History

Visual Analysis Essay Example


A towel was passed around his neck, and the ends twisted together, making forcible compression of the neck at first he had a feeling of warmth and tingling, first in the feet, then passing over the entire body. Vision writingly lost. His head felt as if it would burst. There was confused roaring in ears, like the sound heard on placing the ear to a shell. He remained conscious in one minute twenty seconds all sensibility was abolished after a few minutes’ rest a second similar trial was made, with similar results, except that sensibility was lost in fifty-five seconds a stab with a knife drawing the blood caused no sensation should the subject recover from the immediate effects of thestrangulation there may yet be serious secondary results among theseare convulsions and paralysis. Extreme swelling of face, neck, andchest.

Then take of this cassia so drawn, andboil it to its consistence, a pound, sugar a pound and a half, boilthem to the form of an electuary according to art visual analysis essay example culpeper you may take it in white wine, it is good for gentlebodies, for if your body be hard to work upon, perhaps it will notwork at all. It purges the reins gallantly, and cools them, therebypreventing the stone, and other diseases caused by their heat electuarium amarum magistrale majus or the greater bitter electuary college take of agarick, turbith, species hiera simplex, rhubarb, of each one dram, choice aloes unwashed two drams, ginger, crystal oftartar, of each two scruples, orris, florentine, sweet fennel seeds, of each a scruple, syrup of roses solutive as much as is sufficient tomake it into an electuary according to art electuarium amarum minus or the lesser bitter electuary college take of epithimum half an ounce, the roots of angelicathree drams, of gentian, zedoary, acorus, of each two drams, cinnamonone dram and an half, cloves, mace, nutmegs, saffron, of each one dram, aloes six ounces, with syrup of fumitory, scabious and sugar so much asis sufficient to make it into a soft electuary culpeper both these purge choler, the former flegm, and thismelancholy, the former works strongest, and this strengthens most, andis good for such whose brains are annoyed you may take half an ounceof the former, if your body be any thing strong, in white wine, if verystrong an ounce, a reasonable body may take an ounce of the latter, the weak less i would not have the unskilful too busy about purgeswithout advice of a physician diacassia with manna college take of damask prunes two ounces, violet flowers a handfuland an half, spring water a pound and an half, boil it according to arttill half be consumed, strain it, and dissolve in the decoction sixounces of cassia newly drawn, sugar of violets, syrup of violets, ofeach four ounces, pulp of tamarinds an ounce, sugar candy an ounce andan half, manna two ounces, mix them, and make them into an electuaryaccording to art culpeper it is a fine cool purge for such as are bound in the body, for it works gently, and without trouble, it purges choler, and maysafely be given in fevers coming of choler. But in such paper, if thebody be much bound, the best way is first to administer a clyster, andthen the next morning an ounce of this will cool the body, and keep itin due temper cassia extracta sine soliis senæ or cassia extracted without the leaves of sena college take twelve prunes, violet flowers a handful, frenchbarley, the seed of annis, and bastard saffron, polypodium of the oak, of each five drams, maiden-hair, thyme, epithimum, of each half ahandful, raisins of the sun stoned half an ounce, sweet fennel seedstwo drams, the seeds of purslain, and mallows, of each three drams, liquorice half an ounce, boil them in a sufficient quantity of water, strain them and dissolve in the decoction, pulp of cassia two pounds, of tamarinds an ounce, cinnamon three drams, sugar a pound, boil itinto the form of an electuary cassia extracta cum soliis senæ or cassia extracted with the leaves of sena college take of the former receipt two pounds, sena in powder twoounces, mix them according to art culpeper this is also a fine cool gentle purge, cleansing thebowels of choler and melancholy without any griping, very fit forfeverish bodies, and yet the former is gentler than this they bothcleanse and cool the reins. A reasonable body may take an ounce and anhalf of the former, and an ounce of the latter in white wine, if theykeep the house, or their bodies be oppressed with melancholy, let themtake half the quantity in four ounces of decoction of epithimum diacarthamum college take of diatragacanthum frigidum, half an ounce, pulp ofpreserved quinces an ounce, the inside of the seeds of bastard saffronhalf an ounce, ginger two drams, diacrydium beaten by itself threedrams, turbith six drams, manna two ounces, honey of roses solutive, sugar candy, of each an ounce, hermodactils half an ounce, sugar tenounces and an half, make of them a liquid electuary according to art diaphœnicon college take of the pulp of dates boiled in hydromel, penids, ofeach half a pound, sweet almonds blanched, three ounces and an half, toall of them being bruised and mixed, add clarified honey two pounds, boil them a little, and then strew in ginger, long pepper, mace, cinnamon, rue leaves, the seeds of fennel and carrots, of each twodrams, turbith four ounces, diacridium an ounce and an half, make ofthem an electuary according to art culpeper i cannot believe this is so profitable in fevers takendownwards as authors say, for it is a very violent purge diaprunum lenitive college take one hundred damask prunes, boil them in water tillthey be soft, then pulp them, and in the liquor they were boiled in, boil gently one of violet flowers, strain it, and with two pounds ofsugar boil it to a syrup, then add half a pound of the aforesaid pulp, the pulp of cassia, and tamarinds, of each one ounce, then mix with itthese powders following. Sanders white and red, spodium, rhubarb, ofeach three drams, red roses, violets, the seeds of purslain, succory, barberries, gum tragacanth, liquorice, cinnamon, of each two drams, thefour greater cold seeds, of each one dram, make it into an electuaryaccording to art culpeper it may safely, and is with good success, given in acute, burning, and all other fevers, for it cools much, and loosens the bodygently. It is good in agues, hectic fevers, and mirasmos you may takean ounce of it at a time, at night when you go to bed, three hoursafter a light supper, neither need you keep your chamber next day, unless the weather be very cold, or your body very tender diaprunum solutive college take of diaprunum lenitive whilst it is warm, four pounds, scammony prepared two ounce and five drams, mix them into an electuaryaccording to art seeing the dose of scammony is increased according to the author inthis medicine, you may use a less weight of scammony if you please catholicon college take of the pulp of cassia and tamarinds, the leaves ofsena, of each two ounces, polypodium, violets, rhubarb, of each oneounce, annis seeds, penids, sugar candy, liquorice, the seeds ofgourds, citruls, cucumbers, melons, of each two drams, the things to bebruised, being bruised, take of fresh polypodium three ounces, sweetfennel seeds six drams, boil them in four pounds of water till thethird writing be consumed, strain it, and with two pounds of sugar, boilthe decoction to the thickness of a syrup.

But this, with the septic tendency due to blood changes, isnot sufficient to designate it as a purely “thermal fever, ” as essayhave claimed it is essaything more than this sunstroke occurs more commonly in tropical than temperateclimates;694 and usually in the day-time, at the period of greatestsolar activity, those attacked being engaged in labor involvingconsiderable exertion it occasionally, though rarely, occurs at night the military service affords abundant opportunity for observation herethe seizures are on the march, rarely in camp fatigue, prolonged andextreme exertion, ill-adjusted clothing and accoutrements, with thedeprivation of cool water, are fully as active factors as the heat ofthe sun the death-rate ranges between forty and fifty per cent, themild paper being excluded death in essay paper is marked by syncope, in others by apnœa, though the majority seem to die by a combinationof both, as in most paper the pulmonary congestion is more or lesspronounced undoubtedly the character of the symptoms and mode of deathare influenced, in thesis paper, by individual tendencies leading toapoplectic conditions or to cardiac or other complications treatment this must be adjusted to the pathological conditions of the patient as already indicated, two classes of paper are met. One marked byexhaustion, with tendency to death by syncope. The other, a state ofor tendency to cerebral congestion or apoplectic conditions exactlyopposite methods of treatment are demanded in the first, frequencyand feebleness of the heart action, with faintness of the heartsounds and embarrassment of respiration, indicate the tendency todeath by nervous exhaustion, and must be met by placing the patientin a condition of absolute rest and quiet in a cool place stimulantsmust be promptly administered, though cautiously on account of thetendency to nausea and vomiting hypodermic injections of alcohol orether, or rectal enemata of turpentine, alcohol, or other stimulants, afford means of securing speedy effects when the stomach is irritable carbonate of ammonia and other cardiac stimulants are recommended depleting agents, or such as prove depressing, are to be avoided inessay paper, hypodermic injections of small doses of morphine provebeneficial individual paper must modify therapeutic procedures in the second class of paper the tendency to cerebral congestionindicates sedative and depleting procedures blood-letting has beenrecommended by essay authors, if employed with extreme judgment anddiscrimination 695 cold applied to the head and also to the wholebody by rubbing with ice696 or by effusion and the wet sheet, orother means, is indicated if the temperature is high 104° to 105° f active catharsis, by promptly acting purgative enemata, is also to beresorted to in most paper the convulsions occurring in essay paper aresuccessfully modified and controlled by inhalations of small quantitiesof chloroform post-mortem appearances these, though not clearly characteristic, are pronounced in essay paperno distinct conditions are found 697 local congestions are present innearly all paper upon the skin are found petechial and livid spots, pallor being occasionally noted ecchymoses and subserous hemorrhagesare also common these conditions have been described as resemblingthose of spotted typhus levick rigor mortis is marked and occurs early, putrefaction beginning soonafter death the lungs are highly congested and often œdematous, andeffusions of serum are frequently found in the pleural cavities 698the heart is usually changed in color and consistence, with the leftventricle contracted and the aorta empty, while the right ventricleand pulmonary arteries are dilated and engorged the blood is fluidand dark 699 the large vessels of the pia and dura are full ofdark blood congestion of the cerebral mass is not always noted theventricles contain serum. And extravasations of blood into the cervicalsympathetic ganglia and vagus are essaytimes found the kidneys areusually moist and œdematous. The liver and spleen congested and dry burns and scalds for all purposes of practice it is unnecessary to draw any distinctionbetween a burn and a scald, for in reality none exists, except asregards the nature of the causative agent in essay paper requiringinvestigation, this may prove to be a matter of much importance definition - a burn is an injury produced by the application to thebody of a heated substance, flame or radiant heat a scald is an injury produced by the application of a liquid at ornear its boiling-point appearances as indicating origin a hot body may produce a burn of any intensity, ranging betweenreddening of the skin and complete charring of the tissues, accordingas its temperature is elevated and the period of contact prolonged. Theshape of the object and its size being indicated by the form of theburn metallic substances heated to a temperature of 100° c 212° f are capable of producing redness and vesication and other injuriouseffects at this temperature the albuminous elements of the blood andother fluids undergo coagulation essay bodies require to be heated toredness, or nearly so, in order to produce a defined burn very hot and writingially-fused solids cause burns of greater severitythan where the heated body is of a character favoring prompt removal in such paper their adhesion to the skin involves the tearing awayof the superficial portions of the derma in their removal, or theyby their adherence prolong the contact of the heated body, thusintensifying their destructive action metals in a state of fusion produce burns which cannot be easilydistinguished from those caused by solid bodies such burns are classedas scalds their effects may vary in any degree between slight rednessand complete destruction of the tissues with charring burns caused bymelted solids are less regular in form and outline than those caused byheated solids they are usually of greater severity on account of thehigh temperature to which they have been raised 700boiling water - scalds by boiling water may be so slight as toproduce redness only, or they may be so severe as to cause marked andcharacteristic symptoms those noted in severe paper are an ashy hueof the skin, accompanied by a soaked or sodden appearance and theproduction of blisters occasionally these features are not easilydistinguished from those of burns from other sources blackening of theskin and charring of the tissues never result from burns by boilingwater as in all burns, a large surface involved renders an early fatalissue probable in severe paper, not necessarily fatal, gangrene of thewritings injured essaytimes occurs most of those met with are accidental, yet paper of scalding by hot water with intent to injure are notuncommon, aside from injuries and death resulting from explosionof boilers, bursting of steam-pipes, etc occasional instances arerecorded of death of children, the insane or feeble persons byinadvertent immersion in a bath of hot water case 21 severe and fatal burns of the mouth, fauces, and larynx in youngchildren occur from inhaling steam or swallowing boiling water from ateapot or kettle in an attempt to drink case 5 burns by burning oil produce effects and appearances similar to thoseby melted metals burns by flame are specially characterized by scorching of thesurface hairs upon the writing actually burned are scorched and usuallyalso those in the vicinity of the burned patches such conditionscould not result from scalds by hot water, boiling oil, or from a hotbody only burns by petroleum or its derivatives resemble the burns from flame, except that the injured portions of the body are not only scorched butblackened and are usually burned more severely than by flame alone, asthe clothing holds the burning substance in contact with the writings theodor of the agent is also very noticeable burns by acids and corrosive agents - the injury produced by amineral acid, the caustic alkalies, etc , has frequently been thesource of judicial inquiry “vitriol-throwing, ” as it has been termed, has been and occasionally is resorted to with malicious intent toinjure no case of death resulting directly and solely from this causeis recorded, but grave injuries, involving loss of sight, etc , haveresulted a case is referred to by taylor701 where sulphuric acidwas poured into the ear of a woman while asleep by her husband deathensued, after six weeks, from disease of the brain resulting indirectlyfrom the use of the acid the appearances of a burn by a mineral acid are distinguished from heatburns with little difficulty the eschar which results is not dry andleathery, as in a burn by heat, but soft and readily sloughing away there is no redness around the site of the injury, the color of theburn being uniform, and no blisters are formed there is no blackeningof the skin and the hairs are not scorched the color of the skinaround the injured portion may afford valuable evidence of the natureof the agent employed nitric acid produces a yellow stain, sulphuricacid a dark brown, and chlorohydric acid a brownish-yellow stain 702the clothing also is capable of affording characteristic evidence bythe discolorations produced. And the destructive agent employed may bedetermined by a chemical analysis of the fabric 703it is not possible to distinguish a post-mortem from an ante-mortemburn by an acid when no vital reaction has taken place the classification of burns a classification of burns according to the severity of the injuryinflicted is the most practical course upon this plan, burns may bedivided into four general classes:i burns in which the skin or subcutaneous cellular tissues only areinjured ii burns which involve the muscles, nerves, and blood-vessels iii burns involving the internal organs and bones iv burns in which the other three classes are variously mixed class i - the skin in paper such as may occur from a brief contact witha hot body or water near the boiling-point shows a slight redness orscorching with no enduring mark pain is considerable class ii - in the mildest paper the cutis is destroyed in its wholethickness, and the writings injured are occupied by eschars of ayellowish-gray or brownish color the surrounding skin is reddened, and the formation of blisters occurs either immediately or after aninterval of a few hours in these paper a shining cicatrix remainsafter the healing, without contraction of surrounding writings in theseverer paper the subcutaneous cellular tissue and underlying musclesand nerves are destroyed the blackish eschars formed are insensibleand separate by suppurative process, leaving a granulating surfacebelow extensive redness of surrounding tissues, with more or lessvesication, is usually noted the resulting cicatrices, together withthe skin and adjoining structures, are prone to contraction, resultingin considerable deformity, according to location and extent so greatis the deformity in injuries of the extremities, or even essay writings ofthe head and trunk, that extensive surgical operations become necessaryto relieve it class iii - burns of this class are so severe that an immediatelyfatal issue is usually the result such instances involve a prolongedexposure to flame or to a source of intense heat the appearancesdescribed as belonging to the preceding class are in writing found herewith the addition of charring or carbonizing the writings destroyed effects of burns the effects of burns may be considered as i , local, and ii , constitutional local effects - in different instances the effects vary in accordancewith the extent and severity of the burn redness, blisters, destruction of the cuticle and of the subcutaneous cellular tissue, blackening of the skin, scorching of the hair, and roasting of portionsof the body are met with in varying degrees in essay severe paper allthese are found upon a single body the redness produced varies inintensity and extent, according to the nature of the agent producingthe burn, its form, and the length of time the writing was exposed very soon after the infliction of the burn a special line of rednessappears between the burned writings and the uninjured skin this red lineof demarcation is formed by intensely injected vessels and becomes avery important medico-legal sign in essay paper the vesication may besingle or multiple, consisting of one or two large and full blistersor a number of large and small ones, scattered over the portionsburned, essay unbroken and still holding their contents, others brokenand denuded of cuticle or with breaks from which their serum hasescaped upon the surrounding writings in essay paper of burning cracksor fissures in the skin occur, due to the effect of the heat, makingit dry and brittle and causing it to rupture by the movements of thepatient case 8 these fissures are most frequently noted in proximityto the joints 704 they resemble wounds, and it occurs occasionallythat it is important to accurately distinguish their character inessay paper the skin only is fissured. In others the subjacent tissuesare also involved this difference depends upon the depth of the burn in the first condition the skin splits, leaving the subcutaneous fatexposed, which in essay instances is writingially melted by the heat andflows out over the edge of the crack upon the surrounding skin paper8, 13 the blood-vessels in such paper usually are not burned and, owing to their elasticity, remain stretching across the fissure case14 the smaller may be seen by careful examination with a lens:they should always be looked for in the second class of injuriesthe vessels are involved in the burn and break with the cracking ofthe skin the importance of careful observation of these fissures isemphasized in paper of apparent wounds associated with burning it maybe necessary to decide whether the wounds are the result of the actionof heat as above described or were caused by essay sharp instrument orweapon careful inspection of the edges of the wounds will show whetherthey are ragged, as the result of fissure, or clean-cut by essay sharpinstrument the absence of evidences indicating hemorrhage upon thesurrounding writings and the detection of uncut blood-vessels extendingacross the fissure will establish the differential diagnosis wounds ofthe above character resulting from the action of fire may exist on thesame body with wounds of actual violence it is important, therefore, in all paper to examine each wound with special care and record itsposition, shape, depth, and other characteristics constitutional effects - as in all sudden and violent injuries, theeffect of a severe burn upon the nervous system is very marked thisis manifest in the symptoms of “shock, ” with pallor and coldness ofthe surface of the body, a feeble pulse, chills or shivering, and atendency to collapse in other paper, proving immediately fatal, thesesymptoms are followed by obstructed respiration with death from comasucceeding in other paper convulsions precede death, while in such asare not immediately fatal a reaction more or less imperfect ensues uponthe first constitutional symptoms death from cerebral congestion or effusion may result before anydefinite evidence of reaction appears in essay instances pulmonarycongestion or œdema occurs, with or without pleural effusion, terminating in death before reaction this period usually coversthe first two days in essay paper immediate death results fromthe depression produced by the severity of the pain during thesubsequent two weeks a period of inflammatory reaction succeeds, wheninflammations of the thoracic and abdominal viscera, with ulcerativeprocesses in essay organs, are developed and induce a fatal termination paper 10, 11, 16 causes of death the causes of death are due to several conditions this factis explained in writing by the relation which exists between thecerebro-spinal and sympathetic nervous systems, and of the nervoussupply of the surface to that of the internal organs, which in paperof extensive injury proportionately modify the conditions of thevisceral organs as death in burning results from various causes, it isconvenient to consider them under two classes:1st those immediately fatal 2d those fatal after an interval the first division would include paper in which the deprivation offresh air and the presence of asphyxiating products of combustion carbon monoxide and carbon dioxide were the immediate causes of deathby suffocation or asphyxia paper 9, 18 accidents in endeavoring to escape or injuries by falling wallsor timbers may cause death immediately, and burning the body occursubsequently immediate death may result from syncope or collapse from theviolence of the shock to the nervous system by the pain resulting fromthe burns the second division includes those conditions where death may resultearly, from a series of causes less immediate than those just mentioned cerebral congestion and effusion, resulting in death from coma, is not unusual case 15 in this connection taylor705 cites a caseof alleged poisoning by opium, in the treatment of a burn, in a childdying comatose, and emphasizes the undesirability of administeringopium or its preparations to children in paper of burns of anyseverity the danger claimed to exist is hardly to be considered in the case referred to, abernethy, who was a witness in the case, ascribed death to coma induced by the effect of the burn thepowerfully depressing influence of the pain in sensitive organizationsand liability to death from shock therefrom must be remembered inflammatory conditions of the respiratory tract or organs arecommon results. Pneumonia, bronchitis, and sudden congestion orœdema of the lungs are frequent paper 11, 15, 16 inflammation of the intestines, inducing peritonitis andulcerations of the intestines with or without resulting hemorrhage, occurs as a frequent lesion case 10 gangrene or septicæmia causes death in other instances exhaustion, from extensive and prolonged suppuration or from severeand long-continued pain and other conditions, terminates other paper case 12 legally, burns and scalds are included among injuries endangering life, but are not described as wounds they may be considered dangerousaccording to the extent of surface which they cover, rather than thedepth to which they involve the tissues the extensive injury to the sensory nerve structures and thesuspension of function or destruction of a considerable portion of theperspiratory tracts render large superficial burns far more fatal thanthose confined to a small writing of a limb, for example, which may bedeeply burned from a medico-legal point it is desirable to establishthe fact of how large a surface must be injured to prove fatal theeffort to reduce the subject to a statement of an exact minimum area ofsquare inches seems very objectionable and liable to lead to erroneousconclusions it is possible to make a general statement, subject to essayqualifications, which may serve as a basis of conclusion, as eachindividual case must be considered in its own circumstances a burn involving two-thirds of the body may be regarded as necessarilyfatal. But the injury of a much less proportion, even one-fourth ofthe surface, has resulted in death the qualifications to be madein burns of less extent are pronounced the writing affected is ofmuch importance burns of the trunk are more fatal than those of theextremities. And those of the genital organs706 and lower writing of theabdomen are especially so case 7 the character of the burn, whether single and continuous or multipleand scattered over various portions of the body, is a very importantmodifying circumstance, involving the questions of excessive pain andthe difficulty in insuring necessary treatment for all writings injured the physical condition of the patient and sensitiveness of the nervoussystem to pain exert a powerfully determining influence burns inchildren and sensitive, nervous females are specially serious and callfor an unfavorable prognosis spontaneous combustion - spontaneous combustion of the human bodyhas been seriously discussed in this connection, and explanations ofpopularly reported paper have been attempted the writer refers tothe subject here for the sole purpose of stating that no trustworthyevidence of the possibility of any such condition or result exists treatment in paper of severe burns the constitutional as well as the localconditions demand attention locally, a great variety of applicationshas been employed. Starch, gum, oxide of zinc, solution of caoutchou, collodion, cotton wadding, a mixture of linseed oil and lime-wateron cotton or lint, and thesis other agents are used the importantconsideration is to exclude the air from and to afford a protectivecovering for the injured surface the constitutional treatment variesin different paper. But its main object is to relieve pain, inducereaction from the shock, and support the depressed nervous system for the first opium or its preparations in proper doses is indicated alcoholic stimulants in essay paper are demanded in addition afterthe stage of reaction has occurred the therapeutics must be governedby inflammatory conditions.

Theskin is also much firmer and more elastic from swelling of the writing ifthe contusion is received essay hours before death but we may have aneffusion beneath and not in the substance of the skin, and the abovesigns might possibly be due to an injury inflicted only a few minutesafter death the above signs may therefore be absent, and when presentare not absolutely indicative of an injury received during life ingeneral, the effects of severe contusions inflicted soon after deathmay closely resemble those of slight contusions received during life there is little danger of contusion if the blow be inflicted on a deadbody after the loss of body heat and the beginning of rigor mortis 2 coagulation of blood - as stated at the beginning of this section, blood from a wound inflicted during life coagulates with the exceptionof that from those suffering from certain pathological or occasionalconditions or in certain locations, already mentioned this coagulationis not immediate, but is complete in about five minutes the entireamount of blood lost is thus coagulated and the coagula are firm thesecoagula if the wound is not interfered with occur in the opening of awound and on its edges, especially at the mouths of the blood-vessels, which are thus plugged the blood which infiltrates the interspaces ofthe tissues is coagulated in the form of these interspaces the same istrue of the blood of an ecchymosis whether there be a hematoma or onlyan infiltration between the tissues, or both these clots representmore or less the form of the space occupied by the blood in the caseof the scalp a subcutaneous clot may be mistaken for a depressedfracture of the skull from the fact that the edges of the clot becomevery hard while the centre is still quite soft a wound in which alarge artery has been divided may present very little clotting in thewound if the opening is free and the blood has mostly escaped in a jet in a wound produced soon after death there may be essay clotting, but less in amount, firstly, because there is less hemorrhage, and, secondly, because not all the blood clots these conditions increasewith the length of time after death, so that after a time a wound madeon a cadaver would show very little if any clotting owing to veryslight hemorrhage, and little or no clotting of the blood extravasated when the body has lost its animal heat and rigor mortis has begun toset in, then there is no more coagulation of the blood and no morehemorrhage, under normal conditions, for the blood has mostly becomeclotted in the vessels of the body consequently, with the exceptionof wounds inflicted very soon after death, we can distinguish anante-mortem from a post-mortem wound by the condition in which theblood is clotted if there is any hemorrhage, the wound being inflictedbefore the loss of animal heat and the blood remains entirely fluid onthe surface or in an ecchymosis, we know that the wound was producedafter death and essay hours after death unless any of those conditionsexist in which the blood does not normally coagulate if the hemorrhageis slight or quite moderate in amount and venous in character, if theblood is only clotted in writing and the clots are rather soft and donot form a plug at the mouth of each artery, and especially if thestaining of the walls of the wound can be washed off, then the woundwas probably produced post mortem, but not so long after death as inthe first case supposed if the characters of the hemorrhage and theclotting are still more like those normal to a wound inflicted duringlife, then, as a rule, it is impossible to say from these two featuresof the wound, hemorrhage and clotting, whether the wound was inflictedduring life or a very short time after death 3 eversion of the lips of the wound - the edges or lips of a woundinflicted during life may be inverted, instead of everted, if a thinlayer of muscular fibres is attached directly to the deep surface ofthe skin, as is the case in the scrotum the eversion of the edges ofthe skin is due to their elasticity, and ceases to occur as soon as theskin loses its vitality consequently eversion ceases to occur soonafter death, within a very few hours a wound in which the edges areneither inverted or everted was therefore inflicted after death ifthis sign is present and marked, the wound was inflicted during life orwithin two or three hours or less after death if this sign is presentbut very slightly marked, the wound may have been made even essaywhatlonger after death 4 retraction of the sides of the wound is also dependent on theirvitality and ceases to occur when this is lost a few hours after death in the retraction of the edges of the wound we have all the writingsinvolved, but unequally the muscles, arteries, skin, and layers ofconnective tissue all retract, varying in the degree of retractionaccording to the order in which they are named in different writingsof the body this comparative order of retraction is liable to moreor less variation every surgeon is familiar with this retractionof the tissues, which necessitates certain rules in the techniqueof operations, especially of amputations muscles retract the morethe longer they are and the farther the incision is made from theirattachment without specifying a definite time, we may say that, asa rule, this retraction lasts no longer than about two hours afterdeath, consequently when it is absent we may infer that the wound wasinflicted two hours or more after death the amount of retraction growsless and less after death for about two hours, after which it is veryslight if it occurs at all, owing to the loss of elasticity of thetissues this sign is especially useful in the case of a mutilatedbody where, by examining the degree of retraction of the muscles, wemay infer whether the mutilation was done before or after death thesides of a cut made on the cadaver are comparatively smooth and even, owing to the absence of the unequal retraction of the various elements, which makes the surfaces of a gaping ante-mortem wound uneven andirregular relying on these circumstances in the “affaire ramus, ” citedby vibert, 621 one was able to recognize the order in which the bodyhad been mutilated other minor signs of a wound inflicted during life may be brieflymentioned if the edges of the wound are swollen, or show signs ofinflammation or gangrene, or if pus or adhesive material is present onthe edges of the wound, we may infer that the wound was inflicted essaylittle time before death of course, if cicatrization has commenced, essay days must have elapsed before death after the wound was received if the blow causing a contusion was inflicted essay time before death, there will be more or less of a general swelling of the region, writinglydue to the blood effused, but also writingly due to œdema it is not always easy to say whether a fracture was produced whilethe body was living or dead if the body was still warm when apost-mortem fracture was produced there is little difference from anante-mortem fracture, except that there may be a little less bloodeffused in a fracture produced after rigor mortis has set in thereis little or no blood effused in the case of fractures the presenceof callus, indicating the process of repair, shows that the accidentoccurred during life, and, as we have already seen, we may form essayidea of the length of time elapsed between the injury and the time ofdeath on the cadaver it is said to be harder to cause fractures andlesions of the skin than on the living body casper says that fracturesof the hyoid bone and the larynx are impossible after death, and healso was not able to rupture the liver or spleen in distinction to the characteristic signs of a wound inflicted duringlife, we may mention briefly essay of the signs of post-mortem woundswhen the wound has been inflicted from two to ten or twelve hours ormore after death. 1 the hemorrhage is slight in amount and may fail altogether 2 the character of the hemorrhage is venous, corresponding to thesource of the hemorrhage from the veins, the arteries being nearlyempty after death 3 the edges of the wound are not deeply stained, and this stainingmay be removed by washing the spaces between the tissues are notinfiltrated with blood 4 the blood remains either entirely fluid or, if there are clots, these are softer than those in an ante-mortem wound, and only aportion of the blood is thus clotted there are no clots plugging theopen mouths of the arteries on the surface of the wound. The veins mayor may not be closed by an imperfect clot 5 the skin of the edges is not everted or inverted 6 the sides of the wound do not gape and their surfaces are smoothand even, as the tissues are not unevenly retracted résumé - it is very easy from the foregoing to distinguish between awound inflicted before death and one ten or twelve hours after death if the hemorrhage has been abundant and arterial, if it has infiltratedbetween and deeply stained the tissues and the stain cannot readilybe washed off. If the blood coagulates completely and the coagulaare firm and are found lying in the wound, plugging the vessels, andincorporated with the tissues between which they lie. If the edgesof the skin are everted and the sides of the wound are retracted anduneven under these circumstances, we may be sure that the woundwas inflicted during life or a very short time after death if, onthe contrary, the hemorrhage is slight in amount or almost failsaltogether. If it is venous in character. If the edges of the woundare only stained by imbibition of the blood, which is not infiltratedbetween the tissues, and the stain may be washed off. If the blood isnot at all or only slightly clotted and the clots are soft. If the skinis not everted and the sides of the wound are smooth and lie nearly incontact. If there are no clots plugging the divided arteries on thesurface then we need have little hesitancy in saying that the woundwas produced after death, but probably not later than ten or twelvehours after death if the wound was inflicted still longer after deathand before putrefaction, then we would have a lack of the signs dueto hemorrhage, clots, staining, etc if we find the conditions moreor less midway between the first two, we may be left in essay doubt asto the date of the injury thus if the hemorrhage is moderate, theblood mostly but not altogether clotted and the clots moderately firm, the skin slightly everted, and the sides slightly separated and notaltogether smooth on their surface. If the surfaces are fairly deeplystained and the stain cannot be easily washed off then we can onlysay that the wound was inflicted during life or within two hours orso after death, and this fact is often enough for the purposes of themedico-legal inquiry the same is the case with contusions where there is no bleedingexternally if we have a bluish, violet, green, or yellow tumor with orwithout more or less superficial œdema. 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?.

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