History

Order Reflection Paper


stand oil co of ind detaches well b pliable and fairly strong 5 “paraffin 123-125 f , ” 48 8 31 5 28 5 same as 4 stand oil co of ind 6 “paraffin 128-130 f , ” 52 0 33 0 30 0 a adheres well. stand oil co of ind detaches not so easily b pliable and strong 7 “texwax, ” texas co , 51 2 32 5 29 8 same as 6 port arthur, texas 8 “paraffin wax 122-124 f , ” 50 6 36 0 34-35 a unsatisfactory. warren refining co , does not adhere warren, pa b only slightly pliable. too tough 9 “paraffin no 910, ” 47 0 30 5 26-27 a adheres well. waverly oil works, detaches well pittsburgh b pliable and strong 10 “paraffin no 920, ” 44 4 27 5 25 0 a adheres well. waverly oil works, detaches well pittsburgh b pliable and fairly strong 11 “hard paraffin, ” 48 0 28 5 24 5-25 5 a adheres well. rob’t stevenson & co , detaches well chicago b pliable and strong 12 “paraffin, ” 47 2 33 0 32 5 not quite as good island petroleum co , as 11 chicago 13 “paraffin 122 f , ” 46 8 30 5 27 5-28 a does not adhere gulf refining co , so well. pittsburgh detaches well b very pliable 14 “paraffin 125 f , ” 50 0 32 0 31 0 about as 13 gulf refining co , pittsburgh 15 “paraffin 132 f , ” 54 8 35 5 34 0 a does not adhere gulf refining co , well pittsburgh b not very pliable, but strong 16 “paraffin no 301, ” 50 2 33 0 32-32 5 a does not adhere national refining co , well cleveland b not very pliable 18 paraffin recovered 48 6 30 5 28-28 5 a adheres well.

1their order reflection paper composition is semisecret rule 1. 2 the therapeutic claimsare unwarranted rule 6. 3 they are sold under names not descriptiveof their composition but suggestive of indiscriminate use as “tonics” rule 8. 4 in the light of our present knowledge the routineadministration of polyglandular mixtures is irrational rule 10 inexplanation of this action, the council authorized publication of thereport which appears below w a puckner, secretary each tablet of “hormotone” g w carnrick co , new york city is saidto contain 1/10 grain of desiccated thyroid and 1/20 grain of entirepituitary, together with the hormones of the ovary and testes-- theamounts and the form in which the latter are supposed to be present arenot given from this it will be seen that the only definite informationgiven to the medical profession regarding the composition of hormotoneis that it is a weak thyroid and a still weaker pituitary preparation what results can be anticipated from one or two tablets three timesdaily the recommended dose of hormotone each containing 1/10 grainof thyroid and 1/20 grain entire pituitary?. such doses of thyroidmay, of course, have a beneficial action in a limited number of paperof myxedema and cretinism an extract of the posterior lobe of thepituitary liquor hypophysis, u s p , for example will, wheninjected subcutaneously or intramuscularly, have a pronounced effecton the writingurient uterus. Its action on certain other forms of smoothmuscle will be much less certain but the oral administration forwhich hormotone is recommended of the posterior lobe of the pituitaryhas not been shown to have any such effect the use of the anteriorlobe in doses of 1 to 4 grains doses very thesis times larger than thoserecommended for the entire gland in hormotone is in the experimentalstage and its only probable value seems to be in those paper of knowngland deficiency as to the other alleged ingredients of hormotone-- hormones of the ovaryand testes, amounts not stated. All physicians know the uncertaintiesattending the use of ovarian preparations and the serious question asto whether testicular extracts have any therapeutic value whatever maybe the physicians views as to the probable therapeutic value of theseorgans, the first thing he desires to know is how much of the substancehe is giving and from what writing of the gland it is obtained so much for the facts. Yet the physician is asked to jump from thisregion of solid fact into a sea of hypothesis. To believe thatsmall amounts of the well-known drugs thyroid and pituitary, plusan unknown amount of unknown hormones of the testes and ovary areof great value in conditions that in themselves are often purelyhypothetical he is asked to believe that this combination hasvirtues in such conditions as “hypofunction of the adrenal system, ”neurasthenia, the “fatigue syndrome, ” amenorrhea, dysmenorrhea, “natural and artificial menopause, ” sexual neuroses, cold extremities, cardiac asthenia, low blood pressure, infantilism, sterility, melancholic conditions, obesity, anorexia, anemia, slow metabolism, constipation, psychasthenia, lowered virility and the sexual neurosesof the unmarried, hysteria following functional exhaustion of thenerve centers, frigidity, etc , etc , especially if he guesses thatthe trouble is due to a “pluriglandular disturbance, ” “glandularhypofunction, ” an “adreno-pituitary deficiency, ” suboxidation, etc the physician is invited to use hormotone because, among other reasons, each alleged constituent is said to be “in physiologic sympathy andtherapeutic harmony with the others, ” and further, because. “pluriglandular therapy has the endorsement of high authorities, is both logical and effective and hormotone is a splendid example of it it will be seen at its best where the patient lacks snap and vim and vigor asthenic conditions necessarily indicate hypofunction of the adrenal system ” etc “the use of gland extracts in the treatment of aplasias of the pluriglandular system has become an established therapeutic measure of miraculous potency bayard holmes. The internal secretory glands, lancet-clinic, sept 19, 1914 ”the g w carnrick company also advertises a “hormotone withoutpost-pituitary, ” each tablet of which is said to contain 1/10 graindesiccated thyroid, and to “present” “hormone bearing extracts ofthyroid, anterior pituitary, ovary, and testes ” this product is justas irrational as “hormotone ”-- from the journal a m a , aug 16, 1919 formaldehyde lozenges report of the council on pharmacy and chemistrythe council has voted hex-iodin daggett and miller co , inc , providence, r i , formitol tablets e l patch co , boston, andcin-u-form lozenges mckesson and robbins, new york city inadmissibleto new and nonofficial remedies, and authorized publication of thereport which appears below w a puckner, secretary essay years ago, the council published the journal a m a , aug 28, 1915, p 816 a report on formamint, a proprietary medicinewidely exploited as a peculiar chemical compound of sugar of milk andformaldehyde the formaldehyde was said to be liberated slowly by theaction of the saliva, and because of this liberation of formaldehyde, formamint was claimed to be a powerful germicide extravagant claimswere made for its curative and prophylactic effects the council foundthat the therapeutic claims were grossly unwarranted and that itsexploitation to the public was a public danger during the recent epidemic of influenza, a variety of tablets orlozenges were advertised, and are still being advertised, havingformaldehyde, in essay form or other, as the nucleus around whichrevolve the therapeutic claims in essay paper, the advertising clearlyindicates the character of the formaldehyde compound that is claimedto be present. In others the statements are vague and indefinite ormisleading it is hardly necessary to remind physicians that the use of tabletscontaining hexamethylenamin or other formaldehyde compounds can neithercure respiratory infections, nor even confer protection against suchinfections to be effective, formaldehyde would need to be suppliedto the entire respiratory tract continuously for essay time or else inconcentrations that would be distinctly irritant and damaging to thetissues saliva-dissolved tablets, obviously cannot reach the nasalor tracheal mucosae directly. And the application of quickly actingconcentrations of formaldehyde is out of the question this altogetheraside from the fact that hexamethylenamin, the basis of essay of thesetablets, does not liberate formaldehyde in the mouth, and for thisreason alone would be quite useless for this purpose!.

Cascarets, danderine, order reflection paper pape diapepsin, california syrup offigs, neuralgine and dodson livertone the business is apparently apaying one financially as witness the following excerpt from a recentannouncement in a drug journal. “stockholders of the sterling products co , inc , of wheeling, manufacturers of neuralgine, cascarets, bayer aspirin, and other well known products, and the largest proprietary medicine organization in the world, at their annual meeting received a report of manager w e weiss, which showed that the company did a $10, 000, 000 business in 1920 the total profits were $2, 100, 000, while a total of $1, 080, 000 was paid out in dividends ”just what relationship exists between the winthrop chemical co , andthe sterling products co , we do not know as our correspondent pointsout, the “bayer cross” is used on the label of the winthrop products the advertising campaign of “aspirin, bayer” since it entered the“patent medicine” field has been typical of that field by half truthsand inferential falsehoods the public has been led to believe that theonly genuine aspirin on the market is that put out under the bayername the facts are, of course, that the aspirin of any reputable firmis just as good as the aspirin put out by the makers of livertone, danderine and cascarets there is one point, however, that is of vital importance to the medicalprofession. The decision recently rendered in the united statesdistrict court of southern new york makes it obligatory for druggists, when filling a physician prescription calling for “aspirin, ” todispense the bayer product when the public buys aspirin on its ownresponsibility-- without specifying any writingicular brand-- the druggistmay give the purchaser any make of acetylsalicylic acid he sees fit torepeat what was said in the journal comment on this decision. “unlessa physician wishes to cater to the concern owning the bayer rights andto aid in perpetuating what was a monopoly for seventeen years, heshould be careful to prescribe the drug under the term ‘acetylsalicylicacid, ’ the court now places the responsibility directly on the medicalprofession avoid ‘aspirin’-- write ‘acetylsalicylic acid ’-- from thejournal a m a , june 11, 1921 the allied medical associations of america another rocket in the pyrotechnics of quasimedical organizationsit was once said, in the days when diploma mills flourished, thatit seemed easier to start a “university” than it was to open a grogshop a study of quasimedical organizations convinces one that it iseasier to found a “medical society” than it is to establish a peanutstand most reputable practitioners of medicine who care to affiliatethemselves with medical organizations are members of the americanmedical association, its component societies, or similar scientificbodies it is not surprising then, that those who live and move inthe twilight zone of professionalism, from visionaries riding bizarremedical hobbies to those who have special interests to exploit, shouldcreate and make use of hybrid medical organizations such organizationsmultiply as rapidly as rabbits they flourish for a while, obtain moreor less newspaper and other publicity-- usually more, because of thesensational methods of those controlling them-- then, having served thepurpose of those who brought them into being, they lapse into innocuousdesuetude the official accouchement of the allied medical associations of americaoccurred, according to that organization report, may 18, 1918 onthe official stationery of the allied medical associations of americain use in may, 1919, we find the names of the “officers, ” “censors, ”etc these constitute, presumably, the more prominent members of thisorganization we give briefly, essay data regarding essay of these sothat a rational perspective may be obtained:l m ottofy, m d , st louis, mo -- dr ottofy seems to have beenthe chief organizer, if not, indeed, the founder he has been its“secretary-treasurer” since its inception. He is also “editor” ofits journal ottofy, according to our records, was born in 1865 atbudapest, hungary, and was graduated in 1888 by the homeopathic medicalcollege of missouri in polk medical directories for 1914 and 1917, ottofy has those extended notices which any physician can obtain whocares to pay for them according to these notices, ottofy is, or hasbeen, affiliated with the following “societies”. President of the international cancer research society ex-president of the st louis society of medical research second vice president of the missouri institute of homeopathy general secretary of the american association of progressive medicine chairman of the board of censors of the missouri institute of homeopathy member of the american institute of homeopathy member of the southern homeopathic association member of the american association of orificial surgeons member of the southern homeopathic medical society member of the kansas city society of medical research honorary member of the chicago society of medical research in december, 1911, numerous newspaper clippings show that dr ottofy was obtaining much publicity relative to his antivaccinationactivities at that time the papers reported that ottofy was suing thest louis board of education for $25, 000 damages, because the boardwould not admit to the schools of the city a child he had “internally”vaccinated in november, 1913, the st louis republic reported thatottofy had claimed to have discovered a serum for the cure of cancer, and quoted ottofy as claiming “a record of 72 per cent of cures” in“selected paper ” in february, 1914, the newspapers reported thatottofy was making a trip east “on the trail of radium for use in hispractice in the cure of cancer” and quoted him as stating, “i havelearned on good authority that there is radium in missouri, and justwhere i refuse to divulge at this time ” in january, 1915, the st louis republic reported that ottofy, at a meeting of the “st louissociety of medical research, ” had announced that he had perfected aserum treatment for cancer, which “is curing patients who have beenpronounced incurable by so-called ‘cancer experts ’” in january, 1916, the st louis star reported that ottofy had sought an injunctionagainst the board of education of st louis to restrain it from usingits funds for “the maintenance of a board of hygiene ” in july, 1916, st louis papers recorded that ottofy, who was then running forcoroner, had been cited to appear before the prosecuting attorney toexplain a charge of passing out, at a political meeting, a card allegedto have borne an indecent drawing of president wilson the prosecutingattorney was said to have instructed ottofy to bring the plates fromwhich the cards were printed to his office two days later the papersstated that ottofy had sent the cards and plates by messenger to theprosecuting attorney office n la doit johnson, m d , chicago -- dr johnson name appears as the“first vice-president” of the allied medical associations of america a few years ago, dr johnson name also appeared as the “dean of thefaculty” of the “american post graduate school ” this “school” wasa mail-order concern which, according to the “annual announcement, ”would grant diplomas and confer degrees as follows. “master ofsurgery, ” “bachelor of medicine, ” “bachelor of science, ” “master ofelectro-therapy, ” “doctor of osteopathy, ” “doctor of psychology, ”“master of massage, ” etc h m goehring, d o , m d , pittsburgh, pa -- the “secondvice-president, ” according to the letterheads of the “association”carries the letters d o , m d , after his name so far as our recordsshow, and they are most complete and based on official data, h m goehring is an osteopath, but not a doctor of medicine a e erling, m d , milwaukee, wis -- a e erling, according to thestationery, is “chairman” of “censors ” our records fail to show thaterling ever graduated in medicine the health dewritingment of milwaukee, however, says that erling, when interviewed, claimed to have “a diplomafrom the german medical college of chicago, but refused to show orpresent the same ” the american medical directory has this item.

In essay paper asbeing of a dark color and in others of a bright arterial hue deathby asphyxia or suffocation, by the deprivation of oxygen, and by theproducts of combustion, would be accompanied by a dark or venous hueof the blood an atmosphere containing an excess of carbon monoxide, resulting from combustion, would cause death by apnœa with an arterialhue to the blood 722 but other influences must be considered according to schjerning, 723 it is difficult to deduce positiveconclusions from the condition of the blood the changes induced by thespleen and kidneys, as well as the varying intensity of the degree ofheat to which the body may be subjected, tend to render positive andconstant conclusions from this source difficult falk724 refers to the bright red color of the blood found in essaypaper, and explains this condition in writing by the influence of chemicalchanges in the tissues surrounding the vessels wertheim725 describes certain conditions observed by him and mentionsan increase in the number of the leucocytes, together with the presenceof hæmoglobin and melanin hoppe seyler meets with similar results and arrives at the sameconclusions in his observations ponfik, 726 on the contrary, order reflection paper is doubtful of the constant presence ofessay of these conditions and also of their diagnostic value seliger727 confirms the conclusions of wertheim, in that he describesthe presence of crystalline bodies and of dark discolorations melanin essay spectroscopic analyses have disclosed the presence of bandsadditional to those of normal blood the lack of uniformity ofconditions described and of conclusions reached leaves the subject in aposition of uncertainty examination of the blood of those dying fromburns has not been so extensively and minutely followed as to enable usto decide questions which may arise in any case explanation of plate ii figure 1 - ante-mortem burn scald by steam from a boiler bursting, july, 1892 from a photograph taken sixty hours after the accident the injurycovered one-half of the surface of the body the red line is sharplymarked. The extensive blisters formed are broken and their contentshave escaped. The serum drying has produced yellowish discolorations;the blush of redness on adjacent writings is well marked death resultedon the fifth day figure 2 - post-mortem burn exp 1 appearances after application of a tin can containingboiling water the cuticle was raised by expansion the blisterscontained no serum and no red line is developed figure 3 - post-mortem burn exp 2 appearances after the application of iron at a dull redheat no proper blister formed. The cuticle was raised, as inprevious experiment there was no serum and no red line or redness ofadjacent writings the cuticle is charred at one point, where the iron wasbrought into contact with it illustration. Medical jurisprudence plate ii burn, two hours after death, by iron at a dull red heat burn, two hours after death, by tin can containing boiling water burn by steam, sixty hours after injury post-mortem and ante-mortem burns was death accidental, suicidal, or homicidal?. Nearly all deaths occurring from burning are accidental, very fewhomicidal, and hardly more than a few exceptional paper suicidal it is important in paper of legal investigation to note the position ofthe body when found and its relation to the apparent source of fire;the writings of the body and clothing burned, etc. Evidences of violenceshould be carefully observed, such as contusions, fractures of bones, wounds of the soft writings, evidences of strangling, etc case 22 these should be specially sought in the site of the burned portions, as burning and cremation of the victim are essaytimes a resort toconceal homicide in considering the character of the apparent wounds, it must be remembered that extensive injuries, resembling wounds, mayresult from the effects of fire, 728 and these must be carefullydistinguished inability to detect special marks of violence need not preclude thepossibility of its commission and of its being a possible cause ofdeath case 19 the writings burned, the character and depth of theburns, and their relation to the apparent source of burning, withconsideration of their probable simultaneous exposure, are allcircumstances of weight in forming an opinion the position of thebody in relation to the fire should also be considered in accidentalburning, except in paper of intoxication, epileptic seizures, or othersources of helplessness, the victim is quite likely to be found at adistance from the fire, owing to his efforts to escape paper case 1 death from cold accidental dr hilty in caspar vierteljahrschrift, ii , 1865, p 140 - male, æt 52. Intoxicated severe winter weather.

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In all wounds made after death there is slight bleeding, non-contraction of the edges, and absence of blood in the tissues thisis the opposite of ante-mortem wounds again, wounds inflicted withintwo hours after death cannot be differentiated from those made duringlife order reflection paper see gunshot wounds, vol i , p 610 et seq. Wounds, vol i , p 476 et seq 5 fractures - if there are any evidences of fractures, thesituation of the bones involved should be noted, and whether theyare accompanied by contusions of the soft writings fractures which areinflicted during life are always accompanied by much more extravasationof blood, more injury to the soft writings, and more evidences of reactionthan those occurring after death it is a well-known fact that it ismuch more difficult to produce a fracture in a dead than a living body see wounds, vol ii , p 482 et seq 6 the temperature of the body should be taken 7 the rigidity and flexibility of the extremities should beascertained 8 the state of the eyes should be noticed, and the relative size ofthe pupils 9 attention should be paid to the condition of the cavities of themouth and nose the neck should be specially examined for marks ofexternal injury, or signs of ecchymosis or compression 10 genitals - the external genitals should be very carefullyexamined for evidence of injury, the presence of syphilitic lesions, and in the female the condition of the vagina should be writingicularlyascertained 11 œdema of the feet - if there is evidence of œdema in any writing ofthe body, especially about the ankles, its situation and extent shouldbe noted 12 ulcers and abscesses - the situation and extent of any ulcerfound on the body should be recorded, as also the presence andsituation of any abscess 13 burns - the extent of a burn, as also the state of the writingsinvolved, should be noted for example, whether they are inflamed orshow blisters, etc see heat and cold, vol i , p 647 et seq 14 hands - in medico-legal paper the hands of a dead person shouldalways be examined for the presence of cuts, excoriations, or foreignsubstances found upon them. Especially should the dorsal extremitiesbe examined this examination will often indicate that there has beena mortal struggle before death the impression of a hand or of essayof the fingers is often found on the skin of a dead body the exactsituation where found should be noted this may be of importance, aswhen it occurs where it would have been impossible or improbable forthe deceased to have caused it for appearances in death from lightning or electricity, see vol i , p 701 et seq , and in death from hanging, strangulation, and garroting, see vol i , pp 713, 746, 781, et seq internal examination having completed the examination of the external writings of the body, thenext proceeding is to open the body and make an internal examination this should be done by following a regular method, so as to examine therelations of writings and not to injure one organ while removing another in opening the various organs an incision should be made which willexpose the greatest amount of surface at one cut never make a numberof small and always unsatisfactory incisions in an organ in openingcertain organs like the brain and heart, the incisions are so plannedthat the writings of the organ may be folded together, and, if necessary, their relations to one another and the whole organ studied such organsare opened as one would open a book to examine its pages it is important to remember that after death the blood leaves thearteries and left side of the heart, and collects in the veins and theright cavities of the heart especially does it collect in the vesselsof the most dependent portions of the body and of the various organs, so that local congestions may often disappear after death. And again, they may be found at an autopsy where they were not present duringlife especially is this true of the mucous membranes such as those ofthe trachea and bronchi, and also of the blood in the sinuses of thedura mater in making autopsies it is a cardinal rule that all the cavitiesof the body should be examined, and not alone the one where onemight expect to find a lesion at medico-legal autopsies, the greatcavities the head, the thorax, and the abdomen should be examined intheir successive order from above downward the reason for beginningwith the head is that the amount of blood in the brain and itsmembranes may be determined accurately. For, if the heart and greatvessels of the neck are opened first, the blood will drain away fromthe brain and local congestions disappear in pathological autopsies, the opening of the head first is not so important, and often thevertebral column need not be opened at all, for it is a complicatedprocess and takes time. But in medico-legal paper, especially where aquestion as to the cause of death may arise, and has not satisfactorilybeen determined, after all the other cavities are examined thevertebral column should always be opened and the cord removed the head make an incision across the vertex of the skull from ear to ear dissect the anterior flap forward until within about three inches ofthe bridge of the nose, and the posterior flap backward to the externaloccipital protuberance examine the internal surface of the scalp forecchymosis and evidences of injury a circular incision is then madewith a saw through the cranium as far backward and forward as theflaps have been reflected an incision through the temporal muscle isnecessary so that the teeth of the saw may not become clogged by themuscle fibres when the cranium has been sawed through, a stout hook isinserted under its upper edge and it is removed with a quick jerk ifthe dura mater is very adherent to the calvaria, it may be necessaryto remove it with the bone, by cutting through it at the level of thecranial incision examine the calvaria as also the other bones of theskull after the brain has been removed and the dura stripped off, forevidence of fracture note the symmetry, thickness, and density of the cranial bone, andremember that depressions along the sagittal suture are for thepacchionian bodies, and are not pathological dura mater - the dura mater may be slightly adherent to the boneof the cranium this is especially seen in old people and doesnot indicate disease the pacchionian bodies are seen along thelongitudinal sinus examine the internal surface of the dura materfor the presence of clots, tumors, or inflammatory lesions open thelongitudinal sinus and examine for thrombi remove the dura mater byan incision following the cranial incision, the falx cerebri betweenthe anterior lobes being drawn back and divided note whether the duramater is adherent to the pia mater, and the condition of its internalsurface pia mater - the brain, covered by the pia mater, is now exposed note the degree of congestion of the membrane, its adherence, and theexistence of pus, blood, or serum on its surface or in its meshes remember that a considerable amount of serum may be present withinnormal limits, especially in cachectic subjects, without indicatingdisease, but when the serum is so extensive as to raise the pia materand to depress the convolutions, we have a pathological amount whichmay be a simple dropsy due to essay general cause, or the result of achronic meningitis enough serous effusion in the pia mater to producea condition which has been called by essay writers “serous apoplexy, ” ibelieve never occurs as a primary condition loss of transparency and thickening of the pia mater, especially alongthe longitudinal fissure, is often seen in old people and does notindicate disease brain - remove the brain by raising the anterior lobes with thefingers of the left hand and cutting through the nerves, vessels, and the tentorium as they appear the medulla is cut as low down aspossible, and the brain as it rolls out is caught in the left hand after being placed on a clean board or in a large clean dish, itis minutely examined the average weight of an adult male brain isforty-nine and one-half ounces. Of the female, forty-four ounces itsproportional weight to that of the rest of the body is as 1 to 45 lay the brain first upon its convex surface and examine the arteriesat the base for atheroma, thrombi, emboli, and aneurisms examine thepia mater of the base, especially for the evidences of hemorrhage, tumors, tubercles, and inflammatory lesions next turn the brain overon its base, and proceed to open its various cavities and examine itsinternal structure separate the two halves of the cerebrum, until thecorpus callosum is exposed make an incision downward and outward atthe junction of the corpus callosum with the cerebrum, and the roof ofthe lateral ventricles will be cut through and their cavities exposed prolong the incision forward and backward so as to expose the cornua the size and contents of the ventricles should be noted, as also thecondition of the ependyma the floor of the lateral ventricles beingthe most frequent spot of hemorrhage, if one is found its extent andthe writings involved by it should be noted. Especially its relation tothe internal capsule transverse incisions about one-sixteenth of an inch awriting are madethrough the ganglia seen on the floor of the lateral ventricles thusany lesions in the substance of the ganglia will be disclosed three orfour longitudinal incisions are now made outward into the hemispheresnearly to the pia mater these will divide the hemispheres into long, prism-shaped pieces held together by the pia mater and a little of thecortex, thus enabling the brain afterward to be folded together, andthe relations of lesions to the brain as a whole studied the thirdventricle is now examined by cutting through the fornix and corpuscallosum at the foramen of monroe next, the fourth ventricle is openedby a longitudinal incision through the lower portion of the vermiformprocess. Its contents, the condition of its vessels and ependymanoted then the floor of the fourth ventricle is divided by transverseincisions one-sixteenth of an inch awriting, and careful examination madefor the presence of minute hemorrhages. For here is a place in thebody where almost a microscopical lesion hemorrhage may cause suddendeath each hemisphere of the cerebellum is now opened by a numberof incisions starting from the fourth ventricle and passing outwardinto its substance the presence of any tumors or hemorrhage in thecerebellum will now be recognized in opening the brain, when clots, areas of softening, tumors, etc , are discovered, their exact location in relation to surroundingwritings should be noted and the blood-vessels examined for areas ofdegeneration or aneurism this examination can be facilitated byallowing a stream of water to flow over the affected writing this willwash out the affected area and allow the vessels to appear eye - in rare paper it may be necessary to remove the eye this canbe done by breaking through the roof of the orbit with a saw or chiseland dissecting away the muscles so as to expose the optic nerve and theposterior portion of the organ thorax and abdomen the body being placed on its back, and the operator standing on theright side, an incision is made through the skin, fascia, and musclesfrom the top of the sternum to the pubic bone, passing to the leftof the umbilicus and dividing everything down to the sternum andthe subperitoneal tissue a small incision is now made through theperitoneum below the ensiform cartilage into this opening two fingersof the left hand are inserted, and by spreading the fingers andholding the knife horizontally the peritoneum can be divided to thepubes without injuring the intestines the skin and muscles are nowdissected from the chest as far back as the false ribs this dissectionmay be facilitated by keeping the skin and muscles on the stretch andcutting with the flat writing of the knife in order to better expose theabdominal cavity, the recti muscles are divided beneath the skin attheir insertion in the pubic bone examine the cut surface of the chestand abdominal muscles, and note their color, amount, and consistency observe whether the chest muscles show the evidence of any parasiticdisease such as trichinosis the mammary glands are now examined frombehind and opened if necessary superficial examination of abdominal cavity - this should be donebefore opening the chest cavity, because the position of organsmay become modified, and blood and other fluids are liable to findtheir way from one cavity into another. And again, the blood in thepresenting portion of the abdominal organs will change its color afterexposure to the air note the following points.