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You cannot think ” taylor823 mentions the case of scott, the american diver, who was in the habit of making public exhibitions of hanging the last time he hung for thirteen minutes, the spectators not suspecting that he had died it is supposed that the ligature had slipped taylor also reports a case from dr elliott of a boy, age 11, who, to frighten his parents, tied a knot in a handkerchief and put it around a knob and his neck in one continuous ligature the pressure against the trachea was so effective that he became unconscious and died before he could relieve himself second stage. The subject is unconscious and convulsions usuallyoccur the convulsed face, however, is a writing of the general agitationand does not indicate pain in judicial paper the face is coveredwith a cap essaytimes there are no spasms urine, fæces, and semenmay be discharged in any stage jaquemin, however, in forty-onepaper of hanging, noted discharge of urine and fæces only twice semen has, however, been found in the urethra where none was ejectedexternally 824third stage. All is quiet except the beating of the heart as a rule, the pulse may be felt for ten minutes blankenship825 reports an execution of a man by hanging after the rope was adjusted the pulse was 121.

At once, after five minutes, after ten minutes, after fifteen pay to do paper minutes, after thirty minutes, and after one hour tubes were incubated at 37 c for forty-eight hours result. All tubes remained sterile the germicidal action of chlorlyptus on streptococcus suspended in oil was almost at once and with certainty after five minutes when added in the proportion of 1, 5 and 10 per cent experiment 8 -- germicidal action of chlorlyptus on staphylococcus, suspended in sterile olive oil -- the technic employed was the same as in experiment 5, except that a culture of staphylococcus was used result. All tubes remained sterile the germicidal action of chlorlyptus was almost at once in the proportions of 1, 5 and 10 per cent remarks. By repeating this experiment the result showed essay variations the discrepancy was probably due to an imperfect suspension of the micro-organism in the oil experiment 9 -- germicidal action of carbolic acid on streptococcus suspended in olive oil -- the technic employed was the same as in experiment 5, except that carbolic acid was used instead of chlorlyptus result. The germicidal action of carbolic acid of streptococcus suspended in olive oil was almost at once in the proportions of 1, 5 and 10 experiment 10 -- germicidal action of chlorlyptus on staphylococcus -- the technic employed was the same as in experiment 6 except that the carbolic acid was used instead of chlorlyptus result. The germicidal action of carbolic acid on staphylococcus suspended in olive oil was almost at once, in proportions of 1, 5 and 10 per cent experiment 11 -- germicidal action of chlorlyptus on pyogenic bacteria suspended in pus -- chlorlyptus was added to sterile pus in the proportions of 1, 5 and 10 per cent , and then inoculated with staphylococcus and cultures were made in bouillon at once, after five minutes, after ten minutes, after fifteen minutes, after thirty minutes, after one hour and after two hours, respectively, and tubes incubated for forty-eight hours at 37 c result. Growth was shown in all tubes except those inoculated from tubes in which chlorlyptus was added in the proportions of 10 per cent after one hour experiment 12 -- germicidal action of chlorlyptus on streptococcus suspended in sterile human blood serum -- staphylococcus culture in agar forty-eight hours old was suspended in sterile human blood serum, and to the suspension chlorlyptus 5 per cent in paraffin oil was added in the proportions of 1, 5 and 10 per cent inoculations were made at intervals, at once, after five minutes, after ten minutes, after fifteen minutes and after one hour in trypsinized bouillon tubes were incubated at 37 c for forty-eight hours result. Chlorlyptus showed inhibitory action on the growth of staphylococcus in the strength of 10 per cent , but did not produce complete sterilization similar results were shown with the 5 per cent , and in the 1 per cent chlorlyptus did not show any inhibitory action at all experiment 13 -- germicidal action of carbolic acid on staphylococcus suspended in human blood serum sterile -- the technic employed was the same as in experiment 10 except that carbolic acid was used instead of chlorlyptus result. Carbolic acid produced a complete sterilization in the strength of 10 per cent almost at once, and with certainty after five minutes similar results were produced with the 5 per cent the 1 per cent carbolic acid did not show any appreciable germicidal action on staphylococcus experiment 14 -- toxic and irritant action of chlorlyptus -- six normal guinea-pigs were used for the experiment guinea-pig 1 was injected peritoneally with 1 c c of chlorlyptus, guinea-pig 2 with 2 c c of chlorlyptus, guinea-pig 3 with 3 c c of chlorlyptus, guinea-pig 4 with 4 c c and guinea-pig 5 with 5 c c 5 per cent respectively guinea-pig 6 was used as a control and not injected result. Guinea-pigs 1 and 2 did not show any appreciable disturbance guinea-pig 3 was sick for four days, after which it gradually recovered but it became sick again after one week and died ten days after the injection guinea-pig 4 died over night guinea-pig 5 died six hours after injection guinea-pig 5 was injected at 11:30 with 5 c c chlorlyptus ten minutes after the injection it was lying relaxed, respiration and heart normal, conjunctive reflex present one hour after the injection the animal seemed to present symptoms resembling those of narcosis. Respiration and heart were normal after four hours there was no change in the condition of the guinea-pig except that the respiration was irregular five and a half hours after it showed prostration with irregular respiration and heart action six hours after injection the animal was dead autopsy. The peritoneum showed a congestion and a fibrinous exudation, amount of liquid increased, essay writing of which was probably chlorlyptus unabsorbed spleen about normal, liver congested, kidney about normal, suprarenal glands about normal, lungs normal, pleural cavity obtained no exudation, heart soft, flabby and congested experiment 15 -- toxic and irritant action of chlorlyptus when injected into the pleural cavity -- six normal guinea-pigs used for the experiment chlorlyptus was injected in the pleural cavity as follows.

An uncritical english endorsement 420 cotton process ether 421 dionol 422 the eli products of eli h dunn 424 glover cancer serum 425 glyco-thymoline and poliomyelitis 427 glykeron. Cold storage testimonials 428 gray glycerine tonic. “whose bread i eat his song i sing” 429 hagee cordial of cod liver oil 429 hypno-bromic compound 430 intravenous compound loffler 430 intravenous specialties 435 iodex 436 the william f koch cancer remedy 437 the lucas laboratories’ products 440 “phylacogens” 441 pineoleum advertising methods 442 “proteal therapy” and henry smith williams 443 proteogens 445 pulvane 450 sal hepatica 451 salicon 453 so-called secretin preparations 454 succus cineraria maritima 455 tekarkin 458 tyree antiseptic powder again 462 wheeler tissue phosphates 463 briefer paragraphs 465 writing iv. Contributions from the journal. Miscellany albert abrams, a m , m d , ll d , f r m s 472 acetylsalicylic acid, not aspirin 480 the allied medical associations of america 486 “arsenicals” 491 beer and cancer cures 494 biologic therapeutics and its commercial domination 496 capell uroluetic test 497 chemotherapy and tumors 499 the direct sales company 510 discoveries and discoverers 511 “drug reform” 513 drug therapy. The fallibility of textbooks 515 thomas webster edgar 515 glycerophosphates 520 influenza vaccine 520 intravenous therapy 522 iodin fumes 523 italian physico-chemical company 524 what is liquid petrolatum?. 526 the lowenthal postgraduate course 527 medical society of the united states 531 the national formulary-- a review of the fourth edition 535 nonspecific protein therapy 536 willard ealon ogden 538 “patents” 542 pharmaceutical barnums 545 the pharmacopeia 546 physician stock in prescription products 548 pituitary gland preparations 549 proprietorship in medicine 550 philip rahtjen and his discoveries 553 sodium cacodylate in syphilis 555 tablets. Dependability of dosage 556 therapeutic evidence. Its crucial test 557 “vaccines in toxic conditions” 560 vitamins. Their distribution 561 the william a webster co and the direct pharmaceutical co 564 yeast 566 briefer paragraphs 570 the propaganda for reform in proprietary medicines writing i reports of the council on pharmacy and chemistry foreword the council on pharmacy and chemistrythe council on pharmacy and chemistry was established by theamerican medical association primarily for the purpose of gatheringand disseminating such information as would protect the medicalprofession-- and thus the public-- in the prescribing of proprietarymedicinal articles the council consists of sixteen members, fifteen appointed for a termof five years without pay, and the sixteenth, a secretary, who isalso the director of the chemical laboratory of the american medicalassociation see writing ii at the present time 1921 the membership is. C l alsberg, a m , m d , chief of the bureau of chemistry, u s dewritingment of agriculture, washington, d c c w edmunds, m d , professor of materia medica and therapeutics, university of michigan medical school, ann arbor r a hatcher, ph g , m d , professor of pharmacology, cornell university medical college, new york city a w hewlett, m d , professor of medicine, leland stanford junior university school of medicine, san francisco john howland, m d , professor of pediatrics, johns hopkins university medical dewritingment, baltimore reid hunt, m d , professor of pharmacology, medical school, harvard university, boston w t longcope, a b , m d , new york g w mccoy, m d , director of the hygienic laboratory, u s public health service, washington, d c lafayette b mendel, ph d , sc d , professor of physiological chemistry, sheffield scientific school, yale university, new haven f g novy, sc d , m d , professor of bacteriology, university of michigan medical school, ann arbor w w palmer, b s , m d , bard professor of medicine, columbia university college of physicians and surgeons, new york w a puckner, phar d , secretary of the council, director of the chemical laboratory of the american medical association, chicago l g rowntree, m d , sc d , professor of medicine, mayo foundation, rochester g h simmons, m d , ll d , chairman of the council, editor of the journal of the american medical association, chicago torald sollmann, m d , professor of pharmacology and materia medica, western reserve university school of medicine, cleveland julius stieglitz, ph d , sc d , chem d , professor of chemistry, university of chicago, vice-chairman of the council, chicago at its first meeting in 1905, the council began examining theproprietary and nonofficial medicinal preparations offered tophysicians of the united states, and authorized the publication ofa book new and nonofficial remedies containing descriptions ofthose preparations which were deemed worthy of the consideration ofphysicians it also issued reports reports of the council on pharmacyand chemistry to the medical profession on those preparations whichwere not eligible the council adopted a set of rules by which tomeasure the eligibility of each preparation for admission to new andnonofficial remedies these rules were designed primarily to protectthe public-- through the medical profession-- against fraud, undesirablesecrecy and objectionable advertising in connection with proprietarymedicinal articles the rules originally adopted have been subjectedto revision from time to time to meet changing conditions for theinformation of those who wish to familiarize themselves with the workof the council the rules which are now in force 1921 follow thisintroduction a summary is also to be found in the article, “the workof the council on pharmacy and chemistry, present and future, ” page 12 since 1906, the council has issued new and nonofficial remediesannually in each issue are listed and described the articles thatstand accepted on january 1 of the year of publication the bookdescribes proprietary medicinal articles on the american market thatare found eligible under the rules, and also such nonproprietary, nonofficial articles as give promise of therapeutic usefulness, listingthe acceptable brands articles of a similar character are groupedtogether, and each group is preceded by a general discussion for thepurpose of comparison since 1908, the council has also issued an annual volume, “reportsof the council on pharmacy and chemistry, ” which contains reportson proprietary medicines that were found inadmissible to new andnonofficial remedies the reports issued prior to 1916-- and deemed ofsufficient interest to physicians-- were reprinted in the propagandafor reform in proprietary medicines, ninth edition 1916 the moreimportant reports issued from 1916 to 1921, inclusive, are in thisvolume while it is the chief function of the council to investigate and reporton proprietary medicinal preparations, its work has broadened so thatthe council work may now be characterized as a propaganda for therational use of drugs thus, its committee on therapeutic researchencourages the investigation of questions concerning the actionsof drugs these investigations are brought together in the “annualreports of the therapeutic research committee ” the council also has acommittee on medical teaching which has issued the publication “usefuldrugs, ” a concise, but thorough and up-to-date, discussion of the moreimportant drugs in addition, the council appointed a committee toprepare an “epitome of the u s pharmacopeia and national formulary, ”in which are presented those portions of the united states pharmacopeiaand the national formulary that are of interest to physicians and inwhich is given a concise statement of the therapeutic usefulness ofsuch drugs and preparations official rules of the council on pharmacy and chemistry may 1, 1921 introductionthe following rules have been adopted by the council primarily withthe object of protecting the medical profession and the public againstfraud, undesirable secrecy and objectionable advertising in connectionwith proprietary medicinal articles new and nonofficial remedies -- the book new and nonofficial remediescontains a description of proprietary articles which have beenaccepted as conforming to the rules of the council. And of such simplenonproprietary and nonofficial substances as seem of sufficientimportance to warrant their inclusion mixtures -- for admission to n n r , proprietary pharmaceuticalmixtures must comply with the rules. And, to determine such compliance, they will be investigated by the council the council, however, endorses the principle that prescriptions should be written on thebasis of the therapeutic effects of the individual ingredients forthis reason, it includes in this book only those mixtures that presentessay real advantage there is also an appendix in which are includedthose proprietary articles which, so far as known to the council, comply with the rules, but which do not possess sufficient originalityto be admitted to the body of the book rules governing the admission of proprietary articles to the book new and nonofficial remediesdefinition of proprietary articles -- the term “proprietary article, ”in this place, shall mean any chemical, drug or similar preparationused in the treatment of diseases, if such article is protected againstfree competition, as to name, product, composition or process ofmanufacture, by secrecy, patent, copyright, or by any other means rule 1 -- composition -- no article will be accepted for inclusion inthe book new and nonofficial remedies, or retained therein, unless itscomposition be furnished to the council for publication for simplesubstances, the scientific name and the chemical formula, rational orstructural, if known, should be supplied for mixtures, the amount ofeach active medicinal ingredient in a given quantity of the articlemust be stated the general composition of the vehicle, its alcoholicpercentage, and the identity of the preservatives must be furnished rule 2 -- identification -- no article will be accepted or retainedunless suitable tests for determining its composition are furnished tothe council in the case of chemical compounds, these shall consist oftests for identity and purity in the case of mixtures, description ofmethods for determining the amount and active strength of the potentingredients shall be furnished, if practicable rule 3 -- direct advertising -- no article that is advertised to thepublic will be accepted or retained. But this rule shall not applyto. a disinfectants, germicides and antiseptics, provided theadvertising is limited to conservative recommendations for their use asprophylactic applications to superficial cuts and abrasions of the skinand to the mucous surfaces of the mouth, pharynx and nose but not tothose of the eye, and the gastro-intestinal and genito-urinary tractsand provided they are not advertised as curative agents see commentsto rule 3. And b nonmedicinal food preparations, except whenadvertised in an objectionable manner rule 4 -- indirect advertising -- no article will be accepted orretained if the label, package or circular accompanying the packagecontains the names of diseases in the treatment of which the article issaid to be indicated the therapeutic indications and properties may bestated, provided such statements do not suggest self-medication dosagemay be indicated this rule shall not apply to remedies with whichself-medication is altogether improbable, to vaccines and antitoxinsor to directions for administering or applying remedies when similarimmediate, heroic treatment is indicated rule 5 -- false claims as to origin -- no article will be accepted orretained concerning which the manufacturer or his agents make false ormisleading statements as to source, raw material from which made, ormethod of collection or preparation rule 6 -- unwarranted therapeutic claims -- no article will be acceptedor retained concerning which the manufacturer or his agents makeunwarranted, exaggerated or misleading statements as to the therapeuticvalue rule 7 -- poisonous substances -- the principal label on an articlecontaining “poisonous” or “potent” substances must state plainly theamount of each of such ingredients in a given quantity of the product rule 8 -- objectionable names -- proprietary names for medicinalarticles will be recognized only when the council shall deem the useof such exclusive names to be in the interest of public welfare nameswhich are misleading or which suggest diseases, pathologic conditionsor therapeutic indications will not be recognized the provisionagainst therapeutically suggestive names does not apply to serums, vaccines and antitoxins, or to foods in the case of pharmaceuticalpreparations or mixtures, the name must be so framed as to indicate themost potent ingredients rule 9 -- patented products and protected names -- if the article ispatented-- either process or product, or both-- the number of such patentor patents must be furnished to the council furthermore, if the nameof an article is registered, or the label copyrighted, the registration trademark number and a copy of the protected label should befurnished the council in case of registration in foreign countries, the name under which the article is registered should be supplied rule 10 -- unscientific and useless articles -- no article will beaccepted or retained which, because of its unscientific composition, is useless or inimical to the best interests of the public or of themedical profession explanatory comments on the rulesintroduction -- the council on pharmacy and chemistry was establishedin february, 1905, by the american medical association, primarilyfor the purpose of gathering and disseminating such information aswill protect the medical profession in the prescribing of proprietarymedicinal articles in pursuance of this object, the council examinesthe articles on the market as to their compliance with definite rulesdesigned to prevent fraud, undesirable secrecy and the abuses whicharise from advertising directly or indirectly to the laity sucharticles as appear to conform to the rules are accepted.

No human beingcould survive the passage through his body of an alternating currentof more than 1, 500 volts for a period of even twenty seconds, contactbeing perfect ”the physical phenomena caused in the body by electrocution as atpresent conducted are comparatively simple, and such as we shouldlogically expect the instant the body of the patient enters into thecircuit of the current, all the voluntary muscles appear to be throwninto a condition of violent contraction which continues so long asthe current lasts, and on cessation of the current is replaced bya condition of extreme muscular relaxation all consciousness isapparently lost immediately on the application of the current thisprobably has never returned in any case, but on the removal of the bodyfrom the circuit of the current the relaxation of the muscles causesmovement, and essaytimes, as in the case of kemmler, slight spasmodicmovements of the chest have occurred the pupils in this case weredilated the condition of contraction and rigidity is renewed at eachnew application of the current, to cease immediately when the currentis removed in kemmler chest movements and possibly heart-beat occurred after thefirst contact, the former perhaps half a minute after the cessation ofthe current in slocum there were chest movements and radial pulsation after thefirst contact in smiler no movement of the chest, but radial pulsationafter the third contact in jugigo a slight fluttering of the radialpulse when final contact was broken, which rapidly ceased in hood nomovement or pulse-beat in essay of the patients superficial burns have been caused by imperfectcontact of the electrodes, either on the head or at the position of thelower electrode in kemmler case the cerebral cortex was essaywhataffected under the head-electrode the practical effect of the application of the current to the criminalfastened in the death-chair, as seen by the bystander, is thatimmediately on its reaching him the whole body is straightened andrendered rigid in extension, the extremities tend to straighten out, and the face may grow red and turgid there is reported at timesswelling and turgidity of the neck the whole body remains in thistetanic, stiffened condition until the removal of the current, when allthe muscles relax and the body sinks back into the chair in a state ofcomplete muscular collapse mental or psychical symptoms the third class of results which are found after electrical shocksfrom high-tension currents are the mental or psychical by the use ofthese terms we do not wish to imply that they are voluntary they are, however, so far as our present knowledge of pathology reaches, largelyfunctional this is precisely the class of paper which, when resultingfrom railway accidents, are placed under the head of railway-brainor railway-spine they may be considered in the present state of ourknowledge as traumatic functional neuroses, though it is probable thatwhen our means of examination and investigation are more completewe may succeed in discovering a visible or perceptible lesion thesymptoms affecting motion and sensation in these paper are frequentlyaccompanied by others of an emotional character, and in thesis paperthere seem to be writingially or wholly voluntary conditions and symptomswith the involuntary there is in thesis paper a characteristic loss ordiminution of the force and power of volition, but in others this isnot perceptible these conditions are so well known when produced by other causes thatwe do not consider it proper to enter into a full consideration of themhere, but we cannot leave this important subject without a few generalremarks no form of affection or disease has caused more discussion among themedical profession or figured more prominently in the courts than this, and even now there are thesis questions in relation to these conditionsstill under dispute our own view, confirmed both by observation andexperience, is that the tendency in new england, at least, has beenon the whole to underrate the severity, the duration, and the amountof suffering caused by these conditions that because there havebeen paper of malingering, of deception, and of rapid cure afterthe receipt of damages, and because in addition to this a certainvisible emotional and at times apparently controllable element exists, the profession, and above all the laity, are led to conclude thatthis forms the essential condition and basis of the disease on thecontrary, in a very large proportion of paper the symptoms are such ascannot possibly be voluntarily assumed. They produce extreme discomfortand often much suffering for the patient, and frequently last foryears, rendering their victims incapable of carrying on their formeroccupations fortunately in the patients suffering from electric shock theseverer forms of these affections are not so common in most of thepaper reported recovery has been more or less rapid paper in whichprevious hysteria or neurasthenia have existed are more liable tothese manifestations than persons of a previously equable nervousconstitution, but these latter are by no means wholly exempt toconsider these conditions, as is essaytimes done, as the fault of thepatient seems to us both unwarrantable and unjust lightning we now come to the consideration of the action of electricity inanother form, that of natural electricity or lightning the effectsof this are practically the same as those of the forms previouslydescribed, except such differences as seem to be fairly accounted forby the vastly greater force of the currents with which we have todeal injuries and deaths from lightning stroke have been recognizedand described for thesis centuries, and we have now a large collectionof careful observations on them they occur in most temperate regionswith comparative frequency in france the number of deaths from 1835to 1852 inclusive eighteen years was 1, 308 in england, includingwales, there were in twenty years, 1865 to 1884 inclusive, 416 deaths in 1846 mr eben merriam, of brookline, wrote to mr arago that in thethree last years about 150 persons had been killed by lightning in theunited states in thirty years, from 1855 to 1884 inclusive, we find101 deaths in massachusetts from this cause exposure - injuries and deaths from lightning may occur in variousplaces and under various conditions the severe lightning strokes arepopularly supposed to occur only during thunder-storms, and in thislatitude this is undoubtedly, as a rule, true, but lightning strokesare reported to have occurred, writingicularly in the south, from a clearsky, and there seems no reason to doubt that this may happen it issaid also that dangerous discharges from the earth to the atmospheremay take place at a considerable distance from an atmospheric storm as a rule, the lightning is more likely to strike essay tall object, as a tree or a tower or steeple, and for this reason, and to avoidinjury from falling branches, the shelter of trees should not be soughtduring thunder-storms if lightning stroke be dreaded ships at sea arefrequently struck by lightning, writingly perhaps on account of the heightof the masts and writingly on account of the metal in or on them lightning obeys the same general laws as the other forms ofelectricity and naturally follows the paths of least resistance persons, therefore, who are in the neighborhood of or in contactwith good conductors are in more danger of injury by lightning thanwhen surrounded by or in contact with poor conductors the proximityor contact of a large metallic object exposed in a thunder-storm isconsequently more or less dangerous on the other hand, the absenceof tall objects or of specially good conductors of any kind does notinsure safety in thesis paper persons in fields are struck, and paperare related of persons struck on the prairies in the west in fredetcase a shepherd was found dead in the midst of the barren moors landes in southern france more accidents appear to occur directly to persons out-of-doors thanto those in houses or other buildings when inside buildings, personsstruck are usually near an open door or window through which thelightning enters, and they are more exposed to danger from this sourceif there be essay metal object or good conductor in the vicinity persons carrying or wearing metallic objects render themselves therebymore liable to be injured in this way not only does the liability to injury from lightning vary essaywhataccording to the exposure or position of the person, both in relationto the free access of the atmospheric air and to the contact with orneighborhood of metallic objects or other good conductors, but alsothe severity of the injuries may be largely dependent upon what theyare wearing or carrying and the condition of their clothing at thetime if the clothing be wet it will act as a good conductor, as willalso any metallic object about the person we have already referred tothe action of metallic objects upon the passage of the electricity toand from the body and to the condition of the skin in relation thereto the laws of conduction and resistance are precisely the same for theelectricity of lightning as for the other forms hence the greater theresistance to the electricity at the points where it enters or leavesthe body, the deeper will be the burn thus we find not infrequentlythat the lightning, in its course from the head to the feet, meets witha chain or a truss, and almost invariably at least a portion of thecurrent follows this, causing a deep burn where it again passes intothe skin all the external burns of the lightning, except the initialone, are determined by the position and conditions of the body, theclothing, and the conductors near all electricity obeys the same lawand, roughly speaking, follows the path or paths of least resistance the clothing worn by a person when struck by lightning may be actedupon in the most various ways essaytimes it is wholly stripped off theunfortunate sufferer, who, as in a case reported by cook and boulting, may have to be protected with sacks or other hastily improvisedcoverings in a case reported by nason, a girl of thirteen was struckwhile in the street and most of her clothes stripped off and torn toshreds, and the top of her hat, which contained steel wires, was tornfrom the brim in the case of wilks the body was stripped entirelynaked and absolutely nothing left on except a portion of the left armof the man flannel shirt the clothing is essaytimes torn to thefinest shreds, like those of a mouse nest, as described by van horn, and in another case claes, where the patient was struck while onboard ship, his woollen jacket was torn into fine bits, which stuckto the ropes, and the deck was covered with fibres of wool as fine asthose of cotton-wool in this case the woof of the trousers was said tohave been wholly destroyed, while the web was untouched the clothing is also often burnt not only are holes burnt in it as isusually the case at the point where the lightning strikes and at thepoint where it leaves the body, but it may be set on fire it may befound smoking or in flames of all portions of the clothing injured, perhaps the coverings of thefeet are the most frequently so, as the electricity is very apt toleave the body through the feet, and the resistance opposed is great hence the boot or shoe is frequently injured essaytimes it is piercedas by a bullet, or a large hole is torn in it, or it may be torn topieces or reduced almost to lint, while the foot remains uninjured itmay be torn, shrivelled, and burnt in one case the soles of the shoeshad disappeared. In another the leg of the boot was clearly dividedfrom the sole and both straps were torn out. While again in another theshoe was carried wholly off the amount of injury to the clothing does not necessarily correspond tothe amount done to the body a person may be killed by lightning whilethe clothing is uninjured on the other hand, the clothing may be tornto pieces, carried away, or even writingially burnt, while the portion ofthe body underneath remains unhurt symptomatology - the symptoms of stroke by lightning resemble, in ageneral way, those due to high-tension currents of electricity as inthe case of the latter, they can be divided into the direct, producedimmediately by the lightning itself, and the indirect, or secondary, produced through the medium of other factors in the milder paper the person struck feels dazed and benumbed andmay or may not lose consciousness for a short time at the momentstruck they may have the sensation of a blow, and they often see ablinding flash on recovery of their faculties there may be a temporaryanæsthesia or weakness of one or more extremities, which rarely lastsmore than twenty-four hours there is a general shock to the system, essaytimes slight loss of memory for a time, and occasionally nauseaand vomiting there are often discolorations of the skin of mediumextent, and frequently burns and blisters these persons have usuallyreceived the stroke on one extremity or have escaped the full force in the more severe paper the patient loses consciousness immediatelyand may continue unconscious for essay hours he passes into a conditionof collapse with rapid, feeble pulse and cold extremities, and thepupils are dilated on recovery of his senses the same symptoms as inthe less severe paper, only more pronounced, are found the loss ofmemory may be marked and the intellect temporarily weakened, while theweakness and anæsthesia of the extremities persist longer the externalinjuries, burns, and wounds are liable to be more severe in the fatal paper where death is directly due to the electricity it isusually instantaneous or at least without recovery of consciousness itmay be caused by shock or by apoplexy, i e , intracranial hemorrhageor by the direct effect of the electricity on the brain of coursedeath is often due to burns or to indirect traumatic injuries the indirect traumatic injuries caused by lightning are due either tothe loss of consciousness of the patient, which causes him to fall andthus sustain injury, or to the direct action of the electricity uponhim, knocking him down or throwing him to essay distance, essaytimeswith great violence, or lastly, and perhaps the most frequent cause, to the impact or pressure of objects which are torn or cast down bythe electricity and by striking or falling on a person produce greatinjury thus persons have been killed by the fall of buildings, sheds, or trees which were struck by the lightning, or their branches ofcourse all kinds of traumata may be produced thus the direct external injuries caused by lightning are burns, subcutaneous hemorrhages, discolorations and markings of the skineither dendritic or metallic, lacerations or wounds burns occur in nearly all, perhaps all, severe paper of lightningstroke they may be of any or all degrees, and may extend over verysmall points or over the whole or nearly the whole body they mayconsist in a simple singeing of the hair, or they may be very deep andextend to the bone as before stated, the deep burns are found at thepoints of resistance to the current, at its points of entrance and exitfrom the body, and, to a lesser degree, at all points where its courseis impeded this occurs wherever the clothes are fastened tightly orpressed against the body, hence especially at the neck, waist, knees, and essaytimes at the ankles the position of the burns is determined, therefore, by the point at which the lightning strikes the person, theposition at the moment, and by the arrangement of the dress and thepresence of metallic substances in the large majority of paper theupper portion of the body is the writing first touched by the lightning, and thence it descends along the body to the ground we are apt, therefore, to find a severe burn about the upper portion of the body, the head, neck, or shoulders. Then a scorching, singeing, or burning, more or less severe, in the form of a stripe or stripes more or lessbroad down the body. The burns being deeper where the clothes aretighter or where metallic objects come into contact with or are nearthe body. And finally a deep burn at the nearest point of contact withthe ground, usually the heel or essay portion of the foot the burns, however, vary greatly the eyes may be burnt and severelyinjured or destroyed the lightning has been known to enter the mouthand burn the mucous membrane within the deeper burns not infrequentlyassume the form of holes in heusner paper about twenty whitish-grayspots, varying from the size of a lentil to that of a pea, were foundon the soles of the feet the hair is usually singed and may be burntoff in large areas, or wholly as in a case reported by bernard wounds - these may be direct or indirect we shall speak here onlyof the first like burns they occur usually at the points of greatestresistance, that is, the places of entrance and exit, but they maybe found in any writing of the body they may be clean-cut, as if madeby a sharp knife, or they may be lacerated and ragged with the edgescontused or burnt they may consist of holes which look as if they hadbeen punched out contusions or ecchymoses these may also be produced directly by thelightning, and like burns and wounds are most apt to occur where theresistance is greatest they may be of considerable importance in amedico-legal sense, as in fredet case, where there were ecchymoseson the neck similar to those produced by the fingers of a hand appliedfor strangulation in the case related by cook and boulting the rightside of the body appeared like an exaggerated example of post-mortemstaining there are essaytimes found also dark-brown spots, small orlarge, which may be soft and, when cut, containing fluid blood, or theymay be hard and like parchment, dry, and bloodless on section closely connected with these are the so-called dendroid or dendriticmarks, which are dark-colored reddish bands or stripes, often more orless dichotomously branched, not disappearing under pressure, found onthe bodies of those struck by lightning though usually of the formmentioned, they may assume other shapes, as that of an irregular starwith zig-zag rays balfour has figured an excellent example of these metallic staining of the skin has been known to occur where metalswere in contact with it at the time of the lightning stroke thesestains may be permanent and are due to the introduction of the finelydivided metal richardson has succeeded in producing this artificiallyin animals he found two conditions required, that the metallicconductor should be sufficiently fine to offer resistance to thecurrent and that the current itself should be an electric discharge oflow tension loss of hair is said to have occurred from lightning, though the hairwas not burnt one case has been reported where after a severe strokeall the hair on the body is said to have fallen out symptoms under this heading we shall consider only such symptoms as are, so faras can be ascertained, the direct result of the electricity and notthose secondary to injuries we will consider first those relating to the nervous system loss of consciousness - this occurs to a greater or less extent inall but the very mildest paper it varies throughout all degrees froma slight momentary benumbing of the faculties to the most profoundstupor or coma it may then last hours or even days on recoverythe patient is apt to have essay loss of memory, to be dazed andconfused for essay time, and a certain obtuseness or blunting of theintellectual faculties may persist for a considerable period thisloss of consciousness is often accompanied by flushing of the face anddilatation of the pupils, or on the other hand the patient may presentall the symptoms of collapse loss of memory in regard to the lightning stroke after recovery ofconsciousness is not rare it is frequently complete so far as anyrecollection of the lightning goes, and there may be no remembrance ofthe thunder-storm essaytimes a defective memory persists together withgeneral mental impairment james mental disease - a condition of mental impairment lasting at leastweeks or months may occur mania and the delirium of terror are said tohave occurred various symptoms of the disturbance of the nervous equilibrium are notuncommon among these we may mention tremor, insomnia, and nervousdread of thunder-storms and of electricity there is no doubt that essaypersons who have been exposed to lightning stroke do, at least for atime, become unusually susceptible to the influences of atmosphericelectricity loss of motion paralysis - this is a very frequent result of astroke from lightning hemiplegia is not uncommon in bonnet casethe patient was struck on the head by the lightning, which caused alacerated wound in the left temple, but did not injure the aponeurosis on recovery of consciousness the patient was found to have a lefthemiplegia involving the face and both extremities accompaniedby a diminution of sensation over the left half of the body thesensation became normal in two days, but a writingial hemiplegia remainedpermanently in the case of durand there was a nearly complete righthemiplegia with accompanying hyperæsthesia and essay affection ofspeech deglutition and mastication were difficult, and there waspersistent hiccough there was photophobia and hyperæsthesia thepatient improved in two weeks and finally recovered there is often atemporary hemiplegia nearly all forms of paralyses of the extremities may occur we mayhave paralysis of all the extremities or of both arms or legs, ormonoplegias paraplegia occurs not very rarely it is usually of shortduration it may be accompanied by paralysis of the bladder singlemuscles or muscle groups only may be affected ptosis may occur with paralysis of other branches of the third nerve, causing diplopia facial paralysis occurs also alone. In one case itlasted only twenty-four hours, in another one month difficulty in mastication is essaytimes found, but much more frequentlydifficulty in deglutition is reported retention of urine, dysuria, or incontinentia urinæ may all occur, andthere is essaytimes a paralysis of the rectum, usually temporary, andessaytimes obstinate constipation, which in one case was combined withparalysis of the bladder and monoplegia aphasia in various degrees and various forms of dysphasia or difficultyin speech are not uncommon they are apt to be temporary loss of co-ordination in the lower extremities with writingial paralysisof bladder and rectum is reported convulsions - epilepsy may be brought on by lightning. This wouldbe more likely to occur in a person previously subject to epilepticattacks hysterical convulsions and spasms may also be produced, both immediately and as a more remote result, usually in personspredisposed tetany and catalepsy are said to occur clonic spasms of the whole body and convulsive movements of the limbsare not very infrequent in essay paper a marked sensitiveness remainsfor a time in the limbs struck, so that if touched they are immediatelythrown into clonic spasms disturbances of sensation - pain occurs in nearly all paper it ismost frequently a secondary result of the burns and other injuries not rarely, however, it exists as a direct symptom in the form of aburning or stinging neuralgia in the limb or limbs affected essaytimesthe first sensation on the recovery of consciousness seems to be painall over the body or confined to essay portions only, but the amountand character of the pain, aside from that produced by the injuries, varies much one patient had a burning pain in the back and leg lastingonly half an hour after recovery of consciousness in another casethere were pains all over at the end of the first week on the whole, severe pain in essay or all of the limbs, and less commonly in thehead, without paralysis and lasting essay days is not rare in one casereported by paige the patient had intense pain in the head, neck, arms, and chest. That in the head was constant, severe, and lasted sevendays, elsewhere less constant pain in the arms accompanied by paralysis and anæsthesia and lastingthree months has been reported headache is not rare as a later or secondary symptom disturbances of sensation other than pain are not rare a certain amount of hyperæsthesia almost always exists in the portionaffected immediately after the stroke this is often so marked thatit cannot be wholly due to the burns or other injuries it is usuallyvery temporary and ceases in a few hours in essay paper a permanent orlasting sensitiveness to the action of electricity is said to remain anæsthesia, loss or diminution of sensation, occurs either with orwithout paralysis in the paper reported by balfour, one boy saidhe could not feel his legs and another that his arms were cut off in a case reported by free there was loss of sensation in the rightupper extremity from the elbow to the fingers and in the left lowerextremity from the knee to the toes as a rule, the loss of sensationis temporary and quickly passes away, but it may last, in company withparalysis, for essay time in such paper either an organic lesion or atraumatic neurosis is to be suspected paræsthesiæ are very common after lightning stroke most frequent, perhaps, is the subjective sensation of numbness tingling, formication, and the sense of “pins and needles” may occur reflexes - as a rule, the deep reflexes seem to remain normal thesuperficial reflexes of the writings affected are at least temporarilyincreased special senses - sight - affections of the eye the eye and thesurrounding writings may be directly injured by burning we also find thesisserious conditions caused by the lightning the pathology of which willbe considered later when a person is first struck he may perceive aflash of light or a ball of fire before losing consciousness whileunconscious the pupils are usually dilated, but react sight may be atonce totally lost, but this is usually only temporary there may beamblyopia.

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