which they may be examined the advancement of the sciences and the progress of research in specialfields of knowledge have made expert testimony of large importanceduring the present century the basis of its admission is the factthat there are certain processes of reasoning which an ordinary juryis incapable of performing, even with the assistance of courts andlawyers oftentimes in the administration of justice in our courts, proof is given of circumstances which although admitted would havelittle or no significance in the mind of an ordinary juror, andwhich he would be unable to contrast and compare with other facts, successfully, without the aid of those more familiar with scientificmatters and the inductive process of reasoning than he is in suchpaper it is necessary that the jury should be specially enlightenedby persons who have, through training, skill and experience, acquiredthe power to enlighten them a common instance and illustration ofthis matter is to be found in the case of homicide by poisoning ahuman body is found dead. Externally there may be no indicia toshow positively the cause of death under such circumstances thelaws of all civilized countries permit what is called a post-mortemexamination by skilled physicians, who, finding no external evidencesof the cause of death, are permitted by the officers of the law toremove the internal portions of the body for special and carefulexamination if this discloses traces of inflammation or of lesions ofan abnormal character, further power is vested in the authorities tohave at the expense of the state a chemical examination of the internalorgans if this examination, which is necessarily long and excessivelytechnical, results in the discovery of any poisonous substance, suchas would produce death, and if it is found in sufficient quantities toproduce death, these persons who made the post-mortem examination anddiscovered the outward indications of the administration and effectsof the poison, and the chemists who discovered the poison itself inthe tissues of the body, in sufficient quantities to produce death, are called as experts before the jury the post-mortem examinersexplain what the appearance of the body was, as distinguished from theappearances of the body of an individual who had died from naturalcauses the chemist describes his course of experimentation, thevarious deductions which he made from his experiments, the tests whichhe applied in his investigation in discovering poison, and is thenallowed to testify that the poisonous substance was found in sufficientquantities to produce the physical appearances which the post-mortemexaminers have described, and to accomplish the death of the humanbeing in whose body the poison was found it is obvious that the powerof observation and the skill, which the skilled chemists and physiciansused as the basis of their reasoning in this case, were such as anordinary man, unskilled and inexperienced, would not possess, and theability to use them must have come from the study of treatises onsuch subjects, and from teaching and experience, to such an extent asto entitle the persons so testifying to be considered by the courtsas qualified to express an accurate and sound opinion on the mattersand things under investigation thus it appears how, in such paper, adewritingure became essential to the successful administration of justice, from the strict rule that witnesses shall testify solely to matters offact and observation, and why it has long been considered that essaywitnesses must be allowed to testify to opinions and conclusions again, in a like case, a body is found bearing evidences of wounds orbruises the question to be determined is whether they were inflictedbefore or after death. If before death, whether they were sufficient tocause death essay wounds and injuries might be sufficiently apparentand dangerous so that the common, inexperienced eye would at oncedetect that they were sufficient to cause death but in most instancesthis is not the case, and in such instances the testimony of expertsis required by the necessity of the case, to show that the wounds andinjuries were sufficient to cause death the general rules stated as to subjects for expert testimony - hencethe general rule is, that wherever the facts to be investigatedare such that common experience and knowledge of men do not enablethem to draw accurate conclusions, but are such that the study andexperience of specialists do enable such specially endowed persons todraw accurate conclusions, then the inferences and deductions theyhave drawn can be testified to by those who qualify themselves beforethe court as persons having sufficient skill and experience as suchspecialists to entitle them to give opinions the paper in which experttestimony is permitted to be given are set forth in rogers on experttestimony, sec 6, quoting from jones v tucker 41 n h , 546, asfollows:“1 upon questions of science, skill, or trade, or others of like kind “2 where the subject-matter of inquiry is such that inexperiencedpersons are unlikely to prove capable of forming a correct judgmentwithout such assistance “3 where the subject-matter of investigation so far writingakes of thenature of science as to require a course or previous habit of study inorder to the attainment of knowledge of it ”so also chief justice shaw of the supreme court of massachusetts, innew england glass co v lovell 7 cushing, 319, said:“it is not because a man has a reputation for sagacity and judgmentand power of reasoning that his opinion is admissible in testifyingas a witness if so, such men might be called in all paper to advisethe jury, and it would change the mode of trial. But it is because aman professional pursuit, or his peculiar skill and knowledge of essaydewritingment of science not common to men in general, enable him to drawinferences where men of common experience, after all the facts havebeen proved, would be left in doubt ”to the same effect see muldowney v illinois central r r co , 36iowa, 472. Wharton on evidence, sec 436. Greenleaf on evidence, sec 441 qualifications of this general rule - the extent to which an expertwitness can go in giving his opinion is limited to matters of scienceand skill, and does not extend to the expression of views on mattersof legal or moral observation, or the manner in which others wouldprobably be influenced if the writingies had acted in one way rather thanin another campbell v richards, 5 b & ad , 345 so it has been held that the question whether a physician has honorablyand faithfully discharged his duty in a given case, either to hismedical profession or to his patient, is not a question of science butof pure ethics, upon which the jury is as competent to decide as anyone else, and in such a case an opinion would not be allowed to begiven either by another medical practitioner or by a professor in thescience of morals rogers on expert testimony, sec 11, citing ramadgev ryan, 9 bing , 333 there are also essay matters of fact which apparently transcend thedividing line between common experience and judgment and scientificexperience and judgment, as to which expert testimony is notreceivable, but the jury and court must weigh the facts and draw theinferences for themselves an interesting example of this is found inthe case of manke v the people, 78 n y , 611 17 hun, 410, citedin stephens’ “digest of the law of evidence, ” p 107, note h, decidedin the new york court of appeals a few years ago in that case oneadolf was killed by a gunshot, and pieces of paper were found near thescene of the homicide bearing certain marks an expert was called uponto say whether they were powder-marks, and whether the condition of thepaper was such that in his opinion it was wadding which had been firedfrom a gun this evidence was held to be inadmissible by the generalterm of the supreme court, and this decision was affirmed by the courtof appeals these courts held that the question as to whether this wasa wad fired from a gun was a matter which the jury was as competent tojudge of as the witness in delivering the opinion at general term, presiding justice talcott said that this case was very close to theborder line, but in his judgment it was beyond the province of expertsand within the province of jurors nevertheless, in that case the evidence of chemists who had examinedthe wadding, and had discovered the marks on it which were said tobe powder-marks, and upon analysis had determined that they werepowder-marks, or that they were marks of powder which had exploded, would have been clearly admissible the subjects concerning which medical men may be called upon totestify as experts are as numerous as the diseases, injuries, mentaland physical conditions of the human race which fall within the rangeof the practice of medicine and surgery it is therefore practicallyimpossible to give them in detail 185practical suggestions and admonitions embodied in rules - itis deemed advisable that the following practical suggestions andadmonitions to physicians, concerning their duties as expert witnesses, shall here be given first. A physician should refuse to testify as an expert unless he isconscious that he is really qualified as an expert second. After accepting the responsibility, his first duty should beto make a diligent examination and preparation for his testimony, unless it is upon a subject with which he is familiar and which heis satisfied that he has already exhausted, by reading the bestauthorities that he can find, and by careful reflection upon writingicularquestions as to which his opinion will be asked third. Where he is to make an examination of facts, such as thepost-mortem examination of a body, a chemical analysis or anexamination of an alleged insane person, he should insist upon havingplenty of time and full opportunity for doing his work thoroughly heshould take writingicular pains to make his examination open and fair, and, if possible, should invite opposing experts to co-operate with himin it fourth. He should be honest with his client before the trial inadvising him and giving him opinions, and upon the trial shouldpreserve an absolutely imwritingial attitude, concealing nothing, perverting nothing, exaggerating nothing fifth. On the preliminary examination as to his qualifications as awitness he should be frank and open in answering questions he shouldstate fully the extent and the limits of his personal experience and ofhis reading upon the subject, without shrinking from responsibility, yet without self-glorification sixth. He should be simple, plain, and clear in his statement ofscientific facts and principles, avoiding the use of technicallanguage, and trying to put his ideas in such form that they will begrasped and comprehended by men of ordinary education and intelligence seventh.

Thus, for instance, soranus demanded most energeticallythat the midwife should be “ἀδεισιδαίμων” without fear of anydemon i e , she was not to be superstitious, but free from anyimputation which would render her curative interposition objectionable the profession of the magicians, due to the persecutions to which theybecame subject under the christian emperors valens, valentinian, andtheodosius, became considerably less prominent during the predominanceof christianity, but the ideas upon which it had been erected inancient times still survived. In fact, these ideas were even to acertain extent systematically elaborated during the middle ages, and atthis time a distinction was made between higher and lower, or whiteand black, magic the white magic busied itself with good spirits, theblack magic with the bad ones magicians, therefore, who operated bythe aid of the devil, and even in medicine called in the assistance ofthe devil, were called “necromancers ” for the first time magic becameamalgamated with certain philosophical speculations and also withchristian-dogmatic constituents the methods adopted by magic medicineunder these conditions are so peculiar and are so close to the boundarylines between philosophy and religion that we are really not quitecertain whether to relegate it to the domain of one or of the other but as the fundamental writings of these methods were actually supplied byphilosophy, we propose to defer this discussion for the present, andto take up here another form of medical superstition which was derivedexclusively from religion namely, “sleep in the temple ”§ 5 sleep in the temple - one of the generally practised methodsof medical science during the period of hellenic civilization whichwas still fully under the influence of theism i e , for at leasttwo or three centuries before the hippocratic era was what was knownas “temple sleep ” in fact, this method must be considered a signof a faith distinctly deep and sincere, a faith naive and childlikeindeed. But as a sign of such a faith this method is actually pathetic no taint of superstition could be found in it at the early periodreferred to it was still the pure and unadulterated expression of thegenerally prevailing conception that human art is to no purpose in anycase of disease, and aid must be found with the gods with those godswho regulate and personally execute all terrestrial phenomena down tothe minutest details temple sleep was not degraded into superstitionuntil medicine had come to the conclusion that the phenomena of diseasewere not evidence of an interference by supernatural power in thefunctions of the body, but disturbances of the function of the bodycaused exclusively by natural causes in accordance with this view, which first found its fullest and clearest exposition in the corpushippocraticum, it would seem absolutely necessary for temple sleep tolose all recognition from the art of healing however, this not beingthe case, it was bound to deteriorate into an act of superstitiousmummery, and the principal blame for this sad decadence is to be laidprimarily upon the priests it was their duty especially to lead intothe path of truth the patients who persisted in crowding into thetemples in the spirit of naive and childlike piety they sealed theirown condemnation as fosterers of superstition when they failed todo this duty, and endeavored rather, by every means in their power, to confirm the multitude in their ancient belief that the gods werepractising medicine non-christian as well as christian priests playedthis rôle for thesis centuries with equal ability and equal perseverance, as will be seen from the following brief history of temple sleep the belief in the efficacy of temple sleep had already been thoroughlyshaken during the time of the great hippocrates. Therefore, inthe sixth century, b c , the laughing philosopher of hellenism, aristophanes, the satirical contemporary of hippocrates, in act ii , verses 654 to 750, of his comedy πλοῦτος, severely criticizes themanner and method in which temple sleep was employed let us listento the words in which the poet describes what happened in the templeduring the observance of this rite the god æsculapius, accompanied by his daughter panakeia, appears inthe temple to examine in person the patients gathered there the firstone he meets is a poor wretch, neokleides, who, being blear-eyed, expects cure from the god the medically skilled æsculapius smearsupon the inverted lids of this patient a salve which causes such painthat the poor fellow will probably never seek his help again thesecond patient met by the god is the blind god, πλοῦτος i e , wealth personified here the conduct of æsculapius is entirelydifferent from that which he adopted when treating poor neokleides now he carefully strokes the head of the patient, then produces alinen cloth and carefully touches the lids with it he then callshis daughter panakeia, who winds a red cloth round the head of blindwealth now æsculapius whistles, and two mighty serpents appear, glideunder the purple cloth, and lick the eyes of the patient shortlyafterward the god regains his sight this passage is a cutting satire on practises which undoubtedlyprevailed in the greek temples as early as the sixth century, b c but, nevertheless, it took a long time before the patients losttheir belief in the miraculous efficacy of temple sleep, and thepriesthood continually strove to revive, by the mysterious storiesof various kinds they recounted to doubters, the belief in templesleep the sixth of the marble votive tablets which were found inthe temple of æsculapius at epidaurus shows the kind of miraculousreports invented by the priests the latter were in the habit ofinscribing upon these tablets reports of cures that had occurred intheir sanctuary, for the benefit of the visitors of the temple and forthe still greater benefit of the medical historians. But it is quiteprobable that the priesthood, intent upon curing, were encouraged intheir medico-literary attempts only by the silent hope of creatingan abundant supply of patients by such miraculous reports the abovetablet, no 6 which probably dates from the third century, b c - tellsus that a blind man by the name of hermon, a native of thasos, hadrecovered his sight by sleeping in the epidaurean temple of æsculapius however, it appears that this man hermon had been a miserable wretch, for he disappeared without having expressed his thanks in hard cash naturally such ingratitude provoked the god, and summarily he blindedthe thankless individual again it required a second temple sleepbefore the god condescended to become helpful once more but our tabletdoes not mention anything about the amount of the remuneration paid byour friend hermon who had been twice cured of blindness. Neither isthis at all necessary the miraculous tablet, even without stating theprice, doubtless made sufficient impression upon the minds even of themost parsimonious of future patients altho, therefore, the more enlightened among the greeks recognized, as early as in the sixth century, b c , the futility of temple sleepas a means of healing, the ancient world never relinquished itentirely we encounter it again in the later periods of antiquity thus, for instance, suetonius and other ancient authors tell us thattwo patients, one blind, the other lame, one day approached theemperor vespasian, who happened to be in alexandria, asking him tospit into the eyes of the one and to stroke the paralyzed limbs ofthe other. For they had been notified in temple sleep that they wouldbe restored to health if only the emperor would deign to perform theabove-mentioned manipulations but vespasian was an enlightened rulerwho, in spite of his imperial dignity, did not have much confidence inthe medical qualities of his saliva and of his hands, and accordinglyunceremoniously dismissed both supplicants this caused great terroramong the priests of serapis and among the courtiers, for obviouslythey had interpreted this affair solely as intended in majoremvespasiani gloriam the emperor was importuned, therefore, kindly toaid the unfortunate, but he persisted in his refusal probably he wasright in fearing the loss of his prestige should the imperial medicalpowers prove unequal to the task of curing disease not until thepriests solemnly vouched for the truthfulness of the dream-sending godserapis, and declared a failure of the imperial cure to be impossible, did vespasian stubbornness relent now he spat, and rubbed theparalyzed limbs, and the blind saw, and the paralytic arose and walked §6 church sleep - when, subsequently, the ancient religions died out, and had left the world as an heritage to christianity, temple sleep hadby no means died out also on the contrary, after the lapse of threecenturies, it again came into favor with the christian priests and theuse of it now was scarcely less in favor than it had been a thousandyears previous in the world of the ancient greeks let us mention a fewexamples the first four stories are taken from the works of gregory oftours mummolus, who came to the court of justinian 527 to 565 as theambassador of king theudebert, suffered greatly from calculi of theurinary bladder, and during this journey he became subject to an attackof renal colic things went badly with poor mummolus, and he was ina great hurry to make his will whereupon he was advised to pass onenight sleeping in st andrew church, at pateras, for st andrew hadperformed thesis miraculous cures in this place no sooner said thandone mummolus, greatly tormented by pain and fever, and despairingof life, had himself placed upon the stone flags of the sanctuary, and waited there for the things that were to happen suddenly, towardmidnight, the patient awoke with a violent desire to urinate, anddischarged in a natural manner a calculus which, as st gregory assuresus, was so enormous that it fell with a loud clatter into the vessel from that hour mummolus was hale and hearty, and joyfully started onhis journey homeward in brioude, the capital of the present dewritingment haute-loire, therewas a woman named fedamia, who had been paralyzed for years inaddition to this, she was penniless, and her relatives, therefore, brought her to the church of st julian, who enjoyed a great reputationin brioude, in order that, even if she did not become cured, she mightat least make essay money by begging at the church door for eighteenyears she had lived thus when, one sunday night, while she slept inthe colonnade adjoining the church, a man appeared who took her by thehand and led her toward the grave of st julian on arriving there sheuttered a fervent prayer, and in a moment felt as if a load of actualchains fell from her limbs all this, it is true, happened in a dream, but when the patient awoke she was hale and hearty, and was able, tothe amazement of the assembled multitude, to walk, with loud prayers, to the grave of the saint a certain man, deaf, dumb, and blind, known by the name of amagildus, also tried the sleep in the church of st julian, at brioude but itappears that this saint was not always quite accessible to the wishesof the sick it is true, amagildus was not obliged, like fedamia ofthe previous narrative, to pass eighteen years in the basilica, but, nevertheless, he had to sleep for a full year in the colonnade of thechurch before the curative power of the holy martyr delivered him fromhis ailment veranus, the slave of one of the clergy under gregory, was so violentlyattacked by gout that he was absolutely unable to move for an entireyear thereupon his master pledged himself to advance the afflictedslave to the priesthood if st martin would be willing to cure him toaccomplish this cure the slave was carried to the church, and thereplaced at the feet of the saint the poor wretch had to remain therefor five long days, and it seemed as tho st martin had forgotten allabout him finally, on the sixth day, the patient was visited by a manwho seized his foot and drew it out straight the slave rose to hisfeet in terror, and perceived that he was cured for thesis years heserved st martin as a priest but the most wonderful cure was that of the german emperor henry ii , called “the saint” 1002 to 1024 this emperor, who was of bavarianstock, suffered greatly from the stone, and had retired to the italiancloister monte cassino, inasmuch as this cloister during that periodjustly enjoyed an extraordinary medical reputation but whether themonks of monte cassino, altho well versed in medical art, did not havesufficient confidence in their ability to treat an emperor, or whetherthey were induced by essay other reason, is not known. However, insteadof submitting the imperial patient to the operations of terrestrialmedicine, they surrendered him to the providence of heaven, andmore writingicularly to the sympathy of st benedict this saint fullyjustified the confidence that was placed in him, for, during an acuteperiod in the patient sufferings, he appeared in his own holy person, and with his own holy hands he performed the necessary operation, and, after having pressed the stone that he had removed from the bladderinto the hand of the sleeping emperor, he retired heavenward but hetook care from his heavenly residence to attend to the prompt healingof the operation wound, and this was surely very good of st benedict in fact, his entire behavior during this case was extremely proper andlaudable. For is it not much more fitting that the imperial bladdershould be delivered from its disagreeable visitor, the stone, at thehands of a saint than by those of mortal beings, even if those mortalbeings were the pious and medically skilled monks of monte cassino?. 3the form in which we encounter the christian temple sleep in the abovestories is as like as two peas to that practised in the hellenictemples they are distinguished merely by the fact that the greek godsgenerally hastened to the assistance of the patients after the latterhad spent one night in the temple, whereas the christian saints oftenallowed years to pass before the patient, who was crying for aid, secured relief 3 compare leibnitz, script brunsvic, vol i , page 525 sprengel, vol ii , page 91 christianity has, however, created one variation of the temple sleep, and this is the sleep which is taken, altho outside of the church, atany place whatever, but with invocation of the saints this sleep wassaid to be exactly as efficacious as that taken in the church itself, provided the patient had fervently prayed before falling asleep, andhad writingicularly remembered the saint whose assistance he required the two following narratives, which are also taken from the works ofgregory of tours, may serve as significant examples of this variety oftemple sleep alpinus, count of tours, was so tormented for years by a pain in hisfoot that life had no further joys for him, so that, sleepless andwithout appetite, he took to his bed again and again had he, insecret prayer, appealed to st martin for relief so one day the countsuddenly falls into a deep sleep, during which st martin appears tohim, making the sign of the cross over the diseased foot thereupon thepain suddenly left him, and alpinus was able to leave his couch, fullycured in this case the saint showed himself extremely consideratetoward the sick count, in that he was attired in a smart uniform whenpaying his visit it was his intention, obviously, in choosing thiscostume to gratify the martial tastes of the nobleman. For st martin, when visiting patients, by no means always affected this warlike array, as will be seen from the following story a certain woman was so severely afflicted with campsis of the fingersthat she completely lost the use of her hands even a visit to thechurch which was consecrated to st martin in tours had brought her norelief the patient was obliged to leave the sanctuary with her fingersstill diseased but it seems that this patient was actually of a verycontented disposition.

But as a general rule the contents of the ninth editionof “the propaganda for reform” are of strictly professional interest those physicians who are desirous of obtaining in convenient form thematter dealing with “patent medicines” should order the book “nostrumsand quackery” or the various pamphlets on the same subjects that havebeen issued since “nostrums and quackery” came from the press the ninth edition of “propaganda for reform” contains a number of newarticles, greatly increasing the size of the book it also containsone novel feature which greatly enhances its value the index includesreferences not only to articles in the book, but mba assignment help also to matter onproprietaries not accepted by the council on pharmacy and chemistrywhich appeared in the journal of the american medical association andelsewhere this index makes of this edition of “propaganda for reform”a very full work of reference on proprietaries which are undeserving ofrecognition it should be understood, however, that not all articlesindexed are condemned. Essay are merely discussed and compared resolution endorsing the work of the council on pharmacy and chemistry presented at the san francisco session and signed by all the members of the house of delegates in attendance -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - | resolved, we, members of the house of delegates of the american | | medical association, believe that every effort must be made to | | do away with the evils which result from the exploitation of the | | sick for the sake of gain earnestly believing that the continued | | toleration of secret, semisecret, unscientific or untruthfully | | advertised proprietary medicines is an evil that is inimical to | | medical progress and to the best interest of the public, we | | declare ourselves in sympathy with, endorse and by our best | | efforts will further, the work which has been, and is being, done | | by the council on pharmacy and chemistry of the american medical | | association in the attempt to eliminate this evil | -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - table of contents writing i. Council reports page foreword 1 official rules of the council on pharmacy and chemistry 3 the council on pharmacy and chemistry, present and future 12 “accepted by the council on pharmacy and chemistry” 19 helping the council 20 delays in passing on products 20 cooperation of the pharmaceutical houses 21 budwell emulsion of cod-liver oil, nos 1 and 2 22 rheumalgine 23 gray glycerine tonic 24 tongaline and ponca compound 26 alfatone 28 uricsol 30 jubol 31 urodonal 32 formamint 33 hydragogin 41 filudine 41 lactopeptine and elixir lactopeptine 43 iodum-miller and iod-izd-oil miller 49 elixir iodo-bromide of calcium comp “without mercury” and “with mercury” 52 lecithin preparations omitted from n n r 53 proprietary names for liquid petrolatum 55 seng 55 frosst blaud capsules 56 tyree elixir of buchu and hyoscyamus compound 57 hydroleine 58 curative vaccine, bruschettini 58 stearn wine 59 protonuclein and protonuclein beta 59 hydropsin 61 digitalysatum 63 so-called secretin preparations 64 has secretin a therapeutic value?. 65 radio-rem 79 olio-phlogosis 79 the hypophosphite fallacy 80 pulvoids calcylates 85 sulfuryl monal 86 mark white goiter serum and mark white iodinized oil 87 kora-konia 92 the therapeutic value of the glycerophosphates 93 hydras 96 bromin-iodin compound 97 ammonium hypophosphite omitted from n n r 98 alphozone omitted from n n r 99 calcium glycerophosphate and sodium glycerophosphate omitted from n n r 99 gardner syrup of ammonium hypophosphite omitted from n n r 100 gluten products made by the kellogg food company 100 iodo-mangan omitted from n n r 106 liquid albolene 106 naphey medicated uterine wafers 107 nujol 108 pulvoids natrium compound 108 saloform 110 secretogen 110 iron citrate green 115 aspirin 116 pil cascara compound-robins 117 casta-flora 118 firwein 119 firolyptol plain and firolyptol with kreosote 120 biniodol 121 comparative symptoms resulting from the use of several oily suspensions of red mercuric iodid mercury biniodid 123 corpora lutea soluble extract, parke, davis & co 128 wheeler tissue phosphates 129 the claimed galactagogue effects of nutrolactis and goat rue not substantiated 131 the alleged galactagogue action of galega and nutrolactis 131 the russell emulsion and the russell prepared green bone 134 brom-i-phos 136 creosote-delson and creofos 137 triner american elixir of bitter wine 139 trimethol 140 ferrivine, intramine and collosol iodine 144 eskay neuro phosphates 146 k-y lubricating jelly 147 ziratol 148 gonosan 150 alcresta ipecac 153 iodeol and iodagol 154 capsules bismuth resorcinol compound not admitted to n n r 157 dixon tubercle bacilli extract and dixon suspension of dead tubercle bacilli 158 formosol 158 iodolene, a solution of iodin in liquid petrolatum, inadmissible to n n r 159 kalak water 160 minson soluble iodin “kelpidine” not admitted to n n r 161 nutone 162 tri-arsenole, l o compound no 1 and l o compound no 2 163 unctol 166 v-e-m schoonmaker laboratories, inc 166 hemo-therapin 168 venosal 169 secretin-beveridge and the u s patent law 170 the question of the stability of secretin 171 need for patent law revision 177 surgodine 180 medeol suppositories 181 guaiodine 183 several “mixed” vaccines not admitted to n n r 184 ophthalmol-lindemann 189 silvol ineligible for n n r 189 katharmon 191 iodinized emulsion scott and creosotonic scott 192 campetrodin and campetrodin no 2 193 carminzym 194 phillips’ phospho-muriate of quinine comp 197 b iodine and b oleum iodine 198 b iodine products 199 antithyroid preparations antithyroidin-moebius and thyreoidectin omitted from n n r 202 cephaelin and syrup cephaelin-lilly omitted from n n r and syrup emetic-lilly not accepted 203 colalin omitted from n n r 203 foral 204 granular effervescent bromide and acetanilid compound-mulford 206 holadin and bile salt mixtures 207 liquor santaiva, s & d , omitted from n n r 211 maltzyme, maltzyme with cascara sagrada, maltzyme with cod liver oil, maltzyme ferrated and maltzyme with yerba santa omitted from n n r 211 methaform omitted from n n r 212 pineal gland, red bone-marrow and thymus gland and their preparations omitted from n n r 213 piperazine and lycetol omitted from n n r 214 stanolind liquid paraffin omitted from n n r 214 westerfield digitalis tablets 215 xeroform-heyden and bismuth tribromphenate-merck omitted from n n r 216 cream of mustard refused recognition 218 “pluriglandular” mixtures 218 cerelene not admitted to n n r 219 collosol cocaine not admitted to n n r 221 cuprase not admitted to n n r 222 collosol preparations 223 pulvoids calcylates compound 226 proteogens of the wm s merrell company 227 “arsenoven s s ” and “arseno-meth-hyd” 231 hormotone and hormotone without post-pituitary 234 formaldehyde lozenges 235 lavoris 237 medinal 239 omission of cotarnin salts stypticin and styptol from n n r 240 micajah wafers and micajah suppositories 241 alkalithia 242 arhovin omitted from n n r 243 chloron, chlorax and number “3” 244 elarson omitted from n n r 248 iodiphos 249 mervenol and armervenol not admitted to n n r 249 normal phenol serum cano and methyl-phenol serum cano not accepted for n n r 251 soamin omitted from n n r 253 essay mixed vaccines not admitted to n n r 254 somnoform 255 tablets formothalates 256 triple arsenates with nuclein 256 “anti-pneumococcic oil” and the use of camphor in pneumonia 257 dial “ciba” 259 apothesine 260 eumictine 262 platt chlorides 263 anti-tuberculous lymph compound sweeny and anti-syphilitic compound sweeny 266 syrup leptinol formerly syrup balsamea 268 formitol tablets, ii 271 sukro-serum and aphlegmatol 273 supsalvs not admitted to n n r 274 hypodermic solution no 13, iron, arsenic and phosphorus compound not accepted for n n r 275 parathesin not admitted to n n r 276 chlorlyptus 277 aquazone oxygen water 290 coagulen-ciba omitted from n n r 290 ferric cacodylate omitted from new and non-official remedies 292 libradol 293 helmitol omitted from n n r 295 spirocide not admitted to n n r 296 digifolin-ciba not admitted to n n r 298 essay of loesser intravenous solutions 299 “national iodine solution” not admitted to n n r 300 mon-arsone not admitted to n n r 302 oxyl-iodide not admitted to n n r 304 quassia compound tablets 306 toxicide 307 pil mixed treatment chichester 310 atophan omitted from n n r 313 urotropin omitted from n n r 316 styptysate not admitted to n n r 318 lipoidal substances horovitz not admitted to n n r 320 yeast preparations and vitamin b concentrates 321 writing ii. Contributions from the a m a chemical laboratory the chemical laboratory of the american medical association 322 the work of the american medical association chemical laboratory 322 lead in “akoz” 328 sodium acetate in warming bottles 329 anti-syphilitic compound sweeny 330 “ambrine” and paraffin films 330 the stability of iodine ointments 337 iodolene and the solubility of iodin in liquid petrolatum 344 american-made synthetic drugs-- i 344 standardization of commercial bismuth tribromphenate 348 standardization of procain and examination of the market supply 355 deterioration of sodium hypochlorite solutions 358 syphilodol 359 cerelene 362 dr de sanctis’ rheumatic and gout pills 363 iodex and liquid iodex 365 writing iii. Contributions from the journal. Proprietary products iodin in liquid petrolatum 367 american-made synthetic drugs-- ii 369 nostrums in retrospect 379 bell-ans pa-pay-ans bell 380 anasarcin and anedemin 383 pepto-mangan 387 cactina pillets 391 ammonol and phenalgin 393 fellows’ syrup, and other preparations of the hypophosphites 395 shotgun nostrums 398 tyree antiseptic and aseptinol 401 neurosine and the original package evil 404 anasarcin advertising 407 antimeristem-schmidt 408 antiphlogistine 409 “auto-hemic serum” 409 “autolysin” advertising 413 “basic cancer research” and “cosmopolitan cancer research society” 414 seleni-bascca 416 bell-ans papayans, bell 418 campho-phenique 418 “cinchophen”. Formerly “atophan” 419 “collosols”.

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‘it is, perhaps, impertinent for laboratory men to comment on these clinical results ’it is his point was well taken and it is a profound pity thatprofessor carlson did not observe his own ruling “in the words of a correspondent of the journal of the american medicalassociation, in discussing professor carlson criticism of dr crile‘kinetic drive, ’ ‘it behooves the laboratory man mba assignment help to be circumspect inhis criticism of clinical theories, since going beyond the bounds ofwell-established things weakens his position, not merely with referenceto the writingicular subject under discussion, but with reference toclinical phenomena in general ’ clinical results have definitelyestablished the value of secretogen as the matter now stands thisstatement is beyond criticism “when secretogen was first introduced we assumed that it depended onsecretin for results produced in this assumption we were in goodcompany, as witnessed by the testimony of moore, edie and abram when, in the course of their investigations as to the value in diabetesof a secretin-bearing extract given by mouth, 106 they said. ‘inthe majority of these paper there has been no appreciable fallin the output of sugar in essay of these negative paper there hasbeen noted, however, improvement in the digestion and, in certainpaper, the patient weight has increased ’ they also state thatthe secretin-bearing product ‘appears to stimulate the functionalactivity of the duodenum ’106 they give a most significantreport 107 we quote from the paper as follows:106 all italics are ours g w carnrick company 107 bio-chem jour 1:28, 1906 “‘the patient had been under observation for six months beforetreatment and the sugar was not reducible by diet almost at once thedyspepsia from which he was suffering was relieved and his generalnutrition improved to such an extent that he regained over eighteenpounds in weight, which he had previously lost, and this improvementwas accompanied by complete recovery of his physical and mentalenergies ’106“inasmuch as this improvement could not have been due to the containedsecretin it must have been due to essay other principle containedin the extract our experience and that of the physicians who haveused secretogen establish the fact that moore, edie and abram madeno mistake when they came to the conclusion that what they termed asecretin-bearing extract stimulates the functional activity of theduodenum and improves the digestion “when professor carlson was investigating secretogen he must haverealized that he was dealing essentially with an extract of theduodenal mucosa it is, therefore, all the more surprising, consideringhis extensive researches into the literature, that he should haveignored the testimony of essay of his own authorities, writingicularlyhallion, as to the value of extracts of the duodenal mucosa in duodenalinsufficiencies the meticulous carefulness with which this evidencewas avoided is hardly worthy of the best traditions of physiology, ascience which has truth for its first and last aim “hallion in his ‘la pratique de l’opothérapie’ says that the ‘aims ofduodenal opotherapy are. 1, to supply deficient duodenal juice 2, above all to stimulate and to relieve this organ-- notably to aid theproduction of secretin4-- and so profit by the stimulating actionwhich duodenal extract exercises on the duodenal mucosa which actionwe, enriquez and myself, believe and have experimentally proved, conforms to the general principles of opotherapy 3, by means of theproduction of secretin, to reinforce the biliary, pancreatic andintestinal secretions 4, to stimulate intestinal peristalsis “‘principal indications. Intestinal dyspepsias, intestinalautointoxications, certain forms of constipation and duodenalinsufficiency ’“at the international congress of medicine, madrid, 1903, hallionsaid that he felt justified in stating that duodenal opotherapycorrectly carried out must be classed under the very best methods oftreating dyspepsia 106 the results had been satisfactory and, inthesis paper, remarkable it had been nil in a few paper but it hadnever been harmful in any degree he pointed out that marfan was thefirst to employ this substance clinically marfan had had writingicularlyexcellent results in children of 15 months to 4 years suffering withmarked malnutrition, anorexia and constipation marfan prescribedthe duodenal extract given in milk 106 hallion further remarks that, as he is not a practitioner, he had had only one opportunity to testduodenal opotherapy clinically the case was that of a man of 26 yearswith obstinate intestinal dyspepsia and severe constipation which hadpersisted from childhood this patient had been treated by enemas, laxatives, diet, etc treatment with duodenal extract resulted ina complete cure 106 hallion points out that the most satisfactoryaspect of duodenal opotherapy is the permanent effect produced, 106which bears out his statement that these extracts have the power to aidin the restoration of function and structure of an organ “this has been so well established that the principle is now embodiedin a law which is frequently referred to as ‘hallion law’. ‘extractsof an organ exert on the same organ an exciting influence which lastsfor a longer or shorter time when the organ is insufficient it isconceivable that this influence augments its action and, when it isinjured, that it favors its restoration ’“in ‘la pratique de l’opothérapie’ hallion points out that ‘theopotherapeutic product which corresponds to the affected organrepresents in essay way the stimulating and elective food for thatorgan, and if we supply the organ with a food which is more completethan it necessarily needs, the affected organ can exercise its electiveaction and take up only those substances of which it is in need ’“hallion observations on this point are beautifully borne out bythe classic work of j w draper, as reported in the journal of theamerican medical association, sept 26, 1914 this report gives resultsin both laboratory and clinical experiments “in order to show that fed jejunal and ileac epithelium exerciseessay special detoxicating power, not yet understood but definitelyrecognizable, draper fed a control series of dogs with intestinalobstruction, experimentally produced, on emulsified cells of liver, spleen, pancreas and muscle tissue these animals lived a few hourslonger than not-fed controls, but draper says that it is evidentthat these cells had either no detoxicating action, or a very feebleone compared with intestinal epithelium he used jejunal and ileacepithelium clinically in two instances. 1st, in a female dog which hadhad ‘chronic stomach trouble’ for six months when draper saw her shehad had complete intestinal obstruction for five days, with symptoms oftachycardia, extreme nervousness and great weakness in the hind legs draper removed a pebble from her intestine but her condition was stillgrave “she was immediately put on small-intestine epithelium derived fromtwo dogs of different breed draper says that from a long experiencewith duodenally obstructed dogs, he should not have expected her torecover, but the symptoms gradually subsided and she lived the secondinstance in which he used the epithelium therapeutically was in thecase of a man who suffered from an annular cancer of the intestine withdefinite symptoms of obstruction after the operation, and realizingthat the patient was in a desperate condition, he fed him an emulsionof intestinal epithelium from a dog the pulse improved and the patientlived “essay of draper conclusions are as follows:“‘autotoxemia in intestinal obstruction undoubtedly arises from aninterference with cellular reactions of the intestinal epithelium when small-intestine epithelial cells of healthy animals are placedin the stomach106 of duodenally obstructed animals, such animals havelived nearly twice as long as not-fed controlled animals this evidenceis strongly opposed to the bacterial theory of origin of toxins ’“the point to be emphasized is this. If this emulsion of intestinalepithelium had been fed to a normal dog and a normal man, what wouldhave happened?. absolutely nothing on the other hand, given as it wasto a dog and a man in desperate need it exercised a potent effect “abundant clinical testimony can be cited in support of the opinionsof moore, edie and abram, hallion, marfan and draper as to the valueof extracts of the intestinal mucosa given by mouth in pathologicalconditions we have previously cited the published favorable opinionsof such gastroenterologists as anthony bassler, lewis brinton, g r lockwood, and r c kemp, so there is no need to recapitulate theirexperiences with what they honestly believed to be secretin-bearingextracts, but which were essentially extracts of the duodenal mucosa “supplementing the evidence of these men as to the value of theseextracts we submit an excerpt from a letter from one of the best knownphysicians of edinburgh:“‘i can speak in very high praise of secretogen, which i have used inboth tablet form and as the elixir there is no doubt about its valuein a certain class of intractable indigestion which refuses to bebenefited by any other remedy on several occasions i have been muchgratified by the definite relief obtained in this class of paper ithits the mark also in essay types of obstinate constipation-- i thinkthose paper where the trouble is wrapped up in impaired enervationof the intestine, and where stasis occurs at certain segments of thecanal ’“hallion very pertinently points out108 that it is now accepted thatopotherapy is not substitutive, but homostimulative and he remarksfurther that it is well to bear in mind that the so-called activesubstances which make the extract efficacious need not necessarily bethe hormones ‘it may be the elements of tissue structure which maycome to the aid of the injured organ the hormone should not thereforebe looked on as the only active agent of opotherapy and, while itsaction is important, it need not necessarily be preponderant thechemical isolation of the hormones is, of course, of interest but maynot be as vital to organotherapy as we have thought ’ ”108 presse médicale, 1912, p 433 comment by the council on pharmacy and chemistrythe g w carnrick company, which formerly claimed that secretogen wasefficacious because it contained secretin, now admits this claim to beunfounded notwithstanding, the manufacturers still call their productsecretogen and make for it practically the same therapeutic claims asbefore they now base these claims on vague “principles of opotherapy”and on so-called “clinical testimony ” the burden of proof rests onthem to show that these old claims, already discredited but put forthagain on new grounds, are justified have they done so?. The “clinical te stimony” is not convincing so much of it as isdefinite enough to permit of criticism has already been dealt with theremainder consists of mere assertions. It is not through reliance onsuch evidence that the council can discharge its trust on this side ofthe question there is nothing new to be said-- reassertion of a refutedargument does not constitute fresh proof nor is the case better on the experimental side the statements ofhallion, enriquez, zuelzer and others109 as to the existence of a“peristaltic hormone” not only have failed of confirmation, but alsohave been positively discredited with regard to draper work, whichdealt with acute intestinal obstruction, it is difficult to see what isits relevance to the present issue, writingicularly since draper resultswere obtained with a product derived from the mucosa of the jejunumand ileum and not with an extract of the duodenum such as secretogenpurports to be 109 cf interal schagindweit, e. Experimentelle versuche mithormonal, arch internat de pharmacod , 1913, p 77 the innuendo that the council discriminates in favor of certainmanufacturers, is itself a confession of weakness in publishing this correspondence the council sole object is to putthe medical profession in possession of the exact facts of the case these may fairly be summed up as follows:1 secretogen was originally marketed as a preparation containingsecretin none was found in it 2 notwithstanding proof of this fact, the g w carnrick companyretain the original name of the product, knowing that, by itsassociation with their former erroneous assertions concerningsecretogen, this name must inevitably convey to a physician usingthe product the impression that he is administering secretin in theadvertising literature no hint is given that this original statementwas erroneous 3 the product called “secretogen” has not been shown, eitherexperimentally and by sound clinical evidence, to possess usefultherapeutic properties under these circumstances the council reaffirms its decision -- fromreports of council on pharmacy and chemistry, 1916, p 72 iron citrate green report of the council on pharmacy and chemistryh k mulford company and e r squibb and sons submitted to thecouncil ampules containing solutions of iron citrate green it thusbecame necessary to consider the eligibility of iron citrate greenitself for admission to new and nonofficial remedies as the rules ofthe council provide that nonessential modifications of official ornonproprietary preparations will not be recognized, the above namedfirms were asked to state what advantages, if any, the so-called ironcitrate green had over the official iron and ammonium citrate in replythe h k mulford company wrote that it had come to the conclusion thatiron citrate green and ampules thereof would undoubtedly be consideredby the council as a nonessential modification of an official product, adding.