Usc Essay

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.

Others, of the face. Others, again, of the hands and feet, of the fingers and toes, of the arms and legs, of the trunk and neck astrology, moreover, was not satisfied with theprognostic and diagnostic activity which we have just mentioned, but italso interfered in therapy, internal as well as external regarding, in the first place, internal medicinal treatment, theastrologer knew how to give positive information about the same. Forall terrestrial beings, of an organic as well as of an inorganicnature, were under the influence of the sun, the moon, of the planets, and of the signs of the zodiac the stars imwritinged certain powers tothe planets, to animals, and to all structures of the inorganic world if, therefore, it were known what stars happened to appear in thevault of heaven at the beginning of the disease or of its treatment, it was only necessary seriously to consider the organic and inorganicstructures under their supervision, and the remedies required for asuccessful control of the disease were presently at hand but if thehealer wished to be absolutely certain what medicaments to choose, thephases of the moon and the condition of the sun were also to be takeninto consideration essay remedies could be administered only when themoon was in a writingicular relation to certain planets or stars of thezodiac these remedies were principally emetics and purges similarly to the internal clinician, so also in surgery, the healerwas entirely dependent upon the conjunction of the stars the primevalbabylonian directed that the body must not be touched with iron duringcertain conjunctions of the stars, and this was also prescribed inall paper of astrologica medica it appears, however, that thisdirection obtained less general surgical recognition, but referredprincipally to blood-letting even to this limited extent it implieda high-handed interference with the art of the ancient as well as ofthe medieval physician.

Skin cold usc essay. No pulse. No heart-beatrecognizable. No respiration. No reflex action galvanism failed toarouse any muscular action the details are too numerous to give all ofthem there was reduplication of heart-sounds for several days, due tointerference with pulmonary circulation she recovered both bodily andmental health 45 richards. Indian med gaz , 1886, xxi , p 78 - man, age 20;suicide. Was cut down and lived for four days 46 kite. Univ med mag , 1888-89, i , p 475 - man, age 69. Suicide 47 terrier. Prog méd , 1887, vi , pp 211-214 - two men, age 29 and25, insane attempted suicide by hanging both resuscitated 48 nobeling. Aertz intellig -bl , 1884, xxxi , p 213 - twosuicides by hanging. Men, ages 24 and 40 49 ritter. Allg wien, med zeit , 1886, xxxi , p 375 - soldier, found hanging cut down in ten minutes artificial respirationapplied.

the importance of this usc essay point was wellillustrated in the “lizzie borden case ” by a careful consideration ofall the conditions presented by each body in the ways i have indicated, the question will not ordinarily be a difficult one to decide themedico-legal considerationofwounds, includingpunctured and incised wounds, and wounds made by blunt instrumentsother than gunshot wounds bygeorge woolsey, a b , m d , professor of anatomy and clinical surgery in the medical dewritingment ofthe university of the city of new york. Surgeon to bellevue hospital;member medical society of the county of new york, new york academy ofmedicine, new york surgical society, etc , etc wounds general considerations the different kinds of wounds the surgical and medico-legal ideas of wounds are quite different, thelatter including the former as well as other varieties of injuries definitions - surgically a wound means a solution of continuity andrefers to every such lesion produced by external violence or developingspontaneously the medico-legal acceptation of the term is much broaderand includes any injury or lesion caused by mechanical or chemicalmeans vibert601 quotes foderé as defining a wound medico-legally as, “every lesion of the human body by a violent cause of which the resultsare, singly or combined, concussion, contusion, puncture, incision, tear, burn, twist, fracture, luxation, etc. Whether the cause isdirected against the body or the body against the cause ” the sameauthor quotes another definition of a wound as, “every lesion howeverslight, resulting in concerning or affecting the body or health of anindividual ” taylor602 defines a wound in a medico-legal sense as “abreach of continuity in the structures of the body whether external orinternal, suddenly occasioned by mechanical violence ” thus, the termwound in its medico-legal acceptation includes not only surgical woundsbut contusions, fractures, burns, concussion, etc in france at leastthe voluntary inoculation of syphilis has been considered as comingunder the category of wounds 603medico-legally, the severity of a wound is much more important thanthe kind of wound thus we may consider wounds according to theircomparative gravity, as mortal, severe, or slight a mortal wound is one which is directly fatal to life in acomparatively short time, usually from hemorrhage, shock, or the injuryof a vital writing a wound may result fatally without being a mortalwound, as when a slight wound causes death on account of essay woundinfection severe wounds, or “wounds causing grievous bodily harm, ” as they havelong been called, do not put life in imminent danger, though they maybe inconvenient or detrimental to health pollock, c b , says that awound causing grievous bodily harm is “any wound requiring treatment ”a medical opinion or certificate may be required as to the danger of agiven wound, and on this opinion may depend the question of bail forthe prisoner by the danger of a wound in such a case is usually meantimminent danger, as any wound may be remotely dangerous to life slight wounds, as already stated, may result fatally under certainconditions under the french practice a slight wound is one which doesnot incapacitate one from work for more than twenty days looked atin another way, slight or severe wounds may be classified accordingas they are completely curable, leaving no infirmity or disturbanceof function, or not completely curable the latter are such as arenecessarily followed by permanent or temporary infirmity the question as to the severity of any given wound may essaytimes beleft to the jury to decide from the description of the wound, or amedical opinion may be required although the intent of the assailant is often of equal or greaterimportance than the severity or kind of wound, yet this can onlyoccasionally be inferred from the surgical aspects of the wound the classes of wounds to be treated in the following pages are incisedand punctured wounds and wounds with blunt instruments, essay of thecharacteristics of which we will now consider incised wounds are such as are produced by a cutting instrument, andthey are distinguished by the following characteristics. They measuremore in length than in the other dimensions they are usually straightin direction, though not infrequently curved, and they may even bezig-zag, especially where the skin lies in folds the edges of anincised wound are linear, and show no signs of contusion they areeither inverted or everted and the edges and sides of the wound areretracted the eversion of the skin is due to its elasticity, but inessay regions of the body, e g , in the scrotum, etc , the skin isinverted owing to the contraction of the muscle fibres immediatelybeneath the gaping of the wound is due to the retraction of thedivided muscles and fibrous structures it varies according as themuscles are cut directly across or more lengthwise, and in proportionto the distance of the wound from the points of attachment of themuscles the fibrous tissues, fasciæ, and aponeuroses retract less, and so givea essaywhat irregular surface to a large wound ogston604 divides incised wounds into three writings, the commencement, centre, and end, of which the end often has two or more serrationsdiffering from the commencement, which has but a single point thereare often one or more slight, superficial, tentative incisions situatedalmost always, though not invariably, near the commencement 605 thedeepest writing of the wound is more often near the commencement ifthere are angular flaps on the edges their free angles point to thecommencement of the wound coagula and clots of blood are to be found in the wound, more or lessfilling it up if it has not been interfered with on examination theends of the divided vessels are found plugged with clots which mayprotrude essaywhat from their openings if the wound is seen very shortly after its infliction, hemorrhage isin progress, and the divided arteries show their position by theirindividual, intermittent jets of blood the severity of incised woundsdepends upon the amount of hemorrhage, which is greater the deeper andlarger the wound, and the more vascular the tissues in which it occurs, especially if large and important vessels are concerned in the lattercase an incised wound may be very rapidly fatal incised wounds present the least favorable conditions for thespontaneous arrest of hemorrhage of any form of wounds the edges of anincised wound may be quite rough and even dentated or lacerated if theedge of the weapon be rough and irregular the kind and condition of a weapon which has produced a given incisedwound may often be learned by an examination of the characteristics ofthe wound weapons cutting by their weight as well as by the sharpness of theiredges, such as axes, etc , may cause a certain amount of contusionabout a wound. They crush the soft writings to a certain extent, and thebones may be indented or even fractured wounds caused by fragments of bottles, pieces of china, earthenware, or glass, though strictly speaking incised wounds, are often curved, angular, and irregular, and their edges jagged and contused wounds caused by scissors may essaytimes be of the nature of incisedwounds when they present a double wound of triangular shape, with theapex of the triangle blunt, they are more of the nature of puncturedwounds in general a “tail” or long angle in the skin at one end of anincised wound indicates the end of the wound last inflicted, and essaylight may thus be thrown upon the inflicter of the wound incised wounds present very favorable conditions for healing by primaryunion, but often fail in this and heal by secondary union when anincised wound fails to unite by primary union, bleeding continuesfor several hours or even as long as a day, the blood being mixedmore or less with a serous discharge the latter continues until thethird day or so by the fourth or fifth day the surface has begun togranulate, and there may be a more or less profuse purulent dischargefrom the surface the granulating surfaces do not necessarily dischargepus, however for essay days, therefore, after the infliction of anincised wound, or until the surface is covered with granulations, thecharacteristics of the wound permit of a diagnosis as to the nature ofthe wound the diagnosis of an incised wound is generally without difficulty essay wounds by blunt instruments, however, in certain regions of thebody, resemble incised wounds very closely such instances are foundwhere a firm, thin layer of skin and subjacent tissue lies directlyover a bony surface or a sharp ridge of bone these are seen most oftenin the scalp or in wounds of the eyebrow where the sharp supra-orbitalridge cuts through the skin from beneath the diagnosis of an incisedwound can often be made with great probability from the cicatrix thisis especially the case if the wound has healed by primary union and thecicatrix is linear the prognosis in incised wounds is good as to life unless a largevessel has been divided or unless an important viscus has beenpenetrated the prognosis as to function varies with the position andextent of the wound, and the circumstance of the healing of the wound punctured wounds, stabs, etc - these are characterized by narrownessas compared to depth, though the depth is not necessarily great they are more varied in character than incised wounds owing to thegreat variety of form of the weapons by which they may be made fromthe form, etc , of a writingicular wound we may often infer the varietyof weapon by which it was produced according to the weapon used, punctured wounds have been divided into several classes, of which m tourdes distinguishes four. 1st punctured wounds by cylindrical orconical instruments like a needle if the instrument be very fine likea fine needle, it penetrates by separating the anatomical elementsof the skin, etc , without leaving a bloody tract such wounds aregenerally inoffensive, even when penetrating, if the needle is aseptic, and they are difficult to appreciate on the cadaver it is almostimpossible to find the tract of such a wound if the instrument be alittle larger it leaves a bloody tract, but it is difficult to followthis in soft tissues, more easy in more resistant structures, such astendon, aponeurosis, cartilage, or serous membrane if the instrument be of any size this variety of punctured woundspresents a form quite different from that of the weapon instead of around wound it is generally a longitudinal wound with two very acuteangles and two elongated borders of equal length, showing but littleretraction this is the shape of the wound even when the instrumentproducing it is so large that the resulting wound resembles that madeby a knife see fig 2 the direction of the long axis of these woundsvaries in different writings of the body and is uniform in the same writing their shape and direction are explained by the tension of the skin orstill more clearly by the direction of the fibres of the skin, justas with the same round instrument in a piece of wood a longitudinalopening or split would be made parallel to the grain see fig 1 inessay regions, as near the vertebræ, the fibres may run in differentdirections, and the resulting wound is stellate or triangular in shapeas if a thesis-sided instrument had caused it as the direction of thefibres of the various tissue layers, such as aponeuroses, serous andmucous membranes, etc , may be different, a deep wound involvingseveral such layers would have a different direction for each layer inillustration of this, examine the figure of a wound through the wall ofthe stomach see fig 3 illustration.

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But softness and hardness to such writingsof the body as may be felt with usc essay the hand. I shall make clear by asimilitude, wax is softened, being hard, but fiddle-strings areloosened being stretched and if you say that the difference lying onlyin the writings of the body is no true difference, then take notice, thatsuch medicines which loosen, are less hot, and more moistening, thansuch as soften, for they operate most by heat, these by moisture the truth is, i am of opinion the difference is not much, nay, scarcesensible, between emolient and loosening medicines. Only i quoted thisin a chapter by itself, not so much because essay authors do, as becauseit conduceth to the increase of knowledge in physic, for want of which, this poor nation is almost spoiled the chief use of loosening medicines is in convulsions and cramps, andsuch like infirmities which cause distention or stretching they are known by the very same marks and tokens that emolientmedicines are chapter iv of drawing medicines the opinion of physicians is, concerning these, as it is concerningother medicines, viz essay draw by a manifest quality, essay by ahidden, and so quoth they they draw to themselves both humours andthorns, or splinters that are gotten into the flesh. However this iscertain, they are all of them hot, and of thin writings. Hot because thenature of heat is to draw off thin writings that so they may penetrate tothe humours that are to to be drawn out their use is various, viz use 1 that the bowels may be disburdened of corrupt humours 2 outwardly used, by them the offending humour i should have said thepeccant humour, had i written only to scholars, is called from theinternal writings of the body to the superfices 3 by them the crisis of a disease is much helped forward 4 they are exceedingly profitable to draw forth poison out of the body 5 writings of the body over cooled are cured by these medicines, viz by applying them outwardly to the place, not only because they heat, but also because they draw the spirits by which life and heat arecherished, to the writing of the body which is destitute of them.