History

Med School Essay


In the mean time for, first, the recognition and, second, the surgicaltreatment of perforating wounds of the abdominal viscera, americansurgeons have won for themselves the greatest credit, and an alreadylong list of successful laparotomies after gunshot wounds of theintestines, with intestinal suture or resection, has shown the verygreat value of this procedure, even though it has kept essay would-bemurderers from the gallows these lines are inserted here because the time and effort whichsurgeons have devoted to this kind of surgery deserve only the highestencomiums and encouragement from med school essay the legal profession, although to ourdeep regret they have not always met with the same of the various conditions which complicate gunshot wounds and maketheir results uncertain, delirium tremens is one of the commonest and must always beregarded as one of the most serious it is well known to surgeonsthat a slight injury even, and often a severe one, is enough toprovoke manifestations of this character in intemperate persons themedico-legal question under these circumstances is this. Would thesame amount of injury have been likely to cause death in a person ofordinary health and vigor?. the law as applied to these paper has beenstated by lord hale.

“hartung digifolin merits our attention, especially because it seems to possess all the pharmacodynamic properties of galenic preparations of digitalis without showing any of their disadvantages ”this claim scarcely needs comment, since it is well established thatthe chief “disadvantages” of digitalis are inherent in the principleswhich produce the desired effects of digitalis and may be avoidedto a large extent by a carefully regulated dosage of any digitalispreparation in short, the advertising for digifolin asserts that thisdigitalis preparation has all the advantages of digitalis itself, butnone of its disadvantages this claim has been refuted so frequentlythat manufacturers must be aware that it is untenable further theclaims now made for digifolin are essentially those made nearly fouryears ago at which time the attention of the american agent was calledto their unwarranted character the council declared digifolin-ciba inadmissible to new and nonofficialremedies because the therapeutic claims advanced for it are misleadingand unwarranted -- from the journal a m a , april 2, 1921 essay of loeser intravenous solutions report of the council on pharmacy and chemistrythe council has authorized the publication of the following reporton “loeser intravenous solution of hexamethylenamin, ” “loeserintravenous solution of hexamethylenamin and sodium iodid, ” “loeserintravenous solution of sodium salicylate, ” “loeser intravenoussolution of salicylate and iodid, ” “loeser intravenous solution ofsodium iodid” and “loeser intravenous solution of mercury bichlorid, ”put out by the new york intravenous laboratory, inc w a puckner, secretary the intravenous solutions of “hexamethylenamin, ” “hexamethylenaminand sodium iodid, ” “sodium salicylate, ” “sodium salicylate and sodiumiodid, ” “sodium iodid” and “mercuric chlorid” marketed by the new yorkintravenous laboratory, inc , are solutions of official substances soldunder their official names they would, therefore, be outside the scopeof the council, were it not that special and general therapeutic claimsare made for them such special claims, for instance, are contained inan advertisement in the illinois medical journal for oct 20, 1920, which gives, under the various drugs, a list of diseases in which thedrugs are said to be “indicated ” the council is unable to agree withessay of these recommendations the fundamental objection, however, isthe general claim of superiority and safety of the intravenous method the intravenous solutions named above would naturally have little saleif such special claims were not made for them while the claims may notbe made directly, they are carried by such display phrases as “for theprogressive physician seeking improved clinical results” and “a safepractical office technique ”the council continues to hold that intravenous medication, generally, is not as safe as oral medication even with relatively harmlesssubstances a fact again illustrated by the results of hanzlik andkarsner, 1920, journal pharmacology and experimental therapeutics, 14, 379, and that it does not give “improved clinical results” exceptunder rather narrowly confined circumstances-- namely, if the drugundergoes decomposition in the alimentary tract, if it is not absorbed, if it causes serious direct local reaction or if time is an urgentelement each intravenous preparation for which advantage over oraladministration is claimed, directly or by implication, must be examinedfrom these points of view the council has recognized intravenous preparations which satisfiedthese requirements it is evident, however, that hexamethylenamin, sodium iodid and sodium salicylate do not when given orally they donot undergo material decomposition in the digestive tract, they arerapidly absorbed, they cause no direct local reaction, and in theconditions in which they are used the hour or so which is required forabsorption is immaterial, especially as they are used continuously foressay time mercuric chlorid does indeed produce essay local irritation, but there is as yet no convincing evidence that its intravenousinjection causes less injury than oral administration more experienceunder controlled conditions is needed before the intravenous use ofmercuric chlorid can be approved especially objectionable are thefixed proportion mixtures of sodium iodid with sodium salicylate andwith hexamethylenamin the dosage of all three drugs has to be adaptedto individual conditions this is impossible when giving them in fixedproportions the council voted not to accept “loeser intravenous solution ofhexamethylenamin, ” “loeser intravenous solution of hexamethylenaminand sodium iodid, ” “loeser intravenous solution of sodiumsalicylate, ” “loeser intravenous solution of salicylate and iodid, ”“loeser intravenous solution sodium iodid” and “loeser intravenoussolution of mercury bichlorid” for new and nonofficial remedies becausethey are sold under misleading claims regarding their alleged safetyand efficiency in view of this fundamental objection the individualclaims for each preparation were not passed on -- from the journala m a , april 16, 1921 “national iodine solution” not admitted to n n r report of the council on pharmacy and chemistrythe council has authorized publication of the following report w a puckner, secretary “national iodine solution” is a proprietary sold by the national drugco , philadelphia, pa from inquiries received by the council onpharmacy and chemistry it is evident that the product is extensivelybrought to the attention of physicians by means of circulars the nameimplies that it is a solution of iodin and the inference is given thatit has the advantages of iodin without the disadvantages compositionin view of the foregoing, the council took up the investigation of“national iodine solution, ” and in turn asked the a m a chemicallaboratory to analyze it the chemist report follows:according to the label of national iodine solution, “each fluidouncerepresents three grains proteo-albuminoid compound of iodin national”. Also an alcohol declaration of 7 per cent is made otherwise no information is given as to the composition either of the“solution” or of “proteo-albuminoid compound of iodine ”each bottle contained about 115 c c nearly 4 ounces of a yellowishsolution, acid in reaction, having an odor resembling witch hazel. Itsspecific gravity at 25 c was 0 9860 qualitative tests indicated thepresence of zinc, alcohol, sulphate, an iodin compound the solutiongave tests which indicated a very small amount of free iodin. Mostof the iodin was in the form of ordinary iodid, a small amount ofvegetable extractives, and traces of aluminum and potassium if anyprotein was present, it was in amounts too small to be identified, though a small amount of a nitrogenous compound was present the amountof solids in “national iodine solution” was equivalent to 0 72 percent, and the amount of ash, to 0 2 per cent quantitative estimationsyielded the following. Alcohol by volume 7 0 per cent zinc zn 0 096 per cent iodin free and combined 0 029 per cent sulphate so₄--    0 146 per cent protein n × 6 36 0 012 per cent the above findings indicate that each 100 c c contains about 7 c c ofalcohol, 0 5 gram of zinc sulphate u s p znso₄7h₂o , 0 03 gramof iodin, 0 01 gram of protein calculated as such from nitrogen timesthe factor 6 36 and essay hamamelis water expressed in equivalentapothecary terms, each fluidounce contains essentially. Zinc sulphate 2-1/3 grains iodin free and combined 1/8 grain protein 1/25 grain alcohol 34 minimsthis amount of alcohol is equivalent to about 3-1/2 fluidrams of witchhazel water although the label states that each fluidounce containsthree grains of “proteo-albuminoid compound of iodine, ” yet the sum ofthe protein calculated from nitrogen content and iodin components isequivalent to less than 1/5 grain “national iodine solution” appears to be very similar to “gonocol” thenational drug co , philadelphia, pa , which was analyzed by the bureauof chemistry of the u s dewritingment of agriculture the bureau statedthat “it gonocol consisted essentially of an aqueous solution of zincsulphate, hamamelis water, a small amount of alcohol, 0 38 grain ofiodin, and 0 36 grain of protein per fluidounce ”it is evident that “national iodine solution” is not a solution offree elementary iodin as the name suggests. Instead it appears to bea solution of zinc sulphate in witch hazel water containing less than0 03 per cent of combined iodin and not more than a trace of freeiodin “national iodine solution” is one more to be added to thatalready long list of proprietaries which makes capital of the highesteem in which physicians hold iodin the claimsan advertising circular sent to physicians begins. “dear doctor. We beg to suggest a line of treatment while using national iodine solution which our thesis years of experience has proven to us to give the best and quickest results in the treatment of inflammation of the urethral tract ”in it are given directions for the treatment of “acute gonorrhea, male, ” “anterior urethritis, ” “anterior-posterior urethritis, ” “ardorurinæ and chordee, ” etc , by means of national iodine solution andother proprietaries of the national drug company make in fact thesolution is claimed to be “indicated in all conditions of urethraaccompanied by a discharge ” comment and conclusionsthe therapeutic claims made for “national iodine solution” areunwarranted such a solution is not indicated in all conditions of theurethra accompanied by discharge the advice contained in the circularis equivalent to mail-order treatment of gonorrhea it is of interest to note that the claims for an identical or asimilar solution prepared by the national drug company as a treatmentfor gonorrhea and intended for use by the laity, has been adjudgedmisbranded by the federal authorities notice of judgment no 8150, issued jan 25, 1921 in that it misled and deceived the purchaseror purchasers thereof in the statements regarding the therapeuticor curative effects of the article, which falsely and fraudulentlyrepresent it to be indicated in all conditions of the urethraaccompanied with a discharge, “whereas in truth and in fact it was not ”the council would emphasize that if physicians give heed to advertisingsuch as that sent out by the national drug company for this preparationthe medical profession cannot with good grace protest against theroutine treatment of venereal diseases by quacks and “patent medicine”venders -- from the journal a m a , june 4, 1921 mon-arsone not admitted to n n r report of the council on pharmacy and chemistrythe council has authorized publication of the following report w a puckner, secretary mon-arsone is offered by the harmer laboratories company as “a newand non-toxic arsenical for the treatment of syphilis ” in theadvertisements for mon-arsone it has been claimed that with thisdrug “the toxic, corrosive and uncertain reactions attending the useof arsphenamine have been entirely eliminated” and that “it has atherapeutic value equal to arsphenamine, but extensive case reportsfail to record the slightest toxic reaction following its use ”according to the manufacturers, mons-arsone is disodiumethylarsonate, the sodium salt of ethylarsonic acid, derived from arsenic acid byreplacement of one hydroxyl group by the ethyl group-- aso ch₂ch₃ oh₂ mons-arsone is related to sodium cacodylate, which is the sodium saltof dimethyl-arsenic acid-- aso ch₃₂oh-- derived from arsenic acid byreplacement of two hydroxyl groups by two methyl groups ethylarsonicacid and its potassium salt were described by la coste139 more thanthirty-five years ago, and the use of the sodium salt of methylarsonicacid was proposed in france essay years ago the harmer laboratoriescompany claims originality for mons-arsone in that it was the firstto prepare the sodium salt of ethylarsonic acid and to propose itstherapeutic use 139 la coste. Annalen der chemie liebig 208. 34 it was reported several years ago by castelli140 that sodiumcacodylate and the sodium salt of methyl arsenic acid were devoid ofeffect on experimental trypanosomiasis and spirochete infections careful clinical observations in this country by h j nichols141 andh n cole142 have demonstrated the inefficacy of sodium cacodylatein the treatment of human syphilis 140 castelli, g.

A portion of the ointment which had been made for nearly three months was shaken in a separator with chloroform and a dilute mixture of potassium iodide and sodium thiosulphate solutions after all of the free iodine had been removed the chloroformic solution of the fats was washed several times with a very dilute solution of sodium thiosulphate the chloroformic solution was filtered, evaporated and the residue dried over sulphuric acid 197197 the resultant fatty residue was of a brownish-green color itno longer had either the taste, color or odor of lard it was notedthat the fats, after removal by this method from the freshly preparedointment, were nearly white as the ointment aged the fat becamesuccessively darker in color the separated fat was then tested for iodine by kendall method 198it was found to contain iodine in considerable amounts, butquantitative determinations were not made 198 the method depends upon the conversion of all of the iodinecompounds into iodate by fusion with sodium hydroxide and oxidationwith potassium nitrate the melt is dissolved in water, a little sodiumbisulphite added, the solution cooled and neutralized with phosphoricacid, using methyl orange as indicator an excess of bromine wateris added, and the mixture boiled to expel carbon dioxid and bromine a little sodium salicylate is added, the solution cooled, an excessof potassium iodid added, and the liberated iodine titrated withtenth-normal sodium thiosulphate in the usual way one sixth of theiodine found is obtained from the material assayed, the balance beingfurnished by the potassium iodide added -- jour biochem , 1914, 19, 251 the pharmacopeia of the netherlands directs that iodine ointment shallcontain 3 per cent of potassium iodide and 2 per cent of iodineinstead of equal proportions 4 per cent of each as prescribed bythe u s pharmacopeia likewise the french pharmacopeia directs that10 per cent of potassium iodide and only 2 per cent of iodine shallbe used both of these pharmacopeias use water instead of glycerin asthe solvent loose combinations of iodine and potassium iodide, suchas are represented by the compound having the formula ki₃, have beendescribed the quantity of potassium iodide prescribed by the u s pharmacopeia for the preparation of iodine ointment is not sufficientto form such a compound as ki₃ with all of the iodine directed tobe used since essay of the pharmacopeias use larger proportions ofpotassium iodide more than sufficient to form the compound, ki₃, it seemed worth while to determine whether an ointment containinga greater proportion of potassium iodide than that required by theu s pharmacopeia would be more stable than the official article accordingly a specimen was prepared to contain 4 per cent of iodine, 8per cent of potassium iodide twice the u s p requirement, 12 percent of glycerin and 76 per cent of lard this was assayed for itsfree iodine content immediately after preparation, and found to contain3 68 per cent nine days later it contained 3 70 per cent anotherspecimen of the same iodine strength prepared from grade no 2 ofcommercial lard assayed 3 69 per cent at the initial assay, and sevendays later 3 40 per cent from these experiments it seems likely thatthe free iodine content of the u s pharmacopeia iodine ointment couldbe raised essaywhat by increasing the proportion of potassium iodide the results of these studies confirm the findings of pullen and offried in all essential writingiculars it appears that during the processof manufacture of iodine ointment about 20 per cent of the free iodinegoes into combination with the fatty constituents of the ointment on standing for a month approximately an additional 5 per cent goesinto combination, after which there is practically no loss in freeiodine content in other words iodine ointment which is a month oldis a relatively stable preparation it appears to make no noticeabledifference upon the rate and amount of iodine absorption whetherthe lard from which the ointment is made has a high or a low iodineabsorption value the composition of iodine ointment, which has beenmade sufficiently long to have reached equilibrium, is approximately asfollows. Free iodine 3 per cent iodine combined with fat 1 per cent potassium iodide 4 per cent benzoinated lard containing iodine 80 per cent the u s pharmacopeia requirement that iodine ointment shall befreshly prepared when wanted appears to be unnecessary probably mostpharmaceutical manufacturers are aware of this, for thesis of theminclude the preparation in their trade lists the presence of an iodideappears to be necessary, to prevent practically all of the iodine fromentering into combination with the fat 199-- from the americanjournal of pharmacy, august, 1917 199 in order to determine whether the iodine which is in combinationwith fat is absorbed through the skin, a few experiments were carriedout the dark-colored iodine-containing fat obtained from the ointmentand washed free from potassium iodide by the method described abovewas rubbed thoroughly into the skin of the forearm it was allowed toremain for four hours, after which the limb was scoured with soap suds beginning at the time of the application the urine was collected forforty-eight hours this was evaporated to small bulk and the residuetested for iodine by kendall method small amounts of iodine werefound these findings were taken to indicate that the iodine-containingfat is absorbed to essay extent by the skin it is generally believedthat potassium iodide is not absorbed by the unbroken skin thereforeit seems reasonable to suppose that the principal iodine effectsobtainable from iodine ointment are those due to the free iodinecontained in the preparation, supplemented to a slight extent bythe iodine which is contained in the fatty ointment base -- jour biochem , 1914, 19, 251 iodolene and the solubility of iodin in liquid petrolatumthe council on pharmacy and chemistry was asked to examine apreparation submitted with the statement that it was “iodin crystalsincorporated in a petroleum product ” the name “iodolene” was proposedby the promoters, providing the product was found eligible for new andnonofficial remedies iodolene was stated to have been prepared by treating a liquidpetrolatum, obtained from gulf coast petroleum, with an excess ofiodin. The mixture was subsequently “placed in an oven for threehours ” the claim was made that this method of procedure produced apreparation containing more iodin than market specimens which had beenexamined, namely. “over 1 50 per cent free iodine ”two specimens of the product were submitted, one stated to have beenunfiltered, and the other filtered both of the specimens emitted astrong odor of hydrogen sulphide upon removing the stopper from therespective containers iodin content of iodolene -- the iodin content of the filteredspecimen was determined thus. A weighed amount-- 3 to 5 gm -- wastransferred to a separator by means of 20 c c of ligroin, used inportions twenty c c of 10 per cent potassium iodid solution wasadded and the free iodin titrated with tenth-normal sodium thiosulphatesolution with agitation, the end point being the absence of a yellowcolor in the aqueous layer the amount of free iodin was found to be1 32 per cent the solubility of iodin in liquid petrolatum -- to determinethe solubility of iodin in liquid petrolatum, 200 c c of liquidpetrolatum-squibb said to be composed of hydrocarbons of the naphtheneseries and 200 c c of stanolind liquid paraffin said to be composedchiefly of marsh gas hydrocarbons were each treated with 5 gm ofiodin crystals the two mixtures were maintained for a week at atemperature essaywhat above that of the room and agitated occasionally each was then cooled to room temperature about 22 c , agitated fora day and then filtered the amount of iodin in the preparation madewith liquid petrolatum-squibb was found to be 1 42 per cent the iodincontent of the preparation made with stanolind liquid paraffin was 1 30per cent in view of these findings the prospective manufacturer was advised thatthe council cannot countenance a proprietary name for an unofficial, simple solution of iodin in liquid petrolatum -- from reports a m a chemical laboratory, 1917, p 87 american-made synthetic drugs-- i examination of american-made acetylsalicylic acid paul nicholas leech, ph d at the request of the council on pharmacy and chemistry, the a m a chemical laboratory has undertaken examinations of american-madesynthetic drugs the most extensively used synthetic is acetylsalicylicacid and hence an investigation of this product was deemed expedient for seventeen years acetylsalicylic acid was protected by a unitedstates patent the proprietors were not given a patent in othercountries and sold under the name “aspirin ” in february, 1917, thepatent expired, and since then a number of firms have engaged in themanufacture of acetylsalicylic acid, selling it either as such oras aspirin, modified, of course, by a distinctive firm designation during this period the former manufacturers the bayer co , new york, in past years called farbenfabriken of elberfeld co , new york havebeen extensively advertising, both to physicians and the public, thealleged superior qualities of their product the chemical examination, therefore, was concerned chiefly with tests of purity, and thecomparison of the american brands with the formerly patented product in european countries, acetylsalicylic acid200 is described in thevarious pharmacopeias as a condensation product of acetic anhydrideor acetyl chloride with salicylic acid o-hydroxybenzoic acid generally the test of identification is hydrolysis of acetylsalicylicacid and qualitative tests for acetic acid and salicylic acid forpurposes of purity the requirements are essentially that the specimenshould have a certain melting point, should show absence of salicylicacid by means of ferric chloride the manipulations for the tests arevariously described and leave no appreciable ash the two tests ofpurity most generally employed, however, are the melting point and thereaction with ferric chloride 200 unfortunately, the nondescriptive name “aspirin” has been usedextensively in european literature and has even got into europeanpharmacopeias, instead of the scientific name “acetylsalicylic acid ” melting pointthe melting point of acetylsalicylic acid has been given at varioustemperatures from 118 to 137 c 201. The british pharmacopeiadescribes the melting point at 133 to 135 c. The german pharmacopeia“about 135 c ;” the french pharmacopeia at 135 c. New and nonofficialremedies, 1917, 134 to 136 c the bayer company, in the patent trialat chicago a number of years ago, gave among the “four infallibletests” a melting point of “about 135 c ” several men have carefullydetermined the melting point in recent years emery and wright202 in1912 found that “aspirin, bayer” melted at 130 5 to 131 c in france, françois203 has determined the melting point of pure acetylsalicylicacid, which, according to his method, is 132 c when various samplesof acetylsalicylic acid were examined in this laboratory, it wasfound that the melting point of none was as high as that describedin new and nonofficial remedies or the british, french, or germanpharmacopeias when taken according to the general method of the u s pharmacopeia, vol 9, p 596 on critical observation, it may beseen that the melting point of acetylsalicylic acid is preceded andaccompanied by decomposition if the sample in the melting tube isheated from the original room temperature of the bath to 120 c , thetemperature of melting will be lower than if the bath is first heatedto 120 c and the melting-point tube then placed in the bath 204thus the melting point of acetylsalicylic acid, like so thesis organiccompounds which decompose and do not melt sharply, is unsatisfactoryand cannot be taken as an “infallible test” of purity, especially whendetermined by different operators who do not give their method indetail after making a large number of melting-point determinationsof acetylsalicylic acid, alone and in parallel with other operators, it was decided to use the method described in the u s pharmacopeiamodified by first heating the bath to 120 c before attaching themelting-point tube to the thermometer 201 for reference to older literature see beilstein, ii, 1496 889 202 “the melting temperature of aspirin and salicylic acid mixtures, ”proc assoc off agr chem , 1912. Bureau of chemistry, dewritingmentof agriculture, bull 162 203 “assay of aspirin, ” j pharm chem , 15 117, no 7, 213 204 similar observations were made by emery and wright, who state:“an accurate determination of the melting temperature in this way therate of heating was such as to give a rise in temperature of about 1°per minute is rendered difficult by the fact that ‘aspirin’ decomposeson heating, as evidenced in the depression of the melting temperatureof the pure substance of about 1° for every five minutes’ heating justbelow its melting temperature ”the melting point of purified acetylsalicylic acid was found to be131 5 to 132 5 c corr 205 with the exception of one specimen, which was obviously impure, the various specimens examined meltedbetween 128 and 133 c as may be seen in the accompanying table itwould appear that this range of melting points would be more acceptableand reliable than the melting points described in various standards 205 isolated crystals attached to the walls of the melting-pointtube, awriting from the bulk acetylsalicylic acid, melted at a lowertemperature presence or absence of free salicylic acidit is generally conceded that the presence of salicylic acid in amountsmore than traces is deleterious furthermore, the amount of salicylicacid is a good index of the purity of the acetylsalicylic acid, becausethe test is so delicate that, under favorable conditions, mere tracesmay be determined and, as a rule, the better the product, the less theamount of free salicylic acid the tests appearing in various pharmacopeias for salicylic acid asan impurity in acetylsalicylic acid do not give concordant results, different workers interpreting the results differently, nor are theydetailed in such a manner as to yield maximum delicacy after experimentation, it was decided to establish a “limit” test ofapproximately 0 1 per cent free salicylic acid, when carried outaccording to the following method. 0 1 gm of the substance was placed in a dry colorimeter tube and 1 c c of alcohol, 206 previously distilled over naoh, was added after the acetylsalicylic acid had dissolved, 48 c c of water and 1 c c of fresh 0 1 per cent ferric chloride fecl₃ 6h₂o solution were added at the same time a control was run by treating 1 c c of a “standard” salicylate solution the same as above 207 if within two minutes the color given by acetylsalicylic acid is not more intense than the color given by the “standard, ” the presence of not more than 0 1 per cent free salicylic acid is proved 208 206 an excess of alcohol destroys or lessens the color when only a very minute amount of salicylic acid is present 207 the control should be made each time as standing in the air changes its tinctorial power 208 the presence of pure acetylsalicylic acid does not seem to affect the iron fe salicylic acid coloration the small amount of acetic acid was added to the sodium salicylate control solution 1 to stimulate an acidity approximating the acidity of the acetylsalicylic acid, and 2 since acetylsalicylic acid gives by hydrolysis both acetic acid and salicylic acid, it was thought advisable to add acetic acid to the standard if there is any free acetic acid in a sample of acetylsalicylic acid containing salicylic acid which i believe is generally the case when salicylic acid is present then it would modify the color given by the same amount of salicylic acid alone for this reason it was thought to be more comparable to have the standard contain a slight amount of acetic acid the solutions used were prepared as follows. Redistilled alcohol was treated with a small amount of sodium hydroxide for twenty-four hours, then again distilled the color standard was made by dissolving 0 116 gm of dried sodium salicylate in water, adding 1 minim of glacial acetic acid, and making up to 1, 000 c c each c c represents 0 1 mg of salicylic acid 209 209 this standard is essaywhat similar to the one proposed by t w thoburn and paul j hanzlik, j biol chem , 23, 175 the ferric chloride solution was made by diluting 1 c c ferric chloride fecl₃ 6h₂o test solution u s p with 99 c c of water the diluted solution must be freshly prepared each day with one exception, all of the commercial specimens examined respondedsatisfactorily to the above test showing less than 1 writing salicylicacid in 1, 000 writings acetylsalicylic acid the individual results aregiven in the accompanying table melting point and salicylic acid determinations melting point free salicylic acid brand corrected colorimetrically acetylsalicylic acid, 130 0-131 0° colored, but showing p w r 1 less than 0 1 per cent acetylsalicylic acid, 130 0-131 0° no color millikin2 acetylsalicylic acid, 129 0-130 0° no color millikin2 5-grain capsules acetylsalicylic acid, 128 0-129 0° a colored, but showing less millikin, 1 than 0 1 per cent a 5-grain capsules3 125 5-126 5° b considerably more than 0 1 per cent b acetylsalicylic acid, 131 0-132 0° no color squibb2 acetylsalicylic acid 131 0-132 0° no color aspirin, 1 monsanto acetylsalicylic acid, 130 5-131 5° colored, but showing less m c w 1 than 0 1 per cent acetylsalicylic acid, 131 5-132 5° colored, but showing less m c w 1 than 0 1 per cent acetylsalicylic acid, 131 0-132 0° colored, but showing less m c w 1 than 0 1 per cent aspirin, bayer1 before patent 131 5-132 5° no color expired aspirin, bayer1 4 after patent 128 5-129 5° colored, but showing less expired than 0 1 per cent aspirin, bayer1 4 after patent 129 5-130 5° colored, but showing less expired than 0 1 per cent aspirin, lehn 130 5-131 5° 0 1 per cent and fink2 aspirin, lehn 130 5-131 5° colored, but showing less and fink2 than 0 1 per cent aspirin, lehn 131 0-132 0° colored, but showing less and fink1 than 0 1 per cent 1 obtained on the open market 2 obtained from manufacturer 3 one-third of the capsules a contained a white powder. Two-thirds of the capsules b contained a pink powder having strong odor of acetic acid and not complying with the tests 4 not described in “new and nonofficial remedies, 1917”. The other products are other testsnew and nonofficial remedies, 1917, requires that acetylsalicylic acidshall form a clear solution with warm sodium carbonate solution. Thatsulfates, chlorides and heavy metals shall be absent.

B, flow of pancreatic juice in drops. C, signal showingwhere the intravenous injections were made tracing a. Reading fromleft to right, the five intravenous injections are. 1 three tabletsof secretogen digested with 15 c c 0 4 per cent hydrochloric acidand neutralized. 2 three tablets of secretogen boiled in 15 c c 0 4 per cent hydrochloric acid and neutralized. 3 three tablets ofsecretogen in 15 c c 0 9 per cent sodium chlorid. 4 three tabletsof secretogen in 15 c c of 70 per cent alcohol. 5 15 c c elixirsecretogen tracing b.

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After a very careful examination was identified he wasstrangled by the pressure of fingers. The head was afterward wrappedin a cloth which was held in place by five turns of a cord around theneck. Traces of the furrows made by these cords were found heartempty. No blood in muscles of neck. Hyoid bone intact but superiorthyroid cornua fractured at base 16 horteloup. Ann d’hygiène, 1873, xxxix , pp 408-416 - man founddead on essay leaves in a fountain at bottom of staircase. Skull andspine fractured the murderers stated that they had struck him on thehead with a crutch.