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Then let the oil if any be separated from the water according to art into the number of these waters may be ascribed the tears of vines, the liquor of the birch-tree, may dew culpeper that my country may receive the benefit of these waters, i shall first shew the temperatures, secondly, the virtues of themost usual and most easy to come us essay writing service by. If any should take exceptionsthat i mention not all, i answer first, i mention enough secondly, who ever makes this objection, they shew extreme ingratitude. For hadi mentioned but only one, i had revealed more to them than ever thecollege intended they should know, or give me thanks for doing the qualities and appropriation of the simple distilled waters simple distilled waters either cool or heat. Such as cool, either coolthe blood or choler waters cooling the blood lettice, purslain, water lilies, violets, sorrel endive, succory, fumitory waters cooling and repressing choleric humours, or vapours in the head nightshade, lettice, water lilies, plantain, poppies, viz theflowers both of white black and red poppies, black cheries the breast and lungs violets, poppies all three sorts, colt-foot in the heart sorrel, quinces, water lilies, roses, violets, green orunripe walnuts in the stomach quinces, roses, violets, nightshade, houseleeks, orsengreen, lettice, purslain in the liver endive, succory, nightshade, purslain, water lilies in the reins and bladder endive, succory, winter cherries, plantain, water lilies, strawberries, houseleek or sengreen, black cherries in the womb endive, succory, lettice, water lilies, purslain, roses simple waters which are hot, concoct either flegm or melancholy waters concocting flegm in the head, arebettony, sage, marjoram, chamomel, fennel, calaminth, rosemary-flowers, primroses, eye-bright in the breast and lungs maiden-hair, bettony, hysop, horehound, carduus benedictus, scabious, orris, or flower-de-luces, bawm, self-heal, &c in the heart bawm, rosemary in the stomach wormwood, mints, fennel, chervil, time, mother oftime, marigolds in the liver wormwood, centaury, origanum, marjoram, maudlin, costmary, agrimony, fennel in the spleen water-cresses, wormwood, calaminth in the reins and bladder rocket, nettles, saxifrage, pellitory ofthe wall, alicampane, burnet in the womb mugwort, calaminth, penny-royal, savin, mother of time, lovage waters concocting melancholy in the head, arehops, fumitory the breast bawm, carduus benedictus the heart borrage, bugloss, bawm, rosemary the liver endive, chicory, hops the spleen dodder, hart-tongue, tamarisk, time having thus ended the appropriation, i shall speak briefly of thevirtues of distilled waters lettice water cools the blood when it is over-heated, for whenit is not, it needs no cooling.

“for the source of secretin i preferably use that writing of the alimentary tract of any lower animal-- such as a hog or sheep-- including the gastric pylorus, the duodenum and the jejunum this writing is split open and washed with a normal saline solution to clean the mucosa or mucous membrane of any detritus which may be present the mucosa with the epithelial cells is then removed or separated from the muscular wall by scraping with a blunt knife or in any other suitable way the scrapings or cuttings, which contain the secretin, are then macerated or broken up ” “the macerated mass is placed in a suitable vessel and subjected to the action of an acid solution until digested the time for the digestion of the mass will, of course, depend upon the strength and temperature of the acid solution employed the stronger the solution and the higher the temperature, the shorter the time necessary for complete digestion this period may vary from several minutes to several hours in my experiments i found that the best results were obtained with hydrochloric acid solution of one-tenth to five-tenths of one per cent in strength, although as high as eight-tenths per cent might be used the mixture is brought to a temperature of approximately 210 f , and it may even for a few moments exceed that temperature, but it should be kept below the boiling point, for excessive heat injures or breaks down the secretin molecule and impairs or destroys its activity although i prefer to use hydrochloric acid, i would have it understood that other acids-- both organic or inorganic-- may be employed, provided that the percentage of acidity is regulated to prevent a chemical change in the secretin, and further provided, of course, that the acid has no injurious effect on the human system ” “after the mass has been digested in the heated solution, the decoction is decanted, and after being allowed to cool is passed through a suitable filter until the filtrate is clear i found that by filtering the decoction from four to six times through a carbon filter, i obtained a clear colorless filtrate this is a solution of secretin and the acid which was used, and the clearness of the solution shows that it is practically free from albumoses, gelatin and other impurities such as cell tissues, etc present in the raw material under treatment ” “to the solution of pure and active secretin prepared as above explained, there is added a suitable quantity of blood serum-- say from one-fifth to two per cent or any equivalent medium-- such as albumin solution or a peptone solution-- which will aid and sustain the activating power of secretin as provided by the blood that is to say, any medium having the same power, similar quality or chemical composition that the blood-stream possesses in combining with secretin to stimulate the pancreas the addition of such a medium to the active secretin solution increases the potency of the secretin and its degree of stability by preventing oxidation or deterioration thereof if this strengthening or fortifying medium, as it may be properly termed, is alkaline, it performs the additional function of lowering the acidity of the secretin filtrate it is preferable that the final product be just faintly acid if desired, the final product may be made into an elixir by the addition of aromatics ” “any desired strength of secretin solution may be obtained according to the quantity of acid solution in my experiments i used from ten to fourteen duodena to a pint of acid solution ” “the solution of secretin prepared as above described is characterized by its ability to resist oxidation or deterioration for a sufficient period of time to render the solution available as a commercial article, and is furthermore characterized by freedom from poisonous and irritable chemical substances, whereby the secretin is chemically adapted to the human system to stimulate the pancreas to increased secretion ” “as previously stated, the secretin prepared according to my method may be administered orally to produce the desired physiological action of course, if desired, the secretin might be injected intravenously, but this more or less dangerous procedure is not at all necessary, and i merely mention it here to point out that when i refer to the oral administration of my new secretin preparation, i do not mean to exclude its administration by injection ” “as to the commercial stability of the secretin prepared according to my method, i may say that i have found by actual tests that the preparation maintains its stability for as long a period as five or six months when i refer to my product as being “commercially stable, ” i mean that it resists oxidation or deterioration for a sufficient period to render the same available as a commercial article this period may vary from several weeks to several months, depending upon certain commercial factors well understood by the manufacturer so, roughly speaking, i should say that secretin is commercially stable when it retains its activity from one to six months i do not wish to be understood, however, as limiting myself to these exact figures ”that active secretin may be extracted from macerated intestinal mucosaby weak acids below the temperature of boiling is well known in fact, weak acids at body temperature in contact with the duodenal mucosa leadto the formation of secretin the claims that secretin given by mouthreaches the blood and acts on the pancreas has been made for otherpreparations of secretin it has also been shown that these claims areerroneous 122 thus it would appear that the only novel element indr beveridge patented secretin is the addition of serum, solubleproteins or peptones what reason is there for believing that thiswill render the secretin stable for months, and physiologically activewhen taken by mouth?. we do not believe dr beveridge ever injected hissecretin-- protein mixture-- intravenously in man or animals not underanesthesia, otherwise he would not have stated. “of course, if desired, the secretin may be injected intravenously ”122 carlson, lebensohn and pearlman, the journal, jan 15, 1916, p 178 beveridge patented secretin is not stablei the samples of secretin sent us by dr beveridge -- physiologicaltests were made on four quart bottles of the secretin kindly sent us bydr beveridge june 26, 1916 according to a letter from dr beveridgeof july 20, 1916, those samples of secretin were prepared june 20, thatis, only six days before received by us the material came in darkcolored bottles it was kept in the original bottles and placed inthe ice box immediately on receipt dr beveridge stated the secretin“should remain active until the month of november, 1916, at least ”tests were made on three out of the four bottles the fourth bottlewas not opened, as we desired to learn what change it might undergoin the way of protein precipitation and bacterial decomposition there is nothing in the beveridge method of preparation that insuresa sterile secretin unless it is passed through a berkefeld filter in all our crucial experiments the animals dogs were kept underlight ether anesthesia, a cannula inserted into the pancreatic duct, the blood pressure recorded from the carotid artery and the varioussecretin preparations injected intravenously when inactive secretinpreparations were encountered, control tests were always made withactive solutions of secretin to eliminate possible individualpeculiarities of the animal thus when the pancreas of a dog reacts tothe injection of preparation a, but not to preparation b, it isevident that absence of response to b is due to this preparation andnot to the animal or to the experimental conditions illustration. Fig 1 -- records of carotid blood pressure and secretionof pancreatic juice on intravenous injection of beveridge secretinin dogs x, injection of 10 c c secretin. B, record of flow ofpancreatic juice in drops tracing a, injection of 10 c c of onesample secretin ten days old furnished by dr beveridge tracingb, injection of 10 c c of second sample of secretin ten daysold furnished by dr beveridge tracing c, injection of 10 c c of secretin twenty hours old made by us according to the beveridgemethod showing that the secretin preparations sent us by dr beveridgecontained no secretin each of the three samples of secretin sent us by dr beveridge wastested in the above manner on five dogs the first tests were madejune 27, 28 and 29, respectively, that is, within nine days of thepreparation of these samples of secretin none of the samples wasactive fig 1, even when injected intravenously in quantities up to50 c c. 40-50 c c of beveridge secretin mixture may kill a dog bytoo great lowering of the blood pressure a good secretin preparationyields a copious secretion of pancreatic juice on intravenous injectionof a few cubic centimeters it is not difficult to prepare a secretin, by the original bayliss orstarling method or by the beveridge method, that retains essay activityfor a longer period than nine days hence we cannot account for theabsolute inactivity of these preparations except on the assumptionthat they did not contain any secretin to start with. That is, faultypreparation and absence of physiologic standardization the sample kept intact in its original container for six months becamegradually cloudy, a large mass of amorphous precipitate settledto the bottom and the odor showed bacterial decomposition it isreprehensible, to say the least, to state concerning such a mixture:“of course, if desired, it may be injected intravenously ” the factthat beveridge secretin may be rendered clear by filtering throughcarbon is not sufficient evidence that it is “pure secretin, ” free frombacteria and other injurious substances ii beveridge secretin mixture is rapidly rendered inactive by humangastric juice -- we prepared active secretin solutions by the beveridgemethod, using 0 2 per cent serum as the protein “stabilizer” ?. the addition of the serum does not appear to affect the activityof the fresh secretin preparation if beveridge secretin is ableto act on the pancreas when given by mouth, it is obvious that itmust run the gamut of gastric digestion, except in paper of completeachlorhydria it has been repeatedly demonstrated that all othersecretin preparations are rapidly destroyed by pepsin-hydrochloric aciddigestion is beveridge secretin an exception?. what is there in alittle serum, native albumin, or peptones to protect secretin againstgastric digestion?. The pure human gastric juice used in these tests was secured fromthe fistula case mr f v that has been under observation in ourlaboratory for years 123123 carlson. The control of hunger in health and disease, chicago, 1916 beveridge secretin and bayliss-starling secretin prepared sept 29, 1916 response of pancreas no of drops of secretin date of test quantity of ┌───────────┴───────────┐ secretin bayliss-starling beveridge injected, c c secretin secretin sept 29 10 75 78 oct 2 10 61 61 oct 6 10 28 17 oct 13 10 25 31 oct 27 10 5 6 nov 3 10 7 6 nov 17 10 4 5 nov 30 10 3 4 dec 4 10 2 2 dec 20 10 0 0 -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- two cubic centimeters of fresh gastric juice added to 8-10 c c beveridge secretin, the mixture being kept at body temperature 38 c , renders the secretin completely inactive in from 5 to 8minutes fig 2 there is no exception to this rule, as we haverepeated the test on thesis different secretin preparations and usingdifferent samples of human gastric juice the secretin of beveridgeis just as vulnerable as the secretin of bayliss and starling topepsin-hydrochloric acid digestion on what kind of tests doesbeveridge base his claim that his secretin mixture acts on the pancreaswhen given by mouth?. Iii the relative rate of deterioration of the secretin solutionsprepared according to bayliss and starling and according tobeveridge -- six different preparations of the two kinds of secretinwere made, kept in dark stoppered bottles in the ice box, and tested byintravenous injection in dogs under ether anesthesia from time to timeuntil all influence on the pancreas had been lost one typical seriesof these tests is given by the way of illustration see table on page126 illustration. Fig 2 -- records of carotid blood pressure and flow ofpancreatic juice on intravenous injection of secretin prepared by usaccording to the beveridge method x, injection of 10 c c of thesecretin.

Obvious print and punctuation errors were corrected bold text has been rendered as bold text multiple and antiquate spelling of specialistic words, expecially in french and german, have beed manteined out of consistency and due to the impossibility of determining what the spelling whas at the time this work was composed medical jurisprudence forensic medicine and toxicology by r a witthaus, a m , m d professor of chemistry, physics, and hygiene in the university of the city of new york, etc , etc and tracy c becker, a b , ll b counsellor at law, professor of criminal law and medical jurisprudence in the university of buffalo with the collaboration of j clifton edgar, m d. D s lamb, m d. W b outten, m d. Hon wm a poste. Edward s wood, m d. e v stoddard, m d. Hon goodwin brown. J c cameron, m d. E d fisher, m d. H p loomis, m d. Roswell park, m d. Irving c rosse, m d. f p vandenbergh, m d. J h woodward, m d. george woolsey, m d volume one new york william wood & company 1894 copyright, 1894, by william wood & company press of the publishers’ printing company 132-136 w fourteenth st new york contents pageintroduction, v medical jurisprudence, 1 the legal relations of physicians and surgeons t c becker, 3 the law of evidence concerning confidential communications chas a boston, 89 synopsis of the laws governing the practice of medicine w a poste and chas a boston, 135 forensic medicine thanatological, 293 the legal status of the dead body t c becker, 295 the powers and duties of coroners a becker, 329 medico-legal autopsies h p loomis, 349 personal identity j c rosse, 383 determination of the time of death h p loomis, 437 medico-legal consideration of wounds g woolsey, 457 medico-legal consideration of gunshot wounds roswell park, 591 death by heat and cold e v stoddard, 627 medico-legal relations of electricity w n bullard, 661 medico-legal consideration of death by mechanical suffocation d s lamb, 705 death from submersion or drowning j c rosse, 793 death from starvation e v stoddard, 813introduction the terms forensic medicine, legal medicine, and medical jurisprudencehave heretofore been used interchangeably to apply to those branchesof state medicine and of jurisprudence which have to deal with theapplications of medical knowledge to the elucidation of questions offact in courts of law, and with the legal regulation of the practice ofmedicine medico-legal science therefore includes all subjects concerning whichmembers of the legal and medical professions may seek information ofone another, each acting in his professional capacity it consistsof two distinct branches. That treating of medical law, to whichthe designation of medical jurisprudence properly applies.

And also saith, that, being hung about theneck, it remedies witchcraft both the leaves and berries of misseltodo heat and dry, and are of subtle us essay writing service writings. The birdlime doth molifyhard knots, tumours, and imposthumes. Ripens and discusses them, anddraws forth thick as well as thin humours from the remote writings ofthe body, digesting and separating them and being mixed with equalwritings of rozin and wax, doth molify the hardness of the spleen, andhelps old ulcers and sores being mixed with sandaric and orpiment, it helps to draw off foul nails. And if quick-lime and wine lees beadded thereunto, it works the stronger the misselto itself of the oak as the best made into powder, and given in drink to those that havethe falling sickness, does assuredly heal them, as matthiolus saith:but it is fit to use it for forty days together essay have so highlyesteemed it for the virtues thereof, that they have called it lignumsanctiæ crucis, wood of the holy cross, believing it helps the fallingsickness, apoplexy and palsy very speedily, not only to be inwardlytaken, but to be hung at their neck tragus saith, that the fresh woodof any misselto bruised, and the juice drawn forth and dropped in theears that have imposthumes in them, doth help and ease them within afew days moneywort, or herb twopence descript the common moneywort sends forth from a small threadyroot divers long, weak, and slender branches, lying and running uponthe ground two or three feet long or more, set with leaves two at ajoint one against another at equal distances, which are almost round, but pointed at the ends, smooth, and of a good green colour at thejoints with the leaves from the middle forward come forth at everypoint essaytimes one yellow flower, and essaytimes two, standing each ona small foot-stalk, and made of five leaves, narrow-pointed at the end, with essay yellow threads in the middle, which being past, there standin their places small round heads of seed place it grows plentifully in almost all places of this land, commonly in moist grounds by hedge-sides, and in the middle of grassyfields time they flower in june and july, and their seed is ripe quicklyafter government and virtues venus owns it moneywort is singularlygood to stay all fluxes in man or woman, whether they be lasks, bloody-fluxes, bleeding inwardly or outwardly, or the weakness of thestomach that is given to casting it is very good also for the ulcersor excoriations of the lungs, or other inward writings it is exceedinglygood for all wounds, either fresh or green, to heal them speedily, and for all old ulcers that are of spreading natures for all whichpurposes the juice of the herb, or the powder drank in water whereinhot steel hath been often quenched. Or the decoction of the green herbin wine or water drank, or used to the outward place, to wash or bathethem, or to have tents dipped therein and put into them, are effectual moonwort descript it rises up usually but with one dark green, thick andflat leaf, standing upon a short foot-stalk not above two fingersbreadth. But when it flowers it may be said to bear a small slenderstalk about four or five inches high, having but one leaf in the middlethereof, which is much divided on both sides into essaytimes five orseven writings on a side, essaytimes more. Each of which writings is smalllike the middle rib, but broad forwards, pointed and round, resemblingtherein a half-moon, from whence it took the name. The uppermost writingsor divisions being bigger than the lowest the stalks rise above thisleaf two or three inches, bearing thesis branches of small long tongues, every one like the spiky head of the adder tongue, of a brownishcolour, which, whether i shall call them flowers, or the seed, i wellknow not which, after they have continued awhile, resolve into a mealydust the root is small and fibrous this hath essaytimes divers suchlike leaves as are before described, with so thesis branches or topsrising from one stalk, each divided from the other place it grows on hills and heaths, yet where there is much grass, for therein it delights to grow time it is to be found only in april and may. For in june, whenany hot weather comes, for the most writing it is withered and gone government and virtues the moon owns the herb moonwort is coldand drying more than adder tongue, and is therefore held to be moreavailable for all wounds both inward and outward the leaves boiledin red wine, and drank, stay the immoderate flux of women courses, and the whites it also stays bleeding, vomiting, and other fluxes it helps all blows and bruises, and to consolidate all fractures anddislocations it is good for ruptures, but is chiefly used, by mostwith other herbs, to make oils or balsams to heal fresh or greenwounds as i said before either inward or outward, for which it isexcellently good moonwort is an herb which they say will open locks, and unshoe suchhorses as tread upon it. This essay laugh to scorn, and those no smallfools neither. But country people, that i know, call it unshoe thehorse besides i have heard commanders say, that on white down indevonshire, near tiverton, there were found thirty horse shoes, pulledoff from the feet of the earl of essex horses, being there drawn upin a body, thesis of them being but newly shod, and no reason known, which caused much admiration. The herb described usually grows uponheaths mosses i shall not trouble the reader with a description of these, since myintent is to speak only of two kinds, as the most principal, viz ground moss and tree moss, both which are very well known place the ground moss grows in our moist woods, and at the bottomof hills, in boggy grounds, and in shadowy ditches and thesis other suchlike places the tree moss grows only on trees government and virtues all sorts of mosses are under the dominionof saturn the ground moss is held to be singularly good to break thestone, and to expel and drive it forth by urine, being boiled in wineand drank the herb being bruised and boiled in water, and applied, eases all inflammations and pains coming from an hot cause. And istherefore used to ease the pains of the gout the tree mosses are cooling and binding, and writingake of a digesting andmolifying quality withal, as galen saith but each moss writingakes of thenature of the tree from whence it is taken. Therefore that of the oakis more binding, and is of good effect to stay fluxes in man or woman;as also vomiting or bleeding, the powder thereof being taken in wine the decoction thereof in wine is very good for women to be bathed in, that are troubled with the overflowing of their courses the same beingdrank, stays the stomach that is troubled with casting, or hiccough;and, as avicena saith, it comforts the heart the powder thereoftaken in drink for essay time together, is thought available for thedropsy the oil that has had fresh moss steeped therein for a time, andafterwards boiled and applied to the temples and forehead, marvellouslyeases the head-ache coming of a hot cause. As also the distillations ofhot rheums or humours in the eyes, or other writings the ancients muchused it in their ointments and other medicines against the lassitude, and to strengthen and comfort the sinews. For which, if it was goodthen, i know no reason but it may be found so still motherwort descript this hath a hard, square, brownish, rough, strong stalk, rising three or four feet high at least, spreading into thesis branches, whereon grow leaves on each side, with long foot-stalks, two atevery joint, which are essaywhat broad and long, as if it were roughor crumpled, with thesis great veins therein of a sad green colour, anddeeply dented about the edges, and almost divided from the middle ofthe branches up to the tops of them which are long and small grow theflowers round them at distances, in sharp pointed, rough, hard husks, of a more red or purple colour than balm or horehound, but in thesame manner or form as the horehound, after which come small, round, blackish seeds in great plenty the root sends forth a number of longstrings and small fibres, taking strong hold in the ground, of a darkyellowish or brownish colour, and abides as the horehound does. Thesmell of the one not much differs from the other place it grows only in gardens with us in england government and virtues venus owns the herb, and it is under leo there is no better herb to take melancholy vapours from the heart, tostrengthen it, and make a merry, chearful, blithe soul than this herb it may be kept in a syrup or conserve. Therefore the latins calledit cardiaca besides, it makes women joyful mothers of children, andsettles their wombs as they should be, therefore we call it motherwort it is held to be of much use for the trembling of the heart, andfaintings and swoonings.

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If this tumor fluctuates or ishard, but in either case is elastic. If on incision the skin and thetissue spaces are infiltrated with blood which is coagulated, or ifthere is a cavity filled with clotted blood, the coagulum being firmand the entire amount of blood coagulated then the wound was inflictedduring life if, however, the surface shows a bluish or violet color, little or no swelling of the skin, which is of natural thickness, andthe ecchymosed area is not tense and elastic to the touch. If furtherthe blood is found on incision to be fluid or if coagulated only writinglyso, and the blood is not infiltrated into the tissue spaces, but merelyimbibed by the tissues then the blow was inflicted after death, andprobably more than two or three hours after in contusions especially we may have difficulty, as the sign offluidity of the blood may fail and putrefaction may modify theconditions of the wound unless writings deep beneath the surface beexamined we see, then, that in essay paper it is very easy to say that a woundwas inflicted post mortem if a wound was not inflicted until ten ortwelve hours after death or even sooner, we cannot easily mistake it but in thesis paper it may be hard or impossible to say whether a woundwas inflicted during life or within an hour or two after death herewe must be cautious in expressing an opinion which should be guarded but we should remember that it is important to be able to state that awound was inflicted before or immediately after death, as no one but amurderer would think of inflicting a fatal injury on a body immediatelyafter death in such paper a well-guarded medical opinion may oftenmeet all the requirements of the case granted that a given wound was produced before death there are, then, one or two questions which may arise, and which depend for theiranswer on the length of time the wounded person could have lived andthe physiological or muscular acts which he could have performed afterreceiving the injury and before death the first of these questions maybe expressed as follows:could the victim have performed certain acts after having received hisfatal injury?. the term “certain acts” here refers to almost any thingor things which would require time and strength in other words, thecontinuance of life with bodily and mental powers for a certain timeafter receiving a mortal injury this question may be raised in relation to an attempted alibi of theaccused, who may have been proved to be in the presence of the victima moment before death if after this moment the victim has movedfrom the spot or performed certain acts before death, the attemptedalibi may depend upon the answer to the question as to whether thegiven acts of the victim were compatible with the fatal character ofthe wound an alibi can aid in the acquittal of the accused only whenthe nature of the injury was such that death would be supposed to beimmediate or nearly so great care should be taken on the writing ofthe medical witness in answering this question, for after very gravewounds, proving speedily fatal, the victim essaytimes can do certainacts requiring more or less prolonged effort, as shown by numerousexamples wounds of the brain are especially noticeable in allowinga survival of several hours, days, or even weeks, during which timethe injured person may pursue his occupations where the survivalhas lasted days or weeks, the alibi has no importance, but not ifthe survival is of shorter duration the following case is cited byvibert1 and may be mentioned in this connection, though the woundwas caused by a bullet which traversed from behind forward the entireleft lobe of the brain after the injury the victim was seen byseveral witnesses to climb a ladder, though with difficulty, for hehad right-sided hemiplegia he was found insensible more than half amile away, and did not die until six or eight hours after the injury severe injury of important organs is essaytimes not incompatible withan unexpectedly long survival devergie cites two illustrations ofthis which are quoted by vibert 622 a man received several extensivefractures of the skull, with abundant subdural hemorrhage, and ruptureof the diaphragm with hernia of the stomach the stomach was ruptured, and nearly a litre of its contents was contained in the left pleuralcavity notwithstanding all this, he was able to walk about for an houror so and answer several questions he died only after several hours another man, crushed by a carriage, received a large rupture of thediaphragm, complete rupture of the jejunum, and rupture and crushing ofone kidney yet he walked nearly five miles, and did not die until thenext day more rarely wounds of the great vessels are not immediately fatal m tourdes is quoted by vibert623 as citing the case of a man whodescended a flight of stairs and took several steps after divisionof the carotid artery. Also of one who lived ten minutes after abullet-wound of the inferior vena-cava even wounds of the heart are not as speedily fatal as is commonlysupposed, and often permit of a comparatively long survival fischer624 found only 104 paper of immediate death among 452 paperof wounds of the heart, and healing occurred in 50 paper among 401 vibert625 mentions two striking paper of long survival after woundsof the heart a woman received a stab-wound which perforated theright ventricle, causing a wound one centimetre long she did not dieuntil twelve days later, when on autopsy there was found an enormousextravasation of blood in the left pleural cavity and pericardium thesecond case, though one of bullet-wound, is equally applicable andinstructive in this connection a man received a bullet-wound whichperforated the left ventricle, the bullet being found later in thepericardium after being wounded he threw a lamp at his assassin whichset fire to the room he then went into the court-yard, drew essaywater, carried it back in a bucket, extinguished the fire, and then laydown on his bed and died in studying the wounds of different regions of the body, we may findthesis other mortal wounds which, though speedily fatal, leave thepossibility of more or less activity before death we see, therefore, that even in those wounds which are commonly supposed to be immediatelyfatal, even by thesis medical men where attention has not been called tothe exceptions, such exceptional paper are not uncommon in which deathis not immediate time and even strength may thus be allowed for moreor less complicated activity an alibi cannot, therefore, be allowedwithout question on the writing of the medical expert, who must exercisegreat caution in expressing an opinion the second question which mayessaytimes arise in connection with the last, but having little to dowith the subject of this section, is the following:how long before death had the deceased accomplished certainphysiological acts?. for instance, how long after a meal did he die?. This is hard to answer with precision, as digestion varies with theindividual, and digestion begun during life may go on to a certainextent after death we may be able to say if digestion has justcommenced, is well advanced, or has terminated what was eaten at thelast meal may be learned by the naked eye, the microscope, the color ofstomach contents and their odor the state of the bladder and rectum isessaytimes called in question all the above facts have less bearing onthe case than those in relation to the former question the cause of death from wounds the cause of death should be certain and definite in reality, there isonly one real cause, though one or thesis circumstances may be accessorycauses in most paper of death from the class of wounds which we havebeen considering, there is no difficulty in determining the cause ofdeath so as to be able to state it definitely but if the deceased hadrecovered from the first effects of the wound and then died, or ifdeath seems as much due to disease as to injury, then the real causeof death may be obscure if the medical witness is in doubt as to whichof two causes was the primary cause of death the doubt should be statedat once, as it may weaken the testimony if brought out later wounds may be directly or indirectly fatal they are directly fatal ifthe victim dies at once or very soon after the wound, with no othercause internally in his body or externally from his environment woundsare indirectly or secondarily fatal if the injured person dies from awound disease or complication, the direct consequence of the wound, or from a surgical operation necessary in the treatment of the case wounds may also be necessarily fatal either directly or secondarily, or not necessarily fatal in the latter case death may be due asmuch, if not more, to other causes than the wound, and essaytimes notat all to the wound itself thus death may be due to natural causes, latent disease, an unhealthy state of the body, imprudence or neglectof treatment, or improper treatment, etc these various degrees ofresponsibility of a wound as the cause of death we will now considermore at length i was the wound the cause of death directly?. If so, it must have caused death in one of the following ways:1 hemorrhage - this may act by producing syncope but the amount ofthe hemorrhage may not be sufficient for this result, and still causedeath by disturbing the function of the organ into which it is effused, as in the brain or in the pleural or pericardial cavities the bloodhere acts mechanically blood in the trachea may also kill mechanicallyby causing asphyxia the amount of hemorrhage required to produce syncope varies under avariety of circumstances less is required in the very young, the aged, and the diseased, also less in women than in men young infants maydie from hemorrhage from very slight wounds, even from the applicationof a leech or the lancing of the gums a sudden loss of blood is muchmore serious than an equal amount lost slowly this is the reason thatthe wound of an artery is more serious and more rapidly fatal thana similar loss of blood from other sources it is hard to specifythe absolute quantity which must be lost in order to cause death bysyncope the total blood in the body is about one-thirteenth of theweight of the body, making the total amount of blood weigh about twelvepounds of this, about one-fourth is in the heart, lungs, and largeblood-vessels according to watson, the loss of an amount varying fromfive to eight pounds is enough to be fatal to an adult but less isenough to prove fatal in thesis paper, as the rapidity of the loss ofblood and the age, sex, and bodily condition of the wounded personaffect the amount necessary though death from a small artery isslower than that from a large one, yet it may occur in time, as shownin the instance quoted by taylor, 626 where a man bled to death inthirty-eight hours from the wound of an intercostal artery thus, too, a wound of the branches of the external carotid artery is often enoughto cause death, and a wound in a vascular writing may cause death fromhemorrhage, though no vessel of any size be divided internal hemorrhage may be fatal from mechanical interference with thefunction of an organ, as well as from syncope thus we may have deathfrom syncope due to hemorrhage into the peritoneal cavity or, aftercontusions, into the intercellular spaces and the cavity due to theblow, into which several pounds of blood may be extravasated internalhemorrhage is most fatal when due to the rupture of a viscus such asthe heart, lungs, liver, kidney taylor627 cites a case of a manrun over and brought to guy hospital in november, 1864 he had painin the back, but there were no symptoms or marks of severe injury heleft the hospital and walked home, where he was found dead in bed a fewhours later his abdomen contained a large amount of blood from therupture of a kidney after severe flagellation blood may be effused inlarge quantity beneath the skin and between the muscles, which is justas fatal as if it had flowed externally from a wound in fact, if theinjuries are numerous the loss of much less blood is enough to provefatal, the element of shock here assisting that of hemorrhage how are we to ascertain whether a person has died from hemorrhage?. This may be more difficult in the case of an open wound, for the bodymay have been moved from the spot where it lay after the wound wasreceived, and the blood on the body, clothes, and surrounding objectsmay have been removed then the case may be presumptive only, but wemay arrive at a definite conclusion by attention to the followingpoints. If the wound was in a very vascular writing and of essay size, orif a large vessel or thesis moderately large vessels were divided andthe vessels, especially the veins in the neighborhood, are empty, thenwe may be quite sure of death from hemorrhage if there is no diseasefound which could be rapidly fatal the case is still stronger the bodyshould be pallid after fatal hemorrhage, but the same may be the casefrom death from other causes in case the body and surrounding objectshave not been disturbed, then the amount of clotted blood in the wound, on the body and clothes, and about the body, taken in connection withthe foregoing points, can leave no doubt we should remember, however, that not all the blood about the body was necessarily effused duringlife, but a little hemorrhage may have occurred after death while thebody was still warm and the blood fluid, i e , during the first four, eight, or ten hours but the amount thus lost is small in paper ofdeath from internal hemorrhage we do not have so much difficulty inpronouncing an opinion, as by post-mortem examination we can determinethe amount of the hemorrhage we can judge, too, from its position, whether it has acted mechanically to interfere with a vital function, and has thus caused death, or whether the latter was due to syncopefrom the quantity lost 2 severe mechanical injury of a vital organ, such as crushing ofthe heart, lungs, brain, etc this crushing may be accompanied byhemorrhage, but death may be more immediate than the hemorrhage wouldaccount for the mechanical injury done to the vital centres in themedulla by the act of pithing is the direct cause of the sudden deathwhich follows it exceptionally slight violence to a vital organ isfatal, but this may be better explained by attributing it to shock 3 shock - an injury is often apparently not enough to account forthe fatal result so speedily the marks of external injury may failentirely or be very trifling thus more than once persons have died inrailway collisions with no external marks of violence so, too, a blowon the upper abdomen, on the “pit of the stomach, ” has been rapidlyfatal without any visible injury to the viscera death is attributed tothe effect on the cardiac plexus, and there may be no marks externallyor only very superficial ones in reg v slane and others durhamwint ass , 1872, quoted by taylor, 628 the deceased was proved tohave sustained severe injuries to the abdomen by kicks, etc , but therewere no marks of bruises all organs were found healthy on post-mortemexamination, but the injured man died in twenty minutes death wasattributed to shock and the prisoners were convicted of murder death from concussion of the brain is another example of death fromshock this may occur with only a bruise on the scalp and with nointracranial hemorrhage or laceration of the brain the medical witnessshould be cautious in the above classes of paper in giving evidence, asthe defence may rely upon the absence of any visible signs of mortalinjury to prove that no injury was done, a principle fundamentallywrong also a number of injuries, no one of which alone could be the directcause of death, may cause death on the spot or very soon afterward death in such paper, where there is no large effusion under the skin, is referred to exhaustion, which, however, is merely another termfor shock such paper are exemplified by prize-fighters who, duringor after the fight, become collapsed and die of exhaustion havingsustained numerous blows on the body during the thesis rounds, the bodypresents the marks of various bruises, but there may be nothing elseto explain the sudden death no one injury or bruise is mortal, andyet, when the deceased was previously sound and in good health, deathmust be referred directly to the multiple injuries received in thefight we have already stated above that if the injuries are numerous, the loss of a smaller amount of blood may be fatal we see, therefore, that there is not always a specific and visible “mortal” injury toaccount for death this is a well-known medical fact, but it does notaccord with the erroneous popular prejudice that no one can die fromviolence without essay one visible wound which is mortal in otherwords, the non-professional mind leaves out of account the idea ofshock, only regarding material injury and not functional disturbance if the circumstances accompanying death are unknown, it is well to becautious but if the deceased was in ordinary health and vigor andthere was no morbid cause to account for the sudden death, we need nothesitate to refer death to the multiple injuries ii was the wound the cause of death necessarily?. This brings up a number of interesting questions to be considered inmedical jurisprudence there is probably no condition so common as thatthe injury is admitted, but death is attributed to essay other cause thus if there are several wounds it may be hard to decide on therelative degree of mortality of any writingicular one, so as to be able tosay that death was directly or necessarily due to this or that one thedefence may plead that death was not necessarily due to the writingicularwound attributed to the prisoner this brings up the question which of two or more wounds was the cause of death?.