History

Problem Solution Essay Sample


If theheart is normal, cactus does not meddle with it” j a m a 51:52july 4 1908 will physicians continue to accept the problem solution essay sample statements of an interestednostrum vender-- who submits not a shred of evidence to support hisclaims, but who has a financial interest in convincing them-- even whenhis statements are diametrically opposed to all the evidence that thecouncil on pharmacy and chemistry has been able to secure?. -- from thejournal a m a , jan 19, 1918 article v ammonol and phenalginat the time that synthetic chemical drugs were coming into fame andwhen every manufacturer who launched a new headache mixture claimedto have achieved another triumph in synthetic chemistry, ammonol andphenalgin were born of course, these twins of analgesic pseudotherapywere claimed to be synthetics and were duly christened with “formulas ”they were among the first of the nostrums examined for the council onpharmacy and chemistry, and the false claims made for them were exposed the analyses made for the council showed that ammonol and phenalginwere simple mixtures, having the following composition. Acetanilid sodium bicarbonate ammonium carbonate ammonol 50 25 20 phenalgin 57 20 10the reports of the council on, and numerous references to, these twonostrums may be found in the journal of various dates 245 the reportswill prove interesting to those who are not familiar with, or haveforgotten, the methods of nostrum exploiters at the time the councilwas formed following the council exposure of the false claims madeby the manufacturers of phenalgin, the medical record published anadvertisement of that nostrum in which an attempt was made to discreditthe council report the editor of the medical record was requestedby the council to publish the facts in the case but he refused to do so 245 j a m a 44.

The use of warm waterto insure cleanliness. The avoidance of irritation, especially thatcaused by friction and secretions. A mild astringent to reduceinflammation -- from the journal a m a , march 9, 1918 guaiodine report of the council on pharmacy and chemistrythe following report on guaiodine, marketed by the intravenous productscompany, denver, has been adopted by the council and its publicationauthorized w a puckner, secretary a referee of the committee on pharmacology, in submitting to thecouncil a report from the a m a chemical laboratory on guaiodine, advises that the laboratory examination shows that instead ofcontaining free “colloidal” iodin as claimed, the preparation isessentially an iodated fatty oil, containing only combined iodin equally misleading, in view of the laboratory findings, are theimplied claims that the antiseptic action of guaiodine corresponds tothat of free iodin guaiodine is advertised mainly for the treatment of gonorrhea whileit may be true that the guaiacol contained in guaiodine has essaybeneficial effect, especially when preceded by potassium permanganateirrigation as advised, the advertised claim that “guaiodine acts as aspecific for gonorrhea in a majority of paper” is utterly false the “case records” offered to establish the therapeutic value ofguaiodine are in themselves sufficient to condemn the “evidence ” thefollowing are fair samples. “the second boy came a day or so later with a slight discharge with the characteristic burning and itching, and with symptoms of a beginning gonorrhea, and judging from the source of the infection, it was believed to be so two injections of guaiodine were given when the discharge ceased ” “i have several paper that were completely cured in a very short time i note this, that the first dose causes a cessation of the discharge and the second seems to increase the flow, but the color is changed i give three doses, and then use a mild wash, and in ten days they are well i am very pleased with this preparation and very truly believe that it is the best there is to date for the positive cure of gonorrhea ” report of the chemical laboratoryguaiodine is manufactured by the intravenous products company, denver, colorado the “literature” which accompanies the product describesguaiodine as. “ an electro-chemically prepared iodin, suspended in oil, containing iodin, the same strength as the u s p tincture of iodin, or 7 per cent , together with a therapeutic dose of guaiacol ”the intravenous products company claims that guaiodine is made by an“electro-chemical process of preparing colloidal iodine, ” discoveredby one e b page, and that by this process the tendency of iodin toproduce iodism has been “overcome ” it is said to be “pre-eminentlyan antiseptic and germicide ” guaiodine is a dark brown, oily liquidwith a specific gravity of 0 9845 at 15 6 c and an odor suggestiveof guaiacol its solubilities were those of a fat free iodin wasabsent in the recently purchased specimen traces were presentin an older one steam distillation indicated that the productconsisted of volatile and nonvolatile constituents the volatilematter was concluded to consist, in the main, of guaiacol or essayguaiacol-like body, and the nonvolatile matter to be an iodized fattyoil quantitative determinations indicated that guaiodine containedabout 7 25 per cent of iodin in combination, and that it is composedapproximately of 3 per cent volatile matter and 97 per cent nonvolatile matter hence guaiodine appears to be an iodized fatty oilto which a small amount of guaiacol or essay guaiacol-like substance hasbeen added the council actionon the recommendation of the referee, the council voted that guaiodinebe declared inadmissible to new and nonofficial remedies because offalse statements as to composition and action -- from the journala m a , april 6, 1918 several “mixed” vaccines not admitted to n n r report of the council on pharmacy and chemistrythe “mixed” vaccines which are discussed in the reports that followwere considered by the council during the past year because inquirieshad been received in regard to them in publishing these reports it is desirable that the attitude of thecouncil toward “mixed” vaccines again be stated in view of the rapiddevelopment of bacterial therapy, the possibility for harm that attendsthe use of bacterial vaccines and the skepticism among experiencedclinicians as to the value of vaccines representing a combination oforganisms, the council has felt that it should scrutinize the claimsfor such agents with exceptional care and that there should be admittedto new and nonofficial remedies only those vaccine mixtures for whichthere is acceptable evidence to indicate that the use of the writingicularmixtures is rational in considering the subject the council has borne in mind the fact thatin thesis institutions in which paper are studied and the results oftherapeutic measures carefully observed and controlled, vaccines of anysort are practically never used-- certainly here the stock mixed vaccinehas no recognition experienced clinicians have generally come to theconclusion that mixed vaccines have no specific action and that anyeffect they may produce is due to a non-specific protein reaction as set forth in the reports, in no case was the evidence submittedby the proprietors sufficient to establish the claims made for thepreparations hence none was accepted for new and nonofficial remedies the preparations that form the basis for the accompanying reports areonly a few of the thesis that are being made and sold by essay biologicalhouses doubtless thesis of those not dealt with in this report areequally irrational and sold under claims equally-- or probably evenmore-- unwarranted than those with which the present report deals w a puckner, secretary mixed vaccines-abbottin response to inquiry the council undertook a consideration of thefollowing “mixed{”} vaccines sold by the abbott laboratories:m catarrhalis-combined-bacterin, said to contain killed micrococcuscatarrhalis, bacillus friedländer, pneumococci, streptococci, staphylococcus aureus and staphylococcus albus b coli-combined-bacterin, said to contain killed streptococcusviridans, streptococcus hemolyticus and bacillus coli pertussis-combined-bacterin, said to contain killed bacilluspertussis, pneumococci, streptococci, staphylococcus albus, staphylococcus aureus and micrococcus catarrhalis streptococcus-rheumaticus-combined-bacterin, said to contain killed“streptococci rheumaticus, viridans, etc ” and pneumococci streptococcus-viridans-combined-bacterin, said to contain killedstreptococcus viridans, streptococcus hemolyticus, pneumococcus andstaphylococcus albus the abbott laboratories were asked to assist in the investigation ofthese products and to submit evidence to establish their eligibilityfor admission to new and nonofficial remedies the manufacturer wasinformed that the council accepts “mixed” vaccines or bacterins, provided the usefulness of these products is established by acceptableclinical evidence, and references to the literature bearing on thevalue of the preparations were requested the abbott laboratories submitted specimens of the products, theadvertising matter therefor and a considerable list of references tocurrent literature. All of which was transmitted to the committee onserums and vaccines for consideration in due time a referee of thecommittee submitted the following report. The committee reportthe referee has studied the literature covered by the referencessubmitted in general the articles are favorable to the use ofvaccines, though thesis of these papers do not consider “mixed”vaccines. Indeed, a number of the articles do not discuss treatmentat all, but are devoted entirely to the consideration of etiologyof the disease thesis of the papers are by those who are obviouslyoverenthusiastic on the subject of the use of biologic preparations one paper-- not included in the references submitted by the abbottlaboratories-- records an alarming reaction following a dose of mixedvaccine. No claim is made that improvement followed the following comments on the submitted references are offered:m catarrhalis-combined-bacterin -- only four of the nine referencesgiven deal with the therapeutic use of the vaccine the reportedresults in general were favorable, but essaytimes in the discussionevoked by certain of the papers, views the reverse of those expressedby the author were brought forward the enthusiasm of one writer isshown in his statement that following the use of vaccine in paper ofcarbuncle complicating diabetes the sugar in the urine disappearedor was reduced one observer, who reports excellent results in nasalpharyngeal catarrh, speaks of certain vaccines as “bulk goods, ” whileanother considers “-- -- no 7” as the proper thing it is evidentthat the reports are not based on careful, scientific data, or suchunscientific definition of the product employed would not be used b coli-combined-bacterin -- in the references cited in support ofthis preparation the following general statements are noted.

a disinfectants, germicides and antiseptics, problem solution essay sample 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. And theiressential features are described in the annual publication of thecouncil, new and nonofficial remedies, if they come within the scopeof this book these descriptions are based in writing on investigationsmade by, or under, the direction of the council, but in writing also onevidence or information supplied by the manufacturer or his agents such interested statements are examined critically, and are admittedonly if they appear to be in conformity with the evidence it is, however, manifestly impossible for the council to investigate thecomposition of every complex pharmaceutical mixture, or to checkthoroughly every therapeutic claim. It can give only an unbiasedjudgment on the available evidence criticisms and corrections ofthe descriptions which may aid in the revision of the matter will beappreciated the council judges an article entirely by the facts inevidence at the time of its admission previous noncompliance with therules short of intentional fraud does not prevent the favorableconsideration of an article which is in accord with existing rules infringements of the rules after acceptance of an article for new andnonofficial remedies, or the discovery that the council informationwas incorrect, will cause the acceptance to be reconsidered an articleis accepted for new and nonofficial remedies, and will continue to beincluded in the book, with the understanding that serious violations ofthe rules, after acceptance, will be followed by the omission of thearticle and publication of the reasons for such omission the councildesires physicians to understand that the admission of an article doesnot imply a recommendation acceptance simply means that no conflictwith the rules has been found by the council duration of acceptance -- unless an agreement to the contrary is madeat the time of acceptance, articles admitted to new and nonofficialremedies will be retained for a period of three years, provided thatduring that period they comply with the rules and regulations whichwere in force at the time of their acceptance at the end of thisperiod all articles will be carefully reexamined for compliance withexisting rules writingicular weight will be given to the question as towhether recent evidence has substantiated claims as to the therapeuticvalue of any preparation, this evidence to consist writingly of recentstatements in the literature and writingly of the general esteem in whichthe preparation is held by clinical consultants of the council thereacceptance of articles after such reexamination shall be for threeyears unless a shorter period is specified any amendments to therules, by specific requirements or by interpretation, which may be madeafter the acceptance of an article, shall not apply to such articleuntil the period of acceptance has elapsed at the end of this periodthe article, if it is not eligible under the amended rules, will beomitted the scope of new and nonofficial remedies and appendix -- to aidphysicians and manufacturers in deciding what articles come withinthe scope of this book, or, in other words, to enable physiciansto recognize whether an article which is not described in new andnonofficial remedies has been omitted because it does not needadmission or because it has been rejected, the council furnishes thefollowing more detailed definitions:official articles -- articles official in the u s p or n f do notrequire consideration by the council if they are marketed under theofficial name and if no unestablished therapeutic claims are made forthem these do not require consideration by the council, since standards forthem are provided in these books, and enforced under the provisionsof the federal food and drugs act, except that they may be mentionedfor information consideration by the council becomes necessary if au s p or n f product is offered for sale under a name other thanthat, or the synonyms, under which the product is described in one ofthese books of standards, or if the proprietors or their agents advanceclaims that the product possesses therapeutic properties other thanthose commonly accredited to it modifications of u s p and n f products -- a pharmacopeial ornational formulary product which is marketed under the official titleor synonym, but with well-founded claims that its purity, permanence, palatability or other physical properties excel the official standard, may, if no extraordinary therapeutic properties are asserted, beconsidered as an official article and held not to be within the scopeof new and nonofficial remedies when such products are marketed underthe claim that they possess therapeutic properties other than thosecommonly accredited to the u s p or n f products of which theyare modifications, they shall be subject to the consideration of thecouncil specifically exempted preparations -- foods, in general, unless marketedwith the claim that they possess therapeutic properties shall not, atthe present time, be considered by the council mechanical appliances, at the present time, shall not be considered by the council mineralwaters natural, at the present time, shall not be considered by thecouncil with these exceptions, products which in the judgment of thecouncil are manufactured and marketed in conformity to the principlesunderlying the rules of the council may be accepted for n n r products which are manufactured and marketed in a manner which does notconform to the principles underlying the rules of the council shall notbe accepted for n n r the burden of proof in establishing claimsfor therapeutic properties of products considered by the council shalllie with the proprietor or, when a foreign made product, with theagent who markets the product in the united states to avoid confusionwith nonofficial substances marketed under similar names, the councilrecommends that official substances be prescribed by their officialtitles, followed by the abbreviation “u s p ” or “n f ”.

And he must summon as a witness a surgeon or physician, who must, in the presence of the jury, inspect the body, and give aprofessional opinion as to the cause of the death or wounding 537 thejury, after inspecting the body and hearing the testimony, must rendertheir verdict, and certify it by an inquisition in writing, signed bythem, and setting forth who the person killed or wounded is, and when, where, and by what means he came to his death or was wounded, and ifhe were killed or wounded, or his death were occasioned by the act ofanother by criminal means, who is guilty thereof, in so far as by suchinquisition they have been able to ascertain problem solution essay sample 538 the testimony of thewitnesses examined before the coroner jury must be reduced to writingby the coroner, or under his direction, and must be forthwith filed byhim, with the inquisition, in the office of the clerk of the court ofsessions of the county, or of a city court having power to inquire intothe offence by the intervention of a grand jury 539if, however, the defendant be arrested before the inquisition can befiled, the coroner must deliver it with the testimony to the magistratebefore whom the defendant is brought 540 if the jury find thatthe person was killed or wounded by another under circumstances notexcusable or justifiable by law, or that his death was occasioned bythe act of another by criminal means, and the writingy committing the actbe ascertained by the inquisition and is not in custody, the coronermust issue a warrant signed by him with his name of office, for thearrest of the person charged 541 the coroner has power to compelthe attendance of a witness and testify, and he may punish a witnessfor disobedience, as upon a subpœna issued by a magistrate 542 thecoroner warrant may be served in any county. And the officer servingit must proceed thereon, in all respects, as upon a warrant of arreston an information, except that when served in another county it neednot be indorsed by a magistrate of that county 543 when the defendantis brought before the coroner, he must proceed to examine the chargecontained in the inquisition or information, and hold the defendant toanswer, or discharge him therefrom, in all respects as upon a warrantof arrest on an information 544ii the jury and inquest jurors must be sworn by coroner - the jurors summoned by a coroner toattend an inquest must be from the county or jurisdiction wherein thecoroner is empowered to act he cannot proceed with the inquest untilhe has summoned and sworn the jury the jurors are not challengeable, and therefore they should be carefully selected and sworn by thecoroner himself his duties are judicial and he can only take aninquest super visum corporis, and an inquest in which the jury is notsworn by himself is absolutely void and of no effect 545they must investigate and determine the facts - after being swornby the coroner they must investigate and determine and are the solearbiters of the facts. The coroner duty being to instruct them inthe law they must go, view, and examine the body together, and notseparately it is essential to the validity of the inquest that thejury should view the body 546coroner may compel attendance of witnesses - when the coroner sitsto hold an inquest, he sits as a judicial officer, armed with all theordinary powers possessed by judicial officers he may compel theattendance of jurors whose qualifications are usually such as arerequired of jurors in a court of record it is his duty to presentbefore the jury all the material testimony within his power, touchingthe death as to the manner whereof the jury are to certify, and thatwhich makes for as well as against the writingy accused it is his dutyto summon before his inquest every person whom he has any reason tobelieve possesses any knowledge relative to the death which he isinvestigating he is to summon such persons to attend before him forexamination he has full authority to compel obedience to his subpœnas he has this power by the common law 547 if a post-mortem examinationis made, the examining surgeons should testify before the jury as tothe matters disclosed by the examination 548 the witnesses producedmust be sworn by the coroner, and their testimony reduced to writing byhim or under his direction rights of accused writingy the coroner is not required to take the testimony of the witnesses whoare examined before the jury in the presence of the writingy accused the accused has not the right to be represented by counsel, or tocross-examine the witnesses 549 he is not permitted to producewitnesses before the coroner to show himself innocent of the crime thecoroner is not required to examine any witnesses to establish the guiltof such writingy when brought before him by virtue of process issued afterthe finding of the inquisition 550deliberation by jury and return of an inquisition - after theevidence has been taken, and the jury instructed in the law by thecoroner, the jury should retire to deliberate upon their verdict during such deliberation and until they have arrived at their verdictthe coroner should not be present in the room where the jury isdeliberating after they have agreed on their verdict it should bereduced to writing, and the coroner is bound to accept it as final inhis court the inquisition should then be signed by the coroner andjury 551 if the inquest is signed by the coroner and duly certifiedby him, the jurors having signed by making their cross marks, and thewhole being certified by the coroner, his certificate of the signaturesof the jurors is sufficient and the inquisition is properly made 552if several jurors on the inquest have the same christian and surname, it is not necessary in the caption of the inquisition to distinguishthem by abode or otherwise 553 the law requiring the coroner to makea return of the testimony with the inquisition cannot be satisfiedshort of essay official certificate indicating that the witnesses namedwere sworn before him, to the matter insisted on as evidence against aprisoner at least if there be no formal authentication, there shouldbe proof aliunde that the memorandum presents the testimony of thewitness truly 554iii the effect of the evidence and verdict under the common law formerly, a coroner inquisition was equivalentto an indictment by a grand jury upon which the accused might betried but in this country no person can be tried upon a coronerinquisition, yet the inquisition of a coroner jury finding a personguilty of murder has about the same force against him, until thegrand jury passes upon his case, that an indictment found by them hasthereafter, prior to his trial coroner has power to issue process of apprehension - if a person ischarged with the crime in the inquisition, the coroner has power andhe issues his process for the apprehension of the accused when not incustody solely upon the inquisition the inquisition, though taken inthe absence of the prisoner, and upon the testimony of witnesses hecould not cross-examine, settles the question of his guilt until thegrand jury passes upon the case it justifies the commitment of theprisoner to jail, in the same manner that the testimony of witnessesdoes taken before a justice of the peace the coroner can only examinethe prisoner in the same manner as upon a warrant of arrest or oninformation, and is not authorized to examine witnesses either againstthe prisoner or for him, when he is apprehended by virtue of processissued subsequent to the finding of the inquisition by the jury, or incustody of the coroner without process at the time the same is found privilege of prisoner upon arrest - the prisoner has the privilegeof telling his own story before the coroner, which is to be returnedwith the inquisition, and that is all he cannot be discharged on it, however plausible it may be. And he has not the privilege of proving ittrue before the coroner he should, therefore, not be discharged, andhe cannot have the case investigated again before it is passed upon bythe grand jury 555under the provisions of the new york criminal code the defendantagainst whom an inquisition has been found by a coroner jury isentitled to a hearing before a magistrate, whether he has been arrestedbefore the inquisition has been filed or is arrested after such filing under the provisions of sec 779, in the case of a defendant who hasbeen arrested before the inquisition can be filed, the prisoner isentitled to be examined before the magistrate, before whom he may bebrought, as provided in sec 781, and in the case of a prisoner who hasnot been arrested until after the inquisition was filed, under secs 781 and 783 the defendant is entitled to be heard before a magistratein all respects as upon a warrant of arrest on an information themagistrate must proceed to examine the charge contained in theinquisition, and hold the defendant to answer or discharge himtherefrom 556 the information is the allegation made to a magistratethat a person has been guilty of essay designated crime 557 when evidence taken before coroner of a writingy charged with crime admissible in evidence upon his trial subsequently there is nothing which distinguishes between the proceedings of acoroner inquest and any other official proceedings taken andreturned in the discharge of official duty as to their admissibility inevidence a witness, therefore, may be contradicted by the productionof a deposition thus given by him before a coroner 558 but the lineis sharply drawn in what paper the testimony of a witness examinedbefore a coroner inquest can be used on his subsequent trial, and inwhat paper it cannot when a coroner inquest is held before it hasbeen ascertained that a crime has been committed, or before any personhas been arrested charged with the crime, and a witness is called andsworn before the coroner jury, the testimony of that witness, shouldhe afterward be charged with the crime, may be used against him on histrial, and the mere fact that at the time of his examination he wasaware that a crime was suspected, and that he was suspected of beingthe criminal, will not prevent his being regarded as a mere witness, whose testimony may be afterward given in evidence against himself if he desires to protect himself he must claim his privilege butif, at the time of his examination, it appears that a crime has beencommitted, and that he is in custody as the supposed criminal, heis not regarded merely as a witness, but as a writingy accused, calledbefore a tribunal vested with power to investigate preliminarily thequestion of his guilt, and he is to be treated in the same manner asif brought before a committing magistrate, and an examination nottaken in conformity with the statute cannot be used against him on histrial for the offence 559 so the doctrine as to silence being takenas an implied admission of the truth of allegations spoken or utteredin the presence of a person, does not apply to silence at a judicialproceeding or hearing, and since the proceedings at a coroner inquestare of a judicial character, what there transpired must be consideredas a writing of the proceedings 560 the leading paper which have beenbefore the new york court of appeals upon this important question, and from which that court has finally deduced that rule, may be herereferred to hendrickson case - in the first case the wife of the defendant died suddenly in the morning, and in the evening of the same day a coroner inquest was held the defendant was called and sworn as a witness upon the inquest at that time it did not appear that any crime had been committed, or that the defendant had been charged with any crime, or even suspected, except so far as the nature of essay of the questions asked of him might indicate such a suspicion on his subsequent trial on an indictment for the murder of his wife, the statements made by him at the coroner inquest were held admissible, on the ground that he was not examined as a writingy charged with the crime, that it had not appeared even that a crime had been committed, and that he had simply testified as a witness on the inquiry as to the cause of the death 561 mcmahon case - following this came the mcmahon case, in which it appeared that the defendant was arrested by a constable, without warrant, on a charge of having murdered his wife the constable took him before the coroner, who was holding an inquest on the body, by whom he was sworn and examined as a witness it was held that the evidence thus given was not admissible on the prisoner trial for the murder, and his conviction was reversed upon that ground 562 teachout case - the doctrine of this case was more clearly defined and essaywhat limited in a later case, the teachout case in that case the defendant appeared at the coroner inquest in pursuance of a sub-pœna to testify, and voluntarily attended. He was not under arrest, but was informed by essay one that it was charged that his wife had been poisoned and that he would be arrested for the crime before he was sworn he was informed by the coroner that there were rumors that his wife came to her death by foul means and that essay of those rumors implicated him, and that he was not obliged to testify unless he chose he said he had no objection to telling all he knew the court in delivering its opinion preludes it by a reference to these facts as showing that the statements made were voluntary in every legal sense, and held that a mere consciousness of being suspected of a crime did not so disqualify him that his testimony, in other respects freely and voluntarily given before the coroner, could not be used against him on his trial on a charge subsequently made of such crime on that ground it held the evidence properly admitted, at the same time referring with approval to the mcmahon case, and distinctly limiting the rule of exclusion to paper within its bounds 563 mondon case - then followed the mondon case, where on the finding of the body of the deceased, the defendant was arrested without warrant as the suspected murderer while he was thus in custody the coroner empanelled a jury and held an inquest, and the defendant was called as a witness before the inquest and was examined by the district attorney and by the coroner the prisoner was an ignorant italian laborer unfamiliar with the english language he was unattended by counsel, and it did not appear that he was in any manner informed of his rights, or that he was not bound to answer questions tending to criminate him he was twice examined. On the first occasion the examination was taken by questions put either by the district attorney or by the coroner, and the result written down by the coroner, who then read the evidence over to him, line by line, and asked him if he understood it and if it was the truth, and he said it was, and the coroner then reswore him to the deposition the coroner, after taking the defendant testimony on the first day, came to the conclusion that the defendant did not understand english well enough to be examined, and that it ought to be taken through an interpreter, which was done, in order that they might get it a little better and a little fuller it was held that the defendant testimony was not admissible upon his trial on the indictment 564 it will be seen that this latter case follows in direct line with the rule announced in the mcmahon case and clearly distinguishes another case, the mcgloin case, upon the authority of which the trial court held the testimony of the prisoner in the mondon case admissible mcgloin case - the case of mcgloin was not that of the examination of a prisoner on oath before a magistrate before whom he was taken involuntarily, while in custody, and interrogated by the magistrate, who to all appearance had power to require him to answer, but while under arrest the prisoner said to the inspector of police who had him in charge that he would make a statement the inspector then said that he would send for a coroner to take it the coroner was then sent for and came to police headquarters and took down in writing the confession dictated by the prisoner, the coroner asking no questions and not acting in any official capacity, but as a mere amanuensis to take down the confession and prove the contents it was held that the confession of the prisoner was admissible in evidence upon his trial for murder 565rule in pennsylvania - the rule in pennsylvania is substantially thatwhen the testimony given by the prisoner under oath before a coronerinquest, previous to him being charged or suspected of the murder ofthe individual upon whose body the inquest was sitting, may afterwardbe given in evidence against him, on his trial for the murder of suchperson 566rule in nebraska - the statements of a prisoner to be competentevidence must have been voluntarily made in paper of declarationmade on an examination before a coroner inquest by a person underarrest or charged with the crime and also under oath, they are notadmissible but when the person, although he be subsequently chargedwith the offence, appears voluntarily, and gives testimony, before anyaccusation has been made against him, his statements are admissible inevidence against him on the trial of an indictment for the crime 567medico-legal autopsies byh p loomis, a m , m d , professor of pathology in the university of the city of new york;visiting physician and curator to bellevue hospital, new york;pathologist to the board of health, new york city. President new yorkpathological society, etc , etc autopsies a medical examiner before proceeding with an autopsy, especially ifcalled before the body has been removed from the place where it wasfound, should carefully note certain facts these should be enteredby himself or an assistant with great care, in a note-book, as thisbook can be introduced as evidence in any trial a satisfactory wayis to dictate to the assistant as the examination proceeds, and atthe conclusion the assistant reads the notes taken, and the examinerverifies them surrounding objects position of the body these should be first noted the character of the soil. The conditionof the ground, and whether it shows footprints. If so, their direction;the evidence of any struggle. The presence of any weapon. And finally, the exact position in which the body lies, especially the position ofthe hands and feet this is important, for the body may be found in aposition which the deceased could not have assumed on the suppositionof the wound or injury having been accidental or homicidal if possiblea photograph should be taken of the body in the exact position inwhich it is found if it is absolutely necessary to remove the body, it should be done with great care, keeping the body in as horizontal aposition as possible the character of the surrounding soil should be noted this is ofspecial importance when the body to be examined has been exhumed. Forthe question of preservation of the body and the ability to recognizepathological changes may be brought up at a trial this was animportant point raised in the buchanan case new york, 1893 if a body be found in the water, examine the character of the water andthe temperature, and if found near the shore, the character of shoreand bottom blood - the situation of blood-stains, and their number and extent, on clothing or surrounding objects should be noted this will oftenshow whether a struggle has taken place after receiving the fatalwound, and is also of medico-legal importance if made at the time thebody is found, for it may be so situated as to show that the body hasbeen interfered with after death again, spots of blood found upon articles of clothing or uponsurrounding objects should be noted as to their form and direction, forthey may serve to furnish an indication of the position of the personwith respect to them when the wound was inflicted for example, if thespot was oval, the presumption is that the person was placed obliquelywith respect to the stain while the hemorrhage was occurring the forcewith which the blood was thrown out will in essay measure be indicatedby the obliquity or length of the spot the amount of blood will alsooften indicate whether the person has died suddenly, the exact spotwhere death occurred, whether a struggle took place, and will alsopreclude the possibility of a person moving after receiving the fatalinjury when we examine a body, especially when found in a room, caremust be taken not to be misled by the accidental diffusion of blood bypersons going in and out, or touching the body see blood-stains, vol ii clothing - the examination of the clothing should be thorough adescription of each article should be noted, and the order in which itis removed. For often it is important to prove that the garments wereworn by or belonged to the deceased if any blood is on the clothing, note whether the blood is in large patches, or whether it is sprinkledover the garment. The amount of the blood and what garments are stainedby it note and examine whether the blood has flowed down the frontof the clothing, whether it has soaked the inner garments, or again, whether it has collected along the back. For these appearances willessaytimes demonstrate whether a wound was inflicted while the personwas sitting, standing, or lying down for example, if the throat iscut while the person is lying down, the blood will be found on eachside of the neck along the back and not down the front of the body few suicides cut their throats in a recumbent position, and thisdistribution of the blood may serve to distinguish a suicidal from ahomicidal wound the condition of the clothing may also serve to show whether therehas been any struggle, and the presence of dry spots or mud on it mayessaytimes serve to connect an accused person with an act of murder this is well illustrated in the case of reg v snipe, reported inbeck “medical jurisprudence, ” where evidence was adduced to showthat essay spots of mud on the boots and clothing of the prisoner, whenexamined microscopically, contained infusoria, shells, and essay rareaquatic vegetables the mud of the ditch close to where the body wasfound, as also the mud on the clothing of the dead body, presentedthe same microscopical appearances the medical expert who gave thisevidence swore that in his opinion the mud spots on the body and onthe prisoner boots were derived from the same ditch, for the mudof all the other ditches in the locality was found, on microscopicalexamination, to be different the well-known case which occurred innew york a few years ago, known as the “shakespeare case, ” furnishesan example of the importance of carefully examining all stains on theclothing found on bodies if there are several stabs or cuts on the body involving the dress, itshould be noted whether they are blood-stained, and if so, whether thestain is on the inside or outside of the garments, for essaytimes insimulated personal injury a stain of blood may be inadvertently appliedto the outside of the dress, as in wiping a weapon weapons - if a weapon is found, the character of the weapon and itsexact position should be noted this is frequently of importance intelling whether a person has died from an accidental or self-inflictedwound in a case where death occurs immediately or within a fewminutes, the weapon is found near the body, or often so tightly graspedin the hand that it can be with difficulty removed if the weaponis found near the body it should be noted on which side and at whatdistance, and it must be questioned whether it could have fallen onthe spot or been thrown there by the deceased it is compatible withsuicide that the weapon should be found at essay distance from the body an instance has been recorded where an individual was discovered inbed with his throat cut, and the bloody razor was found closed and inthe pocket of the deceased if a weapon cannot be discovered, or isconcealed, it is strong presumptive evidence of homicide. Especiallywhen the wound is such as to produce speedy death note whether the weapon is sharp or blunt, straight or curved if aknife, the handle and inner portion should be examined, for the blademay have been washed if the wound has involved any large vessels, it is improbable that theweapon can have been thrown any distance from the body, and when it is, there are always fair grounds to expect interference with the originalposition of the body one circumstance which always strongly points tosuicide is the finding of the weapon firmly grasped in the hand of thecadaver the hand of a dead person cannot be made to grasp or retaina weapon as does the hand which has grasped it at the last moments oflife the amount of blood on the weapon should be noted, but it must beremembered that a knife may have produced a fatal stab wound and stillno blood be found on it this is explained by the fact that in a rapidplunge the vessels were compressed, and only after the drawing of theknife and relieving of the pressure blood began to flow, or possiblythe blood may have been wiped off the knife by the elasticity of theskin when a person has died of a gunshot wound, especially at close range, it is important to look for any wadding or paper found in the wound, asin a number of instances the finding of such has led to the detectionof the criminal for example, handwriting has been found on the paper, or it has formed writing of a printed page the rest of which has beenfound in possession of the accused when a gun is discharged near thebody, a portion of the wadding is almost always found in the irregularwound produced post-mortem examination having completed the examination of the surroundings, one next proceedswith the post-mortem examination, which should be conducted accordingto a well-defined plan, following which the results obtained willalways be satisfactory if possible the body should be removed to a large, well-ventilated, andespecially well-lighted room no artificial light, if it can possiblybe avoided, should be used when performing the autopsy. Artificiallight is especially bad on account of its yellowness and its power tomodify natural color thesis diseased conditions cannot be satisfactorilydetermined by artificial light the body should be placed on a hightable, and the facility with which the autopsy is made will oftendepend on having the table high enough to render stooping unnecessary never make an autopsy, if it can possibly be avoided, on a body whilein a coffin, as the examination is always unsatisfactory the size andsurroundings of the room, and how it is lighted, should be entered inthe note-book instruments - if possible the following instruments should be at handbefore proceeding with an examination, although essay of them may bedispensed with. 1 large section knife. 2 scalpels.

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Berl klin wchnschr 49:4, 1912 268 neuberg and caspari. Deutsch med wchnschr 38:375, 1912 neuberg, caspari and löhe. Berl klin wchnschr 49:1405, 1912 269 gers, gaube du. La cuprase et le cancer, paris, 1913 inasmuch as this new type of cancer therapy derives its origin, its justification and its support, in very large measure, from thelaboratory results obtained in animals, it is a matter of considerableimportance to examine those results with care, in order to determinewhether they furnish a satisfactory basis for human therapy, andwhether they justify the hopes to which they have given rise it is safe to assert that the application of chemotherapy to thetreatment of tumors practically dates from the publications ofwassermann he stated the principle that a rational therapy of tumorsmust be based on constitutional treatment it appears evident thatlocal treatment can have only local effects the lymphatic extensionsof tumorous growths, and the often unsuspected metastases in distantorgans must of necessity escape the effects of purely local treatment hence, wassermann reached the conclusion that all treatment of cancerwhich was to be effective, and not merely palliative, must be carriedto all writings of the body by means of the blood stream he thereforeintroduced the use of intravenous injections in the experimentaltherapy of rat and mouse tumors an accidental observation led himto believe that selenium was a substance possessing a high degree ofaffinity for tumor cells in order to insure the penetration of the tumor in the live animal bythis substance, however, he considered it essential to combine it withessay other highly diffusible substance this type of substance, whichwas to act as a carrier of the selenium, he described under the name“cytotrochin, ” from the greek word τροχιά {trochia}, meaning road forthis purpose he selected eosin the eosin and the selenium were thencombined by a method and in a form the details of which have neverbeen published all that we know of this preparation is contained inthe statement that it is very difficult to produce, and that it isextremely unstable and difficult to keep mice can be given amounts offrom 2 to 3 mg of this substance in solution wassermann experimentedwith mice inoculated with transplanted tumors of the types of carcinomaand sarcoma after from three to five intravenous injections of thedrug, he noted that the tumors become softer and fluctuate after stillfurther injections the fluid mass undergoes absorption, and the tumorgives the impression of an empty sac if it is possible to carry theinjections up to the number of ten or twelve, recovery ensues in suchcured animals there remain only the unabsorbed portions of the fibrouscapsule recurrences were not observed in the cured animals wassermannfurther stated that two spontaneous tumors in mice which had beentreated by this method presented favorable results wassermann original presentation gave few experimental details, andhas not been followed by the promised scientific report from hisarticle it is impossible to determine what proportion of his animalswere cured and what proportion failed to survive the treatment from alater paper by keysser270 we learn that by far the larger portion ofthe animals perished during the treatment in the stage of softening, so that a cure was accomplished in from only 3 to 5 per cent of theanimals this is a point of great importance, inasmuch as it furnishesan indication of the highly dangerous character of this mode oftreatment fatal results are attributed by keysser to the absorption oftoxic products from the tumor this contention, however, is supportedby no observations, and it is certainly equally fair to assume thatdeath results from the toxic effects of the compound a microscopicstudy of tumors taken from animals undergoing treatment was made byhansemann he found that the death of the cells was the result ofnuclear destruction 270 keysser. Wien klin wchnschr 26:1664, 1913 within a very few months after wassermann publication, neubergand caspari268 published a paper which was the first of a seriesof studies on the therapeutic effects of the heavy metals on theanimal tumors they used zinc, platinum, tin, selenium, copper, silver and cobalt in the form of certain complex organic compounds, the composition of which is not revealed owing to the fact thatintravenous injections of these compounds produced a specific effect onthe tumors, they are described as “tumoraffin” substances immediatelyafter the intravenous injection of these preparations, there followeda marked hyperemia of the tumor, whereas the remainder of the mousebody appeared markedly anemic the hyperemia was often attendedby hemorrhage into the tumor this first stage was succeeded byliquefaction and absorption followed by recovery in favorable paper the authors failed to state in what proportion of their experiments theanimals died, and in what proportion recovery ensued the second paper on this subject is by neuberg, caspari and löhe, 268in which further details are vouchsafed they state that with thecompounds used by them the toxic and the therapeutic doses approximatevery closely, from which it follows that the treatment, as with thewassermann method, results in a very high mortality smaller dosesproduce no therapeutic effect. On the contrary, they seem to act asa stimulus to the tumor, accelerating the normal rate of growth spontaneous tumors show similar effects, but no cures are recorded only in tumors in which autolysis is active intra vitam does themethod exert any effect consequently the benign primary tumors ofanimals, such as fibromas, are not influenced by it neuberg and caspari are to a great extent responsible for the colloidaltheory of treatment in tumors accepting the observations of petri andothers that the autolytic ferments in tumors are quantitatively greaterand qualitatively different from those present in the normal tissuesof the body, they venture the assumption that the process of recoveryin the experimental tumors of animals is due to the self-digestion ofthe tumor by these ferments ascoli and izar271 had shown that suchferments are materially stimulated by the presence of metals, and moreespecially of metals in colloidal form this contention is apparentlyin harmony with the well-established fact that certain colloidal metalsof themselves are capable of acting under certain circumstances asferments neuberg and caspari were at first of the belief that thecompounds produced by them circulate in colloidal form subsequentlythey stated that these compounds were crystalline substances, but theyassumed, under the influence of the theoretical consideration mentionedabove, that these substances are broken up in the tumor and thereundergo transformation into the colloid state 271 izar. Ztschr f immunitätsforsch , 1913 izar and basile. Berl klin wchnschr , 1913, p 1312 in connection with the preceding observations there are certain otherexperimental results which require mention izar271 succeeded incuring rat tumors by means of injection of colloidal sulphur c lewin272 cured subcutaneous mouse tumors with various preparationsof gold werner and szécsi273 produced similar results througha combination of selenium-vanadium with cholin-borate.