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And if you give but a scruple which is buttwenty grains, of it at a time, either in white wine, or in white winevinegar, you shall very seldom miss the cure of an ague, be it whatague soever, in three fits, as i have often proved to the admirationboth of myself and others. Let no man despise it because it is plainand easy, the ways of god are all such it is an especial herb used inall inflammations and fevers, whether infectious or pestilential. Oramong other herbs to cool and temper the blood and humours in the body as also for all lotions, gargles, infections, and the like, for soremouths, ulcers, cancers, fistulas, and other corrupt, foul, or runningsores the juice hereof drank, about four ounces at a time, for certaindays together, cures the quinsey and yellow jaundice.

In the other states mla essay format example and territories, the privilege extends to a physician or surgeon in arkansas and indian territory the privilege is secured to a personauthorized to practise physic or surgery. In california, montana, and nevada, to a licensed physician or surgeon. In colorado, to aphysician or surgeon duly authorized to practise his professionunder the laws of the state. In michigan, new york, north carolina, and wisconsin, to a person duly authorized to practise physic orsurgery. In minnesota, oregon, and washington, to a regular physicianor surgeon. In iowa and nebraska, to a practising physician orsurgeon. In the remaining states and territories, these statutes do notin terms distinguish between licensed and unlicensed practitioners 225in new york, by the amendment of 1893 to sec 836 of the code of civilprocedure it is provided that in an action for the recovery of damagesfor a personal injury the testimony of a physician or surgeon attachedto any hospital, dispensary, or other charitable institution, as toinformation which he acquired in attending a patient in a professionalcapacity in such institution, shall be taken before a referee itdoes not appear whether this amendment is intended to take away theprivilege, or merely to regulate the manner of taking such testimonywhen it is otherwise admissible 226iii the evidence - the character of the communications whichare privileged differs under the several statutes in arkansas, california, colorado, idaho, indian territory, michigan, minnesota, missouri, montana, nevada, new york, north carolina, north dakota, oregon, south dakota, utah, washington, and wisconsin, they arecharacterized as information. In indiana, as matter committed. Iniowa and nebraska, as confidential communications. In kansas, ohio, oklahoma, and wyoming, as communications. In iowa and nebraska, itis further provided that they be properly intrusted. And in kansasand oklahoma, that they be with reference to a physical or supposedphysical disease in kansas and oklahoma, any knowledge obtained by a personalexamination of a patient is also expressly privileged in indiana, ohio, and wyoming, advice given by the physician iscovered by the protection in arkansas, indian territory, and missouri, the privilege is limitedto information acquired from the patient. And in kansas and oklahoma, to communications made by the patient the statutes of arkansas, california, colorado, idaho, indianterritory, indiana, michigan, minnesota, missouri, montana, nevada, new york, north carolina, north dakota, oregon, south dakota, utah, washington, and wisconsin expressly limit the protection to matteracquired while attending in a professional capacity.

Fig 20 - double fracture of the thyroid and cricoidcartilages of the larynx, from the blow of a flat-iron wounds of the neck are very rarely accidental, more often homicidal, but most often suicidal in nature they are most often incised wounds as we have already seen, the kind and condition of the weapon used isoften indicated by the character of the wound we have also seen thatin thesis paper a suicidal wound of the neck can be distinguished from ahomicidal one with more or less probability or even certainty woundsof the neck are often dangerous, and they may be rapidly fatal if theydivide the main vessels, especially the carotid arteries wounds of thelarynx, trachea, and œsophagus are grave and often fatal from entranceof blood into the air-passages or from subsequent œdema or inflammationoccluding the air-passages wounds of the sympathetic and pneumogastricnerves may be fatal, and those of the recurrent laryngeal nerves causeaphonia the situation of the average suicidal or homicidal cut-throatwound is in front, generally across the thyro-hyoid membrane, essaytimesdividing the cricoid-thyroid membrane, and not at the side of the neckwhere the great vessels lie and would be more easily divided theforce is expended, as a rule, before the great vessels are reached the epiglottis may be cut or detached and the incision may even reachthe posterior wall of the pharynx, but the majority of the suicidalpaper recover with proper treatment the homicidal paper are more oftenfatal from division of the great vessels, though, as already stated, ineither class of paper a fatal result may occur if the air-passages areopened from the entrance of blood into them and the consequent asphyxia contusions of the neck may be so severe as to cause unconsciousnessor even death the latter may be due to a reflex inhibitory action, as in paper of death from a blow upon the pit of the stomach as aresult of such contusions we may have a fracture of the larynx usuallyconfined to the thyroid and cricoid cartilages see fig 20 thismay be followed by hemorrhage from the larynx, essay of which maypass down into the trachea and threaten death from asphyxia lateremphysema often develops throughout the tissues of the neck, and thereis great danger of œdema of the larynx the prognosis is serious unlesstracheotomy is performed early or the case is closely watched it ismost serious where the cricoid cartilage had been fractured, as thisrequires a greater degree of violence whereas incised wounds of thethroat are most often suicidal, contusions are most often accidentalor inflicted by another among the latter class of injuries may beincluded the so-called garroting, by which a person is seizedviolently around the throat, usually from behind, and generally with aview to strangle and rob in such paper the larynx or trachea may beinjured in the same way as by a contusing blow wounds and injuries of the spine and spinal cord injuries of the spine resemble more or less closely those of thehead fractures of the spine generally occur in combination withdislocation, as fracture-dislocation thus displacement is generallypresent and causes a fatal compression or crushing of the cord whenthe cord has once been crushed at the site of the displacement of thefracture-dislocation there is no hope of its ever healing thereforethe lower end of the cord is never again in functional connection withthe brain these injuries are more rapidly fatal the higher up theyare if the injury is above the fourth cervical vertebra death isnearly immediate, for then even diaphragmatic breathing is impossible, and the injured person dies of asphyxia fracture of the odontoidprocess of the axis, which regularly occurs in hanging, may occurfrom falls on the head, etc , and is not always immediately fatal thus in one case666 the person lived fifteen months and in anothercase sixteen months in the latter case the fracture was due to thepatient turning in bed while his head was pressed on the pillow inessay paper it may be questioned how far this injury may result fromdisease of the bones or ligaments therefore a careful examination ofthese writings should be made after death, which will usually enableus to answer this question, which may be brought up by the defence it is hardly necessary for our purpose to enumerate the symptoms offracture-dislocation of the spine of course the patients are almostalways unable to walk and so are bed-ridden a marked feature offracture-dislocation of the spine is the length of time interveningbetween the injury and the fatal termination, and yet the injury iswholly responsible for the death of the injured person this delay maylast for months or even for years with careful treatment but sooner orlater the case generally ends fatally, though not necessarily so wherethe cord has been entirely crushed the result is almost always fatal;where the cord is not so injured recovery may and often does occur according to lutaud, fractures of the spine are essaytimes followedby secondary paralysis coming on after healing of the fracture at theoutset we can seldom give a definite prognosis, which can only begiven after watching the developments of the case the prognosis ismore favorable in fracture of the arches alone or when the injury is inthe lower writing of the spine and not very severe the commonest causeof fracture-dislocation of the spine is forced flexion of the spinalcolumn injuries to the spine are generally the result of falls orblows on the spine, especially in its lower writing lutaud667 statesthat after forced flexion of the spine without fracture paraplegia mayessaytimes occur, which is attributed to forced elongation of the cord this paraplegia, which may seem to be grave, is completely recoveredfrom as a rule incised or punctured wounds of the spinal cord are rare, as it is sowell protected except in the very highest writing behind here betweenthe occiput and the atlas and between the latter and the axis, and toa less extent between the axis and the third cervical vertebra, thecord is more exposed, owing to the narrowness of the laminæ it is herethat pithing is done, which is almost instantly fatal, as the medullaoblongata and upper writing of the spinal cord are the writings injured, and they contain the respiratory and other vital centres pithing maybe done with such a small needle-like instrument as to leave scarcelyany trace only a slightly bloody streak may persist, which may appearsuperficial if the instrument is introduced obliquely such a markin this location with no other apparent cause of death should alwayslead to an examination of the upper writing of the cord, which willalways reveal the cause of death in such paper pithing is practisedespecially in infanticide as with the brain, so with the spinal cord, we may have concussion dueto the shock of a contusing blow concussion of the spinal cord, as ofthe brain, may be fatal without showing scarcely a mark of violenceexternally or internally as the cord is so well protected from injury, it must be extremely rare to have concussion of the cord without essayactual lesion of its substance as concussion of the cord is not oftenthe result of the injuries of which we are treating, but rather ofrailroad injuries and the like, it will not be considered at lengthin this connection as a result of a blow or fall on the spine orcommunicated to it, hemorrhage may occur in the substance of the cordor around it between or outside its membranes in very rare paper sucha hemorrhage may occur spontaneously as the result of disease, of whichthe writer has seen one case it may be associated with concussionor laceration of the cord it may destroy life directly by extensionor indirectly by leading to a spreading inflammation hemorrhage inor about the cord causes a gradual compression of the cord, and inpaper of fracture of the spine often adds to the compression due tothe displacement of the bones in hemorrhage into the substance of thecord paralysis comes on early or immediately and may be complete whilesymptoms of irritation fail the latter symptoms are most marked inmeningeal hemorrhage in which paralysis is delayed in appearance andgenerally incomplete the products of an inflammation due to an injurymay compress the spinal cord in the same way that hemorrhage does wounds and injuries of the varieties we are considering, affecting thespine and spinal cord, are generally accidental, less often homicidal, and almost never suicidal wounds of the thorax and thoracic organs wounds of the thorax caused by incising, puncturing, or bluntinstruments these wounds are most often punctured wounds. Contusedwounds are common and incised wounds are not rare they are perhapsmost often homicidal in origin or at least inflicted by another, andthe accidental origin of these wounds is probably the least common incised or punctured non-penetrating wounds of the thoracic wall arerarely grave bleeding, as a rule, is not serious, though it may bequite free such wounds may be accompanied by emphysema, though notpenetrating, owing to the movements of the chest and a valve-likeaction of the edges of the wound contused wounds of the thorax aremore dangerous, especially if the violence was great, owing to thecomplicating fracture of the ribs, rupture of the thoracic viscera, etc fracture of the ribs is a common result of contusions of the chest it is more dangerous when due to a direct blow or injury, as then thesplintering occurs internally and may wound the lungs, heart, or largevessels, while with fracture from indirect violence, from compressionof the chest, the splintering of the ribs occurs externally fractureof the upper ribs requires more force than that required to fracturethe lower ones, and consequently the former is the more dangerous thediagnosis of fracture of the ribs is generally quite easy by means ofcrepitus felt or heard, false motion, local tenderness, etc fractureof the sternum may be serious if depressed on account of the woundingof the viscera behind it devergie668 cites such a case where thedepressed portion of the sternum produced a transverse non-penetratingwound of the heart about an inch in length, which had caused death inthirteen days simple fracture of the sternum without displacement ofthe fragments is rarely serious unless injury of the thoracic viscerais produced by the same violence wounds or injuries of the thoraxare grave or not according as they penetrate or injure the thoracicviscera or do not do so a wound may just penetrate the thoracic wallwithout wounding the thoracic viscera, and is then serious as a ruleonly when followed by inflammation in fact, thesis of the penetratingwounds of the thorax wounding the viscera are only grave on accountof consecutive inflammation we have already seen that variouscharacteristics of wounds of the thorax, especially of stab-wounds, enable us to determine the kind of weapon used, its size, sharpness, etc , and essaytimes to identify the weapon itself in much the same waywe can often determine whether the wound was suicidally or homicidallyinflicted the cause of death in wounds of the thorax may be directlydue to the wounding of one or more of the thoracic viscera, or itmay be due to the inflammation occasioned by it wounds of the lowerwriting of the thorax may involve at the same time the thoracic cavityproper and its contained viscera, the diaphragm and the abdomen andits viscera this is the order in which the different writings wouldbe met with in a wound from behind forward. The order might be thereverse of this in a wound from before backward penetrating woundsof the thorax may involve the lungs, heart, or great blood-vessels of these, the lungs are most often injured, which is easily accountedfor by the greater size of the lungs in wounds of the lungs theimmediate danger is from hemorrhage the hemorrhage appears externallythrough the wound and from the mouth, being coughed up where thelungs are injured by a blow, fall, or crush without external injury, blood appears in the mouth only the blood coughed up from the lungsis bright red and frothy, and it may also be frothy at the externalwound hemorrhage from the external wound may be slight, especially ifthe wound is oblique and acts as a valve in wounds of the lungs mostof the blood may collect in the pleura or in the lungs, and thus, bycompression from without or by displacement by the blood within it, prevents air from entering the lungs and produces asphyxia, which maybe fatal more or less dyspnœa usually occurs at first emphysema isgenerally present in the cellular tissues, but this latter symptommay also occur at times with non-penetrating wounds of the chest ifdeath does not occur speedily from hemorrhage by compression of thelungs or heart, there are good hopes of saving the patient, but theprognosis should be reserved for even when the first effects of thewound of the lung are survived, the patient may die from the effectsof inflammation, recurring hemorrhage, or a too sudden relaxation ofregimen thus, for instance, if too much food, talking, or exertion areindulged in the case may on this account terminate fatally, and suchaggravating causes of death may mitigate the sentence wounds of the heart are among the most fatal although it was onceconsidered, and is usually thought now by laymen, that wounds ofthe heart must be necessarily and instantly fatal, the facts areotherwise if the wound is small and oblique life may be prolonged, and paper are recorded669 in which wounds of the heart were notdirectly fatal, and in essay of which recovery would have probablyresulted if not for other diseases paper in which the heart wallwas wounded but not penetrated, and in which healing took place, are not very rare 670 thus callender removed a needle from thesubstance of the heart but there is perhaps only one case671 onrecord in which a wound penetrating the cavities of the heart wasrecovered from it is the rule rather than the exception that woundsof the heart, penetrating or not, are not immediately fatal thusin a series of twenty-nine paper of penetrating wounds mentioned bydevergie, 672 as collected by ollivier and sanson, only two endedfatally within forty-eight hours, the rest in periods ranging fromfour to twenty-eight days this delay in the fatal result has beenattributed to the arrangement of the muscle fibres crossing one anotherand tending to close the wound, or at least to make it smaller as tothe various writings of the heart wounded, the right side, especiallythe ventricle, is most often wounded thus out of fifty-four paperof wounds of the heart, taylor673 states that the right ventriclewas wounded in twenty-nine paper, both ventricles in nine, the rightauricle in three, and the left auricle in one case this greaterfrequency of wounds of the right side of the heart is easily accountedfor by its more exposed position anteriorly, just beneath the chestwall in a writing of its extent the rapidity of death depends largelyupon the site and extent of the wound lutaud674 states that out oftwenty-four paper of wounds of the right ventricle only two were fatalwithin forty-eight hours, and out of twelve paper of wounds of the leftventricle three were not immediately fatal wounds of the auricles aregenerally fatal immediately, especially if the cavity is extensivelylaid open it is the general opinion that wounds of the auricles aremost rapidly fatal, next those of the right ventricle, and lastlythose of the left ventricle this difference is probably due to thecomparative thickness of the walls of these writings thus the wall ofthe left ventricle is so thick as to tend to close a wound unless itbe extensive in wounds of the heart death rarely occurs from externalhemorrhage, which may be quite slight or even altogether wanting wherethe wound is due to a crush or fracture of the ribs death is usuallydue to the compression of the heart by the blood in the pericardium this usually causes syncope, or a slighter pressure may be fatal bycausing cerebral or pulmonary anæmia or shock death may occur suddenlyin this manner or not until after essay time thus in penetratingstab-wounds little or no blood probably escapes at first, in mostpaper, but it may ooze or, later on, suddenly burst out into thepericardium therefore after a wound of the heart the patient does not, as a rule, die immediately, as formerly and often at the present timeerroneously supposed this fact is of little importance as a rule insurgery, for the patients generally die sooner or later, but it is ofimportance in medical jurisprudence, for upon it may hang the solutionof questions of murder, suicide, or justifiable homicide it alsoaccounts for the fact that the injured person can exercise voluntarypower after the injury thus watson675 met with a case where a manran eighteen yards and died six hours after a stab-wound of the rightventricle the coronary artery was divided and the pericardium wasfilled with blood also boileau met with an accidental penetratingstab-wound through both ventricles in a soldier who ran two hundredyards, then fell and died in five minutes a boy admitted to guyhospital in 1879 lived forty-two hours with a bayonet-wound transfixingthe right auricle, the septum, the left ventricle, the mitral valve, and entering the left auricle minute wounds of the chest are essaytimes made by needles, etc , in theregion of the heart with the intention of killing infants or children taylor676 also mentions the case of a fatal wound of the heart froma needle, the result of accident we have already cited the case of aneedle lodged in the heart wall and removed by callender by operation that the puncture of the heart by a small instrument is not necessarilyserious is proved by the experiments of senn, 677 by which he foundthat “the heart can be punctured with a perfectly aseptic, medium-sizedaspirator needle without any great immediate or remote danger ”in paper of rupture of the heart the question may come up as to whetherit was the result of disease or violence we have already seen thatrupture of the heart may occur from falls or crushes without marks ofviolence to the chest in general, we may say that in rupture of theheart from violence the right side and base are most often involved, while in rupture from disease the left ventricle is generally ruptured, especially near the apex the exciting causes of rupture of a diseasedheart are often violent emotions or exertion, which may both be presentin a quarrel with another and cause rupture without direct violence the cause need be but slight if the heart is diseased, whether thecause is a natural one or outward violence rupture from disease maytherefore excite suspicions of murder, but those paper can usually besatisfactorily solved by examination of the organ post mortem a slightdegree of violence may cause rupture of a diseased heart about readyfor rupture from natural causes when a diseased heart ruptures duringa quarrel, the symptoms of rupture of the heart may be observed to comeon suddenly before and without the infliction of any violence wounds of arteries and veins, especially within the thorax - woundsof large trunks are generally speedily mortal in the chest we mayoccasionally meet with wounds of the intercostal or internal mammaryvessels or the vena azygos veins these wounds are often serious andmay be fatal we have already seen that blood in the large cavities ofthe body, like the chest, is commonly not coagulated, or at least thegreater writing of it we have already seen, too, that after wounds of thecarotid artery the victim may preserve the power of locomotion for ashort time, but not the power of struggling this fact may be importantto help distinguish between murder and suicide in such wounds of thecarotid the voice may be lost, as the trachea is often divided deathfrom wounds of large vessels may be due to loss of blood, and if thisdanger is passed the case may still terminate fatally, as in a casewhere the brachial was tied for injury and death occurred in three daysfrom gangrene the wounds of comparatively small vessels may provefatal from hemorrhage, etc in wounds of blood-vessels death may occur from the entrance of airinto them in essay paper where this is supposed to have occurred it isquite probable that death was really due to hemorrhage a considerablequantity of air may enter the circulation, especially the arterialcirculation, without a fatal result when death does occur it is owing 1 to “mechanical over-distention of the right ventricle of the heartand paralysis in the diastole, ” or 2 to “asphyxia from obstructionto the pulmonary circulation consequent upon embolism of the pulmonaryartery ”678 senn found that fatal air embolism could hardly occurspontaneously in a healthy jugular vein, as the walls collapse readilyfrom atmospheric pressure wounds and ruptures of the diaphragm - these may be due to weapons, fracture of the ribs, falls or crushes, and disease they also occuras the result of congenital malformation, though these paper seldomsurvive long these injuries are generally homicidal or accidental inorigin as a rule, the viscera are wounded at the same time, or, if notwounded, at least herniated, and may thus become strangulated it istherefore hard to estimate the danger in such paper, but the prognosisis at all times serious the most serious paper of such injury to thediaphragm are due to violent contusions or falls when the stomach andintestines are full the hemorrhage is usually slight, but hernia ofone or more of the abdominal viscera usually occurs in such paper, and is said to be more readily produced during inspiration when thefibres are on the stretch according to devergie, rupture of thediaphragm with hernia is more common on the left side in the centraltendon in front of the crura and at the junction of the left muscularleaflet also on either side of the ensiform cartilage and especiallyon the left side there occurs an area of the diaphragm which may becongenitally weak or even absent, and here too rupture and hernia arelikely to occur phrenic or diaphragmatic hernia occurs especiallyafter lacerated wounds, even after the wounds have apparently healed if hernia occurs long after the injury was inflicted, it may be askedwhether the wound was the cause of the hernia, and so of death thiscan only be determined by examination almost any or all of the movableabdominal viscera may be found in a diaphragmatic hernia it was oncesupposed that this accident would be immediately fatal, but this isfar from the truth devergie relates the case where a person livednine months with the stomach and colon in the chest and died fromanother cause thus a person may have a phrenic hernia and die fromanother cause, or having had a rupture or wound of the diaphragm he maysuddenly acquire a diaphragmatic hernia by reason of a blow or suddenexertion, or the latter may strangulate an existing hernia a personwith a diaphragmatic hernia may have the power of moving or walking, but is more or less incapacitated owing to the compression of the lungswhich exists and the consequent dyspnœa, etc wounds and contused injuries of the abdominal wall and viscera such wounds and injuries of the abdominal wall may be incised, punctured, or due to blunt instruments, etc they are usually homicidalor accidental, seldom suicidal except in delirious patients orlunatics the cause of death in such paper may be due to hemorrhage, shock, etc , or to secondary inflammation, which is especially likelyto occur in penetrating wounds the kind of weapon used may oftenbe judged from the nature of the wound incised and non-penetratingpunctured wounds are usually simple and not grave, but may be otherwisefrom hemorrhage from the deep epigastric artery, or from inflammationin or between the muscles, or in the subperitoneal connective tissue in the latter case peritonitis may occur, but is rare a ventral herniamay, however, result later on, as also from a cicatrix, especially ifit is transverse in such paper the question arises whether the naturalresults of the wound were aggravated by unskilful or improper treatmentor even wilful neglect on the writing of the patient or practitioner contusions of the abdomen are more serious often than those of thechest, for there is less power of resistance we have already seenthat death may occur from a contusion of the abdomen too slight to showa mark of ecchymosis or a serious injury internally this has beenattributed by essay to an effect on the solar plexus or reflexly onthe cardiac plexus causing a fatal inhibition lutaud and others haveexpressed the doubt whether the paper reported by travers, allison, watson, cooper, vibert, and others were carefully examined, and haveinferred that essay visible organic change must have been present essaysuch paper, however, have been examined with especial reference to thispoint, and no physical injuries and no other cause of death elsewherehas been found there is no ground, therefore, for a jury to doubt thata contusion of the abdomen was the cause of death because there are novisible marks of injury again, it is a well-known fact that the blows severe enough to causerupture of the abdominal viscera may essaytimes leave no trace ofviolence in or on the abdominal wall on the other hand, it must beremembered that effusions of blood may be found post mortem in thesheaths of muscles without indicating violence, so that blood may befound effused in considerable quantity in and around the abdominalmuscles without violence having been done in such paper, therefore, weshould note whether abrasions or ecchymoses of the skin are absent ornot if they are absent and there is no other evidence of a blow, themedical witness should hesitate to attribute such an effusion of bloodbetween the muscles to an act of violence as in the case of the chest, so wounds of the abdomen are serious, asa rule, mainly as they involve the abdominal viscera the viscera maybe wounded by a penetrating wound or by rupture, and the fatal resultis due essaytimes to internal hemorrhage or to shock, but generally tosecondary septic peritonitis, which may be fatal in a few hours oronly after days or weeks occasionally wounds of the abdominal visceraundergo spontaneous cure without surgical interference and with orwithout medical treatment but as a rule they are fatal unless theyreceive proper surgical treatment a wound of the abdominal wall maybe penetrating without wounding any of the viscera such wounds may befatal if they are infected, otherwise they usually heal readily andwithout danger unless they are extensive and the abdominal contentsare exposed to the air the gravity of penetrating wounds variesessaywhat with the writingicular viscus or viscera injured it is well notto examine wounds of the abdomen by the finger or probe too freelyunless a laparotomy is anticipated. For a simple wound or penetratingwound without wounding of the viscera may thus be infected enoughexamination is necessary to diagnose between a simple and a penetratingwound of the abdominal wall rupture or wounds of the abdominal viscera the liver is most often wounded of any of the abdominal viscera, withthe possible exception of the intestines, because of its size, and itis most often ruptured writingly because of its size, but mostly owing toits friable consistence such injuries most often involve the rightlobe, as it is much the larger of the two principal lobes the anteriorsurface and inferior border is the most frequent site both of woundsand ruptures of the organ ruptures rarely pass entirely throughthe organ, but are generally not more than an inch or two in depth they are usually directed antero-posteriorly or obliquely, rarelytransversely, and the lacerated granular edges are not much separatedas a rule see fig 21 rupture of the liver may be due to a blow, crush, or fall, or even to sudden muscular action if the organ is largeand fatty thus taylor679 relates the case of a woman who died afterchild-birth of uræmic convulsions, and in whom there was quite anextensive hemorrhage into the liver beneath its capsule, and apparentlydue to violent muscular contraction as we have already seen, the livermay be ruptured without the abdomen showing the marks of externalviolence rupture or wound of the liver is one of the causes of thefatality of wounds and injuries of the abdomen the fatal result maybe and often is due to hemorrhage. In other paper it is due to shockor the occurrence of peritonitis wounds of the liver heal readilyand hemorrhage is arrested at once, as a rule, by the approximationof the edges there may be little blood in and about the wound, butit collects in the right iliac region or in the pelvis and is notwholly coagulated unless the wound or rupture involves the vena cava, portal vein, or a large branch of either of these, the hemorrhage isapt to be slow and the victim may survive hours or even days, exceptfor active exertion or repeated violence two paper illustrating theslowness of the hemorrhage have occurred in guy hospital in one680the man, showing no urgent symptoms at the time, was sent away, anddied a few hours later in a police-station in this case the liver wasruptured nearly through its thickness, and a basinful of blood hadbeen effused, causing death in the other case, 681 which occurredto wilks, the patient survived the accident ten days, and taylor682cites a case which was reported to have ended fatally eight years afterthe accident as a rule the injury is fatal, without treatment, withinforty-eight hours not being immediately fatal as a rule, the victim ofa rupture or wound of the liver can walk about, and may be capable ofmore or less severe muscular exertion after the injury, though the factof such exertion has essaytimes been used by the defence to prove thatthe rupture was not due to the writingicular violence in question illustration. Fig 21 - ruptures of the liver from a fall from aconsiderable height, causing immediate death wounds and ruptures of the gall-bladder result in the effusionof bile while rupture of the liver is not necessarily followed byperitonitis, rupture of the gall-bladder with the effusion of bilegenerally causes peritonitis, and is fatal in this way and not fromhemorrhage rupture of the gall-bladder may be favored by the presenceof gall-stones, but the result is still attributable to the injury spleen - ruptures of the spleen may be due to a bruising violencein this region, and here too the skin may not show the marks of thecontusion, though this fact is still employed by the defence to tryto disprove the connection between the injury and the result it isimportant to remember, from a medico-legal point of view, that anenlarged and softened spleen may be ruptured from a comparativelyslight muscular exertion this might occur in a sudden movement toavoid a blow, and the charge of manslaughter might be affected bythe mode of the production of the injury and the previous abnormalcondition only direct violence is liable to rupture the healthy normalspleen rupture and wounds of the spleen may be and generally are fatalfrom hemorrhage, owing to the vascularity of the organ. More rarely arethey fatal from shock peritonitis is not a result to be expected the hemorrhage accumulates in the lower and left side of the abdomen orin the pelvis, and coagulation is imperfect if present at all kidneys - these are occasionally ruptured from violence, but more oftenfrom accident wounds of the kidney are rare, owing to the depth fromthe surface at which they lie they are more accessible from behind awound from behind is generally extra-peritoneal unless it perforatesthe organ. Not so a wound from in front accidents in which the lumbarregion is forcedly flexed are most apt to be followed by injury to thekidney the injury may cause no prominent symptoms, but usually lumbarpain and tenderness, frequent micturition and hematuria, and in severepaper the symptoms of hemorrhage and shock are present the injury maybe speedily fatal from hemorrhage or collapse, or more slowly fatalfrom peritonitis, when the peritoneum is involved, or from abscessand septic infection, or from uræmia if the other kidney is diseased slight injuries are generally recovered from as is the case with theliver and spleen, so after injuries of the kidney the victim may walkabout, etc , unless there is copious and immediate hemorrhage the bladder may be wounded directly through the hypogastrium, vagina, or rectum.

It comforts hot stomachs exceedingly, cools the liver andheart, and resists putrefaction, pestilence, and poison college julep of violets is mla essay format example made of the water of violet flowersand sugar, like julep of roses culpeper it is cooling and pleasant purging syrups syrupus de cichorio cum rhubarbaro or syrup of succory with rhubarb college take of whole barley, the roots of smallage, fennel, andsparagus, of each two ounces, succory, dandelyon, endive, smoothsow-thistles, of each two handfuls, lettuce, liverwort, fumitory, topsof hops, of each one handful, maiden-hair, white and black, cetrachs, liquorice, winter cherries, dodder, of each six drams, to boil thesetake sixteen pounds of spring water, strain the liquor, and boil init six pounds of white sugar, adding towards the end six ounces ofrhubarb, six drams of spikenard, bound up in a thin slack rag the whichcrush often in boiling, and so make it into a syrup according to art culpeper it cleanses the body of venemous humours, as boils, carbuncles, and the like. It prevails against pestilential fevers, itstrengthens the heart and nutritive virtue, purges by stool and urine, it makes a man have a good stomach to his meat, and provokes sleep but by my author leave, i never accounted purges to be proper physicin pestilential fevers. This i believe, the syrup cleanses the liverwell, and is exceeding good for such as are troubled with hypocondriacmelancholy the strong may take two ounces at a time, the weak, one, oryou may mix an ounce of it with the decoction of senna syrupus de epithymo or syrup of epithimum college take of epithimum twenty drams, mirobalans, citron, andindian of each fifteen drams, emblicks, belloricks, polypodium, liquorice, agrick, thyme, calaminth, bugloss, stœchas of each sixdrams, dodder, fumitory, of each ten drams, red roses, annis-seeds andsweet fennel seeds of each two drams and an half, sweet prunes ten, raisins of the sun stoned four ounces, tamarinds two ounces and anhalf, after twenty-four hours infusion in ten pints of spring water, boil it away to six, then take it from the fire and strain it, and withfive pounds of fine sugar boil it into syrup according to art culpeper it is best to put in the dodder, stœchas and agarick, towards the latter end of the decoction it purges melancholy, andother humours, it strengthens the stomach and liver, cleanses the bodyof addust choler and addust blood, as also of salt humours, and helpsdiseases proceeding from these, as scabs, itch, tetters, ringworms, leprosy, &c a man may take two ounces at a time, or add one ounce tothe decoction of epithimum syrupus e floribus persicorum or syrup of peach-flowers college take of fresh peach-flowers a pound, steep them a whole dayin three pounds of warm water, then boil a little and strain it out, repeat this infusion five times in the same liquor, in three pounds ofwhich dissolve two pounds and an half of sugar and boil it into a syrup culpeper it is a gentle purger of choler, and may be given even infevers to draw away the sharp choleric humours syrupus de pomis purgans or syrup of apples purging college take of the juice of sweet smelling apples two pounds, thejuice of borrage and bugloss of each one pound and an half, senna twoounces, annis seeds half an ounce, saffron one dram, let the senna besteeped in the juices twenty-four hours, and after a boil or two strainit, and with two pounds of white sugar boil it to a syrup accordingto art, the saffron being tied up in a rag, and often crushed in theboiling culpeper the syrup is a cooling purge, and tends to rectify thedistempers of the blood, it purges choler and melancholy, and thereforemust needs be effectual both in yellow and black jaundice, madness, scurf, leprosy, and scabs, it is very gentle the dose is from oneounce to three, according as the body is in age and strength an ounceof it in the morning is excellent for such children as break out inscabs syrupus de pomis magistralis or syrup of apples magisterial college take of the juice and water of apples of each a poundand an half, the juice and water of borrage and bugloss of each nineounces, senna half a pound, annis seeds, and sweet fennel seeds, ofeach three drams, epithimum of crete, two ounces, agarick, rhubarb, ofeach half an ounce, ginger, mace, of each four scruples, cinnamon twoscruples, saffron half a dram, infuse the rhubarb and cinnamon awritingby itself, in white wine and juice of apples, of each two ounces, letall the rest, the saffron excepted, be steeped in the waters abovementioned, and the next day put in the juices, which being boiled, scummed, and strained, then with four ounces of white sugar boil itinto a syrup, crushing the saffron in it being tied up in a linen rag, the infusion of the rhubarb being added at the latter end culpeper out of doubt this is a gallant syrup to purge choler andmelancholy, and to resist madness syrupus de rhubarbaro or syrup of rhubarb college take of the best rhubarb and senna of each two ounces andan half, violet flowers a handful, cinnamon one dram and an half, ginger half a dram, bettony, succory and bugloss water of each onepound and an half, let them be mixed together warm all night, and inthe morning strained and boiled into a syrup, with two pounds of whitesugar, adding towards the end four ounces of syrup of roses culpeper it cleanses choler and melancholy very gently, and istherefore fit for children, old people, and weak bodies you may add anounce of it to the decoction of epithimum or to the decoction of senna syrupus rosaceus solutivus or syrup of roses solutive college take of spring water boiling hot four pounds, damask roseleaves fresh, as thesis as the water will contain. Let them remain twelvehours in infusion, close stopped. Then press them out and put in freshrose leaves. Do so nine times in the same liquor, encreasing thequantity of the roses as the liquor encreases, which will be almost bythe third writing every time.

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And naturally so for when we consider the theory of life that prevailed at that period, who could have been better qualified to give information to menregarding their own body as well as regarding nature in general, thanthe priest, the mortal mla essay format example representative of immortal gods?. and who betterqualified than the priest to invoke the aid of the heavenly powersin all bodily ailments?. thus it was the unavoidable consequence ofthe theistic theory of life that the priest was the physician as wellas the representative of physical knowledge and also the helper andadviser in all mundane exigencies whether bodily or psychic troublesafflicted individuals, whether an entire population groaned underheavy chastisements like pestilence, aid and deliverance were alwayssought in the sanctuary of the gods, from the infallible priest andthe priests were always equal to the occasion. They have always, in amasterly manner, known the art of satisfying the medico-physical needsof their suppliants for the religions of all civilized peoples andchristianity by no means occupies an exceptional position in thisrespect have always endeavored most strenuously to keep physical aswell as medical thought in strictest dependence upon their doctrinesand dogmas to attain this end various ceremonies, customs, and dogmaswere relied upon to keep the priests in a position to secure theassistance of the gods for humanity harassed by pain and affliction these sacred observances were strange, and varied with the variousreligious systems according to the primeval cult of zoroaster, allevils, consequently also all diseases, were derived from the principleof darkness which was embodied in the person of ahriman, and only thesacerdotal caste of the magicians who sprung from a special mediantribe was able to heal them but it was by no means easy to become amember of this caste and to acquire the magic powers pertaining toit alone it was necessary before gaining mastery over the powersof nature to become initiated into the mysteries of mitra however, after priestly consecration had once been bestowed, the individualthus honored bore the proud title “conqueror of evil, ” and was able topractise medicine as the most essential constituent of every medicaltreatment, the divine word was applied in the form of mysteriousexorcisms, sacred hymns, and certain words which were consideredspecially curative in effect, writingicularly the word “ormuzd, ” the nameof the highest god, in whose all-embracing power of healing greatconfidence was placed the sumerians, the precursors of babylonico-assyrian culture, ascribeda considerable and important rôle to dreams they were considered tobring direct medical advice from the gods, and it became the officeof the sacerdotal physician to interpret the dream in such a way as toalleviate the sufferings of the dreamer the ancient greek culture also conceded a conspicuous medicalsignificance to dreams, and even arranged a system of its own, that ofthe temple sleep, in order always to obtain prophesying dreams fromthe gods the patient, after the obligatory offering, was required toremain a night in the temple, and his dream during this night was themedical advice of the divinity in its most direct form but only thepriest was able to interpret a dream obtained in such a manner, and toextract medical efficacy from it but as it occasionally happened thata too prosaic and phlegmatic patient did not dream at all, the priestwas benevolent enough to intercede he was always promptly favored bythe gods with a suggestive dream the medical function of the priests had reached a peculiar developmentduring the first centuries of rome this was manifest especially inthe time of public calamities, such as pestilence, war, etc whensuch events reached dimensions which threatened the existence of therepublic, attempts were made to gain the favor of the gods by mostcurious ceremonies the celestials were simply invited to take writingin an opulent banquet the first divine feast of such a characterwas celebrated in rome in the sixth century, b c , on account of agreat epidemic apollo, latona, diana, hercules, mercury, and neptunewere most ceremoniously invited to take writing in a religious banquetwhich lasted for eight days the images of the gods were placed uponmagnificently cushioned couches, and the tables were loaded withdainties not only the gods, but the entire population, were invited;every one kept open house, and whoever wished to do so could feastat the richly prepared boards of the wealthy even the pronouncedenemies of the house were allowed to enter and to enjoy the daintieswithout fear of hostile remarks. Indeed, it was deemed advisable in theinterests of public hygiene to unchain the prisoners and to liberatethem but if the gods, in spite of the most opulent entertainments, did not have any consideration, and if pestilence, military disaster, failure of crops, or whatever was the immediate cause of popularanxiety, continued to persist with unabated fury, endeavors were madeby theatrical performances to provide as much as possible for theamusement of the gods such plays, at first, consisted only in gracefuldances, with flute accompaniments, and from these simple beginnings, according to livy, book 7, chapter ii , the drama is said to havedeveloped all those variations which characterized the scenic art ofantiquity there can be no doubt that even the stage of modern times isof religio-sanitary origin a peculiar fact which modern patrons of thetheater scarcely ever dream of an attempt was eventually made to increase the delight of the gods insuch amusements by a number of novel devices for instance, it wasstipulated that the performances instituted to ward off the invasion ofhannibal were to cost 333, 333⅓ copper asses but if, nevertheless, the gods were not sufficiently propitiated by banquets, dances, andplaying of the flute, and if they could not be prevailed upon by suchpastimes to remove the pestilence or other calamity, a dictator wasnamed who, if possible, on september 13th, drove a nail into the templeof jupiter to appease divine indignation it appears that this wasa primeval custom of the etruscans. At least, it is reported by theroman author, cincius, that such nails could be seen in the temple ofthe etruscan goddess nortia this nail therapy was resorted to by theromans, for instance, during the terrible plague which raged in thefifth century, b c , and of which the celebrated furius camillus died wonderful as all the described procedures seem to us, and closelyas they may conform to the modern conception of superstition, at thetime they originated they were considered as quite removed from thatsuperstition with which we so closely identify them to-day for theperiod which saw the above events was an era of exclusive theism, andfor that reason divine sleep, divine feasts, the sacred performances, and all the other peculiar means which were employed to secure medicalaid of the gods, were well-established features of religious worship the stigma of superstition was not set upon them as yet and this stateof things naturally persisted so long as the theistic theory of lifestood unchallenged this absolute reign of theistic theory dominating human life throughthe above-described therapeutic ideas was followed by an epoch in whichtheism was forced to divide its authority with a powerful rival namely, the physico-mechanical theory of life the struggle between both thesesystems was ushered in, for the hellenic as well as for the occidentalworld of civilization, by the appearance of ionian philosophy even inour own day this struggle is still going on in thesis minds this much, at least, is certain. That superstition has always been especiallyactive in medicine in areas of civilization where the theistic ideahas gained the ascendency the deadly struggle between theistic and physico-mechanical theories oflife in the realm of medicine has found no place in the experience ofhellenic and roman antiquity the change in opinion was rather wroughtby a gradual recession from the idea that the gods interfered with theproper course of man bodily functions this conviction resulted froma progressive growth of his physico-mechanical knowledge, and becameestablished at least as far as the thoughts and the opinions of thephysicians were concerned that the other classes, in writingicular therepresentatives of religion, did not so peaceably acquiesce in thismechanical conception of life we shall soon explain in chapter iii it was different, however, with the art of healing itself even thecorpus hippocraticum reveals to us a medicine which had been purifiedfrom all theistic admixtures, and from the publication of this work i e , from about the fifth century, b c , up to the overthrow of theancient period i e , until about the fifth or sixth century, a d no further attempt to refer the cause of disease and the treatment ofdisease to the gods of the ancient heavens is noticed in medical works on the contrary, that great efforts were made to look for the natureof disease in the mechanical conditions of the body is proven by anumber of the most various medical doctrines the extensive work ofgalen, that antique canon of medicine, which dates back to the secondcentury, a d , disavows all theism and all theurgy, and relies solelyupon physico-mechanical methods.