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Glycerole of lecithin lecibrin lecithin solution lecithol neuro-lecithin-abbottand that the general article on “lecithin preparations” be transferredto the annual council reports as a matter of record the report was submitted to the manufacturers their replies wereevidently based on commercial consideration, and called for nomodification in the report the referee recommended that the preceding report be published togetherwith the following extracts from the replies of the manufacturers:from armour and company. “we are selling a good deal of lecithol and it seems to be giving satisfactory results in essay quarters we shall continue to advertise lecithol along the lines we have employed heretofore ”from the abbott laboratories. “we can assure you of our confidence in the therapeutic value of neuro-lecithin this has been attested by the reports of favorable results sent us by thesis physicians, as well as by the periodical literature of the last few years which contains a considerable number of very encouraging references to lecithin therapy ”from fairchild bros & foster. “we would like simply to say that the physician and the council must be aware of the circumstances and the purposes which actuated us in placing lecithin at disposal, viz , the studies-- research-- of lecithin and the properties attributed to it and which led to inquiry for and consideration of it the quantities proposed for medicinal use were not suggested by us. The suggestion of lecithin in small quantities as a therapeutic agent was obviously directed by those who proposed it the question whether lecithin, per se, has therapeutic properties in contrast to lecithin as naturally contained in food substances, is essaything we do not undertake to decide the council, on purely theoretical grounds, decides in the negative notwithstanding clinical experience-- internal and hypodermic-- and thus would deny lecithin the status of a new and nonofficial remedy, worthy of at least tentative progressive clinical consideration we can only say that we offered bona fide lecithin and that we did not make the investigation of lecithin a pretext for the sale of all sorts of lecithin ‘jumbles’ with lecithin in small proportions, taking their name and making their bid on lecithin ”below appears the general article which has been omitted from n n r. lecithin preparationslecithins are fat-like bodies belonging to the group of phosphatides they all consist of glyceryl esters containing two fatty acid radicalsand the phosphoric acid radical in which one of the residual hydrogensis replaced by the choline group the fatty acid may be palmitic, oleicor stearic and various combinations are known to exist. For example, distearyl lecithin, stearyl palmityl lecithin and so on the commerciallecithins usually include the closely related kephalins on saponification the lecithins split more or less readily intocholine, the fatty acids and glycerophosphoric acid, and by fusion withalkali nitrate and carbonate they yield alkali phosphate they occur, free or in combination as lecithoproteins, most abundantly in certainanimal tissues, but there are also vegetable lecithins the lecithinsof commerce are obtained usually from yolks of eggs or from calves’ orsheep brains numerous processes have been devised for the preparation of lecithinfrom egg-yolk or animal tissue from egg-yolk it may be obtained bymaking an alcoholic extract and precipitating by cadmium chloride theprecipitate is washed with alcohol and ether, mixed with 80 per cent alcohol and warmed with the proper amount of ammonium carbonate toremove the cadmium after filtering hot and concentrating the filtratethe lecithin is thrown down by cooling to a low temperature-- 10 c orbelow the precipitate is taken up in chloroform and reprecipitated byacetone from tissues it is obtained by extracting with warm alcohol and ether, concentrating the extract, precipitating with acetone and repeating theoperations pure lecithin is white, but the commercial preparations areyellowish-brown wax-like solids, which are not soluble in water butform milky emulsions which exhibit the myeline figures under themicroscope the solubility in cold alcohol or ether is slight, but heataids it lecithins are not soluble in acetone they are hygroscopic andthe water mixtures undergo decomposition on standing they darken onexposure to air and light the alcoholic solution is precipitated by platinum or cadmiumchloride it is decomposed by alkalies with the formation of cholineand trimethylamine the ash contains phosphoric acid the differentlecithins contain from 3 84 to 4 12 per cent of phosphorus and 1 73 to1 86 per cent of nitrogen the ratio of nitrogen to phosphorus shouldbe at 1 to 2 21 lecithin is incompatible with alkalies. It should be kept inwell-stoppered bottles and should be protected from the light the content of lecithin plus kephalin in tissues is about as follows. per cent egg-yolk 8 to 12 egg-white 0 1 to 0 2 liver 2 0 to 3 0 kidney 2 0 to 3 6 lung 2 0 to 3 0 pancreas 2 0 to 3 0actions and uses -- the lecithin preparations have been recommendedin thesis pathologic conditions, especially in malnutrition and sexualdebility moderate doses are said to bring about a marked retention ofnitrogen and phosphorus, but satisfactory proof of this is lacking itis extremely unlikely that the small doses which have been recommendedin pill or tablet form or in emulsions can have any perceptible action, in view of the fact that thesis of our natural foods contain much greaterweights of available lecithins than the medicinal doses provide thereis no good basis for the statement that the free lecithin has a greaterfood value or is more readily assimilated than is the substance asfound in eggs or tissue the reverse proposition is much more likelyto be true, especially when it is considered that the commercialpreparations are usually essaywhat altered or decomposed in the processof separation dosage -- given by the mouth in the form of pills, tablets orglycero-alcoholic emulsions the amount of actual lecithin ingestedin this way is usually small because of the doubtful purity of theoriginal preparation several doses, as commonly administered, wouldbe required to furnish the amount of lecithin present in a smallegg -- from reports of council on pharmacy and chemistry, 1915, p 122 proprietary names for liquid petrolatum report of the council on pharmacy and chemistrythe council has accepted the following report and authorized itspublication w a puckner, secretary a former report of the council liquid petrolatum or “russian mineraloil, ” report council pharm and chem , the journal, may 30, 1914, p 1740 called attention to the large number of concerns that wereplacing on the market liquid petrolatum as a proprietary under coinednames since then the number of such products has increased thecouncil has been requested by several concerns to consider theirproducts put out under proprietary brand names the rules of the council affirm that “the application of ‘trade names’to official or established nonproprietary substances tends to confusionand fosters thesis abuses ” in accordance with this general ruling, the council has invariably refused to countenance proprietary namesapplied to liquid petrolatum the council holds that proprietary orcoined names for this substance are detrimental to medical progress, since they are sure to foster the impression that the writingicularproduct is different from liquid petrolatum manufacturers have beenadvised that there is no objection to distinguishing their productsby the addition of their firm name or the initial representing thefirm name. For instance, “liquid petrolatum, a b and co ” or “liquidpetrolatum, smith ” the council also believes that such designationsas “star liquid petrolatum” or “liquid petrolatum, anchor brand, ”may be regarded as unobjectionable, provided that the words “liquidpetrolatum” are always used in connection with the brand designationand given equal prominence -- from reports of council on pharmacy andchemistry, 1915, p 127 seng report of the council on pharmacy and chemistrythe council has adopted the following report and authorized itspublication w a puckner, secretary seng sultan drug co , st louis is called by the manufacturers.

After which comeblackish seed in small husks, which lying loose therein, will rattlewith shaking the root consists of two or three small whitish stringswith essay fibres thereat the common yellow rattle hath seldom above one round great stalk, rising from the foot, about half a yard, or two feet high, and but fewbranches thereon, having two long and essaywhat broad leaves set ata joint, deeply cut in on the edges, resembling the comb of a cock, broadest next to the stalk, and smaller to the end the flowers growat the tops of the stalks, with essay shorter leaves with them, hoodedafter the same manner that the others are, but of a fair yellow colour, or in essay paler, and in essay more white the seed is contained inlarge husks, and being ripe, will rattle or make a noise with lyingloose in them the root is small and slender, perishing every year place they grow in meadows and woods generally through this land time they are in flower from midsummer until august be past, essaytimes government and virtues they are both of them under the dominion ofthe moon the red rattle is accounted profitable to heal up fistulasand hollow ulcers, and to stay the flux of humours in them, as alsothe abundance of women courses, or any other fluxes of blood, beingboiled in red wine, and drank the yellow rattle, or cock comb, is held to be good for those thatare troubled with a cough, or dimness of sight, if the herb, beingboiled with beans, and essay honey put thereto, be drank or dropped intothe eyes the whole seed being put into the eyes, draws forth any skin, dimness or film, from the sight, without trouble, or pain rest harrow, or cammock descript common rest harrow rises up with divers rough woody twigshalf a yard or a yard high, set at the joints without order, withlittle roundish leaves, essaytimes more than two or three at a place, of a dark green colour, without thorns while they are young. Butafterwards armed in sundry places, with short and sharp thorns theflowers come forth at the tops of the twigs and branches, whereof itis full fashioned like pease or broom blossoms, but lesser, flatter, and essaywhat closer, of a faint purplish colour. After which come smallpods containing small, flat, round seed. The root is blackish on theoutside, and whitish within, very rough, and hard to break when it isfresh and green, and as hard as an horn when it is dried, thrustingdown deep into the ground, and spreading likewise, every piece beingapt to grow again if it be left in the ground place it grows in thesis places of this land, as well in the arableas waste ground time it flowers about the beginning or middle of july, and the seedis ripe in august government and virtues it is under the dominion of mars it issingularly good to provoke urine when it is stopped, and to break anddrive forth the stone, which the powder of the bark of the root takenin wine performs effectually matthiolus saith, the same helps thedisease called herma carnosa, the fleshy rupture, by taking the saidpowder for three months together constantly, and that it hath curedessay which seemed incurable by any other means than by cutting orburning the decoction thereof made with essay vinegar, gargled in themouth, eases the tooth-ache, especially when it comes of rheum. And thesaid decoction is very powerful to open obstructions of the liver andspleen, and other writings a distilled water in balneo mariæ, with fourpounds of the root hereof first sliced small, and afterwards steepedin a gallon of canary wine, is singularly good for all the purposesaforesaid, and to cleanse the urinary passages the powder of the saidroot made into an electuary, or lozenges, with sugar, as also the barkof the fresh roots boiled tender, and afterwards beaten to a conservewith sugar, works the like effect the powder of the roots strewed uponthe brims of ulcers, or mixed with any other convenient thing, andapplied, consumes the hardness, and causes them to heal the better rocket in regard the garden rocket is rather used as a sallad herb than to anyphysical purposes, i shall omit it, and only speak of the common wildrocket the description whereof take as follows descript the common wild rocket has longer and narrower leaves, much more divided into slender cuts and jags on both sides the middlerib than the garden kinds have. Of a sad green colour, from amongwhich rise up divers stalks two or three feet high, essaytimes set withthe like leaves, but smaller and smaller upwards, branched from themiddle into divers stiff stalks, bearing sundry yellow flowers on them, made of four leaves a-piece, as the others are, which afterwards yieldthem small reddish seed, in small long pods, of a more bitter and hotbiting taste than the garden kinds, as the leaves are also place it is found wild in divers places of this land time it flowers about june or july, and the seed is ripe in august government and virtues the wild rockets are forbidden to be usedalone, in regard their sharpness fumes into the head, causing achesand pains therein, and are less hurtful to hot and choleric persons, for fear of inflaming their blood, and therefore for such we may saya little doth but a little harm, for angry mars rules them, and heessaytimes will be restive when he meets with fools the wild rocket ismore strong and effectual to increase sperm and venerous qualities, whereunto all the seed is more effectual than the garden kind itserves also to help digestion, and provokes urine exceedingly the seedis used to cure the biting of serpents, the scorpion, and the shrewmouse, and other poisons, and expels worms, and other noiessay creaturesthat breed in the belly the herb boiled or stewed, and essay sugar putthereto, helps the cough in children, being taken often the seed alsotaken in drink, takes away the ill scent of the arm-pits, increasesmilk in nurses, and wastes the spleen the seed mixed with honey, and used on the face, cleanses the skin from morphew, and used withvinegar, takes away freckles and redness in the face, or other writings;and with the gall of an ox, it mends foul scars, black and blue spots, and the marks of the small-pox winter-rocket, or cresses descript winter-rocket, or winter-cresses, hath divers essaywhatlarge sad green leaves lying upon the ground, torn or cut in diverswritings, essaywhat like unto rocket or turnip leaves, with smaller piecesnext the bottom, and broad at the ends, which so abide all the winter if it spring up in autumn, when it is used to be eaten from amongwhich rise up divers small round stalks, full of branches, bearing thesissmall yellow flowers of four leaves a-piece, after which come smallpods, with reddish seed in them the root is essaywhat stringy, andperishes every year after the seed is ripe place it grows of its own accord in gardens and fields, by theway-sides, in divers places, and writingicularly in the next pasture tothe conduit-head behind gray inn, that brings water to mr lambconduit in holborn time it flowers in may, seeds in june, and then perishes government and virtues this is profitable to provoke urine, to helpstranguary, and expel gravel and stone it is good for the scurvy, and found by experience to be a singularly good wound herb to cleanseinward wounds. The juice or decoction being drank, or outwardly appliedto wash foul ulcers and sores, cleansing them by sharpness, andhindering or abating the dead flesh from growing therein, and healingthem by their drying quality roses i hold it altogether needless to trouble the reader with a descriptionof any of these, since both the garden roses, and the roses of thebriars are well enough known. Take therefore the virtues of them asfollows. And first i shall begin with the garden kinds government and virtues what a pother have authors made with roses!. What a racket have they kept?. i shall add, red roses are under jupiter, damask under venus, white under the moon, and provence under the kingof france the white and red roses are cooling and drying, and yet thewhite is taken to exceed the red in both the properties, but is seldomused inwardly in any medicine. The bitterness in the roses when theyare fresh, especially the juice, purges choler, and watery humours. Butbeing dried, and that heat which caused the bitterness being consumed, they have then a binding and astringent quality. Those also that arenot full blown, do both cool and bind more than those that are fullblown, and the white rose more than the red the decoction of redroses made with wine and used, is very good for the head-ache, andpains in the eyes, ears, throat, and gums. As also for the fundament, the lower writing of the belly and the matrix, being bathed or put intothem the same decoction with the roses remaining in it, is profitablyapplied to the region of the heart to ease the inflammation therein;as also st anthony fire, and other diseases of the stomach beingdried and beaten to powder, and taken in steeled wine or water, ithelps to stay women courses the yellow threads in the middle ofthe roses which are erroneously called the rose seed being powderedand drank in the distilled water of quinces, stays the overflowing ofwomen courses, and doth wonderfully stay the defluctions of rheumupon the gums and teeth, preserving them from corruption, and fasteningthem if they be loose, being washed and gargled therewith, and essayvinegar of squills added thereto the heads with the seed being usedin powder, or in a decoction, stays the lask and spitting of blood red roses do strengthen the heart, the stomach and the liver, and theretentive faculty.

Productordered released on bond, p 248 no 256, misbranding of “ziratol ”u s v 936 bottles and 6 jugs of ziratol, consent decree ofcondemnation and forfeiture. Product ordered released on bond, p 260 the bristol-myers company in replying to the council report madeno offer to declare the exact composition of ziratol, to state theactual phenol-coefficient, or to remove the other objections pointedout in the report of the council in other words, the bristol-myerscompany has abandoned a definite but false claim of high germicidalpower-- a claim which subjected the firm to federal prosecution-- andhas substituted therefor indefinite statements which do not define theactual germicidal efficiency of ziratol -- from the journal a m a , oct 6, 1917 gonosan report of the council on pharmacy and chemistrythe council has adopted the following report on gonosan and authorizedits publication w a puckner, secretary gonosan riedel and company, inc , new york city comes in the form ofcapsules, each said to contain 5 minims of a mixture composed of oil ofsandalwood 80 per cent , and 20 per cent of alpha- and beta-resin ofkava, isolated by a patent process the mixture, as the name implies, is intended for the treatment of gonorrhea this proprietary preparation was under consideration by the council atvarious times from 1905 to 1910 during this time, the council agreedto accept the preparation if the suggestive name was changed, thetherapeutic exaggerations abandoned, and the drug kava admitted to newand nonofficial remedies the name was not changed, the other questionswere left open, and the preparation was not accepted recent and more objectionable advertising of gonosan makes it advisablefor the council to take action and to publish a report the tone ofthis advertising is reflected by the following quotation from a recentadvertising circular. “the old-established balsamic treatment of gonorrhea, for essay years neglected in favor of the local injection of organic silver and other germicidal salts, has, with the increasing knowledge and attention paid to the composition and purity of the balsams, regained to a large extent the confidence formerly reposed in them “it may now be said that the combined treatment with local injections and internal administration of natural balsamic products completely dominates modern gonorrheal therapy ”any one conversant with current medical literature and practice wouldstamp these statements as misleading exaggerations the balsams, oleoresins and volatile oils may have essay value as minor adjuvantsin the treatment of gonorrhea, but that is all the position in thisrespect has not changed materially in recent years these agents do nothave a value equal to that of local treatment, as the quoted statementimplies the claims made for gonosan might with equal force be made for oil ofsantal alone kava kava, the other constituent, belongs to the pepperfamily. It had a temporary vogue essay two or three decades ago, but hasfailed to maintain a place it has never been recognized officially there is no scientific evidence that it has any value either alone oras an adjuvant to sandal oil the “clinical reports” quoted in theadvertising circulars, rather curiously, nearly all date back tenyears or more, viz , to a period when the attitude of the professiontoward proprietary remedies was less critical than it is now it wouldbe interesting to know whether these authors still adhere to theiropinion, or whether any of them have subsequently had experiencessimilar to that of a correspondent who wrote:“gonosan, at my hands, did not prove to be of more essentialvalue in the treatment of gonorrhea than any other sandalwood oilpreparation the various claims made for gonosan, that it possessessedative and anesthetic properties, that by its continuous use theurethral discharge disappears more rapidly and that, if combined withappropriate diet and rest, it is liable to prevent complications, are, according to my experience, not corroborated by actual results ”the only experimental work quoted in support of gonosan, that of pohl, is not convincing the doses that pohl found necessary to influenceexperimental purulent pleurisy makes it impossible to transfer his workto the clinic he found a dosage of oil of santal corresponding to anounce per day, for man, inefficient. Positive results were obtainedonly with 2 ounces per day in order to learn the estimate placed on the therapeutic value of the“balsams, ” an inquiry was sent to the authors of the papers presentedto the section of genito-urinary diseases at the recent meeting of theamerican medical association in new york the inquiry read:“dear doctor:-- an advertising circular for gonosan ‘riedel’ which isnow being distributed begins thus. ‘the old-established balsamic treatment of gonorrhea, for essay years neglected in favor of the local injection of organic silver and other germicidal salts, has, with the increasing knowledge and attention paid to the composition and purity of the balsams, regained to a large extent the confidence formerly reposed in them ’ ‘it may now be said that the combined treatment with local injections and internal administration of natural balsamic products completely dominates modern gonorrheal therapy ’“is the statement correct that the combined treatment with localinjections and internal administration of natural balsamic productscompletely dominates modern gonorrheal therapy?. your reply to the abovewill be appreciated by the council ”seventeen replies were received they bear out the position thathas been outlined only one writer considered the statement evenapproximately justified, and this in the sense that “the majorityof paper receive no other treatment” than a combination of localapplications and systemic medication another stated that, “in ageneral way their statement is true though a trifle too sweeping, ” andthen added that the field of the balsams is rather restricted withthe exception of these qualified endorsements the remaining fifteenreplies characterized the statement as incorrect and misleading thereplies are a valuable contribution to the status of the “balsam”treatment of gonorrhea, and extracts of them are appended to thisreport it is recommended that the council declare gonosan inadmissible tonew and nonofficial remedies, because the therapeutic claims areexaggerated rule 6. Because there is no evidence that the combinationof kava resin with oil of santal is superior to oil of santal alone rule 10. And because the therapeutically suggestive name is conduciveof indiscriminate and unwarranted use of the preparation both by theprofession and the public rules 4 and 8 appendixthe extracts from replies received to the inquiry above referred to, follow:dr b , penn , wrote. “in my practice i have found that local injections are very valuable in the treatment of gonorrhea, but i have never found that the internal administration of natural balsamics dominated modern gonorrheal therapy. While it is an aid, i consider the quoted statement to be very erroneous ”dr f , d c , wrote.

The fellows, schlotterbeck, and nelson, baker preparations are also in conflict with rule1 -- from the pay for someone to write your essay journal a m a , sept 2, 1916 pulvoids calcylates report of the council on pharmacy and chemistrypulvoids calcylates 5 grains was submitted by the drug productscompany, inc , new york, under the following claims as to composition. “when ingested represents the following chemical formulas. Oh c₆h₄ coo₂ ca 2h₂o sr c₇h₅o₃₂ 2h₂o ” “strontium di-salicylate 2-1/2 grs and our especially prepared salt of calcium and acid salicylic adjusted in such nascent form, that these pulvoids upon ingestion will promptly form calcium neutral di-salicylate 2-1/2 gr ” “a combination of calcium and strontium di-salicylate, in seemingly true chemical union ”these statements are rather vague, possibly because they are an attemptto mystify the product, however, may be assumed to be a mixture not achemical combination of calcium salicylate and strontium salicylate the therapeutic claims made for the preparation are. “superior to ordinary salicylates can be taken continuously and indefinitely without gastric irritation, insuring maximum efficiency ” “reports show surprisingly good results, even where the sodium salt fails ”as there is no evidence to show that strontium salicylate, calciumsalicylate or a mixture of the two salts has any advantage oversodium salicylate, these claims cannot be accepted the name and thestatement of composition are objectionable in that they do not revealthe identity of the drugs in “calcylates” and in suggesting that thispreparation possesses radical advantages over salicylates in otherforms the drug products company was told that the facts just mentionedrendered “pulvoids calcylates” ineligible for new and nonofficialremedies the company in its reply objected to the councilconclusions, and in support of its position submitted testimonials froma number of physicians the reply of the company embodied no facts orarguments which had not been considered by the council referee, andthe testimonials from physicians contained no evidence to show that thecombination has any real advantage over sodium salicylate the council therefore declared “pulvoids calcylates” ineligible fornew and nonofficial remedies for the following reasons. Unwarrantedtherapeutic claims are made for the mixture rule 6. The name does notdescribe the composition rule 8, and the mixture is an unessentialmodification of an established remedy sodium salicylate rule10 -- from the journal a m a , sept 9, 1916 sulfuryl monal report of the council on pharmacy and chemistrysulfuryl monal is said to be manufactured by monal frères, manufacturing chemists of nancy, france it is sold in the unitedstates by george j wallau, inc , new york city according to the label. {contains. Sulfuryl combined polysulphurets { 0 35 centigr ” “each pastille { {liberates. Nascent sulphurretted hydrogen { 2 cub cent ”the chemical laboratory of the american medical association wasrequested to check the amount of available hydrogen sulphid anoriginal bottle of sulfuryl monal was used. This contained tabletshaving the taste of licorice extract and an odor of hydrogen sulphid the tablets were found to liberate about 6 c c hydrogen sulphid toeach tablet among the claims made for the preparation are. “dissolved by the saliva, sulfuryl monal reaches the stomach where, under the influence of the gastric juice, it generates nascent sulphuretted hydrogen professor albert robin remarkable researches have proven that it is in the nascent state that drugs produce the greatest effect with the smallest dose being thus eliminated by the entire respiratory tract.

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And also where there is respiratory interferencein the prolonged efforts of tedious labor and in convulsions liman755 found it in those who were hung it is due, according tohofmann, 756 to increased blood pressure and consequent hemorrhages it is of importance as tending to show that there was stasis of bloodin the head and face during life liman757 found cyanosis in theconjunctivæ, lips, back of mouth, and in the muscles maschka758in 234 paper of asphyxia found capillary hemorrhages of the eyes andeyelids 87 times dastre and morat759 pay for someone to write your essay claim that in asphyxia the cutaneous circulationbecomes more active than in the normal state, while at the same timethe vessels of the abdominal cavity are contracted laffont760considers the mechanism of this peripheral dilatation post-mortem stainings hypostases are usually darker in strangulationthan in other forms of death they appear soon, as does alsoputrefaction, because of the quantity and fluidity of the blood signs of hemorrhage from the nose, eyes, and mouth may be visible;as also bloody froth from the mouth and nose chevers761 never sawbleeding from the ears in strangulation taylor762 states that dr geoghegan informed him of a case of suicidal strangulation by a ribbon;the violence was great, there was bleeding from the ear, and the drumwas found ruptured in this case the mark on the neck, which was deep, nearly disappeared after the ligature was removed taylor also sayswilde, of dublin, saw a case of rupture of drum and hemorrhage instrangulation pellier763 says that littré mentions a case of ruptureof tympanic membrane in strangulation by a cord zoufal and hofmannhave offered explanations of the occurrence case 35 the face usually shows pain and suffering. Although essaytimes thefeatures are calm in the latter case there may have been syncope the eyes are usually staring, prominent, and congested, and the pupilsdilated casper764 doubts their prominence budin and coyne765state that in asphyxia the dilation of the pupil progresses to amaximum and then convulsions occur ophthalmoscopic examination duringthe dyspnœa of asphyxia shows a lessened fulness of the retinal vessels the tongue is often swollen, dark, protruding, and essaytimes bitten maschka766 states that if the ligature lies above the hyoid bone, thetongue will be drawn backward. If over or below the bone, the tip ofthe tongue may appear more or less between the jaws the hands are usually clinched and may have in their grasp articleswhich, under the circumstances, have a medico-legal value the external generative organs are essaytimes congested. Erection ofthe penis may have taken place and persisted the vagina may be moist tardieu, devergie, and casper767 deny that these appearances areusual involuntary discharges of urine, fæces, and seminal fluid may haveoccurred there is nothing characteristic in their appearance all the external appearances of asphyxia are usually more marked instrangulation than in hanging internal appearances - the mark usually there is hemorrhage into theloose connective tissue under the mark and in the subjacent muscles;in most paper isolated and circumscribed, but essaytimes extendingbeyond the line of the mark hemorrhage from compression by the fingersis more marked than that from ligature 768 essaytimes there is onlyfulness of the subcutaneous veins the carotid arteries may suffer rupture of their inner and middlecoats, especially in atheromatous subjects and when the compressionhas been great friedberg769 states that the injury of the carotid, if there is hemorrhage into its middle and internal coats, is a proofthat the strangulation occurred during life, and probably from pressureof the fingers on the neck, without any regard to any disease of theartery he reports two paper the examiner should be careful not toinjure the artery with his forceps the vessels may contain clots the neck occasionally suffers extreme injury, and, owing to theviolence used, this occurs oftener in strangulation than inhanging 770 occasionally the neck is broken the hyoid bone may be fractured see case 5 maschka771 saw one casein eighteen of erdrosselung and five paper in fifteen of erwürgen the trachea is essaytimes torn, or may be folded on itself the cartilages of the larynx, especially if calcareous, may befractured this is more likely to affect the thyroid than cricoid the fracture would appear to occur only as the result of enormousforce. Especially in the young in whom the cartilages are so elastic the experiments of keiller772 on cadavers led him to conclude thatfalls on the larynx, even from a height and with superadded force, areunlikely to fracture that organ.