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It helps the ricketsand worms in children, provokes urine, and gently without purgingdisburdens the body of choler and flegm. It succours the lungs, opensobstructions, and resists putrifaction of blood gums are either temperate, as, lacca, elemi, tragacanth, &c intemperate, and so are hot in the first degree, as bdellium, gumof ivy in the second, galbanum, myrrh, mastich, frankincense, olibanum, pitch, rozin, styrax in the third amoniacum in the fourth euphorbium gum arabick is cold colophonia and styrax soften gum arabick and tragacanth, sandarack or juniper gum, and sarcocollabind gum of cherry trees, breaks the stone styrax provokes the menses opopanax gently purges flegm from the prickly cedar when it is burned comes forth that which, withus, is usually known by the name of tar, and is excellently good forunction either for scabs, itch, or manginess, either in men or beasts, as also against the leprosy, tetters, ringworms, and scald heads all sorts of rozins fill up hollow ulcers, and relieve the body sorepressed with cold griefs the rozin of pitch-tree, is that which is commonly called burgundypitch, and is essaything hotter and sharper than the former, beingspread upon a cloth is excellently good for old aches coming of formerbruises or dislocations pitch mollifies hard swellings, and brings boils and sores tosuppuration, it breaks carbuncles, disperses aposthumes, cleansesulcers of corruption and fills them with flesh bdellium heats and mollifies, and that very temperately, being mixedwith any convenient ointment or plaister, it helps kernels in the neckand throat, scrophula, or that disease which was called the kingevil inwardly taken in any convenient medicine, it provokes themenses, and breaks the stone, it helps coughs and bitings of venomousbeasts. It helps windiness of the spleen, and pains in the sides thencecoming both outwardly applied to the place and inwardly taken, ithelps ruptures or such as are burst, it softens the hardness of thewomb, dries up the moisture thereof and expels the dead child bitumen jadaicum is a certain dry pitch which the dead sea, or lakeof sodom in india casts forth at certain times, the inhabitantsthereabouts pitch their ships with it it is of excellent use tomollify the hardness of swellings and discuss them, as also againstinflammations. The smoke of it burnt is excellently good for the fitsof the mother, and the falling-sickness. Inwardly taken in wineit provokes the menses, helps the bitings of venomous beasts, anddissolves congealed blood in the body ambergreese is hot and dry in the second degree, i will not disputewhether it be a gum or not.

At last when you conceive it strong enough, boil both herbsand oil together, till the juice be consumed, which you may know by itsbubbling, and the herbs will be crisp. Then strain it while it is hot, and keep it in a stone or glass vessel for your use 6 as for chymical oils, i have nothing to say here 7 the general use of these oils, is for pains in the limbs, roughnessof the skin, the itch, &c as also for ointments and plaisters 8 if you have occasion to use it for wounds or ulcers, in two ouncesof oil, dissolve half an ounce of turpentine, the heat of the firewill quickly do it. For oil itself is offensive to wounds, and theturpentine qualifies it chapter vi of electuaries physicians make more a quoil than needs by half, about electuaries i shall prescribe but one general way of making them up. As foringredients, you may vary them as you please, and as you findoccasion, by the last chapter 1 that you may make electuaries when you need them, it is requisitethat you keep always herbs, roots, flowers, seeds, &c ready dried inyour house, that so you may be in a readiness to beat them into powderwhen you need them 2 it is better to keep them whole than beaten. For being beaten, they are more subject to lose their strength. Because the air soonpenetrates them 3 if they be not dry enough to beat into powder when you need them, dry them by a gentle fire till they are so 4 having beaten them, sift them through a fine tiffany searce, that nogreat pieces may be found in your electuary 5 to one ounce of your powder add three ounces of clarified honey;this quantity i hold to be sufficient if you would make more or lesselectuary, vary your proportion accordingly 6 mix them well together in a mortar, and take this for a truth, youcannot mix them too much 7 the way to clarify honey, is to set it over the fire in a convenientvessel, till the scum rise, and when the scum is taken off, it isclarified 8 the usual dose of cordial electuaries, is from half a dram to twodrams. Of purging electuaries, from half an ounce to an ounce 9 the manner of keeping them is in a pot 10 the time of taking them, is either in a morning fasting, andfasting an hour after them. Or at night going to bed, three or fourhours after supper chapter vii of conserves 1 the way of making conserves is two-fold, one of herbs and flowers, and the other of fruits 2 conserves of herbs and flowers, are thus made. If you make yourconserves of herbs, as of scurvy-grass, wormwood, rue, and the like, take only the leaves and tender tops for you may beat your heart outbefore you can beat the stalks small and having beaten them, weighthem, and to every pound of them add three pounds of sugar, you cannotbeat them too much 3 conserves of fruits, as of barberries, sloes and the like, is thusmade. First, scald the fruit, then rub the pulp through a thick hairsieve made for the purpose, called a pulping sieve. You may do it for aneed with the back of a spoon. Then take this pulp thus drawn, and addto it its weight of sugar, and no more. Put it into a pewter vessel, and over a charcoal fire. Stir it up and down till the sugar be melted, and your conserve is made 4 thus you have the way of making conserves.

Hot and dry in the thirddegree, helps the bitings of venomous beasts, such as have taken opium, hemlock, pay someone to do my report for university or poppy. Provokes urine, brings down the menses, helps oldcoughs. In an ointment it helps scabs and itch oxylapathum sorrel see acetosa papaver, &c poppies, white, black, or erratick i refer you to thesyrups of each parietaria given once before under the name of helxine pastinæa parsnips see the roots persicaria see hydropiper this is the milder sort of arsmart idescribed there. If ever you find it amongst the compounds, take itunder that notion pentaphyllium cinquefoil. Very drying, yet but meanly hot, if atall. Helps ulcers in the mouth, roughness of the wind-pipe whencecomes hoarsness and coughs, &c helps fluxes, creeping ulcers, andthe yellow jaundice.

Iodin gr 1 bromin gr 1/4 phosphorus gr 1/100 thymol gr 2/3 menthol gr 2/3 sterilized oil gr 1the only statement regarding its method pay someone to do my report for university of preparation is the line“solution in cod liver oil, norwegian ” according to the promoters, “bromin-iodin” is. “a powerful anti-tubercular agent for hypodermic use in pulmonary and laryngeal tuberculosis useful in other forms of tubercular diseases, and in non-tubercular pulmonary diseases of a sub-acute or chronic nature ”the “formula, ” in the form in which the manufacturers publish it, iseither impossible or meaningless, according to the interpretation thatmay be given it is impossible if it is intended to indicate the actualcomposition of the product because that would mean that the oil isalleged to contain free or uncombined iodin, bromin and phosphorus both on theoretical grounds and also in the light of the findings ofthe chemical laboratory of the american medical association, it isnot possible that all these constituents can be present in the freestate the formula is meaningless if it is intended to convey the idea, merely, that iodin, bromin, phosphorus, thymol, menthol and sterilizedoil are combined to form “bromin-iodin ” in the absence of any detailsof the method of manufacture, it is futile to attempt to pass judgmenton the actual composition of the preparation the use of an almost identical product said, however, to containonly 1/2 grain iodin to each fluidram was described in 1908 by dr ingraham of binghamton, n y , in “five years successful experiencewith a special mode of treating pulmonary tuberculosis ” in 1910 thejournal1 characterized the preparation as “one of the innumerable‘treatments’ for pulmonary tuberculosis that have arisen, had theirday and, more or less gracefully, retired ” if the preparation hadvalue for the purpose for which it is recommended, its use during thesetwelve years should have secured its general recognition there is nosatisfactory evidence of its therapeutic efficacy the council refusedrecognition to bromin-iodin comp and, after submitting this report tothe bromin-iodin chemical company, authorized its publication -- fromthe journal a m a , dec 23, 1916 ammonium hypophosphite omitted from n n r report of the council on pharmacy and chemistryammonium hypophosphite was admitted to new and nonofficial remediesin 1908 as a preliminary step in the consideration of a preparationcontaining it-- “gardner syrup of ammonium hypophosphite”-- becausethe council standardizes unofficial products before consideringpreparations or mixtures of these the therapeutic use of hypophosphites being irrational see, “thehypophosphite fallacy, ” report of the council on pharmacy andchemistry, the journal, sept 2, 1916, p 760, the salt, ammoniumhypophosphite, deserves continued recognition only on condition thatthis salt of ammonium is superior to other salts from which may beobtained the effect of the ammonium radical it has been claimed thatammonium hypophosphite has a less objectionable taste than otherammonium salts used for similar purposes this claim would meritserious consideration if in addition to being less objectionable tothe taste, the effects of ammonium hypophosphite were equal to or moredesirable than the official ammonium salts there is no evidence thatthis condition is met by the hypophosphite salt ammonium hypophosphite has long been known, yet it is not officialin the austrian, belgian, british, french, german, hungarian, italian, swedish, swiss or united states pharmacopeias neither is itmentioned in the leading textbooks on materia medica, pharmacology ortherapeutics in short it appears to be an instance of an obscure andsuperfluous salt selected for proprietary exploitation since the continued recognition of ammonium hypophosphite would tend toperpetuate the hypophosphite fallacy, and because there is no evidencesupporting its advantage as a means of securing the effect of ammoniumsalts the council directed its omission from new and nonofficialremedies -- from reports of council on pharmacy and chemistry, 1916, p 51 alphozone omitted from n n r report of the council on pharmacy and chemistrythe following advertisement appeared in the new idea september, 1916, a house organ of frederick stearns & co , the proprietors ofalphozone:illustrationin the light of our present knowledge the claim that alphozone is apreventive of infantile paralysis is without warrant and the advicethat the public depend on it for this purpose is reprehensible anddangerous therefore, the council directed that alphozone be omittedfrom new and nonofficial remedies -- from reports of council onpharmacy and chemistry, 1916, p 50 calcium glycerophosphate and sodium glycerophosphate omitted from n n r report of the council on pharmacy and chemistrycalcium glycerophosphate and sodium glycerophosphate were acceptedfor new and nonofficial remedies chiefly in order that these productsmight be standardized these mixtures now being defined in the newedition of the u s pharmacopeia, this reason for including themin n n r no longer exists the report of marshall the journal, feb 13, 1915, p 573 which has the endorsement of the council thejournal, sept 30, 1916, p 1033 shows that organic phosphoruscompounds are split up into inorganic phosphates before absorption, that the animal organism can synthesize its complex organic phosphorusconstituents from inorganic phosphates and consequently that theglycerophosphates, so far as their phosphorus value is concerned, arenot superior to other phosphates in fact, sodium and phosphate aremore effectively administered as neutral or acid phosphate it isevident that sodium glycerophosphate is a superfluous pharmaceuticalpreparation, writingicularly when the difficulty of obtaining a pureproduct and its high price is considered so far as its calcium valueis concerned, calcium glycerophosphate has no advantages over suchcalcium salts as the carbonate, phosphate, lactate, or chlorid in viewof the foregoing, the council directed that sodium glycerophosphateand calcium glycerophosphate be omitted from new and nonofficialremedies -- from reports of council on pharmacy and chemistry, 1916, p 52 gardner syrup of ammonium hypophosphite omitted from n n r report of the council on pharmacy and chemistryin recognition of the considerable revision of the therapeutic claimsmade by the manufacturer, gardner syrup of ammonium hypophosphitewas retained in new and nonofficial remedies, 1916, and the proprietoradvised of this provisional retention in the most recent advertising for this ammonium hypophosphite syrupthe claim is made. “besides being an active expectorant syrup of ammonium hypophosphite gardner is useful as an alterative and resolvent and by virtue of its phosphorus element, which is in the form of a hypophosphite, ph₂o₂, has a tonic value ”as detailed in the report of the council “the hypophosphite fallacy” the journal, a m a , sept 2, 1916, p 760 careful studies showthat the hypophosphites are devoid of the “alterative” and “tonic”actions claimed by the manufacturer of gardner syrup of ammoniumhypophosphite accordingly the council voted to omit gardner syrup ofammonium hypophosphite from new and nonofficial remedies and authorizedpublication of this report -- from reports of council on pharmacy andchemistry, 1916, p 55 gluten products made by the kellogg food company report of the council on pharmacy and chemistryfor over two years the council has had under consideration certainproducts offered for the use of diabetics by the kellogg food companyof battle creek, mich these are. Pure gluten biscuit pure gluten meal 40 per cent gluten biscuit 40 per cent gluten flour 40 per cent gluten meal 20 per cent gluten meal the council found these products ineligible for new and nonofficialremedies because the statements of composition writingicularly of starchcontent were insufficient and because the exploitation of the productsto the laity was objectionable june 21, 1915, the company promised toplace a statement of the starch content on the package of each glutenproduct, to place on the gluten flour sacks a caution that diabeticsuse the flour only on the advice of their physicians, and to revise itsadvertising in accordance with the suggestions of the council nothingfurther having been heard from the company, in april, 1916, specimensof the product were obtained, through a layman, direct from thekellogg food company these specimens, together with the advertisingmatter received at the same time, and also a letter of advice from thecompany to another layman, were sent to the council referee, whosereport follows as will be seen, the referee finds that the amountsof carbohydrates contained in pure gluten flour, 40 per cent glutenflour and pure gluten meal are greater than the amounts claimed inthe company published analyses. That in the two first mentioned theamounts of protein are less than the amounts claimed. That exaggeratedclaims are made on all the labels and in the advertising literature, and that the company prescribes directly to the patient the following report was sent to the kellogg food company forconsideration in reply the firm stated that a revision of itsadvertising was under consideration but would make no statementas to how soon this revision would be carried into effect as theconsideration had already consumed two years, the council decided togive the profession the facts and authorized publication of the report at the same time the kellogg food company was advised that its productswould be considered further whenever any submitted evidence warrantedthis w a puckner, secretary referee reporti submit herewith my report on certain foods offered by the kelloggfood company for the use of diabetics i shall discuss these productsfrom the standpoint of the claims made on the label, from thestandpoint of the company toward nonmedical treatment as revealed in aletter to a layman, and lastly, on the basis of the claims made for thefoods in the company literature claims made on the label pure gluten biscuit referee company water 8 30 5-10 ash 2 04 1-2 protein n × 5 7 73 87 75-80 fiber 0 12 2 4-3 carbohydrates 14 84 0-5 fat 0 81 0 25-0 70 starch 4 02 0-5the sample analyzed does not contain the amount of protein claimedfor it it also contains more starch than one might suspect from thecompany analysis a more conservative claim would be “starch lessthan 5 per cent ” the company makes the error of using the terms“starch” and “carbohydrates” as synonymous if the maximum figures ofthe company analysis are used, the carbohydrates would amount to5 per cent , whereas i find 14 84 per cent the claim on the label“guaranteed to contain less than 5 per cent of carbohydrates” isincorrect the next claim, “each ounce of this gluten contains 23 gramsof protein and represents 95 calories” is approximately correct, as myanalysis shows 20 9 grams of protein and 103 calories the following remarks under “vegetable proteins” are in my judgmentexaggerated. “leading authorities are now agreed that meat, fish, eggs and other animal proteins are greatly inferior to vegetable proteins in diabetes, often increasing the sugar output and the dangerous acidosis which leads to diabetic coma after thesis years of experimentation, we have succeeded in perfecting a process whereby the carbohydrates are excluded ”in this connection, von noorden, whom the company constantly quotes, says. “in the slighter forms of diabetes, the influence of meat albumins is not great and it is difficult to demonstrate the reaction of the patient to different forms of albumin it may be necessary to add more albumin than the patient can actually take before glycosuria indication is reacted once a medium amount of albumin is exceeded, say 70 to 80 grams, the glycosuria increases, no matter what the type of albumin is ”my analysis also shows that the carbohydrates are not excluded fromthis food as claimed above 40 per cent gluten biscuit referee water 8 50 ash 1 48 protein n × 5 7 41 15 fiber 0 08 carbohydrates 47 81 fat 0 98 starch 36 98no analysis is supplied by the company, but this may be called properlya “40 per cent gluten biscuit ” the company claims, however, that thisis “best for diabetics, ” which is not true here, as in the case of “40 per cent gluten flour, ” the companylabel attributes to “dr wm osler in ‘practice of medicine, ’” thefollowing quotation. “of gluten foods, thesis are very unpalatable, others are frauds a good gluten flour is made by the battle creeksanatarium co , mich ” i have no way of knowing to which gluten flourof the company dr osler had reference the “pure gluten meal” might becalled properly a “good gluten flour, ” but this “40 per cent glutenflour” is no better, and no worse, than the average gluten flour on themarket the quotation from osler gives an entirely false impression 40 per cent gluten flour referee company water 8 62 5-10 ash 0 89 0 5-1 protein n × 5 7 33 63 40-45 fiber 0 08 1-3 carbohydrates 55 35 40-45 fat 1 43 0 2-0 5 starch 48 04 my analysis shows 6 37 per cent less protein than the companyminimum, and 10 35 more carbohydrates than their maximum in past yearsi have found the protein in this brand to range from 35 0 to 42 9 percent using the factor 5 7 it is true that the manufacturer doesnot state what protein factor is used in his reported analysis, but asin four other brands 5 7 is used, it is fair to assume that the samefactor applies to this as well at least such should be the case, asotherwise the manufacturer analyses would be meaningless even usingthe factor 6 25 this later sample contains only 36 88 per cent ofprotein the following statement, in my judgment, as applied to a foodcontaining over 48 per cent of starch, does not hold water. “thisfood is of special service in paper of glycosuria and in the milderforms of diabetes ” with this brand as with “40 per cent glutenbiscuit” the manufacturer again uses the misleading quotation fromosler 40 per cent gluten meal referee company water 7 30 5-10 ash 1 36 1-2 protein n × 5 7 41 55 40-45 fiber 0 10 1-2 carbohydrates 48 58 40-45 fat 1 11 0 2-0 5 starch 36 59 40-45the claimed analysis is justified by my findings i must takeexception, however, to the following statement. “prepared with greatcare from a good grade of spring wheat, by our special process, whichpreserves the natural food properties of the product ” the companyevidently tries to carry water on both shoulders, on the one handclaiming a reduction in the starch content, while on the other claimingthe preservation of all “the natural food properties ”20 per cent gluten meal referee company water 7 65 5-10 ash 1 22 1-2 protein n × 5 7 24 68 20-30 fiber 0 12 1-2 carbohydrates 65 41 65-70 fat 0 92 1-2 starch 51 24 65-70the company analysis is confirmed as the company claims directlythat this is “not a diabetic food, ” any criticism of its use forthat purpose is disarmed however, again exception must be taken tothe statement that “the natural food properties of the product” arepreserved pure gluten meal referee company water 4 60 5-10 ash 0 96 1-2 protein n × 5 7 76 78 75-80 fiber 0 08 1-3 carbohydrates 16 77 0-5 fat 0 81 0 25-0 70 starch 6 77 0-5the minimum claim as to protein is justified again the companyconfuses carbohydrates and starch, and the food instead of containingfrom 0 to 5 per cent of “carbohydrates starch” actually contains16 77 per cent of carbohydrates, of which 6 77 per cent is starch once more the statement that “the natural food properties” arepreserved is untrue as applied to a wheat product deprived of most ofits starch in justice to the company, it should be noted that on the labels of“pure gluten biscuit” and “pure gluten meal” appears the warning:“every person suffering from diabetes should be under the care ofan experienced physician, ” and on the label of “40 per cent glutenmeal, ” “persons suffering from diabetes should use this food only onthe advice of a physician ” on the other hand, the suggestion on thelabel of “pure gluten meal, ” “write for a copy of diabetic foods andhow to use them” is a more or less direct invitation to self-treatment moreover, a letter dated may 9, 1916, apparently dictated for thekellogg food company by one ruth french, in reply to an inquiry from alayman, gives direct advice with no reference whatever to a physician claims made in a letter to a laymanin addition to this inconsistent attitude the letter makes certainclear misstatements, as follows:“40 per cent gluten flour actually contains 40 per cent of puregluten, making it a perfectly safe article of diet in all but thegravest paper of diabetes from our gluten flour excellent bread, gemsand puffs are made that perfectly satisfy the craving for bread with noharmful results ” this flour contains 33 63 per cent of gluten, not 40per cent. It is not “a perfectly safe article of diet in all but thegravest paper of diabetes, ” for if one reads the literature correctly, starch restriction is more necessary in mild than in severe paper ofdiabetes furthermore, the bread, gems and puffs made from such a flourdo not “satisfy the craving for bread with no harmful results ”in the next paragraph of the letter, undue emphasis is laid on the“objectionable properties” of flesh foods, a statement only in accordwith the tenets of extreme vegetarians i also doubt very much whetherthe statement is true that “under a diet of our diabetic foods thethirst to which diabetics are so often subject is usually very muchrelieved ”in the next paragraph the assertion is made that “the diet indicated is in keeping with the ideas of the highest medical authorities meat is entirely excluded from the dietary ” my reading of theliterature does not show that the leading authorities take any suchposition later on reference is made to von noorden claim as to thesuperiority of vegetable over animal proteins, which i have alreadydiscussed under “pure gluten biscuit ” certain detached sentences ofvon noorden might justify such a statement, but a reading of all hesays on the subject leads to a very different conclusion claims made in an advertising bookletthe whole booklet is written from the standpoint of an extremevegetarian, and therefore is often misleading in its conclusions page 5 “the researches of ogata and others have shown that cane sugaris a less wholeessay food than the natural sugars found in fruits andproduced in the body by the digestion of starch, that is, fruit sugarsand malt sugars ” in opposition to this i quote from von noorden, theirown authority, “die zuckerkrankheit und ihre behandlung, ” berlin, 1910, page 270:“that levulose, milk sugar and inulin are more useful than the othercarbohydrates is a common opinion, but the importance of their use inpractice does not correspond with the theory in light paper the formof carbohydrates makes little difference. In severe paper the advantagefrom using levulose, milk sugar, etc , is only slightly greater thanfrom using bread and flour only in certain paper does it appearto me that the special form of carbohydrates possesses any writingicularsignificance ”on page 92 of the same work von noorden tells us that of thecarbohydrates dextrose is the worst, with maltose almost as bad inspite of the fact that kellogg exploits his “meltose, ” the “newcarbohydrate, ” as of special value for diabetics he also says thatlevulose increases glycosuria only about half as much as dextrose, when used occasionally, but with long use it is as bad as dextrose andstarch page 5 the company refers to sugar as “possibly also causingdiabetes ” sugar or any other carbohydrate may under diabeticconditions cause an increase of glucose in the urine, but i do notbelieve that any food or any diet can cause diabetes page 7 “that the large use of meat and eggs is not only detrimentalbut positively dangerous in thesis paper of diabetes is now a well knownand recognized fact ” the dietaries of well known authorities ondiabetes are not in harmony with this statement page 13 “it has been discovered that the complete suppressionof carbohydrates from the dietary is not only unnecessary but ishighly detrimental and even dangerous ” “the complete suppression ofcarbohydrates from the dietary” is the only means the physician has todetermine the diabetic carbohydrate tolerance if carbohydrate-poorfoods are so “highly detrimental and even dangerous, ” why does thecompany exploit foods like “pure gluten flour” and “pure glutenbiscuit, ” whose chief claim to excellence is their comparative freedomfrom carbohydrates?.

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Has a bone ever been fractured?. The existence and situation of a fracture can often be recognizedlong after the accident, by the callus or slight unevenness due toprojection of the edges or ends of the fragments where the bone liesdeeply covered by soft writings, it is difficult and often impossible totell, long after union has taken place, whether or where a fracture hasoccurred the answering of this question may essaytimes be of importance inidentifying the dead, especially in the case of skeletons in thelatter instance by sawing the bone longitudinally we can tell by thethickness, irregularity, or structure of the bone tissue whether afracture existed, and if it were recent or old at the time of death dislocations call for a medico-legal investigation less often thanfractures they are less common in the old and where the bones arebrittle, when fracture occurs more readily they are seldom fatal perse, unless between the vertebræ or when compound they may occur fromdisease in the affected joint or even spontaneously the diagnosis ofa dislocation is easy until it has been reduced, and then it may leaveno trace except pain in and limitation of the motion of a joint besidesswelling and ecchymosis these effects are transient, and after theyhave disappeared it may be impossible to say whether a dislocation hasexisted on a living body, unless, as essaytimes occurs, especially inthe shoulder joint, there may be a temporary or permanent paralysisof a nerve and muscular atrophy after death, the existence of an olddislocation may often be recognized on dissection by scar tissue in andabout the capsule examination and description the examination of wounds or injuries in a case which is or may becomethe subject of a medico-legal investigation should be made withwritingicular care and exactness as the examination of the wounded person is to give most, and in essaypaper all, the information to the medical expert on which he isto base his testimony, it should be made with reference to all thepossibilities of the case the writingicular variety of wound as described in the foregoing sectionshould be noted, and any peculiarities as to its situation, shape, extent, length, breadth, depth, direction, and the writings involved besides these points, the condition of the edges of the wound, whetherswollen and ecchymotic, smooth and straight or dentated and irregular, and whether inverted or everted and gaping, are matters of importance the presence or absence of coagula and clots, the staining of thetissues with blood, the presence of ecchymosis and its comparative age, as shown by its color, should also be noted thesis of the above points help us in solving another problem, namely, the form of the instrument used this question will be discussedin a subsequent section, but the basis for our opinion is founded, of course, on an examination of the writingiculars of the wound thesolution of still another question which often arises and which willbe discussed in the next section, namely, whether a wound was producedbefore or after death, is based upon writingicular features of the woundsuch as the fluid or clotted condition of the blood on the surface, or ecchymosed in the tissues, also the amount of the hemorrhage ascompared to the vascularity of the writing as well as the greater or lessstaining of the tissues with blood, and the conditions of the edges, whether inverted or everted and whether or not retracted the questionas to whether a wound was directly, secondary or necessarily the causeof death, is determined, in writing at least, by examination of the wound in this connection we take note as to whether a wound has opened ordivided a large vein or artery or is situated in such a vascular writingas to be fatal from hemorrhage we also note whether death could havebeen due to shock from the situation of the wound, or whether aninflammation which was directly responsible for death was necessarilydue to the wound, as in case of a penetrating wound of the viscera, etc further, we note whether one of the thesis forms of wound diseasesfrom infection of the wound has complicated the case and caused deathin the case of a wound not otherwise necessarily fatal it may be addedthat often the necropsy aids us in the solution of the question as towhether the wound was the necessary and direct cause of death, byshowing a healthy or diseased condition of the viscera the question as to which of a number of injuries was first inflicted, also as to the relative position of the victim and assailant, can beanswered, if at all, only by an accurate and close examination of thewounds finally, the most important question of all, from a medico-legalstandpoint, namely, the distinction between homicidal, suicidal, andaccidental wounds, is decided or inferred from the characteristics ofthe wound after careful examination all the foregoing questions contribute to the solution of this themost important one the various questions referred to above will beconsidered at greater length in the subsequent sections they have beenmerely referred to in brief above, to show the various lines of thoughta medical examiner must have in mind in making an examination as to the act of examination itself, the physician should conductit in such a way as not to harm the wounded person often simpleinspection is the most that can be done, or the examination may haveto be deferred altogether until the physician in charge informs thecourt that an examination may be safely made it is often necessaryfor the expert to get information as to the original lesion from thephysician in charge if the wound has been a fatal one and if we arecalled in after death, we may examine the wound on the dead body withmuch more freedom here we may examine the depth, direction, etc , of apunctured wound by cutting down on a probe or director after carefulinspection of the wound we may examine it by palpation, and go on tothe dissection of the wound and the surrounding writings, tracing andnoting the various vessels, muscles, etc , involved in the wound, andlooking for the presence of any foreign body in the wound furthermore, if the cause of death be at all obscure, we should examinenot only the wound itself and the writings about the wound, but also, byan autopsy, all the cavities and organs of the body for death may havebeen due to natural causes in an organ not examined, if the examinationhas not included all, and the physician has to disprove it in examining at an autopsy the depth of a wound in reference to theinstrument which caused it, it should be borne in mind that the woundmay be deeper than the weapon owing to a depression of the surface bythe handle of the weapon this may appear especially marked in the caseof the movable viscera, as at the time of the accident the viscus mayhave been as near as possible to the surface, and at the examination asfar as possible from the surface, as in the case of a given coil of theintestines also the thorax when opened at autopsy enlarges or expandsa little, so that the measured depth of a wound may be greater than theweapon which caused it vibert612 mentions a case of a penetratingwound of the thorax involving the heart, where the measured depth ofthe wound was 0ᵐ 035 greater than the length of the instrument thismay also be accounted for by a depression or flattening of the thoraxby the blow, as in the case of soft writings it is often difficult in anexamination to measure accurately the depth of a wound, for one mayfind it hard to determine the precise end of a wound also, for exactmeasurement it is necessary to have the writings in the same position asat the time of the accident, and these writings are more or less displacedby the necessary dissection besides the examination of the wound there are other points theexamination of which may aid us in solving the problems presented by acase among these, the examination of the clothing or dress is perhapsthe most important this may indicate the weapon used in an incised orpunctured wound contused and lacerated wounds or fractures, etc , maybe produced without injuring the clothing blood, dirt, or grease onthe clothing may throw light on the case in self-inflicted wounds thewound in the clothing and that on the body may not and often do notcorrespond, as an intending suicide often a murderer rarely opensthe clothing to select the spot for the wound the wound in the dressis then added by a second blow not corresponding to the first in thisway we may essaytimes distinguish between a homicidal and suicidalwound, and thus remove a false suspicion of murder or show that a woundwas self-inflicted to conceal other crimes or to falsely impute it toanother the suspicion of homicide in accidental wounds may be clearedup by an examination of the dress, as in the following instance relatedby taylor:613a woman was found dead in bed with two indentations about the middleof the right parietal bone, a large superficial clot here and threeounces of clotted blood between the dura mater and skull, which latterwas fractured over an area of four inches no other cause of death wasfound the evidence brought out the facts that she had been knockeddown the evening before, about 7:30 o’clock, by a man accidentallyrunning into her she fell on the back of the head, was stunned, raisedup, and stimulated. She then walked home, ate her supper, and waslast seen at 9 o’clock by a fellow-lodger who let her in and noticednothing unusual the next morning she had evidently been dead essaytime suspicion fell upon the lodger, who had often quarrelled withher, and the two claws of a hammer found in his room corresponded moreor less closely with the two indentations found in the skull at theadjourned inquest, however, the bonnet worn by the deceased at thetime of the accident was found to have two indentations on the back ofit corresponding to those on the woman skull and containing dust anddirt, and rendering probable what from the history seemed unlikely, that the fall in the road caused the fatal injury the examination ofthe dress thus avoided an unjust accusation of murder contused and lacerated wounds and fractures or dislocations may beproduced without injury to the dress, especially if the latter beelastic or yielding the comparison of the wound in the clothes withthat on the body may indicate the position of the body at the time ofthe blow the examination of the clothes of the injured person mayindicate a struggle which would support the idea of homicide a bluntinstrument may indirectly cause an injury by striking essaything in oron a person clothes instances have been reported where a wound hasbeen caused by an article in the pocket, or worn outside the clothing, without any trace of an injury to the clothes or pocket lining 614the examination of the dress may further show which of several cuts orstabs was first inflicted this is shown by the staining of the edgesof the cuts in the clothing, the edges of the first cut or stab showingno blood-stain or only on the inner surface, as the knife is cleanof blood on entering and all that is removed by the clothing on itswithdrawal is found on the inner edges if the edges of the cuts in theouter layers of clothing are bloody, it is evident that the knife wasalready bloody when used, and the corresponding wound was not the firstinflicted the imprint of the bloody hand of the assailant may essaytimes be foundon the clothing of the one injured, and is especially important asevidence, when the hands of the assaulted are not bloody in the caseof a severe wound, especially if it is likely to become the object of acriminal investigation, the physician should always require to see thedress of the wounded the examination of the clothing which the accusedwore at the time the assault took place may give important evidence byshowing evidences of a struggle or blood-stains absence of the latterwould not prove the innocence of the accused, as the clothes actuallyworn may be destroyed and others substituted, or the marks and stainsmay be removed in the latter case, the eye of a medical man may detecttraces of blood which otherwise would go unnoticed, and a microscopicaland chemical examination would reveal the real character of the stain besides the examination of the clothing of the accused, the examinationof his person may furnish evidence of his being engaged in a more orless desperate struggle by the scratches, marks of nails, contusions, bites, etc , on the face, neck, front of chest, forearms, and hands if the accused should attempt to explain these wounds and spots, thelatter may or may not verify the explanation, and thus additionalevidence may be obtained as to the guilt or innocence of the accused it is well for the medical expert, as well as for others, to collectthe statements of the wounded person relative to the circumstances ofthe injury also, if the accused will vouchsafe any such statements wemay compare these with one another and with the facts indicated by thewound, etc other points to examine, especially in paper of suspected suicide, may be briefly mentioned the presence of the weapon in the hand ofthe victim and firmly grasped in general indicates suicide, if itcorresponds to the weapon causing the wounds, for otherwise it mayhave been used for defence if not in the hand, note the spot wherethe weapon was found in the case of a suicide, the hand as well asthe weapon held by it is likely to be bloody, also in case of murderthe generally empty hand is apt to be bloody, as the hand is naturallycarried to the wound we cannot further describe the thesis points which the medical examinershould bear in mind in making an examination in a medico-legal case, without repeating too fully what will be given at greater length insubsequent sections, reference to which should be made for furtherwritingiculars tardieu proposed as a basis for examining and studyingwounds, 1 to visit the wounded person and see what state he is in, and to determine 2 the nature, 3 the cause, 4 the consequencesof the wound also if the wounded person is dead 5 to examine thebody for the cause of death in order to see if the latter is due to thewound also 6 to determine the circumstances of the affray the description of a wound should be given in plain language, avoiding the use of scientific terms or expressions, so as to bereadily understood by judge and jurors otherwise the usefulness of themedical expert is very much decreased the description should also beprecise and sufficient to justify the conclusions arrived at as to thecause of a wound, its gravity and results, and the weapon used witha view to exact statement in description, it is well to take notes asto the result of the examination and not depend merely on memory theobject of the witness should be to be understood and not to be thoughtthoroughly scientific was the injury inflicted before or after death?. This is a question which may often be asked in paper of fatal injuries, and it is one which must be answered as definitely as we are able, forthe defence may rest on the assertion that the wound or injury was postmortem and not ante mortem what are the means we have to enable us toanswer the above question?. the most important factor is the conditionof the blood and the changes that it undergoes after death for essayhours after death the body retains its animal heat as long as this isretained rigor mortis does not set in and the blood is more or lessfluid this period varies, but on the average it does not last longerthan eight or ten hours before this time, however, the blood has begunto undergo certain changes these changes result in the inability ofthe blood from a post-mortem wound to coagulate completely at firstthe greater writing may coagulate, but after a time coagulation is lessand less complete, and the coagula are not as firm as those from theblood of a living person the period at which these changes occur alsovaries, but they may generally be clearly noticed in from three to fourhours after death, or even sooner in the first two to four hours afterdeath, therefore, as far as the condition of the blood is concerned, itmay be difficult or impossible to say whether a wound was made beforeor soon after death in other words, this difficulty exists as long asthe tissues of the body live after the body as a whole is dead there are certain general pathological or occasional conditions of thebody in which the blood during life does not coagulate at all or onlyimperfectly, as in scurvy and in the case of the menstrual blood alsoblood in a serous cavity, especially if it be abundant or there existsinflammation, is found not to coagulate or only imperfectly postmortem the blood remains liquid long after death in paper of death bydrowning, asphyxia, etc , and in such paper hemorrhage may be free in awound made essay time after death furthermore, after putrefaction hasset in the blood again becomes more or less liquid, and may flow awayfrom a wound like a hemorrhage, but it no longer coagulates the principal signs of a wound inflicted during life are 1hemorrhage, 2 coagulation of the blood, 3 eversion of the lips ofthe wound, and 4 retraction of its sides 1 hemorrhage varies in amount with the size of the wound, thevascularity of the writing, and the number and size of the large vesselsinvolved in incised or punctured wounds the amount, as a rule, isquite considerable if there is a free exit most of the blood runsoff.