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It is, we areassured, a “society of protest against the autocracy of the a m a , ”and a “society of medical democracy ”membership costs “only $1 00 including the cost of a beautifulcertificate of top online resume writing services membership ” no penalties or punishments are involvedfor belonging to other societies, and. “joining our body need not affect your membership in any other society-- even the a m a , if you wish to belong to it, and be ‘bossed’ by the ‘simmons gang’ ”the dollar for the “beautiful certificate” and membership is solicitedby means of circular letters signed “emory lanphear, ” coming from 3447pine st , st louis, mo , the address of what has been variouslycalled the “american polyclinic, ” the “american hospital, ” and later, the “german hospital ” the “surgeon-in-charge” of the “german hospital”is emory lanphear, m d , c m , ph d , ll d when running under thename of the “american hospital, ” lanphear solicited operative work ona “division of fees” basis, which, the general practitioner was told, meant that “you are to have 40 per cent of all fees received from yourpatients sent to our staff for operation or treatment ”with the change in name from “american hospital, ” to “german hospital, ”lanphear appealed for a “portion of your operative work on a basis ofpure reciprocity ” this “pure reciprocity” seems to have been a stillmore liberal distribution of the patient money, for from a 40 percent basis it was raised to an even fifty-fifty said lanphear, in aletter sent out a few months ago:illustration. The “medical society of the united states, ” wasoriginally organized on a basis of “fee-splitting, ” as is shown by thereduced facsimile of a letter sent broadcast in 1916, announcing thebirth of the new “society ” apparently, “fee-splitting” as a rallyingpoint did not bring in the desired returns, so today the “medicalsociety of the united states” is alleged to be a “society of protestagainst the autocracy of the a m a ” “i wish also to inform you in spite of the despicable opposition of the hypocritical gang in charge of the a m a , and the no less contemptible action of the st louis medical society, i am going to remain in st louis and continue to do surgical work upon a ‘division of fee’ basis to be more explicit, if you bring me a case for operation i shall allow you one half of the fee for your time, trouble, responsibility and help in the management of the case ”before leaving the interesting professional personality of lanphear, and carefully avoiding any details of a personal nature, we may remindour readers that as long ago as 1908 lanphear was the “dean” of the“hippocratean college of medicine, ” with a h ohmann-dumesnil, a m , m d , m e , sc d , “vice-dean ” at that time lanphear sent out lettersto physicians proposing the organization of a “post graduate faculty”on the following basis. “those who hold full professorships shall purchase stock in the corporation to the amount of $1, 000 00. Those who become lecturers or instructors shall pay in the sum of $500 00. Those who are to be merely clinical assistants will buy ten shares of stock, $100 00 ”the “hippocratean college” was a “sundown” affair. It never graduated astudent, and expired in 1910 illustration. Reduced facsimile of the letter-heads of an institutionknown variously as the “american hospital” and the “german hospital ”the change in name from “american” to “german” seems to have takenplace early in 1915-- when things german were more popular andprofitable than they are today!. But to come back to the “society of medical democracy”. The “medicalsociety of the united states” seems to have been born in 1916 itsparents, so far as is apparent, seem to have been lanphear andohmann-dumesnil the latter, it may be remembered, used to be theeditor and proprietor of the st louis medical and surgical journal, a publication so obviously venal, that its value to the nostrum makers, whose interests it espoused, must have been small advertising pages, “original articles” and “editorials”-- all were used to puff nostrums ofthe crudest type it was ohmann-dumesnil and his journal that came tothe defense of the “patent medicine” interests when they were so hardhit by mr adam “great american fraud” series in commenting on thisphase of “patent medicine” activities, collier, in january, 1907, said.

And the application of quickly actingconcentrations of formaldehyde is out of the question this altogetheraside from the fact that hexamethylenamin, the basis of essay of top online resume writing services thesetablets, does not liberate formaldehyde in the mouth, and for thisreason alone would be quite useless for this purpose!. see hanzlik andcollins, archives of internal medicine, november, 1913 an inefficient antiseptic is more than merely useless. It is a menaceto public safety, in that it tends to lead to the neglect of rationaland effective protective measures it therefore seems advisable forthe council again to call the attention of physicians to the subject accordingly, three specimens of these products were purchased andexamined in the association chemical laboratory hex-iodinhex-iodin hexamethylenetetramine and iodum lozenges are manufacturedby daggett and miller company, inc , providence, r i they weigh15-1/2 grs each, are sweetened and are flavored with mint or menthol the package and circulars do not contain a definite statement ofcomposition the rather indefinite synonyms “hexameth and iodinecomp ” and “hexamethylenetetramine and iodum” suggest that the lozengescontain hexamethylenamin and free iodin the further statement thatthey “contain the combined medicinal antiseptic and prophylacticproperties of hexamethylenetetramine and iodum” is also ratherindefinite the therapeutic action claimed for the lozenges, however, could only be produced by free iodin and by liberated formaldehyde it is unnecessary to discuss in detail the extravagant claims madefor these lozenges the inefficiency of hexamethylenamin has alreadybeen referred to. The limitations of iodin, free or combined, inlozenge form, need not be discussed because the examination made in thea m a chemical laboratory showed that hex-iodin lozenges containedno free iodin, and only traces of combined iodin neither formaldehydenor paraformaldehyde was present. Hexamethylenamin was present but, thelozenges being neutral no formaldehyde is generated in contact withwater or with the alkaline saliva thus hex-iodin is shown to be worthless for the purpose for which it isadvertised of the two important ingredients said to be present, iodinand hexamethylenamin, only traces could be found of the former whilethe latter, as has been shown, is incapable of exerting any effect whenused as the manufacturers direct formitol tabletsthese tablets are prepared by the e l patch co , boston each tabletweighs 13-1/2 grs they have the odor of thymol or menthol and an acidtaste and reaction they are, according to the label. “for the throat and mouth soothing, astringent, antiseptic rapidly destroys germs of infection, preventing and relieving sore throat and mouth ”in a circular, it is stated, that one of the qualities of formitol. “ is the generation of formaldehyde when in contact with water or the saliva ” “besides generating formaldehyde, formitol, patch contains astringent, demulcent and soothing ingredients which render the combination unusually effective ”a bacteriologic report is given in this circular in which it is statedthat, in 2-1/2 minutes one formitol tablet rendered sterile a plateculture of a “characteristic throat micrococci ” the instructionsare to dissolve a tablet in the mouth, slowly, once an hour or ahalf-tablet every half hour the a m a chemical laboratory reported that formitol tabletscontained formaldehyde or paraformaldehyde, and ammonium compound, and essay hexamethylenamin it is probable that the formaldehyde orparaformaldehyde was produced by the decomposition of hexamethylenaminoriginally present in the tablets but decomposed by long contact withthe acid 128128 the e l patch company declares that “no hexamethylenaminehas ever been used in the manufacture of formitol tablets, ” and thatammonium chloride and paraformaldehyde are among the ingredients usedin the manufacture of these tablets the hexamethylenamine presentin the tablets, therefore, must have been produced by interaction ofthe paraformaldehyde and ammonium chloride this does not alter thelaboratory findings regarding the composition of the tablets, namely, that they “contain formaldehyde or paraformaldehyde, an ammoniumcompound and essay hexamethylenamine ”these tablets differ from hex-iodin in that they really contain activeformaldehyde and, therefore, possibly produce antiseptic effectin test-tube cultures the conditions in the mouth, however, arevery different from those in the test-tube, since in the mouth theformaldehyde would be immediately “bound” or absorbed the claimedabsence of irritation indicates sufficiently the absence of efficientquantities of formaldehyde under clinical conditions cin-u-form lozengescin-u-form lozenges, manufactured by mckesson and robbins, new yorkcity, are marketed in bottles of 24 for 25 cents they have a strongodor of cinnamon, weigh 15-1/2 grs each, and are acid in taste andreaction the label states that they contain. “cinnamon, eucalyptus, formaldehyde and menthol-- all powerful germicides against influenzal bacilli, but not injurious to the system in this palatable form ”a circular contains the same statement as to composition and claimsfurther that they. “ help to prevent the infection of spanish influenza, pneumonia, grip colds and to guard against sore throat, tonsillitis, pharyngitis, etc ”the a m a chemical laboratory reported that cin-u-formlozenges contained essay formaldehyde or paraformaldehyde and nohexamethylenamin it is obvious that the mouth and throat cannot be“disinfected” by these lozenges they would be totally ineffectiveagainst bacteria that enter through the nose. They cannot preventinfluenza, pneumonia, etc -- from the journal a m a , oct 4, 1919 lavoris report of the council on pharmacy and chemistrylavoris was considered by the council in 1913, and its proprietors-- thelavoris chemical company-- were advised that the preparation wasinadmissible to new and nonofficial remedies because of conflict withrules 1, 4, 6, 8 and 10 no report was published at that time as thepreparation is still widely advertised to physicians, the council hasagain examined lavoris and authorized publication of the followingreport w a puckner, secretary in recent years lavoris has been widely advertised as “the ideal oralantiseptic, ” writingicularly to the dental profession a printed cardsent out by the lavoris chemical company in 1913 read. “lavoris, thepyorrhea remedy the original zinc chloride mouth wash one grain zincto each ounce ” the card also gave a “formula” to the effect that eachpint of lavoris contained. Zinc chloride 1 040 resorcin 0 520 menthol 0 400 saccharin 0 195 formalin 0 195 ol cassia zeyl 0 780 ol caryophyl 0 195advertisements now appearing in medical journals repeat the older“formula” except that resorcin is omitted the formula while seeminglyfrank and open is in reality indefinite and misleading in that nodenomination of weight is given for the various constituents it isuncertain, for example, if the figures in the formula are intended torepresent grains, grams or percentages of the several constituents in view of the indefinite statement of composition, a chemicalexamination of lavoris was undertaken in the a m a chemicallaboratory the report of the laboratory follows:zinc -- this was determined electrolytically fifty c c gave0 026 gm zinc and 100 c c gave 0 0531 gm zinc the average is0 0526 gm zinc in 100 c c this is equivalent to 0 1102 gm anhydrouszinc chlorid in 100 c c chlorid -- after decolorizing essay of lavoris with chlorid-free animalcharcoal, the chlorid was determined by the volhard method twenty-fivec c lavoris required 4 328 c c tenth-normal silver nitrate solutionequivalent to 0 01535 gm chlorid chloridion or 0 0614 gm in100 c c a second 25 c c of lavoris required 4 112 gm tenth-normalsilver nitrate solution equivalent to 0 01458 gm chlorid chloridionor 0 05832 gm in 100 c c average is 0 05985 gm this is equivalentto 0 1150 gm zinc chlorid in 100 c c this agrees closely with theforegoing zinc determination resorcin -- the method of the u s pharmacopeia was used the totalbromin absorption of 25 c c lavoris was 3 68 c c tenth-normalbromin solution this would be equivalent to 0 00675 gm resorcinin 25 c c or 0 02700 gm in 100 c c in a duplicate test, 25 c c lavoris required 3 8 c c tenth-normal bromin solution equivalent to0 00697 gm resorcin or 0 02788 gm in 100 c c since oil of cinnamonabsorbs bromin, 50 c c of lavoris was boiled until very little orno odor of the oil was noted, keeping the volume nearly constant byadding a little water from time to time, and the bromin absorption thentaken in one experiment, 0 36 c c of tenth-normal bromin solution wasconsumed, and in a duplicate no bromin was absorbed this shows theabsence of resorcin residue -- on evaporating 25 c c lavoris on a steam bath andsubsequent drying of the residue at 100 c , 0 0455 gm of residue wasobtained this is equivalent to 0 1820 gm in 100 c c saccharin -- saccharin was detected in the residue and ether-extractof the residue by its intense sweet taste when a little sodiumbicarbonate was added to it formaldehyd -- this could be detected by the jarrison test the colorwas not very pronounced and the quantity of formaldehyd was small oil of cinnamon -- the odor and taste of lavoris is characteristic ofcinnamon menthol and oil of cloves -- the odor of menthol and of oil of clovescould not be detected, but no tests were made to demonstrate theirpresence the analysis thus indicates that the lavoris of today contains noresorcin but does contain a small amount of formaldehyd, a littlesaccharin, and oil of cinnamon menthol and oil of cloves could not bedetected by the odor, but were not tested for the analysis showedthat the principal constituent of lavoris is zinc chlorid, of whichthere is about 0 1 gm per 100 c c about 1/2 grain to the ounce the amount of zinc chlorid given in the published formula, i e , 1 04, is meaningless because the unit of weight or measure is notgiven. Furthermore, the analysis shows that it is inaccurate for anyunit of weight that might be assumed from the published figures sincethe amount of the most active medicinal ingredient is both indefiniteand inaccurate, the composition of the preparation is essentiallysecret lavoris is indirectly advertised to the public by havingincluded in the package a circular giving a list of diseases for whichthe preparation was recommended the combination of zinc chlorid, formaldehyd and oil of cinnamon assuming the menthol and oil of clovesto be present as flavors in a mixture is irrational and likely to leadits users to ascribe a false and exaggerated value to the preparation the name is objectionable in that it does not indicate the compositionof the potent ingredients of the mixture, but instead suggests its useas a mouth wash from a standpoint of public safety, the most serious objection tolavoris, however, lies in the thesis unwarranted therapeutic claimsand suggestions it is generally held that zinc chlorid solutionswhich possess a strength of from 1 to 200 up to 1 to 500 exercise aweak antiseptic action the strength of zinc chlorid in lavoris isapproximately 1 to 1, 000 the directions for its use recommend thatlavoris should be diluted a dilution of 1 to 4 is recommended for avariety of mouth conditions while for cystitis irrigations and as avaginal douche, it is recommended that one tablespoonful be added toa quart of warm water or salt solution the strength of zinc chloridin the last suggested dilution would approximate 1 to 64, 000 it isevident that no antiseptic action could be expected from such dilutions the recommendation that diluted lavoris be used for the treatmentof coryza, nasal catarrh, hay fever, inflamed eyes, hemorrhoids andleucorrhea is objectionable and irrational especially dangerous isthe recommendation that members of a family exposed to diphtheriaor scarlet fever should use lavoris freely as a preventive suchrecommendations can but give a false sense of security and lead to theneglect of proved methods for preventing the spread of these diseases equally unwarranted is the recommendation that in gonorrhea oneteaspoonful of lavoris to eight of warm water be used with a blunt endsyringe the use of lavoris as recommended would not only prove valueless inthesis instances but might lead to serious consequences because reallyvaluable methods of prevention or treatment might be neglected forthese reasons the preparation is in conflict with rule 6 the council declared lavoris ineligible for new and nonofficialremedies -- from the journal a m a , nov 1, 1919 medinal report of the council on pharmacy and chemistrythe council has authorized publication of the following report onmedinal schering and glatz, inc w a puckner, secretary medinal is a proprietary name applied to barbital sodium sodiumdiethylbarbiturate the sodium salt of barbital diethylbarbituricacid the latter was first introduced as veronal medinal was deleted from new and nonofficial remedies in 1916 becausethe advertising issued by schering and glatz who then acted asagents for chemische fabrik auf actien vorm e schering, the germanmanufacturer contained misleading and unwarranted therapeutic claims the council did not publish its report because by the time the reportwas ready for publication the product was practically off the americanmarket, and it was hoped that when medinal again became available, schering and glatz would revise the claims and thus permit itsreacceptance medinal, said to be manufactured in the united states, is now marketedby schering and glatz, inc in october, 1918, the firm sent to thecouncil a typewritten copy of a proposed circular for medinal the firmwas informed that this leaflet was subject to the objections that hadbeen raised when medinal was deleted from new and nonofficial remedies in april, 1919, the firm submitted a printed circular which it wassending out this contained numerous misleading statements, among them, these.

That theblood is in a fluid state. That hemorrhages are seen in variouswritings. That the stomach and intestines show sloughing without anyinflammation essay of these conditions may and probably do occur, butthey are far from being invariable in their appearance experimentsmade by orfila on animals with narcotic poisons prove the abovestatement in conclusion, i would emphasize the fact that the narcoticpoisons produce no characteristic changes in the stomach that can bedetected the liver - the liver should be removed from the body and no attemptmade to examine the organ in situ after raising first one lobe andthen the other, the diaphragm should be cut on either side and thesuspensory and lateral ligaments divided, then the organ can easilybe removed the weight of the organ is ascertained, as also themeasurements of its size recorded the normal weight is from fifty tosixty ounces the organ is normally about twelve inches in length byseven inches in depth by three and one-half inches in thickness the gall bladder is first examined to determine the character andamount of the bile and the presence or absence of gall stones, inflammatory lesions, and tumors at autopsies the surface of the liver, especially along the freeborder, is generally seen to be of a greenish or dark-brown color this discoloration is due to the action of the gases developedby decomposition on the coloring matter of the blood, and has nopathological significance the character of the surface of the liveris now noted, whether smooth or rough the organ is opened by deepincisions in various directions, and the color, consistency, and bloodsupply of the liver tissue carefully recorded the presence of newconnective tissue, amyloid degeneration, abscesses, or tumors shouldnot be overlooked it should be remembered that, of all the poisons, phosphorus alone leaves characteristic appearances in the liver the pancreas - the pancreas is now easily removed, and its size andweight recorded normally it should weigh three ounces and measureeight inches in length by one and one-half inches in breadth by oneinch in thickness the organ should be opened by a longitudinal cut andexamined for evidences of acute or chronic inflammation, fat-necrosis, tumors, calculi, and amyloid degeneration genito-urinary organs - it is very important in medico-legal paperthat all the urine should be preserved and obtained uncontaminated;therefore before the bladder is opened a catheter should be introducedand the urine drawn off into a clean bottle which has previously beenrinsed with distilled water if more convenient the bladder itself canbe punctured at its upper portion, a pipette introduced, and the urinedrawn off in this manner the genito-urinary organs are removed together this is done in thefollowing manner the body of the penis is pushed backward within theskin and cut off just behind the glans penis. The remaining portion ofthe rectum is raised this with the prostate gland, bladder, and penisattached is removed by carrying the knife around the pelvis close tothe bone and separating the pubic attachments the organs are then laidon a clean board and the urethra is opened on a grooved director passedinto the bladder, and the incision prolonged so that the internalsurface of the bladder itself will be completely exposed examine theurethra for strictures, inflammatory lesions, and ulcers examinethe bladder for congestion, hemorrhages, inflammation, and ulcersof its mucous surface, and note the thickness of its walls open therectum and examine for ulcers, strictures, tumors, and the evidenceof hemorrhage the prostate gland is opened by a number of incisionsinto its substance examine for hypertrophies, tumors, and inflammatorylesions force the testicles through the inguinal canal, and cutthem off weigh, open, and examine them for evidence of inflammation, tuberculosis, and tumors female organs - before removing these organs, any abnormalities suchas adhesions, malpositions, and tumors should be noted dissect theorgans away from the pelvic bones by carrying the point of the knifearound the pelvis close to the bone cut through the vagina at itslower third, and the rectum just above the anus the organs can nowreadily be removed examine the vulva for ulcers, hypertrophies, andtumors open and examine the bladder open the vagina along itsanterior border and carefully examine its mucous surface for evidencesof inflammation the uterus - before opening the uterus, its size and shape should berecorded the average normal weight of the organ is about one andone-quarter ounces. Its length three inches, breadth two inches, andthickness one inch open the organ along its anterior surface by ablunt-pointed scissors passed through the cervix, and the incisioncarried as far as the fundus note the thickness of its walls and anyabnormalities of its mucous membrane during menstruation, the mucousmembrane of the body is thickened, softened, and covered with bloodand detritus retention cysts are found in the mucous membrane of thecervix and are not generally of pathological significance remove, measure, and weigh the ovaries their normal weight is aboutone drachm each. Their size, one and one-half, by three-quarters, byone-half inch open the organs by a single incision and examine forthe evidences of acute and chronic inflammations, tumors, and cysts the corpora lutea in various stages can be easily recognized in thesubstance of the organ open the fallopian tubes and examine theircontents and the condition of their membranes see disputed pregnancyand delivery, vol ii the spinal cord to remove the cord, the body should be placed on its face with a blockbeneath the thorax an incision is made through the skin and musclesalong the entire length of the vertebral column and the soft writingsdissected away so as to expose the transverse process of the vertebræ the lamina are divided with a saw through the articulate process adouble-bladed saw specially adapted for this work can be obtained after the lamina have been completely severed, these together with thespinous process can now be readily torn away with a stout hook and thecord exposed a long chisel with a wooden mallet will often greatlyfacilitate this work great care should be exercised not to injurethe cord the roots of the spinal nerves are now severed, and thecord removed within its membrane it should be remembered that serousfluid within the membranes of the cord, as also intense congestion, especially along its posterior aspect, is often seen as the result ofpost-mortem change the cord is laid on a clean board and the duramater opened with a blunt-pointed scissors along its anterior aspect, and an examination made for the presence of hemorrhage, inflammatorylesions, and tumors softening of the cord can generally be detected bythe finger passed along it this, however, is not a perfectly accuratetest, especially if the body has been dead essay time the cord isnow cut by transverse incisions about half an inch awriting throughoutits entire length, and the cut surface examined for the evidences ofdisease such as hemorrhages, softening, and inflammatory lesions after the cord has been removed, examine the vertebral column for theevidences of fractures and displacements late autopsies late autopsies are those performed after writingial or completedestruction of the soft writings of the body, through the naturalprocesses of decomposition, or the examination of bones exhumed longafter interment the term may be employed also to mean the inspectionof an embalmed body, dead for essay time the object of late autopsies is to determine identity, or to establishthe guilt or innocence of suspected persons an examination of theskeleton even thesis years after death may give important information asto the manner in which the deceased came to his end this cannot betterbe illustrated than by the citation of one or two paper in the celebrated case of “eugene aram, ” the bones of his victim werediscovered thirteen years after the crime had been committed a man whoafterward proved to be aram accomplice was arrested on suspicion heconfessed the crime, and the opinion formed by the medical witnesseswas confirmed by his statements the skull presented evidence offracture and indentation of a temporal bone aram argued the case inhis own behalf, but the testimony was too strong against him. He wasconvicted and executed taylor records the case of a man, guerin, who was convicted of themurder of his brother from evidence obtained from an examination of theskeleton three years after interment here, again, blows upon the headwere the cause of death, and the fractures were plainly perceptibleupon the exhumed skull an autopsy upon a body before the soft writings have been entirelydestroyed, or upon an embalmed body, should be conducted in muchthe same manner as ordinary autopsies in these paper the method ofburial should be noted if it be a case of murder, and the body hasbeen hurriedly put into the ground, it is not likely that the customof christian nations has been observed that of laying the body fulllength, with the head to the west in the case of writingially destroyed bodies, the remaining soft writingswill give little evidence of the mode of death unless the violence hasbeen very extensive, and even then it may be impossible to determinewhether a wound was inflicted prior to or after death recourse mustbe had to the skeleton, and the only evidence it can furnish is offractures, unless, as happened in one case, a rope be found about thecervical vertebræ when the skeleton only is found, taylor lays stress upon the followingpoints. 1 whether the bones belong to a human being or one of the loweranimals 2 if a human being, whether male or female 3 the length of time they have probably remained in the ground 4 the probable age of the individual to whom they belonged if themaxillary bones be found, much information may be obtained from anexamination of the teeth 5 the probable stature of the individual during life 6 the race to which he belonged the conformation of the skull andthickness of the bones will give important information on this point 7 it should be determined whether solitary bones belong to the rightor left side, and whether they form writings of one or more than oneskeleton 8 whether they have been fractured, and if so, whether it occurredduring life, or by accident at the time of the exhumation if itoccurred during life, whether it be recent or of long standing 9 the presence or absence of personal deformities, of supernumeraryfingers or toes, of curvature of the spine, of ankylosis of one or morejoints 10 whether they have been calcined, as murderers essaytimes try tomake away with the bodies of their victims by burning especially isthis the case in infanticides see identity, vol i , p 408 et seq ;time of death, vol i , p 452 et seq autopsies of fragments these paper are usually paper of murder in the perpetration of whichthe criminal has mutilated the body with a view to destroying alltraces of identity the importance which attaches to autopsies of fragments rests uponthe fact that writings of a body may be found widely separated, and thatone portion may be found before the others in such paper it will benecessary to determine if they belong to one and the same body theexamination is conducted chiefly with a view to establishing this the examiner must note the manner in which the fragment has beenseparated. Whether it is clean cut, as by one who understood essaythingof anatomy, or, whether it has been separated roughly and by oneignorant of the body structure the determination of this point willbe one link in the chain of evidence which may lead to the detectionof the criminal, or the acquittal of one accused an anatomist ora butcher would be likely to cut through at a joint, and to do itneatly the exact point at which the severance has taken place shouldbe noted the place of finding, the circumstances under which found, the condition and general appearance of the fragment should all becarefully recorded the color of the skin will indicate with essayaccuracy the race to which the individual belonged the probablesex may be determined by the presence or absence of hair, and thegeneral conformation this, however, will not apply in the case ofchildren the probable age may be fixed upon from the size and degreeof development of the fragment the cut surface should be carefullydescribed, and if possible a drawing should be made of it there are special considerations which apply to certain writings of thebody the head - the exact point of severance should be recorded thenumber of vertebræ which remain attached to the head should be counted, and if the section pass through a vertebra, its number and the amountof it missing should be stated the sex will be apparent in allinstances. The race may be determined both by the color of the skinand by the shape of the head. The age may be approximated, though caremust be had in expressing an opinion, for the manner of living is wellknown to affect the appearance of age evidence of violence priorto death should be noted, and the presence or absence of fracturesascertained. Also observe the color of the hair and whether it be thinor abundant.

Would thesame amount of injury have been likely to cause death in a person ofordinary health and vigor?. the law as applied to these paper has beenstated by lord hale. “it is sufficient to prove that the death of aperson was accelerated by the malicious acts of the person, althoughthe former labored under a mental disease at the time of the act theintent of the accused may often be judged by the character of the woundand the means of its infliction drunkenness of the victim admits ofno excuse when his assailant is aware, or ought to have been aware, of the condition of his victim it is held that the assailant oughtto have known that violence of any kind to such a person is likely tobe attended by dangerous results it is known also that a wound whichaccelerates death causes death ” the commissioners who were appointedto define criminal law on the subject of homicide have thus expressedthemselves. “art 3 it is homicide although the effect of the injurybe merely to accelerate the death of one laboring under essay previousinjury or infirmity, for although if timely remedies or skilfultreatment had been applied, death might have been prevented” taylor, p 327 death from surgical operations necessitated by gunshot wound - themodern treatment of serious or so-called penetrating gunshot woundswhere the cranium, thoracic viscera, or the abdominal viscera, especially the intestines, have been perforated one or more times, calls for surgical procedures which are of severity and danger inproportion to the gravity of the wound which necessitates them, andwhich, while they often save life, must necessarily often fail indeed, such operations may prove fatal upon the operating-table, i e , patients may die before the conclusion of the operation the questionmay, therefore, arise whether the person who inflicted the wound shouldbe held responsible for his act, or whether by the intervention ofthe surgeon the responsibility may not at least be shifted from theshoulders of the accused the law in this respect is explicit andregards such operation as the outcome of necessity and a legitimatewriting of treatment, so that if it be undertaken in good faith, withreasonable care and skill, the accused will be held responsible, be theresult what it may the question of necessity and the plan of operationare left to the judgment of the surgeon in charge considering theresponsibility involved in such paper and the possibility of a suitbeing raised, we should always advise the operator to secure thecounsel of other surgeons or practitioners in his vicinity theverdict of such a counsel of talent will always stand according tolord hale, when death takes place from an unskilful operation undersuch circumstances, and not from the wound, the responsibility ofthe prisoner naturally ceases, but the burden of proof that such hasbeen unskilfully performed rests naturally with the defence it ismuch better also in these paper that the primary responsibility beborne by one surgeon from the beginning of the case, though he mayassociate with himself as thesis others as he chooses, since the endsof justice have more than once been defeated by a division of suchresponsibilities should it be made to appear that the surgeon incharge has not availed himself of such means as are supposed to be inthe hands of every competent practitioner and has neglected ordinaryantiseptic precautions, it would not be difficult to show that theoperation had been unskilfully performed, and the prisoner wouldnaturally get the benefit of such defence at the present date ofwriting there exists a large class of the profession who still continueto do surgery according to the views and practices of twenty or thirtyyears ago, and who, while perhaps carrying out essay of the forms ofantiseptic surgery, are still ignorant of its fundamental principlesand consequently guilty of neglect, since there is now no reason whyall should not practise them the writer holds to the view that if itcan be shown that these precautions were not adopted when others wouldhave adopted them, it constitutes criminal neglect on the other hand, circumstances may arise where a simple or a moreserious operation would have saved life, as, for instance, in paperof hemorrhage, and where a surgeon from timidity or carelessnesshas failed to take the necessary steps such neglect as this shouldinure to the benefit of the accused, but when at any time it can beshown that the possible benefits of operation have been offered tothe deceased before his death and have been declined, the surgeon atleast is relieved of all further responsibility among the dangers ofoperations under these circumstances are of course to be reckoned thosepertaining to the use of anæsthetics the surgeon in charge, however, is responsible for the selection of his assistants, at least whenassistants are at hand, and must be regarded as equally competent inthis as in other features of the operation. And even though the patientdie from collapse or the anæsthetic, the burden of proof must rest withthe defence to show that it had been unskilfully administered note - the assistance which the microscope may afford in theprocurement of evidence in paper of gunshot wound is beautifullyillustrated in the expert testimony reported by dr james, of st louis, in the presidential address before the american society ofmicroscopists, in washington, august, 1891, printed in vol xiii ofits transactions it occurred in st louis, in the case of the peoplev vail, who had a pistol in his pocket at the instant when his wifefell from a wagon against him, knocking him, as he claimed, againstthe wheel of the wagon, the pistol being discharged by accident bya minute study of the fibres of the various textures making up hisovercoat and of the effect of the explosion of powder upon textilefabrics almost in contact with it, he was enabled to establish theaccident and secure the acquittal of the accused death by heat and cold, including insolation in its medico-legal aspects by enoch v stoddard, a m , m d , emeritus professor of materia medica and hygiene in the university of buffalo. Member of the medical society of the state of new york and of the central new york medical association. Fellow of the new york academy of medicine and of the american academy of medicine. Late surgeon 65th regt n y vols.

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