History

What Is Persuasive Essay


Ibid , ref , 1913, ii, 1060 within a comparatively brief period of time, therefore, it fell to thelot of a number of observers, using strikingly different substances, to produce therapeutic effects amounting in a certain percentage ofpaper even to cure in the experimental tumors of the lower animals the various procedures have little in common both metals andnonmetallic substances have been employed either in colloidal what is persuasive essay form orin combination with organic radicals in essay instances a diffusiblecarrier is combined with the basic substances. In others not all ofthe preparations appear to possess a high degree of toxicity, althoughadequate data on this very essential feature are almost invariablywithheld wassermann results with eosin-selenium were soon critically examinedby other observers uhlenhuth274 and contamin275 were unable toconfirm his observations, but their negative results are attributedby keysser to the fact that they were not in possession of the properformula for the preparation of the eosin-selenium compounds as usedby wassermann apolant, 276 however, in ehrlich name confirmedwassermann findings 274 uhlenhuth, dold and bindseil. Ref , münchen med wchnschr , 1912, p 1782 275 contamin, detoeuf and thomos. Bull de l’assn franç pourl’étude du cancer, vi, 62 276 apolant, h. Vi tag der freien vereinigung für mikrobiologie , berlin, 1912 ref münchen med wchnschr , 1912, p 659 the most important critique of eosin-selenium has been contributedby the subsequent investigations of one of wassermann originalcollaborators, f keysser 277 keysser publication contains a largenumber of very careful observations on the various forms of eosinsupplied by the german manufacturers, as well as on other matters whichcannot here be considered in detail he finally reached the conclusionthat the eosin furnished by the manufacturing house of sandoz wasthe most effective for his purposes, inasmuch as it combined thelowest grade of toxicity with the highest capacity for discoloringthe tissues the selenium he used in the form of selenio-vanadiumfurnished by clin of paris, which was the identical preparation usedby werner and szécsi in combination with borcholin the maximum doseof this selenio-vanadium is 0 06 c c for each gram of mouse eosin, 0 01 gm , dissolved in 0 5 c c of physiologic salt solution, is mixedwith 0 5 c c of the selenio-vanadium this mixture is then used forintravenous injections the results produced by the injection of thismixture are to all intents and purposes similar to those obtained bywassermann, except that keysser induced cure in a larger proportion ofanimals, namely, from 6 to 8 per cent it is evident from his carefuldescription of his experiments that the treatment is extremely toxic tothe animals the therapeutic dose is considerably greater than one-halfthe toxic dose this accounts for the fact that an extremely largeproportion of the animals perish during the course of the treatment the tumors failed to be influenced unless the dose given fell verylittle short of the fatal amount moreover, in order to accomplish acomplete cure, at least eight to ten injections must be given, and inessay instances not less than fourteen 277 keysser, f. Ztschr f chemotherap , 1914, orig , ii, 188 keysser most important conclusions, however, were obtained byfollowing an altogether different line of procedure it has beenpointed out by carl lewin272 that the therapeutic results obtainedfrom subcutaneous mouse tumors, however encouraging, could not belogically applied to the treatment of human cancers the subcutaneoustransplanted tumors, as is well known, are as a rule limited by adistinct capsule and show no tendency to infiltrative growth in thiswritingicular they present a most striking difference when comparedwith human tumors on the other hand, the metastases of mouse tumorsin the internal organs present an infiltrative mode of growth andthus approximate very much more closely to the human type of tumors keysser, therefore, determined to test the therapeutic effectivenessof his compounds on tumors implanted in various organs he developed atechnic which enabled him to implant tumors in the liver, the spleen, the kidneys and other writings of the mouse by means of injection throughspecial needles, often without the assistance of a cutting operation the tumors so implanted grew rapidly, and within from two tothree weeks reached the size of cherry pits the growth wascharacteristically infiltrative animals with these tumors were thensubmitted to intravenous injection of the therapeutic agents in exactlythe same fashion as the animals carrying subcutaneous tumors theresults, however, were absolutely different whereas the subcutaneoustumors invariably showed a much more intense discoloration than theother tissues of the mouse, this feature was entirely lacking in thecase of the internal tumors softening and liquefaction, which almostinvariably follows on the third or fourth injection in the case ofsubcutaneous tumors, and which is the first symptom of cure, neverpresented itself in the case of the internal tumors their consistencythroughout the treatment was indistinguishable from that of the tumorsof control animals the treatment, in fact, appeared to exercise notthe slightest influence on internal tumors there was neither cessationnor retardation in growth, but the tumors continued their normal rateof destructive increase with the production of metastases, leadingeventually to the death of the animal either during the course of thetreatment or shortly thereafter microscopic changes, such as had beenobserved by hansemann in the case of subcutaneous tumors, were entirelylacking no matter in what organ the tumors were implanted, theseresults remained the same no matter what type of tumor was employed, whether carcinoma, adenocarcinoma or sarcoma, the therapeutic outcomewas regularly and consistently nil these results induced keysser to determine whether or noteosin-selenium could actually be shown to exercise a deleteriouseffect on cancer cells outside the body in order to do this he made asuspension of mouse tumor cells in salt solution and mixed this withthe eosin-selenium-vanadium, using the latter in amounts equivalent tothree times the fatal dose for a mouse after the mixture had stoodfrom one to three hours, it was injected either subcutaneously orintravenously into mice in order to test the vitality of the cells in every instance the injections resulted in the production of tumorswhich could be in no way distinguished from the tumors produced byuntreated cancer cells in other words, the therapeutic preparation hadabsolutely no effect on the tumor cells in the same way keysser carried out experiments along the linesinaugurated by neuberg, using a combination of glycocoll and copper he also tested the combination of borcholin with selenium-vanadiumused by werner and szécsi he was able to confirm the fact that bothof these substances produced an unmistakable therapeutic effect onsubcutaneous tumors on the other hand, they were absolutely withoutinfluence on the internal tumors in this respect, therefore, they wereentirely comparable with the eosin-selenium compound the theoreticalbasis constructed by neuberg, which rests on the assumption that themetallic compounds stimulate autolytic processes in the tumors, wasalso subjected by keysser to destructive criticism finally, keysser showed that none of these therapeutic agents wereeffective even in the case of subcutaneous tumors, unless the latterhad reached at least the size of cherry pits if a therapeuticinjection were made immediately after inoculation of the tumors, noeffect was observed the tumors grew exactly as in the control animals, and the injected animals died in about the same period of time as they all of these facts, which taken together constitute a very remarkableand convincing piece of scientific investigation, permit of butone conclusion it is quite clearly established that none of thepreparations of which the therapeutic effectiveness has hitherto beenproclaimed exercise any direct influence on the life or developmentof the tumor under certain very definite and restricted conditions, however, they do appear to produce certain changes in the tumors, and in a small proportion even cures these results, however, areobtained only in the case of tumors which are subcutaneous in locationand not smaller than a cherry pit in size keysser interpretationof the striking differences between tumors is of interest in thisconnection he believes that the constant palpation and examinationof the subcutaneous tumors, which is prompted by interest in theexperiment, produces circulatory changes with hyperemia and hemorrhage these circulatory changes are responsible for the increased tendencyof the injected substances to lodge in the tumors, thereby possiblyincreasing the tendency to autolysis which the circulatory changes haveinaugurated it is, of course, questionable whether this explanationcan be regarded as final in a series of experiments which i performedthesis years ago, i was able to show that sodium iodid when injectedintravenously accumulates in tumors in larger amounts than in any othertissue of the body in rats a similar observation has been recordedby wells, de witt and corper 278 in the same way i found thatvarious dyes, such as congo red, when injected intravenously, could bedemonstrated in tumors long after the rest of the body had recoveredits normal color. The liver alone vied with the tumors in this respect the dyestuff was invariably sharply localized in the necrotic portionsof the tumor the conclusion seemed obvious that, owing to circulatoryconditions or possibly even to chemical conditions, the dye wasretained longest in the necrotic writings of the tumor this effect wasunquestionably not due to handling, inasmuch as the animals in myexperiments were not palpated from the time of injection until death 278 wells, h g , de witt, and corper. Ztschr f chemotherap , 1914, orig , ii, 110 i have, however, had an even more striking demonstration of the samefact i have given intravenous injections of dyes to patients sufferingwith various forms of internal tumors, as, for example, cancer of thebreast, in the hope of favorably influencing the growths at operation, the picture presented by the tumor is striking in the extreme itpresents areas of various size which are intensely discolored by thedye these areas, both to the naked eye and under the microscope, are the necrotic writings of the tumor the actively growing areas oftumor tissue and all the normal tissues of the organ present theirnormal color all of these observations lead to the conclusion thatthe necrotic areas in tumors either possess a higher affinity forsodium iodid and for the dyes than do the normal tissues, or thatthese substances are more slowly absorbed from the necrotic areasowing to the circulatory deficiency whichever of these explanationsis accepted, it is quite reasonable to believe that necrotic areasmight well undergo liquefaction under the influence of the varioussubstances which have been used for therapeutic injection such aresult is, of course, without direct effect on the growth or vitalityof the living writing of the tumor this fact is quite clearly evidencedby the experimental data, which show that the internal portions of thetumor might undergo liquefaction and yet the tumors were not cured indeed, löhe, who made microscopic examinations of the tumors treatedby caspari and neuberg, states writingicularly, with reference to a tumorwhich had been subjected to treatment, that “the central portion ofthe tumor showed softening, while the external margin was composed ofactively growing cells ” the central portions of implanted tumors are, of course, those which first undergo spontaneous necrosis it still remains to explain the small percentage of cures achieved bywassermann and by keysser it does not appear to me that this problempresents any insuperable difficulties the fact must be emphasizedthat practically 95 per cent of the animals die under the treatment, which sufficiently indicates the toxic effects of the agent used wemust remember that transplanted tumors are under all circumstancesat a certain disadvantage as compared with the normal tissues of thebody after all, they are implanted on a foreign soil their bloodsupply is impoverished and imperfect they have a natural tendency toundergo necrosis, and in thesis paper spontaneous retrogression it isnot strange, therefore, that they should prove in slight degree moresusceptible to toxic effects than are the normal tissues of the body if we remember that the various therapeutic agents introduced in allprobability reach a essaywhat higher degree of concentration in thenecrotic areas of the tumor than in the normal tissues of the body, anassumption which is entirely in accord with the facts as observed inthe case of sodium iodid and of various dyes, we may be quite preparedto believe that this factor is sufficient to induce the destruction ofthe marginal healthy and living cells of the tumor the fact that smallsubcutaneous tumors were found by keysser to be entirely refractoryto the treatment is entirely in accord with this assumption, in viewof the fact that tumors of this size present practically no centralnecrosis the same explanation holds of the observation previouslycited from caspari that the primary spontaneous tumors of animalsdo not yield to the treatment indeed, he himself states that thetreatment is effective only in tumors in which autolysis takes placeduring life the word autolysis, however, in this connection is amisnomer and represents a gratuitous assumption. As an actual fact, one is entitled to say only that such tumors undergo central necrosis, in all probably owing to defective circulatory supply the process isexactly similar to the coagulation necrosis described in the case oftubercles by weigert if autolysis occurs, it is only secondary to thepreceding necrosis this explanation, however, is confronted by the fact that the internaltumors produced by keysser showed no tendency to effect a localizationof the dyes, and correspondingly no tendency to be affected by thetherapeutic agents one might be permitted to inquire whether theseinternal tumors had undergone any necrosis keysser unfortunately makesno mention of this matter it is certainly true that the infiltrativemode of growth of the internal tumors, which is entirely differentfrom that of the subcutaneous implantations, is associated with amuch better blood supply and a lessened tendency to undergo necrosis that such tumors can undergo necrosis, however, is evidenced bycertain illustrations given by carl lewin in his paper on internaltumors but such changes usually occur only in advanced stages tojudge from his plates, keysser worked with relatively small tumors, an assumption which is rendered even more likely by the fact that hisinjections were undertaken in a fairly early stage of their growth inthis connection i may quote certain experiments of my own on internaltumors 279 the implantations made in my experiments were produced byintravenous injections of a tumor suspension into the jugular vein ofrats such injections resulted almost invariably in the production ofa large number of tumors in the lungs, which, as is well shown in thefigures accompanying the original article, differed very markedly insize the smaller of these tumors are composed throughout of activelygrowing cells, while the large tumors present an area of centralnecrosis exactly as do the subcutaneous tumors if such an animal begiven an intravenous injection of a dye such as congo red, it will befound that the larger tumors present an area of central discolorationcorresponding to the area of previous necrosis, while the smallertumors, like normal tissues, are not colored thus, it is clear thatthe internal tumors implanted in animals are subject to the same lawsconcerning the distribution of dyes and, of course, other substances asare the subcutaneous tumors as i have stated previously, an exactlyanalogous observation has been made in a human breast tumor in theabsence of any contradictory evidence, therefore, i think that it isperfectly justifiable to assume that keysser failed to achieve a resultin the internal growths simply owing to the fact that those growthspresented practically no areas of necrosis at the time of his injection 279 j m research, 1913, p 497 another theoretical question which bears closely on the recenttherapeutic investigations in human beings concerns the rôle ofcolloids, as such, in the procedure it is quite clear from what hasalready been said that all experiments with animal tumors have beenlargely influenced by the belief that metals in the colloidal formexercise a peculiar and characteristic influence on the destructionof tumors even when the therapeutic agents have been introducedin crystalline form, as by neuberg and caspari, the authors findthemselves compelled to assume that the metals are reduced to colloidalform within the tumors for the latter assumption there is absolutelyno evidence.

Toledo, etc , what is persuasive essay r r co v rodrigues, 47 ill , 188. Same v prince, 50 ill , 26. Indianapolis, etc , r r v morris, 67 ill , 295. Cairo, etc , r r co v mahoney, 82 ill , 73. Atchison, etc , r r v beecher, 24 kansas, 228 same rule does not prevail in united states in case of accidents to passengers - the paper just noted were all paper of employees in the paper of injured passengers it has been doubted whether the same rule applied, essay state courts holding that in that case there is no obligation to furnish medical and surgical attendance, but that the physician attending must look to the persons whom they attended union pacific r r co v beatty, 35 kansas, 265. Brown v missouri, 67 missouri, 122 different in england - in england a different rule prevails one more humane and in consonance with the moral obligation imposed by the relationship of the writingies in walker v the great western r r co , a recent case law reports, 2 exch , 228, chief-justice kelley, in the course of the argument, made this remark. “must a board be convened before a man who has his legs broken can have medical attendance?. ” but in cox v the midland counties r r co 3 wellsby, h & g , 268, the station master, employed as the chief officer of the passenger and other dewritingments, called in a surgeon to perform an operation upon a passenger injured by a train the road was held not liable on the other hand, in langan v great western r r co 30 law times, n s , 173, a sub-inspector of railway police was held to have implied power to employ a surgeon for an injured employee but in arkansas an attorney for a railroad company was held not authorized to do so st louis, etc , r r co v hoover, 53 ark , 377 doctrine in indiana the more sensible one - the more sensible doctrine seems to be established in this country, in the state of indiana at least, in the case of terre haute r r co v mcmurray 98 ind , 358, in which the court held that where there was great necessity for the employment of a surgeon, the conductor of a train has authority to employ the surgeon, if the conductor is the highest officer in rank on the ground at the time but in that case the court expressly states that this liability grows out of the exigencies of the case. Not out of any theory of general authority authority of railroad physician to employ nurses, etc , doubtful - it has also been disputed whether the authority of the company physician extended far enough to render the company liable for services performed by nurses employed by him, or for board and lodging engaged by him for injured employees in bingham v chicago, etc , r r co 79 iowa, 534, it was held that the authority was sufficient, but in that case testimony appeared tending to show that an agent of the company who had authority to employ the physician had authorized him to employ two nurses the converse doctrine namely, that the fact that a physician of the company was authorized to buy medicines on the credit of the company does not authorize the inference that he has power to render the company liable by a contract for board and nursing of a person injured on the company road was held in maber v the chicago, etc , r r co , 75 missouri, 495. Brown v the missouri r r , 67 missouri, 122 to the same effect, see louisville, etc , r r co v mcveigh, 98 ind , 391. Cooper v n y c & c , 6 hun, 276. And st louis, etc , r r co v hoover, 53 arkansas, 377 2 redfield on railways, 114. On the other hand, where a physician and surgeon has been duly employed by a sub-officer or servant of the railroad company, ratification of this employment, by those having authority to employ him and to render the company liable, will be inferred from slight circumstances such was the case of louisville r r co v mcveigh, which has been cited and in another case where information of the fact of the employment had been conveyed to the company general manager, and he had neglected and omitted to repudiate the employment or to terminate it, and the surgeon went on and performed services, it was held that from these facts a ratification will be inferred indianapolis r r co v morris, supra see also toledo, etc , r r co v rodrigues, supra.

Cod liver oil, pure norwegian, 25 per cent malt extract, 9-1/3 per cent beef juice, glycerine, hypophosphite lime, hypophosphite soda, chemically pure, 1-1/2 grs each to the oz fl ext nux vomica, 3/64 of what is persuasive essay a minimum in each teaspoonful it is advertised with claims that will lead thoughtless physiciansand a confiding public to depend on it in paper in which fresh air, hygienic surroundings and nutritious food are of prime importance a sample package the phrase “as recommended by your physician” andother statements suggest that it is expected to be given the patientby the physician and thus effectively advertise nutone to the publicdescribes nutone as an “agreeable concentrated nutritive tonic emulsionof malt extract, beef juice and cod liver oil, combined with nervetonics and bone nutrients ” emphasizing the nutritive value of this“malt extract, beef juice, and cod liver oil” preparation, it isadvised, “as nutone is rich in nutritive properties, it is well tobegin with one-fourth teaspoonful, gradually increasing to regulardose, which is. Adults, 1 to 2 teaspoonfuls after meals and at bedtime children according to age ” it thus appears that adults are to takethis preparation as a “nutritive” in doses which represent from 3 to12 grains of sugar on the assumption that malt extract may contain asmuch as 50 per cent sugar and 8 to 30 minims of cod liver oil withunstated, but probably equally small, amounts of beef juice a consideration of the negligible food value of nutone as well asof the inefficiency of the other components and the claim that itis indicated in “malnutrition, ” “wasting diseases” and “incipientphthisis” classes nutone with that large group of shotgun mixtureswhich do harm in that dependence is placed on them in conditions inwhich the patient will probably be restored to health if proper medicaland hygienic measures are adopted in time the council declared nutone inadmissible to new and nonofficialremedies because it is an irrational shotgun mixture advertisedindirectly to the public with unwarranted therapeutic claims and anondescriptive therapeutically suggestive name -- from reports ofcouncil on pharmacy and chemistry, 1917, p 154 tri-arsenole, l o compound no 1 and l o compound no 2 report of the council on pharmacy and chemistrytri-arsenole -- according to the advertising of themedical supply company of atlanta, ga , “tri-arsenole” is“merco-arseno-benzo-chloride, ” and the claim is made. “this compound is the result of thesis years’ research the toxicity has been fully tested upon animals before using clinically, the latter having proven such complete success, we take pleasure in presenting it to the public ” “the manufacturers of tri-arsenol, before placing it upon the market, tested it biologically ”tri-arsenole is “recommended and suitable for the treatment of primary, secondary, tertiary and hereditary syphilis it has also been foundvery useful in pellagra and malaria ” the preparation is supplied inampules containing varying amounts of the dry substance it is to bedissolved in water and is to be administered intravenously in theadvertising attention is called to the yellow color of tri-arsenole;this, and the style of package suggest that it is a preparation similarto salvarsan in reply to a request sent the medical supply company for thequantitative composition and chemical formula of the compound“merco-arseno-benzo-chloride” and for the details of the biologic testby which its toxicity is claimed to have been determined and evidencefor its efficiency, the following statement was received. “tri-arsenole no 1 equals to each ampoule, gr sodium chlorid 4-1/2 hydrarg chlor -cor 1/4 arsenous acid 1/4 sodium benzoate 4 hydrastin resinoid 2 tri-arsenole no 2 equals to each ampoule, sodium chlorid 4 hydrarg chlor -cor 1/2 arsenous acid 1/2 sodium benzoate 4 hydrastin resinoid 2 tri-arsenole no 3 equals to each ampoule, sodium chlorid 3-1/2 hydrarg chlor -cor 3/4 arsenous acid 3/4 sodium benzoate 4 hydrastin resinoid 2 tri-arsenole no 4 equals to each ampoule, sodium chlorid 3 hydrarg chlor -cor 1 arsenous acid 1 sodium benzoate 4 hydrastin resinoid 2the request for information regarding the animal experiments said tohave determined the toxicity was ignored, nor were references suppliedto clinical reports demonstrating the value of the product the council declared tri-arsenole inadmissible to new and nonofficialremedies because of conflict with the rules as follows:in the absence of details of the method used, the claim that thepreparation has been tested biologically is in conflict with rule 2, which requires that for preparations claimed to be physiologicallystandardized the method of testing must be published so as to permit ofcontrol by independent investigators the claims that “merco-arseno-benzo-chloride” is “the result of thesisyears research, ” that its “toxicity has been fully tested upon animalsbefore using clinically” and that clinical use has “proven suchcomplete success” have not been substantiated by evidence and must beheld as unwarranted the name is in conflict with rule 8, which requires that pharmaceuticalmixtures shall bear names descriptive of their composition further, the name “tri-arsenole” by its similarity to diarsenol, the canadianbrand of arseno-phenolamin hydrochlorid, suggests that thispharmaceutical mixture is a chemical compound similar to salvarsan moreover, the danger of confusion is increased by the addition ofthe hydrastis preparation which imwritings a yellow color like that ofsalvarsan to the solution obtained when the colorless mercury andarsenic compounds of the mixture are dissolved again, the synonym“merco-arseno-benzo-chloride” conveys the false impression thattri-arsenole is a definite chemical compound the label does not declare the poisonous constituents claimed tobe contained in the mixture. Namely, “arsenous acid” and corrosivemercuric chlorid rule 7 there is no evidence that arsenous acid arsenic trioxid usedintravenously is efficient and safe as a spirocheticide, and theadministration of this drug in conjunction with mercuric chloridin fixed proportion is irrational and dangerous-- writingicularly sobecause of the implied similarity of tri-arsenole to arsenphenolaminhydrochlorid salvarsan, diarsenol rule 10 l o compound no 1 and l o compound no 2 -- in submitting thesepreparations to the council, the medical supply company stated that“no 1” was “composed of the following ingredients. Chloral, camphor, menthol, iodin, and oil of gualtheria, incorporated in a fatty base each ounce contains fifteen grains of chloral hydrate, nine grainsof resublimed iodine ” “no 2” was said to have the same compositionas “no 1” except that the oil of gaultheria had been omitted themedical supply company was informed that the rules of the councilrequired declaration of the amounts of each therapeutic constituentof pharmaceutical mixtures and that, therefore, in addition to theinformation furnished the amounts of camphor, menthol and oil ofgualtheria should be given for “no 1” and the amount of camphor andmenthol for “no 2 ” the following reply was received. “l o compound no 1 equals to each tube, chloral hydrate gr 15 camphor gr 22 menthol gr 7-1/2 iodin resublime gr 3-2/3 oil of gaultheria m 3 petrolatum, q s oz 1 l o compound no 2, the same as above formula for l o c no 1, except the oil of gaultheria which is omitted ”it should be noted that when the preparations were submitted each ounceof the preparation was claimed to contain 9 grains of iodin, whilein the subsequent letter the company declares that they contain only3-2/3 grains to the ounce if it be assumed that the unit intendedis the avoirdupois ounce, the preparation should contain 2 06 percent of iodin according to the first statement and 0 84 per cent ofiodin according to the second statement while the dark color of thepreparations suggested the presence of appreciable amounts of freeiodin, the a m a chemical laboratory reported that an examination ofthe specimens submitted by the medical supply company showed that “no 1” and “no 2” each contained but 0 033 per cent of free iodin.

Ashes also in the œsophagus and stomach, but none in larynx or what is persuasive essay bronchi the second infant was in manure. A greenish stuff was found in the mouth and stomach the third in bran confessed to by the mother. The nose and mouth were full, but there was none in the throat. A few grains in the trachea tardieu experimented on rabbits and guinea pigs by burying them in bran, sand, and gravel, essay of them being alive and the others dead in those buried alive he found the substance filling the mouth and nose to the base of the tongue. In most of the paper the œsophagus and trachea were not penetrated in the animals first killed and then buried, the substance had not passed into the mouth or nose in one case only he found ashes in the larynx and trachea of a rabbit which had been buried thesis hours after death in a box of ashes matthyssen934 held a guinea pig, head downward, with its nose under mercury. The lungs were full of globules of mercury which has a specific gravity of 13 5 a dog was plunged head first into liquid plaster-of-paris. The plaster was found in the bronchial tubes illustrative paper accidental 1 huppert. Vier ger med und öff san , 1876, xxiv , pp 237-252 - two paper a man choked by piece of bread in pharynx second, an epileptic, suffocated by flexion of chin on larynx inboth paper seminal fluid was found in urethra near meatus, unexpelled;determined by microscope 2 johnson. Lancet, 1878, ii , p 501 - boy swallowed penny, becameblack in face. Eyeballs protruded. Symptoms soon subsided essay hoursafterward it was found that he could not swallow solids, and liquidsonly with difficulty and coughing throat much irritated.

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Ibid , p 313 - boy, what is persuasive essay age 10 abrasions over front ofneck, especially near left ear, probably from ligature. Also abrasionon upper writing of chest, probably from forcible pressure underneaththese marks the veins were much distended trachea minutely congested;contained much frothy fluid lungs showed rupture of essay of theair-vesicles. Entire tissues distended with blood and frothy fluid dark fluid blood in both sides of heart large quantity of fluid inpericardium brain much congested eyes congested tip of tonguebetween teeth other organs normal 5 mackenzie. Ibid , february, 1889, p 44 - hindoo woman, age notgiven, strangled by another, stronger woman necroscopy. Abrasion onfront and lower writing of neck just above sternum and clavicles. Fourinches long, three broad. Five superficial lacerated wounds on sidesof neck, four on left, one on right, apparently nail scratches twocontusions below and behind lower jaw also contusions on thighs nospots of ecchymosis on neck contusion under skin of lower writing of neckand upper writing of chest, eight inches long, four broad left greatercornu of hyoid bone fractured both upper cornua of thyroid cartilagefractured. Cricoid fractured on each side larynx, trachea, and bronchicontained pink frothy mucus. Mucous membrane congested lungs muchcongested. Pink frothy mucus in bronchi. No emphysema nor apoplexies right side of heart full of dark blood. Left side empty liver, spleen, and kidneys congested stomach and intestines normal bladder empty internal genitals normal brain congested 6 mackenzie.